Sustainability of Health Care on the Pueblo - ABSTRACT: Sustainability of Health Care on the Pueblo The goal of this proposal to develop a Plan of Action to place the Pueblo of San Felipe?s Health Clinic under the authority of the Pueblo through a Title I PL93-638 Contract. The Pueblo of San Felipe (PSF) currently has a PL93-638 Contract for Community Health Representatives, Public Health Nurse, Diabetes, Pharmacy, Dental Program and Behavioral Health, but the Medical Clinic remains under the authority of Indian Health Services (I.H.S). The Planning phase will explore the merits of contracting the Medical Clinic with the goal being able to achieve greater flexibility in managing the development of a responsive health care system. On March 26, 2020 Governor Ortiz of the Pueblo of San Felipe declared a State of Public Health Emergency for the Pueblo due to the COVID-19 pandemic. Subsequently, the Pueblo of San Felipe Governor Ortiz signed Executive Orders instituting a moratorium on out of travel for employees and tribal members and establishing a Stay at Home order, in addition to an approved Emergency Operations Plan. It is widely accepted that Native Americans including those on the Pueblo are particularly at risk of experiencing devastating consequences of COVID-19. ?When you look at the health disparities in Indian country, this includes the Pueblo of San Felipe?high rates of diabetes, cancer, heart disease, asthma, and then you combine that with the overcrowded housing situation especially where you have multigenerational homes with an elder population, those who may be exposed or carriers, the risks are high. An essential value in the delivery of healthcare is that it be culturally sensitive for the tribal Pueblo of San Felipe members --- Cultural factors significantly influence the perspectives of the community members of the Pueblo of San Felipe regarding traditional health care practices. To most effectively deal with the health care needs of the tribe, it is necessary for he
althcare providers to understand, respect, and demonstrate sensitivity to the values and implications of the cultures of the pueblo. It is imperative that healthcare providers possess a basic understanding of the pueblo's cultural beliefs, values, and practices to enable the holistic caregivers to appreciate the importance of appropriate interactions and techniques, hence, making healthcare more readily accepted the tribal members. There is a critical need to incorporate holistic care with modern medicine to improve the interaction of providers and tribal members.A Plan of Action determining feasibility for a Title I Contract arrangement for the Health Clinic will be the outcome. A Planning Team consisting of the Pueblo?s lawyer, an independent expert Consultant on IHS operations, Pueblo Health Board Representative, Interim Director of the Health & Wellness Department and key Pueblo medical staff (2), Tribal Administrators (2), 2 representatives from the Pueblo?s Tribal Council will provide a thorough analysis and research, so the Planning Team will increase their understanding of the complexities of the IHS budget and its implications for a shift to a Title I contract arrangement. The long-term goal is sustainability of the health programs while providing culturally appropriate care. Sustainability encompasses efficiencies in the identification of need, the delivery of health care services in a timely and culturally appropriate manner, and financially, to ensure optimal care at a fair and equitable cost, utilizing available 3rd party revenue support as appropriate.
