Cherokees discuss IHS Medical Center takeover

By Teddye Snell
Tahlequah Daily Press

TAHLEQUAH, Okla. – As the CN Health Committee eyed a feasibility study on assumiing control of the local hospital, they said the Keetoowahs have no standing to launch a similar campaign.

While the Cherokee Nation Health Committee spent Tuesday morning discussing plans for its feasibility study for Hastings Indian Medical Center, the United Keetoowah Band of Cherokee Indians announced its own plan to take over the hospital.

The UKB announced its “intent to contract all Indian Health Services facilities in the Tahlequah services unit” in a press release, stating UKB members “have been traditionally underserved by the IHS facilities in the area.”

IHS operates the hospital, but the Indian Self-Determination Act provides the option for the Cherokees to take management control of the facility. The Cherokee Nation already operates the contract health services department for HIMC, and the feasibility study will examine whether the tribe will assume some or all operations of its direct care services.

Cherokee Nation Communications Director Mike Miller indicated the UKB may be setting its sights too high.

“The UKBCIO has no right or ability to run a hospital,” said Miller. “They don’t have the governmental authority to dispense aspirin, much less do surgery. Over the past 15 years of IHS contracting, the Cherokee Nation has built a health system of nine clinics that is the envy of tribes all over the country.”

Miller believes the UKB announcement is posturing, and won’t be followed by results, as the tribe lacks jurisdiction to make such a decision.

“This will go the way of all grand announcements the UKBCIO makes, like their fleet of 100 trucks, and their casinos in Arkansas and Alabama – a lot of big talk, but nothing ever actually happens,” said Miller. “In the grand scheme of things, this is just another sad attempt by UKBCIO to assert rights it doesn’t have.”

According to Miller, IHS contracts with tribes to operate health care facilities based on a tribe’s treaty rights and jurisdictional area.

“UKBCIO has no treaty rights and no jurisdictional area,” said Miller. “The fact that UKBCIO has no jurisdictional area was underscored again just last week when a federal court in Muskogee ruled UKBCIO could not receive HUD funding because it has no jurisdictional area.”

A week before that, he added, the federal government denied the UKBCIO’s request to take land into trust, again keeping the UKBCIO without any jurisdiction.

“Since tribes can only exercise IHS contracting within their jurisdictional area, UKBCIO’s announcement means nothing,” Miller said. “There is nothing to suggest that IHS or any other agency of the federal government would attempt to reverse hundreds of years of treaties with the Cherokee Nation and countless federal court rulings that say the UKBCIO has no jurisdiction; only the Cherokee Nation has jurisdiction over Indian Country within our 14-county area.”

UKB Chief George Wickliffe believes the CN would fall short in caring for patients or employees, should it gain control of the hospital.

“The UKB is concerned that a proposal made by another tribe to provide services in the area will not address the real health care problems faced by eligible Indians in the Tahlequah service unit, nor will it adequately protect the present employees of the facilities at [Hastings],” said Wickliffe.

Miller said the UKB announcement is nothing more than a ploy to complicate the self-governance process the Cherokee Nation has already undertaken, and places unneeded uncertainty in the minds of employees and patients.

“Cherokee Nation has already said that, upon any transition of services to Cherokee Nation, that all Hastings employees will be offered the opportunity either remain as federal employees or become tribal employees,” said Miller. “Our goal, as we stated last week, is to keep every employee, should any transition occur. Employees would be given the opportunity to pick the compensation package they feel would benefit them the most, either federal or tribal.”

“Also, the Cherokee Nation has a highly accredited health care system that is recognized nationwide as a top example of tribal medical care,” he said. “Any transition of services to the Cherokee Nation would be done with the idea of serving patients better, and Cherokee Nation has a track record of being able to do it.”

During the Cherokee Nation health committee meeting, District 8 Councilor and committee Chairman Dr. Bradley Cobb stressed the importance of properly addressing the tribe’s intentions, and that the council will be responsible for making any final decision.

“A feasibility study will be made and presented to the tribal council,” said Cobb. “The purpose of the study is to uncover questions to be addressed by the council.”

Melissa Gower, CN Health Services group leader, outlined the process for the tribe’s study.

“Over the next 90 to 120 days, all the pros and cons of taking over some or all of the operations at Hastings will be thoroughly reviewed,” said Gower. “We will render our decision on the study by June 1. With IHS, you have to allow 90 days for negotiation before entering into a compact or an agreement.”

Gower indicated her group is outlining a plan, and is looking at developing teams with members of both the Cherokee Nation and IHS.

HIMC CEO Ed McLemore also fielded questions from councilors, saying third-party payments had increased 41 percent in 2003-2004, from $22.8 million to $30.8 million.
“Patient encounters have increased as well,” said McLemore. “We serve approximately 244,000 annually, and are feeling pressured for more space and services.”