Health Center Feasibility Study done by Blue Stone
By Joe Morey
The LCO Tribe submitted an application last month for the I.H.S. Joint Venture Funding program, which, if approved would pay for operations and payroll for a new tribal health center for the next 20 years.
Regional IHS received notice from the Division of Facilities Planning and Construction (DFPC) that the Joint Venture Construction Program Final Application (Phase II) Qualifying list will be released on Wednesday, December 11. On that date the tribe will be notified if it moves forward in the application process with a handful of other tribes.
In the meantime, as part of the process, Blue Stone Strategy Group was retained by the LCO Tribal Governing Board (TGB) to do an assessment of the current health facility and make sure a new clinic is feasible for the Tribe.
On Tuesday, Dec. 3, Blue Stone president, John Moors, and founder, Jamie Fullmer, presented their findings to the TGB. They reported there have been a lot of distractions at the clinic and these distractions have had a negative impact on employee morale.
Moors said they asked employees what they believe the clinic does well and 64% of respondents said patient care and compassion topped their list, and 40% said the quality of care.
“Those are the strengths of the clinic,” Moors said. He also added that overall staff perception of how the tribal membership views the clinic is that the clinic is operating below average.
Moors said that 88% of respondents stated there is no open line of communication with the TGB or the Health Advisory Board (HAB) and the staff.
“You have a committed team and they are passionate about what they do,” Moors told the TGB. He added it is important the clinic creates a new image and plan for the future, and that they maximize their current operations.
During the assessment, Blue Stone asked what the clinic needs to be operating at a capacity that provides care for all Tribal members. Answers included;
"Staff is divided and needs help coming together as a team."
"Communication within departments and across departments needs improvement. Our admin and other programs are at a lack of communication as for certain things that need to happen."
"We need a meaningful budget, with direction from an experienced health board."
"We need more qualified medical staff for multiple roles and planned services, however, most professionals in the area are very reluctant about accepting positions at the health clinic because of the past and current reputation of high staff turnover."
"There is a need for additional doctors and staff enrichment (cultural training, team atmosphere, interactive training, increased communication)."
"The health clinic should be run independently from tribal governance."
Moors told the TGB that the current structure at the clinic is part of the problem. As part of their recommendations, Blue Stone advised the current Health Advisory Board be disbanded and a new Medical Board of Directors be established.
“There has to be a medical board with an ability to govern,” Moors said. “We believe for financial stability at the clinic, there has to be a separation.”
Blue Stone recommended in its Action Plan that TGB appoint a new Health Board that will consist of at least a medical professional, a financial professional, a TGB member and other important representations from the community. They also recommended hiring a Chief Executive Officer for the clinic and that the Health Board has oversight over the CEO.
Moors said although the TGB should consider community members first for the CEO, they should not try to minimize the importance of having a qualified person in the position.
“You can’t be half in. We’ve seen compromise and short cuts, and what we've seen is the council doesn’t get what they were hoping for,” Moors said.
As for the Health Board, Blue Stone said the positions should have some form of compensation, most likely, a stipend.
“Ultimately, the Health Board is going to be expected to help move the clinic to a for-profit operation,” Moors added.
Moors concluded by stating, “If you separate, you have to over-communicate. This will set the standard. If you get this right, you’ll have many opportunities.”