Top U.S. officials visited the Southcentral Foundation (SCF) on August 31 to discuss its innovative health care system for Alaska Natives.
Discussions with representatives from the U.S. Department of Health and Human Services centered on SCF’s Nuka System of Care, which is created, managed, and owned by Alaska Native people. The health care system aims to help people achieve physical, mental, emotional and spiritual wellness, according to the SCF website.
The customer-driven health care system has lead to improved health measures across the Alaska Native population. It has also decreased costs and staff turnover. (SCF employs more than 1,400 people and manages more than 60 health care programs and services. SCF, founded in 1982, is the nonprofit health care affiliate of Cook Inlet Region Inc., an Alaska Native Corporation.)
HHS Secretary Kathleen Sebelius inquired how the Nuka System of Care can be translated to other settings.
Katherine Gottlieb, SCF president and chief executive officer, stressed listening to the wants and wishes of those receiving services. She recommended redesigning services around long-term trusting relationships and empowering customer-owners to own health issues at personal and systems levels.
Along with Sebelius, Director of the Indian Health Service (IHS) Dr. Yvette Roubideaux and U.S. Senators Lisa Murkowski and Mark Begich, all present for the visit, discussed progress at the Alaska Native Medical Center, and the local consequences of the national debate on health care and the deficit.
SCF officials noted that health care for Alaska Native and American Indian people has been “prepaid” in exchange for land and resources, stated an SCF press release. Historically, the federal government has not fully met the obligation, Gottlieb said. According to a U.S. Civil Rights Commission study, per capita funding on Native health care is only one-third of the national average, and barely one-half the amount of per capita spending on federal prison health care. Gottlieb noted that in the last two years IHS funding has increased more than in the past. Sebelius said the Obama administration is working to further address this disparity.
“In addition to the IHS budget shortfalls, Congress has repeatedly underfunded the contract support costs SCF needs each year to self-govern and deliver health care services to 58,000 Alaska Native and American Indian people,” stated the SCF press release. “Last year, SCF’s contract support cost payment shortfall was calculated at $5.5 million. Additionally, SCF is building a 90,000-square-foot outpatient facility in Wasilla as part of a Joint Venture with IHS, which requires Congress to fund a sizeable portion of the staffing costs – a possible challenge with all of the deficit reduction activities.”
As the visit winded down, U.S. health officials took a tour of the innovative Anchorage Native Primary Care Center. The center focuses on customer comfort and clinical spaces that do not appear to be a medical atmosphere. The site employs optimal use of light, color and texture, Sebelius pointed out.