THE FIGHT FOR QUALITY HEALTH CARE AT WINNEBAGO COMPREHENSIVE HEALTH CARE SYSTEM

WINNEBAGO, NE – On Monday, February 27th, 2023, the Director of the Indian Health Service (IHS) took a tour of the Twelve Clans Unity Hospital, and visited with the Winnebago Comprehensive Healthcare System (WCHS) board and Tribal Council. They presented some of the successes and discussed how they can work together to improve access to quality healthcare for tribal members who utilize Twelve Clans for services.

                The WIN was invited to attend the presentation to the IHS board. Roselyn Tso, IHS HQ Director, Joe Amiotte, IHS Acting Great Plains Director, Ann Church, IHS HW Chief of Staff, Jillian Curtis, IHS HQ Chief Financial Officer, and William Bearshield, IHS Program Specialist were the administration in attendance from the Indian Health Service.

                Representing WCHS board were David Edwards, WCHS Chief Executive Officer, Sharon Frenchman, WCHS Chief Administrative Officer, Austin Schanzenbach, WCHS Chief Transformation Officer, Beth Wewel, WCHS Chief Financial Officer, Mona Zuffante, WPHD Chief Public Health Officer, and Sara Mcintosh, ARNP, FNP-BC TCUH Deputy Chief of Staff.

                Lastly representing the WTN, Victoria Kitcheyan, Tribal Chairwoman, Lorelei Decora, tribal secretary,  Isaac Smith TC member, and Danelle Smith, Attorney Big Fire Law.

                In July of 2018 the WTN assumed management of the former Omaha-Winnebago Hospital, which was formerly run through direct health care services through IHS. Since then, strides have been made to improve what was already a broken system.

                Frenchman shared, “we had a really strong, dedicated team all through those four years after the assumption. We brought on a new team, and we’re proud of the team we have, and we’re anxious to keep moving forward.”

                During that presentation, Kitcheyan expressed “on behalf of the council this has been a real journey for the tribe and council.”

                In July of 2015 the hospital lost its certification.

In a study done on it stated “the IHS refused to discuss individual cases of at least five unnecessary deaths at the IHS hospital, and countless other instances of deficient care, according to a federal survey report and testimony.

                Back in 2014, the Centers of Medicare and Medicaid Services ordered the hospital to take corrective action. However, by July 23, 2015 the CMS had revoked the hospitals Medicare and Medicaid Certification and said the staffing and oversight flaws posed “immediate jeopardy to patient health and safety.” ( modernhealthcare.com/specialre/wounded-care-winnebago-struggle/ )

                Reflecting on the past, the leadership of the tribal council members that were in office at the time of assumption. They made the decision to take action towards self-determination and self-governance.

                Where under the Indian Self-Determination and Education Assistance Act. The federal law was designed to give tribes the ability to assume administration of programs performed by the federal government to serve their communities.

                Self-governance allows the tribe additional flexibility to utilize federal funds associated with the IHS programs and activities.

                Where we are at in the present, WCHS and the WTN is continuing to move forward. Smith was the former CEO at WCHS at the time of assumption, she expressed “there will always be more work to do. Our approach in Winnebago is that we’re in a continual process of improvement and figuring out how to do things better for our people.”

                Kitcheyan adds “we have a very intentional goal on getting this place back on its feet. It’s all about the people. We acknowledge that the tribal members are the folks that use this facility, they are who we want to succeed for.”

                Looking to the future, some of the top priorities at WCHS are strategic planning, financial planning, budgeting, and developing an overall vision of the healthcare system.

                Upon the short-term planning, Edwards shared “we want to say, what’s our vision? So that what we design is fulfilling our vision more fully. There’s daily activity on all of these things to move those forward, to have us as a high functioning organization. As we go into the 2024 fiscal year of planning, we will kind of have our ducks in a row and say how can we take this to the next level?”

                At  the time of assumption there were approximately 199 employees, at a 45% vacancy rate. To date WCHS is at 326 employees. Recently filling eleven more positions and will be at a 100% capacity rate.

                Frenchman adds “we’re glad about that, we need everybody to help provide the care for our patients and our community.”

                One of the major goals is accreditation. Zuffante adds “we (Winnebago Public Health Dept.) have been doing a lot of policy development. We did submit all our documentation on August 30th, 2022.”

                Later comes the pre-site visit, and then finally the actual site visit. “We’ll be in the elite of the top ten tribally public health accredited hospitals in the country.”

                Some of the goals of the emergency department are to increase access to care. McIntosh expressed “we’re trying to get our patients into appropriate care for preventative care and maintenance of their health so they’re having the continuity of the care.”

                Other long term goals are looking towards renovation and modification of space, implementing detox services, and returning shares back to the tribe within the Drug Dependency Unit, as well as a dialysis center.