Chickasaw Nation Rural Health Outreach Program
| Topics |
Aging
American Indians, Alaska Natives and Native Hawaiians
|
| States served |
Oklahoma
|
| Description |
The Chickasaw Nation, a federally recognized Indian
tribe, is responsible for providing health care to all Native
Americans living within a 13-county area in south-central
Oklahoma. The region has been hit hard by poverty and a dire
shortage of health care professionals. In fact, the area has been
designated a health professional shortage area by the Health
Resources and Services Administration. At the time of the
grant award, many areas in the region had no access to
geriatric health care, jeopardizing the health and well-being of
the region’s oldest citizens.
The Chickasaw Nation Rural Health Outreach Program
was designed to provide a range of primary health care
services to Native American elders living in the most rural
and remote areas of the region. Specifically, the program was
designed to expand services to areas where geriatric care was
not available. The program also placed strong emphasis on
serving Native American elders who were homebound, frail,
or lacked transportation to visit area health clinics on a regular
basis.
To support this project, the Chickasaw Nation Carl Albert
Indian Health Facility (also known as the Chickasaw Nation
Health System) in Ada established a consortium of
organizations. The consortium included the Ardmore Indian
Health Clinic in Ardmore, the Tishomingo Indian Health
Clinic in Tishomingo, and the Durant Indian Health Clinic in
Durant. The three clinics provided general and specialized
health care, as well as dental and limited optical health care. |
| Services offered |
Grant funds were used to establish a “portable clinic”
within the Carl Albert Indian Health Facility. The clinic
consisted of routine primary care visits designed to promote
health, prevent disease, and treat illness. The Rural Health
Outreach Team consisted of a geriatrician, a nurse
practitioner, and a licensed practical nurse. The team traveled
to outlying Chickasaw Nation clinics and the homes of elderly
patients who were not able to travel to a clinic for care. The
geriatrician, whose salary was funded by the grant, made
rounds to local nursing homes at least two mornings each week.
One day a week, the Rural Health Outreach Team
traveled to the three outlying clinics in Ardmore, Tishomingo,
and Durant. Also, a nurse and nurse practitioner spent 2 days a
week visiting homebound patients who were unable to travel
to the nearest clinic. Seeing patients in their homes can take
many hours because of the cultural and educational barriers
that may arise when serving elderly Native Americans.
Establishing trust between the provider and the patient is a
critical step that must occur before quality health care and
health education can be provided.
In addition, the Rural Health Outreach Team traveled to
area senior citizen sites to check blood pressure levels,
monitor blood sugar, administer flu vaccines, and distribute
information about aging and illness. Team members also were
available for telephone consultations with health care
providers in the Chickasaw Nation Health System and other
providers in the Indian health system throughout Oklahoma.
At first, the team members traveled to clinic sites and
homes using a four-door vehicle. Later, the trips were made in
a van that provided adequate space for portable equipment
such as an EKG monitor, Holter monitors, blood pressure
machines, dopplers, nebulizers, an oxygen saturation monitor,
bandages, supplies, exercise equipment, stools, a TV/VCR
combination unit for patient education, brochures, and
handout materials. |
| Results |
The program hoped to achieve four major goals:
- To provide efficient and effective health care services
to Native American elders
- To obtain and maintain professional staff members
who were qualified to provide care
- To develop a centralized health care center
specifically designed to provide health care to Native
American elders
- To sustain program operations once grant funding
expired
For the most part, all of these goals were achieved. The
first goal was achieved by expanding the program’s services
to include senior citizen sites, nursing homes, outlying clinics,
and home visits. The second goal proved to be the most
challenging because of short periods of staff vacancies in the
first 2 years of the project. It was not until the third year of the
project that all vacancies were filled and the team was fully
functional. The third goal was achieved by establishing the
Carl Albert Indian Health Facility as the central office for
coordinating project activities.
In addition, the outlying clinics
in Ardmore, Tishomingo, and Durant provided office space
for team members during their visits. The fourth goal was
achieved by using third-party billing as a means to obtain
reimbursements for services rendered. Eighty percent of the
patients seen during the project had third-party health care
resources such as Medicare, Medicaid, and private insurance.
The most important lesson learned was related to coping
with key staff vacancies. Although staff vacancies cannot
always be foreseen or avoided, programs such as this one
must identify strategies for ensuring the smooth conduct of the
program—even when key positions are not currently filled. |
| Replication |
The mobile clinic model is applicable to many other rural
areas in which there are large elderly populations and
significant transportation or geographic barriers to accessing
health care services.
The Chickasaw Nation Health System has assumed
responsibility for what is now called the Elder Care Program.
Program services are funded via third-party reimbursements
and tribal funding. The program continues to offer the mobile
clinic, and team members still travel to the outlying clinics,
nursing homes, and homes of elderly homebound patients to
provide care. However, due to an expansion of the Chickasaw
Nation Health System, the project’s home base is moving to a
more accommodating clinical setting with the system’s
hospital. |
| Source |
Outreach Sourcebook, Vol.10, 2000-2003, Office of Rural Health Policy
|
| Contact person |
Marty L. Workman
Chickasaw Nation Health System
1001 North Country Club Road
Ada, OK 74820
Phone: 580-421-4544, Ext. 2408 |
| Date added |
May 15, 2009 |
Summaries of success stories are provided by RAC for your convenience. Please contact the success story contact person directly for the most complete and current information.
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