NSHC board meets, public concerns remain unaddressed
The Norton Sound Health Corporation Board of Directors completed their three-day meeting Thursday, Feb 1 in the hospital’s third-floor board room. Nineteen board members were seated at the table, one was excused and the representative from Little Diomede called in.
Around Nome, particularly in the online social media, attention has been focused on the termination of two long-time physicians and the no-hire letter to a third, a young doctor who grew up in Nome. However, business had been dealt with at previous meetings and the agenda for this meeting did not touch on those issues. Only in the public testimony at the beginning of the board meeting did the subject of the three physicians come up.
There was the call to order, an invocation, roll call, approval of agenda and approval of minutes from the Sept. 2017 Annual Board Meeting and two subsequent Special Full Board Meetings. Then it was time for public comments.
First up was Tula Huffman.
“When can I talk? This is tribally owned. I’m part owner. I request that I be allowed to speak.”
“Start right now Tula,” said the chair. “You’ve got five minutes.” Huffman requested that all non-Natives leave the room, a request that was denied. Huffman spoke of the painful loss of her brother in 2014 and how she felt let down by the hospital.
Next to speak was Sue Steinacher. She directly addressed the loss Dr. Head, her primary care physician. Steinacher suffered a spinal injury in a sledding accident 18 years ago and as a result has much experience with pain medications. She described Dr. Head’s effective handing of her condition and how he helped her transition off the medication which had been prescribed by a rehab doc in Anchorage.
“But now that I’m about to lose Dr. Head, my primary care physician for the last 20 years, I feel I have to say something,” said Steinacher. “I am not here to place blame. And I am not calling for anyone in the administration to lose their job. Angie has been a friend and a neighbor for many years and I know her to be a good person as are all of you. But I wholeheartedly hope and pray that this board will reconsider the firing of Dr. O’Neill and all the action taken against those who’ve spoken up in her defense.”
Lew Tobin was next to speak and he made it quick.
“I would just like to say, contrary to what it might seem, this is still my favorite hospital in Nome, Alaska.”
Martha Outwater Parker spoke next and addressed directly the controversy over the terminated physicians.
“I am here in support of the people who would like to that you recall the decision that you have made toward the doctors who know us,” she said. “The doctors that live here that eat our food. They go hunting, they know how to put the food away. They know all of these things. They grew up here. Dr. Head and Dr. Karen O’Neill are very entwined with our communities.”
“It is good that there are many doctors that you can choose from,” she continued. “But these are the ones that know us, that know our families. Dr. Head treated my mom, he treated all of us and we were very happy to see Benjamin Head coming up and wanting to be here too. These are the people that know us.”
A final citizen who spoke did not identify herself but spoke of the need to put more local people in leadership positions and the need to look at the board composition.
After a brief executive session NHSC President and Chief Executive Officer Angie Gorn delivered her report. The printed report runs 51 pages and details the activity of the organization over the past year. Gorn’s talk lasted 28 minutes as she touched on points she wanted to emphasize to the board.
“The second page of my report really summarizes the accomplishments under the different divisions and I have a few other highlights. I’m going to start with sharing that and won’t go into every piece of my report,” said Gorn.
The report details accomplishments and developments in workforce, clinical services, finance, quality/risk management, compliance/legal, engineering and environmental health, and self-governance and public relations.
Among the notable points made are that there are 707 direct hire employees, 280 employees were trained in Cultural Orientation and Historical Trauma Training and 247 scholarships were funded.
New medical staff leadership includes Dr. Mark Peterson and Dr. Paul Gloe. Emergency room visits have been reduced by 10 percent by offering “Same Day Clinic” in Nome Primary Care and by expanding hours. Visits by physicians to the villages increased from 732 in FY2016 to 1,675 in 2017. Health Aide visits increased by 1,000. Two more full-time tribal healers were hired.
Cash collections increased by $11.3 million to $64 million. Medicaid enrollment increased by 1,050. Patient travel improvements were made, including a travel liaison based in Anchorage.
Reminder cards for immunizations and vaccines were distributed to the region’s population as were colonoscopy screening reminders to those eligible.
Opioids dispensed by the NHSC pharmacy since FY 2015 have decreased by 45 percent. Prenatal visits have increased for women in the first trimester. The organization received three quality improvement awards in FY2017 for colon cancer screening, asthma evidenced-based strategies and heart measures medications.
The Indian Health Services granted $1.8 million to build health professional housing in Savoonga. NSEDC awarded $2 million toward construction of the Wellness and Training Center in Nome. Pilings and construction for the MRI facility begins in February. Morgues/outbuilding were erected in Koyuk, Shishmaref and Stebbins. Projects are underway in Wales, Elim, and Shaktoolik. Construction of a new clinic in Shaktoolik will begin in June.
NSHC has redesigned its corporate website and continued weekly updates, which are distributed through Facebook, Nome Announce and Nome Post.
Tribal hire is at 61 percent. On employee wellness day the facility closed and workshops were offered in the following areas: Food is Medicine; Power of Laughter; Nutrition and Weight Loss; Indigenous Spirituality; Financial Wellness; Yoga; Fitness and Total Wellness; Stress relief and tobacco use; Introduction to Dog Mushing and Improving the patient experience.
Dr. Mark Peterson took over as the new Medical Director, replacing Dr. David Head. Dr. Paul Gloe was approved by the Board of Directors as Chief of Staff. “Much appreciation goes to Dr. Head for his thirty years of continuous service at NSHC” reads the CEO report.
NHSC currently has two dental health aides, called DHATs. One is in Unalakleet and one in Savoonga who also goes to Gambell. A third is being sponsored and once she is finished with her training she’ll go to St. Michael.
Progress has been made in the plans for an operating room, which will begin with ear, nose and throat, pediatric dental, and ophthalmology surgery. Eye surgery means primarily treatment of cataracts.
Wellness division growth includes bed bug kits and education, injury prevention supplies, and education on demand. That means when a problem such as the mumps outbreak appears there is an educational response.
Patients who travel to Anchorage for medical services can be complicated, not only getting there and getting back presents problems, but getting to appointments in the city can be difficult. The Patient Travel Liaison position was created in Anchorage to assist patients in the city.
Frederick Murray of Elim was named to the executive committee. Martin Aukongak was named Chairman of the Board of Directors. Heather Payenna was named Vice-Chair and Preston Rookok second Vice-Chair.
Next Ukallaysaaq T. Okleasik guided the board through what began as a complicated exercise using phones and laptops but soon evolved into an effective tool for organizing the direction the board wanted to go in strategic planning. After voting on the top priorities for the upcoming year the order of emphasis looked like this:
1. Create regular communication opportunities with patients, managers and employees for avenues to participate in problem solving performance.
2. Improve the scheduling of patient care for cost effective housing travel etc. Reduce travel costs and increase patient convenience.
3. Greater integration of the unique cultural values traditional medicine and knowledge into compliance and quality standards for effective healing and treatments, improvements, and suggestions.
4. Village clinics facilities maintenance program.
5. Wellness Center development.
6. Increase access to specialty services, prevention exams and primary care appointments for all patients.
7. Create a five-year facilities master plan.
8. Enhance high school programs for growing the region’s own into health careers.
9. Human resource task force to recruit past and current scholarship graduates into NSHC positions.
10. Update policies procedures and reporting for better understanding work processes and improved staff direction guidance including reports developed in layman’s terms and that a common person can read monitor key indicators and make good effective decisions.
On Wednesday, Jan. 31 Dr. Mark Peterson appeared before the board and each member introduced himself or herself to the new medical director. A board member asked Dr. Peterson if the previous director was cooperating in the transition and Dr. Peterson answered that he was.
Next up was the Clinical Services Executive Summary report presented by Philip Hofstetter and Lucy Apatiki. “NSHC has been working toward integrating care with the patient at the center of that care,” reads the introduction.
Board members asked the two what percentage of the visits come from the villages and why the hospital is called the Nome Hospital. Preston Rookok of Savoonga brought up the lack of preparedness for disasters. Lucy Apatiki talked about historical trauma and its effect on healthcare.
“We continue to monitor the indicators identified in historic trauma response theory which indicate that historic trauma and colonization are creating health disparities in our beneficiaries,” she said.
“Finding qualified, well-trained physicians continues to be a priority for the medical staff,” reads the printed report. “Recruiting efforts are recurring to obtain highly qualified family practice physicians and a pediatrician.”
The report contains considerable detail on trends and innovations in care delivery to the villages.
Engineer Mike Kruse gave a run down on what’s happening with construction and maintenance. Construction on the Wellness Center is to resume on Feb. 4. Megan Stimpfle talked about sewer and water in the region. There are still five communities without it. In those villages people are more likely to have skin infections and common colds and more likely to be hospitalized.
Thursday’s session was spent with motions to accept committee reports and usual board meeting business. A motion to donate $25,000 to Kawerak for the Katirvik Cultural Center was read. The center is used in cultural orientation for new NSHC employees pointed out one board member.
“I know they would appreciate a contribution to help with their operating expenses,” said Angie Gorn. The board voted unanimously to contribute the money.
Next the board sang happy birthday to June Walunga of Gambell and a very tasty cake appeared.
A motion to sponsor Aaron Burmeister with $10,000 in the Iditarod was the next item. The veteran musher had requested sponsorship and stated he wants to run the race for wellness. He has received support from NSEDC and also from the Bering Straits Native Corporation. In the past NSHC has supported Joe Garnie and Palmer Sagoonick in their Iditarod efforts. Joe Garnie’s anti-diabetes message was “Stop the Pop” said one board member. A vigorous debate over whether to award the money to Burmeister ensued, with one board member saying she didn’t want to donate money to a musher living in Nenana. Another board member described dog poop as now being toxic because of the scientific feeding of race dogs, stating that villages make the mushers park their dogs away from buildings. Countering the contention that Burmeister is an outsider, Berda Willson stated she’s known Aaron since he was an infant and he’s not an outsider. Although he’s a smoker, he said he would remain tobacco free for the duration of the race.
“That’s going to be a long nine days without a cigarette,” says one board member to his neighbor. But the motion carried and Aaron Burmeister will mush for wellness.
After more routine board of directors motions and voting on reports the meeting adjourned.