Government , Health

Congress passes bill removing Health Authority Board duty to make personnel decisions

After discussions among Osage Nation health officials, Executive Branch and Congress members during the August special session, the Seventh ON Congress passed a bill removing the Health Authority Board’s duty to make personnel decisions for the Wah-Zha-Zhi Health Center.

On Aug. 11, the Congress passed bill ONCA 20-59 (sponsored by Congresswoman Brandy Lemon), which is an act “to remove the Health Authority Board’s duty to make all personnel decisions.”  

Also during the special session as the bill was discussed and debated, Health Authority Board members Nancy Keil and Chairman Dr. Patrick Tinker resigned, leaving three board members to continue serving.

According to ONCA 20-59, the language removed from Osage law establishing the Health Authority Board is the board’s duties/ responsibilities to make all personnel decisions regarding executive (healthcare) administration and all employees or contractors that provide patient care at healthcare facilities including the Wah-Zha-Zhi Health Center. Personnel matters will be handled by the Nation’s Human Resources Department as a result of the law change.

Lemon, a former WHC employee, said proposing the bill was not an easy decision adding “I know how it feels when you’re not heard and when you feel that you have no avenue and that is the main driving force behind why I chose to sponsor this legislation.”

ONCA 20-59 was the subject of discussion during two Congressional Health and Social Service Committee meetings during the Aug. 5-11 special session, including an executive session closed to the public to discuss sensitive personnel matters allowed by Osage law.

In the Aug. 5 public committee discussion, Health Authority Board member Michael Bristow noted the HAB law allowing the board to handle personnel matters came about because under the prior structure, there was a lag time in hiring clinic employees. “The hiring process was delegated to Dr. (Ron) Shaw (the WHC Chief Medical Officer/ CEO) and severed our relationship with the Osage Nation HR Department was to streamline the hiring of medical providers. As Dr. Shaw presented, it was taking up to 90 days to secure an offer to professionals, medical providers. When we did streamline the process, it worked out very well… we are currently fully staffed right now.”

Bristow added: “We had an unforeseen consequence and the Health Authority Board acted as the HR in which we handled a complaint by one of the providers and we reached a satisfactory resolution for each party involved. And I really don’t see there was an issue with the hiring process, we’re starting to hammer out our own problems as we see it.”

Congresswoman Paula Stabler, a former WHC manager, said she agreed with Bristow noting the hiring and firing process streamlining worked and felt the bill moves the clinic operations backward and “the clinic needs to focus on the clinic.”

Lemon said she’s heard from clinic employees and patients who felt they had no avenue to handle conflict resolution and she added the Congress confirms the HAB members and “we are charged by our Constitution to uphold the health and wellness of our people.”

Before his resignation, Tinker told the committee the HAB was working on a restructuring of the organization considering the clinic services expanded as a result of the Nation assuming management of operations thanks to the Indian Health Service multi-year funding agreement. The clinic is profiting well and plans are being discussed to build a larger facility, he added stating some type of business model for the clinic is being investigated.

Regarding the conflict resolution discussion in general, Tinker said he did not believe conflict resolution is a board function at the level of the HR situation discussed. “We’re not really supposed to be resolving employee issues, it should go up the chain of command… when people have issues, they should go to their supervisors on up the chain of command. It should be extremely rare the board gets involved in day-to-day operations like that. I want to say that emphatically: The board does not belong in day-to-day operations at the clinic… It’s also industry-standard to have non-interference clauses where the board members don’t interfere with day-to-day operations.”

“I want to say the clinic is booming and that it’s moving fast, we’re going to build a new clinic, we have the resources to do so… we get reports nicely from the CEO… Dr. Shaw should handle the (employee vacation requests, Paycom HR matters, etc.),” Tinker said. “I do not think the board is the first stop for conflict resolution in ‘Susie stole my lunch!’ or whatever it might be that’s not for the board, it should come up through the chain of command.” 

After two committee meeting discussions, the Congress issued final debate comments before voting on the bill on Aug. 11.

Congresswoman Jodie Revard said she voted “yes” for the bill after listening to various sides including the Health Authority Board and employees. She also referred to the Constitution, which states “that Congress shall establish a merit (based employment) system that includes a grievance procedure. Our people voted on this governing document and they voted to include the language to ensure our employees are treated fairly and allowed due process. (This bill) will provide structure that is clearly needed… I’ll be voting ‘yes’ for the employees and I’ll be voting ‘yes’ to uphold our constitution.”

Congresswoman Alice Goodfox said she voted for the bill, noting: “I took out all the calls, emails, texts and people talking to me about why they want me to vote for it or against it and came to my decision based off one thing, which is the clinic is not an LLC, they are looked at as a program, but not a program, it’s a very unique situation. Currently, the only employees that don’t follow Osage Nation Human Resource policy and procedure are employees that work for entities of the Osage Nation that have already been designated as LLCs, so our gaming (casinos) don’t follow our (HR) policy and procedure, nor does (ON) Ranch Board employees, nor does Osage Home Health… Because of that, I think (the clinic employees) need to follow the Osage Nation's policy and procedure when it comes to HR issues.”

“When this clinic opened, we didn’t know if we could make it or not,” Stabler recalled of the clinic’s transition to operating under a compact/ multi-year funding agreement with IHS. “Most people believed we could not, but we did, we ran it better than the last 50 years, it was long days and hard fights, and it’s more successful, offers more services, more true healthcare to our people than before and it’s profitable enough to sustain itself and to build a new clinic. And instead of being proud, we seem to be damning the organization… Yesterday we lost two of the most diligent dedicated board members not because of the language of the bill, but because of the personal attacks. Is this bill going to pass? Yes, I think so. Because what choice do we have? We’ll move back five years and start over… The only other thing I want to add is in the Constitution, tribal officials and employees shall refrain from using tribal positions to improperly influence the deliberations, administration, or decisions of established board or commission proceedings and that’s what we expect of our boards to take charge of these things.”

Congressman Tillman said with Tinker and Keil’s resignations, he did not have the same strong faith commitment that the remaining board would handle the personnel matters going forward, so he would be voting “yes” for the bill. “It’s just really disturbing to me that something that was really operating and functioning well within the Nation has now taken a major blow with the resignation of an esteemed heart surgeon and the other board member (Keil, who is Tillman’s aunt and who he previously refrained from voting for board confirmation to avoid a conflict of interest).

In closing remarks on the bill, Lemon said: “I absolutely agree with the comments made concerning our employees not having a legitimate structure avenue for personnel issues. In some of our meetings, board members did stress that they were concerned about the hiring of certain personnel, specifically providers, which would be doctors, counselors, dentists and pharmacists. And prior to the 2017 change of the structure of this board, they did not have all of the personnel under them and it was changed… We did hear from our HR director and (director of operations for the Executive Branch) concerning issues that have been voiced to them… Ultimately this can get very emotional and we have to try to remove the emotion from it.”

Lemon said she believed the three remaining board members are capable of continuing their duties, adding “just because one member leaves an organization or a board does not mean that everything is going to fall apart. I have never been a proponent of individuals who use tactics in a way as leverage by resigning or threatening to resign… This legislation was not brought forth to down the clinic, the clinic is doing wonderful things and making money… But I am going to be the voice today for our employees or any other patients that have issues that haven’t been able to get them resolved in conflict resolution.”

ONCA 20-59 passed with an 11-1 vote with a “no” vote from Congressman RJ Walker. On Aug. 13, Standing Bear signed the bill into law.

After the bill’s passage, Bristow issued a statement on behalf of himself and the remaining board members Cecelia Tallchief and Cindra Shangreau. Regarding Tinker and Keil’s resignations.

“We were saddened by the resignations of both our chair and vice chair (Keil). We thank them both for their valuable service and we will miss them and their expertise. We will be electing new officers at a later (HAB) meeting,” Bristow said.