The Osage Nation Health Authority Board voted May 12 to offer the post of chief medical officer to a doctor whose name was not released and was referred to only as the “person named in Envelope A.”
Board chair Cindra Shangreau said that the doctor was not being named because he had asked to remain anonymous until he accepted the contract and could give notice to his current employer.
According to other sources at the WahZhaZhe Health Clinic, he is a currently a Tulsa doctor, board certified in pulmonary and critical care with more than 35 years of medical experience, some as an administrator. His wife is also a medical provider who had sought work at the clinic, but it is unclear whether that will come to pass.
The doctor will replace Amanda Bighorse, a Doctor of Osteopathic Medicine whose 10-month tenure as CMO was marked by dissatisfaction from clinic staff – disappointment that the health board members now appear to share despite some dismissing the criticisms when they first arose.
Their unhappiness was on display during the meeting, when they were informed that the clinic was considering relinquishing $215,000 in grant money back to the Centers for Disease Control because the ball had been dropped, both in spending the funds as well as keeping grant managers informed when those whose salaries were paid from the grant were terminated or left their jobs.
The grant money must be spent with issues related to Covid-19. Under former WZZHC CMO and CEO Dr. Ron Shaw, all of the grant money earmarked for equipment, such as hundreds of thermometers and pulse oximeters for Covid patients, was all spent – but money for some salaries and a website was not.
The health board decided that instead of giving the money back to the CDC, it would ask the federal agency for a second “no-cost extension” and budget modification to try to spend the money in the next six months. The deadline to request the extension was May 16.
The shortfalls could dampen the clinic’s ability to obtain future grants from the CDC, which is quite strict about grants management, said Christa Fulkerson, the Nation’s director of grants.
“When you do a no-cost extension request, you have to have a reason why you didn’t spend the money, that’s really the key to it,” Fulkerson told the board. “So, if you can, give us a reason why you didn’t spend the money?”
Board members pointed to the resignations of Dr. Shaw and Bighorse, but Fulkerson pressed.
“What they’re going to ask is between Dr. Shaw’s resignation and then hiring on the new person that just resigned, what happened between there and why didn’t you guys spend the money?”
Clinic manager Kirk Shaw responded: “There were attempts made to get some of these done but there were questions about what’s the purpose of this.” He said that Dr. Shaw – who died of brain cancer months after he resigned – had pursued an interactive billboard that was to be funded by the grant but wanted it located by Main Street at Lynn Avenue, just east of where a new clinic is in the works. At the time, the Nation didn’t own land where the billboard should be placed.
More recently, the grant money hasn’t been spent on a budget analyst, communications specialist and website upgrade, as called for.
“This last time there was no, um, I won’t say cooperation, but no approval I guess,” Kirk Shaw said.
Interjected board member Michael Bristow: “I think it would be fair to say there was no cooperation.”
Fulkerson: “No cooperation with who?”
Bristow: “With the clinic administration.”
Fulkerson: “Since Dr. Shaw left … how many months was Dr. Bighorse here?”
Bristow: “10 months.”
Fulkerson: “So, they’re [the CDC] going to be like, ‘Why didn’t they do anything in 10 months?”
Board member Cecelia Tallchief: “Lack of leadership.”
Shangreau: “Lack of leadership, I guess you could say.”
Fulkerson said that the CDC would therefore want to know what the clinic was going to do to remedy such problems in the future.
Bristow summed it up: “Actively seeking a new CEO.”
At least one potential candidate for the CEO position has been identified: A former WZZHC manager who has worked as a health administrator for other tribes.
Clinic poised to spin off as independent enterprise
At the outset of the board’s meeting, Principal Chief Geoffrey Standing Bear warned that members were going to have to get cracking on making hires to legally conform with the health care reform act that the Osage Congress passed during its Hun-Kah session that ended last month. The law, which makes the clinic a standalone business enterprise like the Osage Casino enterprise.
Standing Bear said that the law was “very unclear as to the effective date” but he had conferred with Attorney General Clint Patterson who determined that it would go into effect 60 days after Standing Bear signed it on April 25, which means it becomes law on June 24.
In its current state, the clinic is a tribal service that uses the Nation’s accounting, information technology, human resources and other departments to function, but when it becomes autonomous, it will have to perform those tasks itself.
There’s wiggle room: The clinic can pay the Nation for accounting, HR, IT and other services during the transition, and shed those bills as it staffs those departments itself.
Standing Bear said that the total of such indirect costs for the clinic amounts to $2.5 million to $3 million a year.
“This is quite a shift,” Standing Bear told the board. “You’re going to have to hire your own legal counsel. You’re owned by the Nation but managed by the board. You won’t send a budget to the chief or Congress. You’re going to have to do what the law says.”
Tallchief said that the board had wanted the law to take effect in January 2023, but a mix-up led to the earlier date.
Standing Bear said that he didn’t foresee any major issues with the transition – as long as the board gets to work on it.
“The money is there,” he said. “It’s just a matter of staying with the federal system but that means you have to get on it now.
“It’s better if you take the 45 days instead of rushing it, but someone needs to be working on it every day.”
The chief said that, assuming he’s reelected in June, he intends to reappoint all of the same people to the board when the new law takes effect, thereby dissolving the current board.
Moving toward the clinic’s new independence, the board worked on job descriptions for an accountant and human resources director.
As they went over descriptions suggested by the tribal human resources department, the board lapsed into hilarity when they saw some of the requirements for a clinic HR director, including that candidates would be required “to talk and hear,” and that they might be required at times “to stand, walk, reach with arms and hands, climb or balance” and “to stoop, kneel, crouch or crawl.”
“Crawling would be a bonus, I guess!” Bristow said.
With much laughter, the board had its assistant, Melissa Cole, delete the language.