The Wahzhazhe Health Center’s Si-Si A-Pe-Txa Board delivered an annual report to Congress, revealing the ‘Super Clinic’ is on track for completion in the fall of 2025. The WZZHC has also transitioned by “95 percent” to its own entity separate from the Nation and has many new projects underway.
The Si-Si A-Pe-Txa Board is currently overseeing no less than six projects ongoing at the Wahzhazhe Health Center: the new clinic, the primary residential treatment (PRT) campus on track for completion in June; a state-of-the-art assisted living facility in Hominy; an upgraded mobile medical unit, and a small ambulatory program grant through the Indian Health Service which will create a satellite clinic in Skiatook complete with a pharmacy.
The board’s goals through 2026 remain to “rapidly grow while improving our financial picture; create an organization-wide atmosphere of teamwork; expand and retain our mix of medical/clinical/support staff; educate our community; sustain … accreditation [coming up in the next thirteen months], and preserve our workforce,” according to Clinic Director Kirk Shaw, who presented at Congress’ Health and Social Services Committee on April 11 on behalf of Mark Rogers.
In opening highlights, Shaw reported the health system has hit “record revenues” through March of 2024, including $7 million in cash collections – and they are projected to hit $18 million by the end of fiscal year 2024. “We have given out awards … selected by peers and employees, closed the new clinic loan for $50 million, and continue to sustain high patient satisfaction scores,” he said, of some of WZZHC accomplishments over the past year.
Shaw was also proud to share that the new specialty clinic staff had been stabilized and now boasts seven specialty clinic providers. “That’s something Dr. Little and Mark have been working on feverishly over the last year,” he said.
Transitioning away from the Nation
The WZZHC transition away from the Nation to their own independent enterprise is now 95 percent complete, Shaw said, while going on to note that a few sticky areas remain and some of those will be longer-lasting entwinements with the tribe. Among the items still hanging on to the Nation are “grants … [but] HR is fully transitioned, our accounting is fully transitioned … legal has transitioned from the Attorney General’s office,” Shaw said, adding that facilities have transitioned too. “Almost fully – except for the facilities that we’re still paying space costs on.”
Most recently, the WZZHC transitioned their Information Technology and phones, which left the clinic’s phones down for thirty minutes during the first week of April. Additional upcoming transition plans include taking over their own maintenance and groundskeeping, which will occur when the new primary residential treatment center opens in August, following a June construction completion and admin move-in. “We expect to have a ribbon cutting in August,” he said. “We’ll have a very nice ribbon cutting for that.”
Construction on the new “super clinic” in downtown Pawhuska will be visibly and dramatically “going up” by July, said Shaw, and other upcoming manifestations of new WZZHC facilities include a series of billboards, arranged by their own in-house public relations department. The purpose of the billboards to go up in Bartlesville and Skiatook, Shaw said, is “getting back all the patients we lost.”
New Facilities Details
Of the Primary Residential Treatment campus facilities, the men’s PRT facility will have 12 beds, and the adolescent building will have 16 total beds, split equally between male and female assignments. For the women’s PRT, they will have 12 beds – and the newly-created transitional housing will accommodate six males and six females.
WZZHC CEO Mark Rogers has been “on them since the beginning,” regarding mobile medical units, said Shaw. Recently, two new staff persons have been hired to work at the 33-foot and 39-foot mobile medical units, both of which will circulate in Osage County, according to a Facebook schedule to be up later this month. Those two mobile medical units will stay on-site during all of the June dances and are newly equipped with wheelchair lifts.
Additional projects by the WZZHC include a 9,500-square-foot small family practice office with a pharmacy, currently slated to be built across the street from the Skiatook Casino. Referred to by WZZHC leaders as the “small ambulatory program,” the facility will be a satellite clinic functioning as an extension of the main clinic. A total of 3.5 million dollars are allocated to the project, which is underway with the Indian Health Service (IHS) as of this April.
‘Hominy Retirement Mecca’
A new state-of-the-art assisted living project in Hominy – which Congressman John Maker has said sounded like “the Hominy retirement Mecca of the world” – has been sub-awarded $8 million dollars to move from concept to scope of work. A design-build is the next step, Shaw reported to Congress.
“We have enough information to do a design-build,” he said, referencing a type of design process that is an alternative to the traditional architectural design model, in which architects begin the process, and then contractors follow. The advantage of the design-build process, compared to the traditional model, is that they have shorter timelines and tighter budgets due to contractors and engineers weighing in on designs from the very beginning, rather than participating in project revisions after the design is done. In part due to the design process the WZZHC has chosen, the assisted living project is expected to be completed quite quickly.
During an earlier spring 2024 presentation to Congress, Senior Services Director David James of Osage Nation Health Services outlined the specifics of the soon-to-materialize assisted living vision, which will eschew the typical nursing home layout for a cluster of more multi-resident cottages. These cottages, each of which can house 16 elders, will allow residents to cook their own meals or bake if they want to; participate in activities that are culturally appropriate for Native Americans; and generally, have a high living standard complete with well-staffed nursing care.
Michael Bristow, Si-Si A-Pe-Txa Board vice president, has said the WZZHC assisted living facility will be different from some tribally-run elder homes because the WZZHC has a more sustainable business model and won’t experience frequent lawsuits and face high risks of shutting down. Such dubiously run elder home projects tend to be privately-owned facilities that are focused on profit, and as a result, are grossly understaffed.
Bristow explained, “In the private sector … lawsuits have usually stemmed … from the private company needing to reduce the cost of [operations] so they can increase their profits, usually with reduced staff, which leads to errors.” Unlike these facilities, the WZZHC assisted living project will have enough nurses to handle medication, bathing, changing, meals, “everything,” said Bristow, rather than leaving all of that to one professional who has been set up to fail by the nurse-to-elder ratio. “When you provide enough workers … then lawsuits don’t happen, or they’re very, very infrequent,” he said. “Us being in the Osage Nation, we’re in a unique position. That cannot happen.”
The assisted living cottages will cost approximately $1 million per structure, with an additional cost of $800,000 designated for activities, per cottage. For elders’ medical needs, they will rely on the mobile units and possibly, although it is not yet in the works, a “plus-care after-hours clinic” which would be akin to urgent care.
Congresswoman Brandy Lemon was quite excited about the assisted living project, which she described as sorely needed. “There are not a lot of places,” she said. “[This] provides housing to Osages who might return.”
Counseling Center
Billing had recently stopped at the Counseling Center, which is looking to redress 339 incomplete claims tied to billing and coding errors. With the help of a consultant, Face Rock Enterprises, the claims should be filed and will amount to $260,000. The WZZHC is now getting “coding right, billing right, [and is] headed in the right direction,” said Shaw.
The counseling center is currently under budget by $600,000, due to using contract therapists. Recently, the counseling center moved contract therapists to employees, which will help the WZZHC utilize compact funds. “That’s a transition,” said Shaw.
Despite this being one of “the main things we wanted to talk about,” there were few other comments relating to mental health services.
Clinic addressing prevention
Dr. Tony Little got emotional when it came to talking about saving lives, not only through treatment, but through prevention.
After noting that patient satisfaction scores are exceeding 90 percent, sometimes ranking between 95 and 100 percent, he said with tears in his voice: “Our job is to save lives and prolong life, and one of the things we have to do in this business is address prevention. … colon cancer is the number two killer in this country right now.”
He then spoke of the importance of accessing an accessible at-home alternative to a colonoscopy, called Cologuard. “You poop in a jar, and you mail it in,” said Little, and noted the test’s 93 percent efficacy rate on detecting colon cancer. “There’s only about 3 or 4 percent difference on a colonoscopy and a Cologuard,” he explained and said the clinic formerly couldn’t do the non-invasive colon cancer test because they didn’t have the setup. But now, they are the first tribe in the nation to have third-party billing with Cologaurd, meaning, “it can be done, they can save lives,” said Little.
He urged early detection and checkups among patients, who are at astronomic risk rates of the particular cancer because of the foods they consume as part of modern high-fat, low-nutrient diets. “Somebody in this room has been touched by colon cancer,” Little said. “Once it’s outside that colon, we can’t fix it. But if it’s inside the colon, we can fix it. If you haven’t got that done, you better come see us.”
Lemon agreed, “Cologuard is … even more simple than what he said. It’s really not disgusting. It’s a very simple test to do and the results come back really fast. You need to toot your horn on that one.” She added she would like to see more education and prevention options on the causes of colon cancer, too, rather than just on early detection.
“I’m just wondering if there’s going to be something you’re going to be speaking about, an idea on prevention about what we put in our bodies, and what we put on our bodies and if – being sovereign – we can adopt our own guidelines if we so choose.” She then clarified further, saying, “it’s not trying to tell you, ‘you can’t eat this and you can’t eat that,’ it’s just, let’s learn about it, to help to prevent colon cancer. And if [a food is] not good, what amount is acceptable.”
The doctor responded that there was a program to that effect, and it was focused on youth. “We’re starting a childhood obesity clinic. … our first meeting is in June. This is something that’s really needed across Indian Country. We know that obesity causes a lot of problems – not just the teasing, but I’m talking about later on in life.” He added that among other prevention efforts are mammograms, and chest CT scans.
“On another,” Little added, “our diabetic prevention. I’ve always been a little judgmental about how our diabetic education goes. I come from a whole family of diabetics. So, I get to see what happens in these other states where my siblings have. What they do is wonderful, there’s just so much more that can be done,” he said.
Diabetes affects kidneys and eyes, he said, and shared that he is revamping the diabetic department at the clinic. “The two ladies we have in charge, you’re not going to get anything past them,” asserted the doctor.
The clinic has been upgrading what they’re offering in other specialty service areas, too, over the last several months. Among recent improvements are two new podiatry tables for a new specialist to do foot work on, and a psychiatrist on site all day, every day.
For more on the specialty services available through the clinic, read https://osagenews.org/construction-of-new-wahzhazhe-health-center-delayed-until-2025/.
