638 contract sought for health center

By Kathy Helms
Diné Bureau

WINDOW ROCK — Utah Navajo Health System wants to amend its Indian Self-Determination Contract to include the Monument Valley Health Center.

The biggest difference this will make for patients served in the Utah portion of Oljato Chapter and the Monument Valley Community, according to Donna Singer, Health System CEO, is that they will be able to use the contract health money and be able to refer patients out directly from their facility for emergency care, surgery and specialty services.

Because the clinic does not provide those services, Singer said, “As it stands now, even though we do the work-up and know what is needed and can make the arrangements, we can’t send them out.”

For example, if a person suffering from an apparent heart attack is brought to the clinic and it is determined the individual needs to be airlifted to the medical center in Flagstaff, the patient first has to be transported by ambulance to Kayenta hospital to be approved for referral and air transport.

“We have to send them back to the Kayenta Service Unit because that’s where the contract health money is, and then they have to go through the same process all over again through the IHS system to be referred out.

“It puts us in a life-threatening situation in regard to care for our patients,” Singer said.

Delegate Evelyn Acothley, who recently received Intergovernmental Relations Committee approval of legislation authorizing Utah Navajo Health System to amend its PL93-638 contract, said that when the legislation came before IGR in 2007, it was requested that supporting resolutions be obtained from the affected chapters.
“All chapters were notified and all chapter resolutions were passed,” she said. The chapters include Aneth, Dennehotso, Kayenta, Mexican Water, Navajo Mountain, Oljato and Teec Nos Pos.

Wilford Jones, chair of the UNHS board, and Singer told IGR that patients from Monument Valley Health Center sent back to Kayenta have to wait several hours and sometimes days before being referred for the needed service.

If Kayenta Service Unit is out of contract health funds, the patient may not be referred for the service, they said.

Singer said the Kayenta hospital steering committee has expressed concern that approval of a 638 contract for Monument Valley Health Center may have a negative impact on funding for a new hospital and that patient numbers will be reduced.

“The hospital facility that Kayenta is planning on building, UNHS totally supports that. That’s a desperately needed facility,” she said. “There are 25,000 people that are served by the Kayenta Service Unit.”

Patients needing services not provided by the Monument Valley Health Center still will be referred to Kayenta hospital, she said. “The patient count remains the same, irrespective of the 638 contract.”

Robert Billy Whitehorse, also a member of the UNHS board, said they recently dedicated the new Health Center building, which was built by Utah Navajo Trust Fund money. “It’s one of those facilities that’s really outstanding. Now they request to start operating under 638.”

Whitehorse said that with IGR’s approval, now UNHS can go to IHS and negotiate with them.