SOUTH CENTRAL FOUNDATION AND THE NATIVE ALASKAN MEDICAL CENTER, Part I:
Several people have asked for information about where I work and what I am doing. I have found trying to explain the health care system here to be a daunting task. It is so incredible!
So, I will first introduce you to the CEO of South Central Foundation as I think her story sets the stage very well for an understanding of this incredible program.
My first introduction to Kathleen Gottlieb was a picture of a pretty Native Alaskan woman that appeared to be in her late 20s or early 30s. I was amazed to find a woman so young in such a position of power (she is actually 54). I was even more amazed when I learned her story.
Ms Gottlieb is Aluet, born on Kodiak Island to an Aluet mother and Filipino father. She was one of 12 siblings. Kathleen was 12 when her mother died and she was left to raise the seven siblings remaining at home. Not surprisingly she dropped out of school at the age of 16 and had her first child (she nw has 6 children and 22 grandchildren).
As is shockingly common here, Kathleen found herself in an abusive marriage, but after several years she found the courage to plan and pull off a well-timed escape aboard the Seldovia ferry. She was cast ashore with two children, no job and no education.
What follows is the most inspiring story! Kathleen Gottlieb earned a GED and an AA in business from the University of Alaska Anchorage. In 1987 she went to work as a receptionist for South Central Foundation (SCF). While working and raising six kids she earned a BA in business administration from Alaska Pacific University in 1990. Get this: After two years on the job she advanced to deputy director of SCF! Four years after she signed on she became acting executive director! She earned her MBA in 1995 and ten years later this high school drop was CEO of one of the most powerful coorporations in Alaska and APU conferred an honorary doctorate!
She recently conceptualized and spearheaded a new program called the Family Wellness Warriors Program which focuses on bringing domestic violence out of the closet, making it a real part of dialogue across the state. For this, and other accomplishments, she was awarded the MacArthur Fellowship (popularly known as "genius grants"). This honor is accompanied by a $500,000 no strings attached grant which has no reporting requirements. She has used part of the money to start an employee health program.
Ms Gottlieb is described as creative, passionate and driven. This is reflected in the organization-this is the most creatively run, can-do place I have ever worked!
Kathleen was drafted by the Clinton administration in the mid 90s to help draft rules to guide the Indian Health Service in surrendering funds and responsiblity for Native health care to tribal organiztions. In Alaska, under her leadership, the Alaska Native Medical Center emerged as one of the first tribally owned and operated, full-service, Native health care systems in America.
In 1982 when Southcentral Foundation was incorporated under the tribal authority of Cook Inlet Region, Inc and services were handed over from the goverment there were 12 staff and 3 programs. In 2004 there were over 1200 staff and 65+ programs!
SCF is described as "a shining example" of what can be done with private sector energy and determination! It's an example of Natives obtaining a measure of self-determination. The setup is that the 300 plus cultures of Alaska formed several corporations along geographic rather than tribal lines. Within these corporations there are regional health corporations and regional hospitals to which the Indian Health Service hand over the dollars to be managed.
South Central is the corporation I work for (through CompHealth) in Alaska. SCF delivers care to over 400,000 Native Alaskans. These services include primary health care, family medicine, emergency services and surgery, dentistry, optical care, and physical therapy. Other programs address prenatal care, headstart, preschool, fetal alcohol syndrome, substance abuse, domestic violence, mental health counseling, elder care, complementary healthcare and traditional healing. Across the board the focus is client/owner centered and holistic! The key points are shared responsibility, a commitment to quality and family wellness.
When you try to imagine this place don't think about the local hospital-think about Southwestern Medical School or some other teaching, research hospital and you will be much closer to a real picture of SCF and the Alaskan Native Medical Center.
Organization charts are not a the typical pyramid shape-they are groups of intertwining circles all with the client-owner in the middle and the employee in each of the circles.
The Native Hospital is considered a magnet hospital-which means that it has been identified by nursing leadership as an outstanding place to practice nursing. The model of nursing management used is known as "self governance" which basically gives the bedside nurse the most power in the nursing structure.
The Joint Commission for the Accreditation of Hospitals is not stringent enough for this place! Although they are accredited by JACHO and recently passed a surprise visit with NO dings, they use a more exacting system called the Baldridge National Quality framework. SCF has acheived step three, which is apparently quite an accomplishment-the goal is the Baldridge award.
Do you see why this is so difficult to explain! I will be doing a follow-up blog on
1) a closer look at a few of the programs
2) a look at the Primary Care Clinic (PCC) where I work
3) what it's like to be a provider of care in this system
Don't pack your bags unless you are Native American because you can not recieved care in this system unless you have your card identifying you as Native American or Native Alaskan. I will say that many Native Americans come up here to receive care-to the extent that there is a two person department whose job is to make sure that people really belong here or plan to stay before receiving the benefits.
It is truly an experience of a lifetime to work in this system!