Tsaile/Wheatfields suspicious of '638 effort
By Cindy Yurth
WHEATFIELDS, Ariz., March 29, 2012
That was the message from Tsaile/Wheatfields Chapter to Canyon de Chelly Comprehensive Health Services Inc., the local nonprofit interested in running the Chinle Comprehensive Health Care Facility and its affiliated clinics under Public Law 93-638, at a public hearing here last Friday.
There have been rumblings about "going '638" - turning the present IHS facility over to local management - for at least a decade in Chinle.
In 2004, the Navajo Nation Council's Intergovernmental Relations Committee gave the board of the hospital permission to submit a management grant proposal to the IHS.
But first, the corporation has to get all 16 chapters in the Chinle Service Unit on board, which is proving a difficult task.
Twelve of the 16 have passed resolutions supporting the conversion, but Many Farms, Lukachukai, Tsaile/Wheatfields and Chinle are resisting.
Chinle actually passed a supporting resolution in January, but came back in February and rescinded it.
"At the January meeting, there was just a small number of people," explained Chinle Chapter Manager Teresa Thompson. "Then when more people started hearing about it, they felt like they needed to do more research.
"I'm not sure they were really saying 'no' so much as 'This is a big decision and we need to make sure we really understand it,'" Thompson said.
That seemed to be the prevailing attitude in Tsaile/Wheatfields as well.
"Other chapters may just pass resolutions," said Tsaile/Wheatfields Chapter President Zane James. "Here, we like to ask questions."
Among the 50-odd people at the public hearing, several pronounced themselves "confused" by the board's presentation although, to be fair to the board, most attendees had come in late and missed most of it.
"I'm sorry," said Canyon de Chelly board member Rosita Tsosie. "I thought we were going to be clear. I thought we were going to give you the information you needed. But it seems like the longer we talk, the more confused you get."
Tsosie said the board would re-craft its presentation and come back at a later date.
Most of those at the meeting wanted to know how a '638 facility is funded and what happens to the existing employees.
The board members explained that IHS continues to fund the hospital.
"It has nothing to do with funding," said board member Robert Salabye. "It's a management tool."
Under PL '638, Salabye explained, the hospital could actually increase its funding because it would be free to seek other grants besides just the IHS base funding.
'638 institutions can seek outside grants and accept outside insurance, as well as hold investments.
As for the employees, explained board member Bessie Allen, they would have a choice.
Commissioned officers in the Public Health Service would continue as federal employees assigned to the hospital or clinic under a memorandum of agreement. Civil servants would be offered a direct-hire position, or they could continue to be paid by the IHS under the Intergovernmental Personnel Act.
If the employee wanted to remain part of the IHS and work for an IHS facility, he or she could request a transfer.
And while federal employees are naturally protective of the raises and benefits they've obtained through collective bargaining, Allen said that, in these days of federal budget cuts, it's rosier in the largely non-unionized private sector.
"The federal government, the whole hiring is frozen," Allen said. "People are being furloughed. They're not getting their cost-of-living increases. We wouldn't have to abide by that."
At the Winslow Indian Health Center, which went '638 in 2002, salaries and benefits for direct employees are so much better than the IHS positions that several people who had stuck to their IHS status for years have since decided to move over to direct employment, said administrator Michelle Hardy-King.
According to Hardy-King, the Winslow facility has also been able to increase its staff by 65 percent, add a surgical and cardiology clinic, and replace its tiny traditional hogan with a large new one with restroom facilities and a waiting room.
"You know what they're doing out there?" asked Allen rhetorically, "They have dental on wheels. I can't even get dental care in Piñon."
Hardy-King said the Tsaile/Wheatfields meeting felt very familiar.
"What this chapter is going through, we went through the same thing," she told the crowd. "The questions, the insecurities ... this is something normal."
She advised the Chinle board to be patient, come back as often as necessary to explain the '638 transition, and meet more often to revise its presentation.
Tsosie said the board would take Hardy-King's suggestions, and the concerns of the community, to heart.
"You have very good questions," she said. "You're guiding us with the questions that you have. We want everybody to know what '638 is so that they can make a good decision."