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Alaska Blog 1- Gumboot Determination (2 comments)
Posted by: Michael LeavittWednesday, July 30th, 2008
Along streambeds in Alaska, the Gumboot, a small black snail like creature, attaches itself to rocks and clings with the might of superglue. To Alaska Natives, Gumboot is a delicacy worth the considerable effort it takes to pry it off the rocks. The Gumboot hangs on with determination.
When Ethel Lund, a woman of small stature in Juneau and a group of other tribal leaders (mostly women), decided the region needed better health care they knew it would require tenacity. The tiny Gumboot became their inspiration.
For thirty years, they stuck to the task with Gumboot determination. The result of their efforts is the Southeast Alaska Regional Health Consortium (SEARHC), an Alaska Native health organization which now has 700 employees and provides care to thousands of Alaska residents who belong to 18 different tribes.
I met Ethel Lund and several others when I visited them in Juneau to learn about the unique challenge of getting health care to the tens of thousands, mostly tribal members, who live in hundreds of villages throughout Alaska. They have written the history of SEARHC in a volume appropriately titled Gumboot Determination.
The history tells of SEARHC’s formation in 1975 as a non-profit tribal health consortium of 18 Native communities throughout Southeast Alaska. It was one of the first organized under the Indian Self-Determination and Education Assistance Act, which allows the Indian Health Service to turn programs and facilities over to tribal management.
I have come to admire community health organizations. Each has a story. Rarely were they formed by government. Typically, like SEARHC it was a group of people getting together to help others. Nearly all of them have something in common. Developed by dedicated people who didn’t know what they were getting themselves into when they started but through Gumboot determination, they got it done.
SEARHC operates under a board selected by tribal leaders in each of the communities served. They appear to be moving aggressively into use of technology. Roald Helgesen, the President and CEO, told me they were at the early stage of implementing a comprehensive electronic medical record system. This makes a lot of sense given their treatment model. They are treating through Community Health Aides/Practitioners, people in many different parts of the region. (I plan to write about this model tomorrow.)
Leadership team for SEARHC with Secretary Leavitt
CLOCKWISE FROM TOP: Mark Gorman, Vice President, Community Health Services, SEARHC; Andy Jimmie, Chairman, Alaska Native Health Board; Bill Martin, President, Central Council Tlingit Haida Indian Tribes; Roald Helgesen, President/CEO, SEARHC; Norman Sarabia, Vice President, Douglas Indian Association; Jan Hill, Chairperson of the Board, SEARHC; Ethel Lund, President Emeritus, SEARHC (with red jacket and white blouse); Doloresa Cadiente, President, Tlingit and Haida Indians of Juneau; MOL; Chris Mandregan, Acting Deputy Director, Indian Health Service, DHHS; Ken Truitt, General Counsel, SEARHC.
CENTER: Janis Sheufelt, Medical Director, Ethel Lund Medical Center, SEARHC.
I also learned about their deployment of a remote pharmacy program. Using a device that resembles a large soft drink vending machine, prescription drugs can be dispensed in remote areas. The drugs are pre-packaged. The patient punches prescription number and other information. The information is vetted three times before it is released by a licensed pharmacist remotely, who talks to the patient on the phone. There were other innovations I will write about later in the week many of which, I think could/should be used to make health care delivery more efficient in less remote medical settings.
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Secretary Leavitt, I thoroughly enjoyed your comments on the Kaiser HealthCast yesterday (7/29); I attended on line. Thank you for your leadership at HHS and for the encouragement as a fellow novice blogger(www.RauserHealthReview.com).
“Gumboot Determination” will be needed to preserve the financing and delivery of health care in the private sector. Thanks for the additional inspiration.
secretary leavitt! i really enjoy your blog and comments keep on posting
Thanx