The Curyung Tribe passed a resolution this weekend, urging the Bristol Bay Area Health Corporation Board of Directors to hold a special meeting. The resolution calls for the termination of the Kanakanak Hospital CEO and COO as well as the replacement of the BBAHC Executive Committee.
The Curyung Tribe in Dillingham is calling for the removal of top Kanakanak Hospital administrators and for the Executive Committee of the Bristol Bay Area Health Corporation’s Board of Directors to be replaced. The tribe adopted a resolution at its annual tribal meeting on Nov. 10. It asks the BBAHC Board of Directors to hold a special meeting to address alleged violations of the corporation’s bylaws.
The resolution urges the BBAHC board to do three things: direct the CEO “to immediately terminate the Chief Operations Officer, terminate the employment of the Chief Executive Officer [and] replace the current Executive Committee Members with other Board of Directors.”
According to the resolution, tribal members' frustration with the health corporation is longstanding.
It reads, “For the last three years, the tribal membership has voiced concerns with the health delivery provided by BBAHC in the areas of diagnosis, privacy, Native preference in hiring, and most recently medication errors.”
The resolution also allows the Curyung Tribal Council to leave BBAHC and work with the Indian Health Service to authorize a different tribal health organization to provide health care to the tribe’s membership.
Members of the Curyung tribe approved the resolution by a vote of 114 to 12.
Desi Bond was among those who voted in favor of the resolution. She said she has made numerous formal complaints about treatment she has received at Kananak Hospital, even as recently as last week.
“I voted yes because it’s time for a change. It’s time that we are taken care of in the way that we should be. There’s people here. There’s organizations here. There’s the Curyung Tribe here that can help make a difference. They can bring us the proper health care. They can help us, and we can then have our trust back with our health care,” said Bond.
Kim Williams, a Curyung Tribal Council Member Chief who also sits on the BBAHC Board of Directors, explained that the tribe is asking for changes in hospital leadership because a recent Centers for Medicare & Medicaid audit found that hospital administrators and the BBAHC Executive Committee did not respond adequately to pharmacy deficiencies that placed patients in danger.
“That’s what our membership said. Clearly there’s an administrative and a governance piece to this CMS audit that really needs to be addressed, and the only people that can address that are the Board of Directors of Bristol Bay Area Health Corporation,” said Williams.
The hospital has developed a plan of correction for deficiencies that CMS enumerated. That plan includes hiring and training pharmacy staff, and CMS has given BBAHC until January 11 to bring the pharmacy into compliance
However, the tribe is not satisfied with what it knows about the plan of correction.
“We’ve yet to hear whether or not they have done anything to address the lack of response and action taken from the administration or the Board of Directors,” said tribal administrator, Courtenay Carty.
The tribe alleges that the deficiencies in leadership outlined in the CMS audit constitute a violation of BBAHC bylaws.
The Chair of the BBAHC Executive Committee, Mark Angasan, sent a letter to the Board of Directors on Thursday, expressing support for Kanakanak Hospital administrators. Angasan sharply criticizes Williams for her communication with tribal members about the CMS audit and alleges that she has a conflict of interest because her daughter and son-in-law are former pharmacists at the hospital. The letter also urges the Board of Directors not to call a special meeting.
“CMS has removed our immediate jeopardy status, and we have until January to show that we have implemented the steps in the corrective action plan that we will submit on November 15, 2018,” said Angasan. “You would not have all of the information about the CMS audit if we hold a board meeting now, during the holidays. The annual meeting is scheduled for early March, and I encourage you to wait to hear the whole story then.”
The health corporation disputes the idea that its leadership did not take action to address deficiencies in the pharmacy prior to the CMS audit.
BBAHC said in a statement, “A lot of misinformation has made its way around the community over the last couple of weeks… Parts of the CMS audit report are being taken out of context, misconstrued, and mischaracterized. For example, Tribal members are being told management did nothing in the summer of 2018 even though meeting minutes during that time clearly identify specific actions taken, such as the hiring of consultants from ANTHC [Alaska Native Tribal Health Consortium].”
The hospital said that improving the quality of care for patients is its top priority and highlighted an “A” rating it received on an audit the Health Resources and Services Administration conducted in October.
In order to call a special meeting of BBAHC Board of Directors, a majority of the board needs to sign a petition to hold a meeting. The board is made up of tribal representatives, one from each of the 28 Alaska Native tribes that authorizes BBAHC to provide health services to its members. So far six have signed the petition to hold a meeting: Curyung, Levelock, Clark’s Point, Togiak, New Stuyahok and Portage Creek.
If the meeting is called, it would take a majority vote by the board to terminate the CEO and replace the Executive Committee as Curyung has requested.
“Our community, our tribe fought very hard to get this hospital here and to get it in our community,” said Carty. And our main goal is to get the problems fixed and continue serving our tribal members the way we should be. If we’re not able to do that through these changes in the administration and addressing the governance structure, then, yes, the council has the authorization to rescind our health care resolution, but that’s not the first step.”
If the Curyung tribe decides to leave the Bristol Bay Area Health Corporation, that could have a significant impact on Kanakanak Hospital’s funding, according to Williams. She said that a third of the money BBAHC receives from IHS is tied to the Curyung tribal population. Carty said the tribe sees leaving BBAHC as a measure of last resort and, if Curyung were to leave the health corporation, the process could take more than a year and would involve significant input from tribal members.
Contact the author at avery@kdlg.org or 907-842-2200.
