Last May, the Curyung Tribal Council passed a resolution to withdraw its membership from BBAHC. Now, tribal leaders are responding to concerns that a withdrawal would destabilize health care in the region.
The Curyung Tribe says that it wants to remain a member of the Bristol Bay Area Health Corporation. But it does not yet know if mediation will bring about what the tribe sees as necessary changes.
As Curyung and the corporation move toward the final round of mediation, tribal leaders are stressing that there would be no lapse in health care if they do withdraw.
“The Indian Health Service is not going to approve our removal unless we have a plan in place," said First Chief Thomas Tilden, speaking at a public meeting held by the tribe on Tuesday. "So we have to make sure that our tribal members and other members in this community continue to receive healthcare. That is going to happen.”
The earliest the tribe could withdraw would be in May. At the tribe’s public meeting Tuesday, people expressed concern about that rapidly approaching deadline. Nathalie Dull said she was worried about how such a swift transition would affect care for her family.
“Most of you know my daughter spent the better part of last year in the hospital," she said. "So just not having any clue about how services will be provided, if May is really, like, the date, is just a little nerve-wracking.”
But the tribe said it would most likely not pull out in May, instead extending the date of withdrawal to allow time to coordinate services with BBAHC and decide on a path forward, making the May deadline effectively mute.
If mediation doesn’t result in an agreement, the tribe said it has an array of options. It could pull out entirely, keep some services at Kanakanak Hospital in Dillingham, which is managed by BBAHC, create a clinic in Dillingham, or receive services at Kanakanak Hospital under a different healthcare provider. It could even create a new regional healthcare organization, with the working name of the United Bristol Bay Tribal Health Consortium.
Robert Clark, the CEO and president of BBAHC, said at the hospital’s public meeting last month that the mediation process would determine what the outcome would be for regional health care.
"I'm talking about some what-ifs, and different issues that we don't have agreement on yet," he said. "And it's up to the board to decide. They ultimately are in charge. But for day-to-day operations, the executive committee does have a lot of — is holding a lot of weight."
In order for Curyung to remain in the health corporation, the tribe said that several major changes have to take place. First Chief Tilden said that Curyung and the other member tribes had to be given more of a say in the corporation’s management.
"We have to have a voice on that board. They have to give the power back to the full board,” he said.
Second Chief Gayla Hoseth said the tribe had two different plans to change BBAHC's bylaws. The first would eliminate the executive committee and subregional officers. The second option would retain the executive committee, make all of its actions subject to full board ratification, add a subregional officer for Dillingham, and reform executive committee voting. Both options call for the board to eliminate the position of second vice chair, limit officer terms to one year, call for quarterly board meetings, authorize villages to replace their representatives on the board, and limit the use of executive sessions.
More frequent board meetings, Hoseth said, would provide additional opportunities for each tribe to voice its concerns.
“We want unity amongst the region, and we want to make sure that everybody’s voice is heard," she said. "We want to make sure that we have the best quality healthcare that we could possibly have, and that patients are getting sent out to Anchorage in a timely fashion.”
Geoff Stromer, an attorney for the health corporation, said if the tribe withdraws, it would still have a number of options that will determine what its healthcare services will look like.
“Curyung will still have the option of pick and choosing what programs it wants to take or leave, and it hasn’t really gone through that process yet,” he said.
Third Chief J.J. Larson said the tribe is optimistic they will ultimately have more control over the type of healthcare provided in the region.
“I think it’s hopeful either way," he said. "If we decide to stay and things work out because things are changed for the better, that’s hopeful. If we do decide to leave I think that there are some things that we can do that haven’t been done around here that can be better.”
Curyung and BBAHC pick up their final mediation session this week, during the health corporation’s annual full board meeting.
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