Conversely, the group learned, support issues arise again when the injured person returns to his or her home community. “When people are discharged, they lose access to the support and resources they’ve come to know. It’s sometime hard to re-establish the feeling of connection in their home community.”
The group identified transportation as a particularly important issue on Tribal lands. Wheelchair-accessible public transportation is hard to find. ASSIST! to Independence provides transportation to clinical appointments for Medicaid clients, but is not funded for general transportation needs. In addition, roads on the reservation are most often unpaved and without sidewalks. This is particularly difficult for people with wheelchairs and other durable medical equipment, which wears out more quickly than insurers support.
Another important component of the group’s itinerary was a visit to the Hopi Health Care Center in the village of Polacca, located at the base of First Mesa.
The JCAHO-accredited Critical Access Hospital has been serving the Hopi Tribe since 2000. The 15-bed facility is under the auspices of Indian Health Service, a program of the U.S. Department of Health and Human Services.
“We learned the Center was designed to have the feel of a Hopi village,” says Ms. Snyder. “It incorporates a central meeting place and all rooms are connected to that area.”
In addition, the Center’s design incorporates use of natural materials, such stone, and lots of windows and skylights to allow for natural light. A healing garden and a sunny meditation room provide comforting areas for patients and families.
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Service areas within the Center reflect many of the public health issues that are important to the community: diabetes care, dental services, optical care, substance abuse and behavioral health supports, as well as emergency care.
Twelve doctors, six dentists, six pharmacists and two optometrists staff the Center. Most are IHS clinical professionals who rotate through the Center as part of their training.
“We learned that staffing is a challenge,” says Ms. Snyder. “On the one hand, the rotation of staff ensures that the Center is staffed by new doctors who bring enthusiasm and new ideas. On the other hand, that rotation means that relationships are always changing, and that’s hard on the community.”
To encourage recruitment of staff, the Hopi Tribe has spent about $8 million to build housing close to the Center.
“Above all, we got a real sense of the Center’s commitment to promoting wellness, not simply treating disease,” says Ms. Snyder. “That’s part of the Hopi culture, and it is reflected throughout the Center’s operations and in the perspective of its staff and leadership.”
Another highlight of the visit included a walking tour of Old Oraibi, led by Ms. Sekayumptewa. The village, which dates back to 1100 A.D., is considered to be the oldest continually inhabited village in North America and is generally closed to visitors.
In addition, the group was invited to the home of a family of a child with traumatic brain injury to discuss service needs with family members.
“We were honored to have the opportunity to learn more about the services and resources available to people with disabilities in Hopi as well as to learn more about some of the challenges facing community members,” says Ms. Snyder. “Our visit was an important step in the continuing efforts of the Tribes and State to bring their disability service communities closer together.” |
