Annual Report 2020

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Indian Health Care Resource Center of Tulsa

Annual Report 2020 IHCRC 2020 1


We are people of hope who believe peace comes from within. We are people of strength who believe love and kindness are a way of life. We are people of community who walk together in harmony.

When we wrote these words for Dance of the Two Moons 2021, we had no idea how truthful they would become. While this Annual Report is a review of FY20 (July 1, 2019 through June 30, 2020), it is difficult, at times, to remember life before March 2020. So much has changed. Our delightful colorful world seems to have turned grey. Yet, it is in the midst of struggle we often find strength. The design for this Annual Report symbolizes IHCRC’s response to the eclipse that has covered the land. While the world struggled, we found strength. Our world remains colorful and bright. Together we have adjusted. Together we have found hope. Together we found harmony. Together we can heal our world.


Welcome to our world...



Photo from 2019


About the Organization Indian Health Care Resource Center (IHCRC) is a community response to the funding and healthcare disparities of Tulsa’s urban Indian community. From a community survey to building a state-of-the art facility, IHCRC has remained dedicated to providing quality, comprehensive healthcare to Tulsa area Indian people in a culturally sensitive manner that promotes good health, well-being, and harmony. More than 250,000 individuals have walked through the doors of IHCRC during its almost 44 years of service. IHCRC continues to focus on its vision of eliminating health disparities, expanding innovative family-focused practices, and embracing an approach to care that strengthens physical, mental, emotional, and spiritual wellness within the Indian community. More than 160 staff members, approximately 60% of which are themselves Native American, provide cutting edge care for almost 12,000 Native Americans annually. The wide array of integrated services operates through a multidisciplinary, patient-centered, medical home model of care. The one-stop shop houses the following service areas: • • • • • • • • • • • • • • • • • •

Primary Care for all ages Internal Medicine Pediatrics including well child Obstetrics Public Health including a new COVID-19 and Immunization Clinic Optometry Dentistry Pharmacy Laboratory Radiology including x-ray, mammography, and ultra sound Behavioral Health Substance Abuse Prevention and Treatment Systems of Care Wrap Around Services Social service connection through medical social workers Domestic violence prevention and intervention Health Education and Wellness including diabetes management, dietitians, and exercise Transportation Programs for Youth including suicide and drug abuse prevention and cultural activities.

IHCRC’s commitment to quality is evident in its accreditation by the Accreditation Association for Ambulatory Health Centers (AAAHC) and its certification as a Medical Home by AAAHC. Indian Health Care Resource Center hires with an Indian preference and is an “Indian-controlled business.” Incorporated as an Oklahoma nonprofit corporation in 1978, Indian Health Care Resource Center operates as an urban Indian health center, independent of tribal or federal control. A Board of Trustees (all of whom are Native American) meets bi-monthly to determine issues of policy and governance.

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IHCRC 2020


2020 Letter from the President and the CEO It has been 43 years since IHCRC opened its doors. We have experienced many things throughout the years. Through each we have learned, grown, and continued to provide quality health care for Native Americans. The challenges of 2020 may have been new, but our response remained the same. Fiscal year 2020 started like any other. Summer camp was winding down, the old church building was coming down, plans were being made for the first Youth Summit and the Annual Meeting, and the staff were busy preparing for calendar year 2020. We celebrated on March 7th with our Roaring Twenties Dance of the Two Moons, by Monday everything had changed. There is much to say about the past year and especially the last 6 months. Inside this report you will see and hear the changes and adaptations, the strength and stamina, the caring and compassion, and the determination of our IHCRC staff members. You will learn from them what it has been like to work in this world. As Board President, I would like to thank our Chief Executive Officer and Chief Operating Officer for their leadership during this time. IHCRC is lucky to have such strong and talented professionals to lead the organization. To all IHCRC staff, I say thank you for continuing to provide quality care despite the challenges. As Chief Executive Officer, I wish to thank our Board for their ongoing leadership, our donors for their ongoing support, our patients for trusting us, and our staff for everything they do. I`m so proud of the staff for coming to work every day, taking care of the patient`s needs and being more than willing to do whatever is ask of them.

Above: Brandon Caruso President, IHCRC Board of Trustees Below: Carmelita Skeeter, Chief Executive Officer

We are a people of hope and so we continue to believe in a return to normalcy at some point in the future. Until then, we will continue to adapt, to work together, to build each other up, and to bring brightness back to a gloomy world. Together we can heal the world.

Brandon Caruso, President, IHCRC Board of Trustees

Carmelita Skeeter, CEO

IHCRC 2020

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Meet Our American Indian Community

Stomp Dance2020 January 2020 IHCRC 2020 88 IHCRC


Community and COVID

By: Tonia Gist, Community Relations Specialist It’s Noon the first Wednesday of the month and typically the Native American Community Committee (NACC) would be gathering in the IHCRC boardroom chatting and conducting business over lunch. NACC is our community partnerships in action. The committee is made up of representatives from Blue Cross Blue Shield of OK, AEP/PSO, ONE Gas, Williams, ONEOK, the American Indian Chamber of Commerce, American Airlines as well as several individuals. While we are no longer meeting in person we are still finding ways to come together to support each other’s projects and serve our Native American community. This year the largest most recognizable projects are Dance of the Two Moons, IHCRC Native American Youth Summit and Greater Tulsa Area Indian Affairs Commission’s Native American Day. These projects are just the highlight reel and do not reflect all the little ways we have supported each other. From one company helping another form a Native American Employee Resource Group to supporting each other’s fund raiser with an in-kind donation – it’s these little things that form the relationships that compel us to help each other. I am writing this as I finish working on Native American Day. With the event over I find myself a little in withdrawal. At first I thought it was because I’d gotten used to doing certain tasks several times throughout the day. But the truth is I already miss the people. I had gotten used to seeing the committee every Thursday on Zoom. I had seen several people in person while picking up various items. And we had two glorious filming days in which I got to see even more of our community partners in person. While these people aren’t a part of your everyday work environment or your personal friendships I find that you do hold space for them. You look forward to hearing about their lives. You want to hear about their successes. You look forward to opportunities to help. It is hard to realize how much these moments and these people come to mean to you until they are gone. One positive thing about going virtual due to COVID-19 has been the reach. During Native American Day, we reached over 866,000 people with over 64,000 responses on the live event from all over the world. The Native American Day celebration stream was filled with education and culture. Many people were grateful we shared that with them. It was obvious from the responses that people are craving and seeking ways to connect. Even with this great reach I still look forward to the day when our group can meet in person again.

Tonia Gist

10,594

Unduplicated Patients

Patients by Age

3,477 Age 0-17

1,598 Age 18-29

3,272 Age 30-54

1,284 Age 55-64

999 Age 65+

Patients by Tribe

5,494

Cherokee Nation

2,118

Muscogee Creek Nation

1,011

Choctaw Nation

256

Osage Nation

199

Chickasaw Nation IHCRC 2020

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Healing Our World

We All Want to Be a Superhero

By: Tanya Cain, RN, BSN, Chief Operating Officer Every kid dreams of being a superhero. Whether that hero be Batman, Wonder Woman, Princess Anna, or Luke Skywalker, we all want to be someone’s hero. In March 2020, I joined Marvel, DC, Disney, and George Lucas as the manager and creator of superheroes. It’s not simply about WHAT they do it is also about WHO they are as people. The superheroes I have managed care about others. They follow scientific health guidelines to keep others safe. It has never been about protecting them. It has always been about protecting YOU. For months now, these superheroes have donned their masks five days a week, many for 10-12 hours a day. They have not complained. They have not waivered. They understand the science despite what others in the world may say. I too have become a masked hero (although at times I may feel like a villain). Today, I want to implore YOU to join our Caring Superhero World. Treat this virus with the utmost respect. Wear your mask at ALL times when out in public and encourage others to do the same. Remember, your masks protect OTHERS, they do not protect YOU. Wash or sanitize your hands every time you think about it – whether they need it or not. As a nurse, I beg you to wear a mask (three layers at least) and to practice good hand hygiene. If you are feeling the slightest bit ill – stay home! Using the rules of our Caring Superhero World, YOU will become one of us. Stay up-to-date by checking the information WE provide. Social media does not have a medical or epidemiology degree. Our hope of ending this “new not so normal” is for all of us to become masked superheroes. After all, isn’t that what we all dreamed of being someday?

Tanya Cain 10

IHCRC 2020


33,010 Patient Visits

Medical Visits

14,550 Family Practice

1,928

Internal Medicine

7,674 Working in the COVID Clinic By: Justin Hubbard, Medical Assistant

My experience working in the COVID-19 Clinic might be different from others. I was diagnosed with COVID the last part of June and it was absolutely terrifying. There were times I went to bed believing that I wouldn’t wake up the next morning and I was afraid that I was going to die alone and that no one would know. I was afraid to go back to work on the ICU Step down unit where I was working at the time. Although I was feeling better, I didn’t want to get sick again or get any of my patients sick. Luckily, a friend told me about the job at IHCRC. When I came to work at IHCRC in the COVID Clinic I didn’t really know what to expect. I had taken care of patients at bedside but never in a clinic setting. I just knew I had to continue to work in health care because I wanted to help people. It took me a bit to have the courage to test patients. However, I soon learned that my experience with COVID helped me better understand the fear and the anxiety that the patients were going through. I have been able to share my experience with patients and help put their minds at ease because they knew someone that beat it.

Pediatrics

594

Obstetrics

3,330 Radiology

4,932 Laboratory

507

COVID-19 Tests March-June 2020

The COVID Clinic has been very busy the last couple of months and sometimes that makes for very long days. I always say that when someone is coming to see the doctor or is in the hospital that they are going through a pretty rough time. My job is to make the process as easy as possible for them.

Justin Hubbard IHCRC 2020

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Healing Our World I Miss the Old Days

By: Dr. Jennifer Jones, Optometrist COVID has affected so much of our personal and professional lives. I’m thankful that my immediate family has (so far) been unscathed by this virus although sadly it has drastically decreased my face to face connection with family as we are trying to keep one another safe. My parents’ 50th wedding anniversary was in August and in any other year, we would have had a big celebration with all our friends and family for this lifetime milestone…but COVID. And, I keep thinking about what we will do about getting together for the holidays? My husband and I both have family members more vulnerable to getting very sick or worse from this virus. But, our parents want to see their kids and grandkids! Professionally, the most obvious change is the fabulous PPE attire that I wear into exam rooms. Frankly, it’s hot…I mean I’m sweating. I had to add fans to all my exam rooms. I’ve been the optometrist at this clinic for 23 years. I know many of my patients personally at this point…we have long term relationships. But, what about new patients? I feel like the PPE “blocks” my empathy or emotions from being seen by new patients. I wonder if they know that I care like the patients that I’ve known for so many years. And, the underlying societal anxiety is getting to so many people. A few of my normally anxious patients are “over the top” anxious now. And, patients that have never felt anxiety are sharing their nervous feelings… and I get it because I feel it, too. I don’t want a “new normal”…I just want to go back to the old days…like it was in January 2020.

Dr. Jennifer Jones 12

IHCRC 2020


7,231 Patient Visits

1,923 Optometry

5,308 Dental

Dental During the Pandemic By: Arthur Holleman, DDS, Dental Director

Like all of you reading this, 2020 has been a very trying time for the dental department here at IHCRC. The ongoing pandemic halted our operations to all but emergency care for a time and eventually led to many changes in the way we deliver dental services. We have had to make hard choices in the interest of protecting our wonderful patients and team members. This has reduced the number of patients that we can currently serve and led to a difficult balancing act of protecting our most vulnerable patient populations from the COVID virus while also providing the critical dental care our patient’s need. In keeping with making patient safety our highest priority, we have incorporated additional infection control measures into our practice during the pandemic. These include pre-procedural rinses, use of N95 masks and full face shields, use of additional intra-oral suctioning devices during cleanings and placing air filtration systems in the operatories. Appointment times within the department have been lengthened to allow for additional disinfection measures and to allow for any aerosols in the operatory to settle prior to disinfection and seating of the next patient. We are staggering appointments to minimize the number of patients in the dental reception area at any one time. We are constantly reviewing recommendations from the CDC, WHO, ADA, and IHS to inform our decision making. Most of all, we are eagerly looking forward to the resumption of more normal operations and a return to the volume of direct patient care we were able to provide prior to the pandemic.

Dr. H. IHCRC 2020

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Healing Our World

Making the Best of a Crazy Year

By: Miranda Kohut, Pharm.D., Pharmacy Director Pharmacy rose to meet the challenges COVID brought to the best of our abilities while still striving to maintain quality customer service for our patients. While others were slowing down, we were busier than ever. Over the past fiscal year, pharmacy processed 260,107 prescriptions, averaging out to near 1,100 prescriptions per day. This was an increase of over 9,100 prescriptions from the past year. In doing so, we experienced over 49,000 patient visits to the pharmacy. After closing off the pharmacy lobby, we began a drive-thru only service for our patients, often running prescriptions curbside to help enable the increased flow of traffic. Like everyone around the world, COVID has personally disrupted the lives of pharmacy staff members as well but the team has rallied together to make the best of this crazy year. This year allowed time to dig deeper into what we could offer to our patients as well as time for other technological improvements to be made within the department. Pharmacy now has a free app available for patients to use to request medication refills. We are in the middle of transitioning to a new phone messaging system and soon we will be switching to updated devices for use in the drive-thru. We also have an additional refrigerator to accommodate our growing number of cold storage “Will Call� prescriptions. Pharmacy has been short-staffed and yet continues to keep up with the volume demanded of us. We added an additional pharmacist to our team this year and are excited about the new clerks that will soon be joining us. We are using this time to cross-train amongst ourselves, strengthening our collective team, and to dream about new ideas for a future pharmacy build.

Miranda Kohut 14

IHCRC 2020


50,158 Patient Visits

Pharmacy

49,000 Pharmacy Visits

Adapting to a New World

By: Stacy Berg, MS, LPC, CDCES, Health Education & Wellness Director The Health Education and Wellness department has been steadily growing each year. A large portion of our patients have diabetes. When the clinic had to temporarily halt services in March, our department was impacted just like every other department. During this time, our department prepared to start offering telehealth visits to patients and also make sure they were supplied with their diabetes testing supplies. Once we opened back up, the education staff began offering telehealth appointments to those who were concerned about leaving home. We were also able to educate patients about the precautions the clinic is taking to protect patients and staff. The majority of our patients quickly resumed inperson education visits.

260,107

Prescriptions Filled

Health & Wellness

1,988

Diabetes Education

258

Nutrition Counseling

966

Exercise Education

The fitness program had to close the clinic gym, so we have also been doing Zoom fitness visits with patients. This has been a big success. We have been able to add new individuals to the fitness program who live far away from the clinic and also exercise with children who are doing school studies from home. Run Club halted all practices and in-person races in March. Since that time, participants have been doing practices on their own and participating in local virtual races, such as the Komen Race, Keep Tulsa Moving and the Quarter Marathon. Our staff members have been fortunate to all be working during this time and look forward to continuing services with all of our patients as we continue through this pandemic.

Stacy B. IHCRC 2020

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Offering Hope The Importance of Flexibility

By: Jason Menting, PsyD, Behavioral Health Director We often talk about the importance of being flexible in behavioral health. Flexibility provides such mental health benefits that we are often teaching it to those with whom we work. In 2020, we had to heed our own advice. In a matter of days of the pandemic, our staff went from seeing all patients in person to completing all appointments over the phone and then quickly transitioned to video conferencing. In many cases, our clinic staff adjusted the focus of treatment to address life stressors brought on by the pandemic while also maintaining focus on long-term goals. They did so in spite of experiencing their own life stressors that they put aside in order to serve the patients of IHCRC. The most visible accomplishment was the implementation of telehealth. The department was able to implement a new type of services in a matter of weeks. Typically, this type of change would have taken months to implement. The Behavioral Health Department collaborated with other departments to develop a process and obtain the necessary equipment. Within the department, staff shared their own experiences and examined relevant literature to ensure that we provided services that was both beneficial and safe for our patients to use. Each staff member quickly completed training on providing telehealth services. As a result, we have a system for conducting telehealth that can be used after the pandemic. In order to ensure that our patients were not left without services, our staff made hundreds of check-in telephone calls while the telehealth program was being developed in order to ensure that folks were well. The implementation of telehealth was a big accomplishment and a noticeable one. However, there is something less noticeable that our staff did during the pandemic. They put their own worries aside in order to provide patients with a sense of stability. Our clinical staff do this on a day-to-day basis but it was more apparent during a time of so much uncertainty, particularly since our staff were also affected by the pandemic on a personal level. During a time of uncertainty, they worked with patients to focus on things they could control. They taught skills to address the immediate challenges while also developing longer term perspectives. Our staff did this while experiencing a lot of uncertainty in their own lives that they put aside to help those in need.

Dr. Jason Menting 16

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Connecting the Dots During a Pandemic By: Kristi Whitaker, MSW, LMSW, Social Worker

As a medical social worker, I am tasked with helping to connect the dots of a health care provider’s treatment plan for a patient. How can I help a person keep their appointments and maintain access to lifesaving medications when that person sleeps under a bridge or is involved in an abusive relationship? Our typical resources came to a screeching halt when the pandemic hit. When our city is ordered to shelter at home, how do we effectively check in on our families, elders and high risk patients while also keeping ourselves safe? Another aspect of my work is crisis response for our patients experiencing severe mental health symptoms, such as thoughts of ending their life by suicide. In a moment where creating connection and rapport is essential, I am now tasked to do so while half of my face is hidden behind a mask. I must now overcome the inability to fully read a patient’s covered face for cues that may offer more insight into their crisis. But if there’s one thing social workers are able to rock, it is creative problem solving! On a personal level, COVID-19 has affected my daily life in several ways. My grandparents watch my daughter while my husband and I work, so when the pandemic hit this was an immediate concern. My husband and I have had to change our work schedules, continuously adjust to new information and situations, while also trying to give our kid as much “normal” as possible. We have had to tell family members that we cannot be around them for various reasons, some being that family has different beliefs about COVID-19, even doubting it entirely. I eventually did test positive for COVID-19, despite taking all precautions possible.

8,859 Patient Visits

Behavioral Health

71

Systems of Care Families

633

Domestic Violence Prevention Individuals Served

350

Suicide Prevention Program Participants

While I was lucky to have a mild case, it required me and my family to quarantine for the mandatory period. In both my personal and professional life, I’m seeing individuals struggle in many ways. People that would consider themselves highly functioning, healthy adults are becoming overwhelmed, anxious, and fearful of the unknown. This is at a time when support and resources are not easily accessible, especially for the person who may be seeking therapy services for the first time in their life. No matter who a person is or what their beliefs may be, this pandemic is affecting every single person in one way or another.

Kristi Whitaker

IHCRC 2020

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Providing Strength

Being Forced To Change, Changed The Force By: Stacie Nutt, Chief Human Resource Officer

My COVID-19 story started on Monday, March 9th, 2020. I woke up the Monday morning following our Dance of the Two Moons annual fundraiser at Hard Rock event center and thought to myself, “no way, this is the first time in 13 years I’m hungover the Monday after two moons”. I called in sick that day. The next day was not much better but I came to work anyway. After a lovely flu swab up my nose, Kasi Ketcher confirmed my fear, FLU! I don’t even remember hearing the word COVID before leaving the office that day. And once I got home, I was glued to my bedsheets for several days. I just knew death was eminent. By Monday the 16th, I was back in the daily routine and ready for whatever may come my way. Little did I, or anyone else know, what that was about to be. With everyone in the world, shifting their focus to “managing a pandemic 101”, it became clear my role would be understanding and implementing the legal requirements under the Families First Coronavirus Response Act (FFCRA). That regulation became effective April 1st, 2020. School systems across the country made the difficult choice to not go back to the classroom after spring break.

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And the recommendation for everyone on the planet was to stay home. Conversation after conversation after conversation, all different but all the same. “How am I going manage all of this? How am I going to keep my job, keep my paycheck, and keep my kid focused on their virtual school studies, all at the same time, while I’m also supposed to self-isolate in order to stop the spread of the virus? No, really Stacie, how am I going to manage all of that?” This is when my depth of love for human resources was able to shine. And thank the Lord we have an amazing CEO who tries her hardest to make sure we take care of our staff. Our staff are what makes this organization the awesome place it is. If we take care of our staff, our staff will take care of our patients. Taking care of our patients, taking care of our customers, that’s the core of our business. As a lifelong HR professional, I can tell you first hand the accuracy in this next statement as I’ve seen it happen time and time again. “Take care of our staff and our staff will take care of business.” While Tanya Cain and the clinical staff were busy figuring out how to keep the clinic open, while being super vigilant about infection control and risk management, HR was busy figuring out how to stagger schedules and allow staff to facilitate at-home schooling. This became a springboard to implementing the flexible scheduling we had only dreamed about until this time. At this point, at the point of a global pandemic, we had to figure it out and make it work. And I believe we are still trying to figure it out, and will be for a while longer. Because of covid 19, we figured out how to offer a four 10’s work schedule, a 4.5 day work schedule, a five 8’s work schedule that starts at 6:30am. We also approved certain jobs to work remotely. None of these opportunities would have happened if not for COVID-19. Another blessing was the requirement to make changes to our IHCRC Board meetings. Board meetings are now conducted at noon via Zoom. This has resulted in increased staff satisfaction, better attendance from board members and quicker, more efficient use of our time. As the title of my story reads, Being Forced To Change, Changed The Force. We were just forced by the uncontrollable world around us, to make drastic changes to many of our processes. We rocked it, and we are still making improvements and changes as we go. When we start making required changes, even when forced to by the uncontrollable, we are also invested in those outcomes. Those changes lead to more quality improvement in service, product, process, efficiency, effectiveness, access, continuity, etc. These changes enable our organization to move forward and successfully meet the need of our patient, clients, and community, all the while supporting and encouraging the staff who are balancing ALL of it. I continue to pray for those who have lost their loved ones, who have lost their jobs or their homes, their futures. And I sympathize with and greatly admire those who have fought the COVID-19 disease and lived to tell about it. We all, under this one roof, have experienced all of those things. But what an opportunity we continue to have under these uncontrollable circumstances. As we grieve the pain and losses, let’s also look for joy in the blessings that came from the changes. Changes we wouldn’t have otherwise made. Being forced to change, changed the force of our priorities and from that, amazing things are happening.

Stacie Nutt IHCRC 2020

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Providing Strength

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Stay Safe. Stay Well. Stay Hopeful. By: Debbie Starnes, Development Director

I have been a writer most of life. Words on a page come easy to me. In my younger days my writing focus was on poetry and song. At some point I tried my hand at a novel. (It is still in process.) As I began my nonprofit career, news of my writing abilities quickly traveled and grant writing, public relations, and marketing began part of my daily life. Certainly, there have been times when writing has been difficult. Usually I walk a bit and let the words flow in my mind. Never have I experienced the difficulty I encountered during the pandemic. Communication is always key when things are changing day-to-day. Responding to a pandemic requires active communication with patients, with volunteers, with donors, and with staff. Before we knew it, the Development Team found ourselves knee deep in COVID-19 statistics, myths, protocols, and information. Finding truth was important, as was trying to maintain a positive attitude and sense of humor. The three of us found ourselves struggling to do these things. Eventually, we found our way. Every communication I sent ended with these words: “Stay Safe. Stay Well. Stay Hopeful.” It became our motto and we remain hopeful to this day. Much has changed since March. John spends most of his time recording and editing videos. Tonia spends a great deal of time on Zoom or the phone with community members. I continue to write, to share as much positivity as I can, and to interject humor wherever possible. We have adapted and we continue to adapt every day. I would be remiss without thanking our sponsors and donors who braved the day COVID-19 hit Tulsa to raise almost $200,000 for Native American youth. Many of you have already become Early Bird Sponsors for 2021. A special shout out to our Development Committee who has continued to meet virtually providing support and encouragement along the way. Personally, I want to thank John and Tonia for their hard work, their adaptation, and their strength. I could not ask for a better team. Finally, on behalf of the Development Team, I say thank you to Carmelita and Tanya. You have kept all of us at IHCRC safe. You have treated us well. You have thanked us for our service. I am certain we speak for most employees when we share our gratitude for your leadership, care, and concern. Stay Safe. Stay Well. Stay Hopeful. Together we can change our world.

Debbie Starnes

DTM20 Presenting Sponsor Williams

White Buffalo Patron

The Anne and Henry Zarrow Foundation

Eagle

Hard Rock Hotel and Casino Tulsa IHCRC Jeans Pass Staff

Wolf

Blue Cross and Blue Shield of Oklahoma

Bear

Chickasaw Nation Choctaw Nation of Oklahoma Ruth K. Nelson ​Jim and Sharon Ruley Carmelita Skeeter Tiger Natural Gas United Healthcare Community Planof Oklahoma

Buffalo

Childers Architect, LLC Commerce Bank Crowe & Dunlevy Diagnostic Laboratory of Oklahoma, Inc. Eller&Detrich, P.C./CamGlass, Inc. Flintco, LLC Interior Logistics Mabrey Bank Oklahoma City Indian Clinic ONEOK ONE Gas Native ONE ONE Gas Inclusion and Diversity Osage Casinos OSU Medicine Public Service Company of Oklahoma Southern Plains Tribal Health Board

Patrons

American Indian Chamber of Commerce Dr. and Mrs. Jay Anderson Brittany Dias Janice Edmiston and Ceasar Williams The Phillips Family The Law Offices of Ken Ray Underwood

Slick Six

Citizen Potawatomi Nation​ Valerie Duvol​ One Fire Associates, LLC Kayla Kramer Kaw Nation Jack Murray/HoganTaylor Floyd Rogers and Luzana Graff

IHCRC 2020

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Providing Strength Recognizing a Culture of Caring Circle of Life and Four Elements recognizes donors who have shown their commitment to sustaining IHCRC’s mission by consistently giving to the programs that support our Native American community. Value placement is based on donor’s cumulative giving within the past five years (July 1, 2014 – June 30, 2020).

Circle of Life

American Cancer Society, Inc. Blue Cross and Blue Shield of Oklahoma H.A. and Mary K. Chapman Charitable Trust Choctaw Nation of Oklahoma Griffin Communications Hard Rock Hotel and Casino Tulsa

Susan G. Komen Tulsa Affiliate Southern Plains Tribal Health Board Tulsa Community Foundation (LARC) University of Pittsburgh The Anne and Henry Zarrow Foundation

Four Elements

Fire ($25,000-$49,999) The Notah Begay III Foundation Flint Family Foundation Public Service Company of Oklahoma

Mrs. Carmelita Skeeter Delores Titchywy Sumner Telligen Community Initiative

Tiger Natural Gas Williams/The Williams Foundation

Janice Edmiston and Ceasar Williams Flintco/Flintco Foundation First National Bank of Broken Arrow Interior Logistics Meeks Group Muscogee (Creek) Nation Ruth K. Nelson

Nike, N7 Fund Oklahoma City Indian Clinic Osage Casino OSU Medical Jim and Sharon Ruley Ken Ray Underwood Law Office Urban Inter-Tribal Center of Texas

Oklahoma City Indian Clinic ONE Gas ONEOK Phoenix Plumbing Works, Inc.

Edward E. Rogers Larry and Janet Smith United Healthcare Community Plan

Earth ($10,000-$24,999) Dr. and Mrs. Jay Anderson Canyon Creek Energy Chickasaw Nation James R. Childers Architect Inc. CommunityCare Commerce Bank Diagnostic Laboratory of Oklahoma

Wind ($5,000-$9,999) CamGlass Eller & Detrich, P.C. Burt B. Holmes Lee Marks

Water ($1,000-$4,999) Dr. and Mrs. Akberali American Indian Chamber of Commerce Oklahoma American Airlines, Inc. AmericanChecked Inc Alison Anthony and Mark Wilson Tom and Sherry Askew Citizen Potawatomi Nation Mr. Chris and Dr. Leigh Barrow Stacy Berg Donna Birkenfeld Bob and Gloria Bitting Russell Brown

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IHCRC 2020

Dr. Robert Burlingame - Hunt Mill Hollow Ranch Greg Burn Larry and Tanya L. Cain Jim Cameron Lupe Cole Dr. & Mrs. Tom Colpitts Conner & Winters, LLP Donnie and Gayla Cox Crowe & Dunlevy Michael and Heidi Dawson Devol & Associates Brittany Dias

Dr. Jose and Mrs. Cheryl Echevarria Ann and Luke Essman Deni Fholer Trilla Frazier Judy A. Gibson Dr. Jesicah Gilmore and Dane Bowin Global Scaffolding & Insulation LLC Lance and Colette Gopffarth Jo Ann Gower Jenny Graham Great Plains Lending Hillcrest Healthcare System Hogan Taylor, LLP


Water ($1,000-$4,999) Continued Deanna Holman DeAnn Johnson Kaw Nation of Oklahoma The University of Oklahoma-Anne and Henry Zarrow School of Social Work Kimberly-Clark Kayla Kramer Mabrey Bank Dr. & Mrs. Dean Martin Teresa and Robert Burkett Mr. and Mrs. Jay Mounce Hogan Taylor, LLP Brian and Stacie Nutt Nancy O'Banion

Daniel Olson Dr. Jami Bartgis Osteopathic Founders Foundation Elizabeth Parrott The University of Oklahoma Foundation, Inc. Karen Payne The PENTA Building Group James R. Phillips Prescor, Inc. Arden and Joyce Roberts Floyd Rogers and Luzana Graff Drs. Emmanuel and Divina Roman The University of Oklahoma - Tulsa

Tim and Joanna Shadlow Louise Short Mr. David Krapff and Dr. Geeta Silas Debbie Starnes Ross O. Swimmer Ross and Margaret Swimmer Brenda Taylor, LPN Transit Advertising, Inc. Two Feathers Media Consultants Hank and Jeannie Van Veen Mary Ann and Andrew Vassar Bill Wamego and Carol Hinkley Joseph Williams Mollie Williford

2020 Donors

Thank you to all the 2020 Donors who help support the day to day operations of the clinic, as well as, the educational and health programs that have served our Native American community within the past fiscal year. Agitsi Stained Glass Dr. and Mrs. Akberali Connie Allen Brent & Rebekah Allison Larry and Linda Almanza American Indian Chamber of Commerce Oklahoma Dr. and Mrs. Jay Anderson Ellen Archie Tom and Sherry Askew Jennie Barnes Mr. Chris and Dr. Leigh Barrow Dr. Jami Bartgis Stacy Berg Marissa Bigfeather Amanda Billetdoux Donald Bingham Donna Birkenfeld Bob and Gloria Bitting Nancy and Robert Blocker Blue Cross and Blue Shield of Oklahoma John Bouchard Brandon and Amber Boyd Dr. Ranelle Bracy-Lewis Joe Don Brave Ms. Lisa Michelle Broam Karly Brown Russell Brown Donna Cagle Larry and Tanya L. Cain Erin Calabrese Jim Cameron

Kimberly Canady Carly Castley Chickasaw Nation James R. Childers Architect, Inc. Choctaw Nation of Oklahoma Citizen Potawatomi Nation Lupe Cole Commerce Bank CommunityCare Nathalie Cornett Jose and Sheree Cosa Virginia Cox Donnie and Gayla Cox Crowe & Dunlevy Troy and Diana Cupps Lauren Cusick Tammy Davis Michael and Heidi Dawson Devol & Associates Diagnostic Laboratory of Oklahoma Brittany Dias Dina Dixon Chelsea Donaldson Rachel Dugan Elizabeth A. Duncklee, LCSW Dr. Jose and Mrs. Cheryl Echevarria Janice Edmiston and Ceasar Williams Eller & Detrich, P.C. Jeremy and Crystalle Evans Executives of Tulsa Trenton Fedrick Deni Fholer David Kollmann

Flintco, LLC Flintco Foundation Ashley Flurry Amanada Fousek Tia M. Fowler Judy A. Gibson Dr. Jesicah Gilmore and Dane Bowin Owen and Myriam Gilmore Tonia D. Gist Mannie Golden Jo Ann Gower Anthony Gresham Cassey Gutierrez Jordin Hackney Jenifer Hamma Herbert P. Haschke Adrienne Hefner Kelly E. Henderson Hogan Taylor, LLP Deanna Holman Jessie Holmes Homeguard Construction, Inc. Jennie Howard Valerie Howard, DO Dr. Melissa R Hudmon Molly Hurst Interior Logistics Norman Jackson Glenitria DeAnn Johnson Jonas Family Vic and Robyn Jones Ruth K. Nelson

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Providing Strength 2020 Donors Continued Kaw Nation of Oklahoma Dawnna Lynn Keller Sarah and Joe Kennedy The Kerr Foundation, Inc. Kasi Ketcher Kimberly-Clark Ranie Kirk Karen Knight Kayla Kramer Jennifer Lamirand Angie Lanning Fatima Lara-Rodriquez Megan Leath Mary Carolyn and Bob Lengacher Quannah LittleAxe Harold Blackston Lofton Mabrey Bank Lee Marks Mike McBride III and Dawnette Brady Bridget McClendon Margaret McIntosh Jason and Stefanie Menting Ashlee Metcalfe Faith Miller Cory Moore Tracy Moore Mr. and Mrs. Jay Mounce Bobby and Vicki Mouser Mike and Vivian Murphy Jack Murray Jennifer Neal Jacquelyn Nickel Leah Nickell Brian and Stacie Nutt Nancy O'Banion Oklahoma City Indian Clinic Oklahoma City Indian Clinic Daniel Olson ONE Gas Inclusion & Diversity ONE Gas Native ONE ONEOK Alicia Kay Ortman Osage Casino Elizabeth Parrott Kendall Payne Karen Payne Mickey Peercy Goldie Phillips James R. Phillips Steve Poleman/Rich & Cartmill, Inc.

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Opal & Ronnie Price Christina Ralston Cindy Reed Mary Revels Ryann Richey Jessica Rimer Arden and Joyce Roberts Floyd Rogers and Luzana Graff Edward E. Rogers Drs. Emmanuel and Divina Roman Kristy Roper Alyssa Rowan Mary Rule Jim and Sharon Ruley Nancy J. Ruth Tim and Joanna Shadlow G.A. Shannon and Elnora Supernaw RL Shears Company Becky Sheofee Charmayne Shorty Mr. David Krapff and Dr. Geeta Silas Public Service Company of Oklahoma Mrs. Carmelita Skeeter Larry and Janet Smith Southern Plains Tribal Health Board Leah Speer Debbie Starnes Robyn Sunday-Allen Judy Supernaw Julie Taylor Brenda Taylor, LPN Angela Thacker Karen Thomas Therese Tierce Tiger Natural Gas Tulsa County Tulsa Community Foundation Ken Ray Underwood Law Office United Healthcare Community Plan University of Colorado University of Pittsburgh Dennis and Tamara Walden Paulette A. Wamego Kevin Wamego Shawna Webb Rene Wesson Kristi Whitaker Drs. Matt and Cyndi Wilkett Shelly Williams Sherry Williams

LaToyia and Eucild Williams Joseph Williams Williams Stacey Wilson Nicole Woodmansee Shannon Woodstock Rachele Young John and Melissa Young Youth Services of Tulsa


Society of the Medicine Wheel

Society of the Medicine Wheel members are committed to providing financial strength to improve the health and well-being of IHCRC patients on an annual basis. Thank you for being a part of our Caring is Strong Medicine team! Dr. and Mrs. Akberali Tom and Sherry Askew Stacy Berg Michael and Heidi Dawson Elizabeth A. Duncklee, LCSW Deni Fholer Tonia D. Gist

Sarah and Joe Kennedy Harold Blackston Lofton Mr. and Mrs. Jay Mounce Nancy O'Banion Elizabeth Parrott Opal & Ronnie Price Becky Sheofee

Leah Speer Brenda Taylor, LPN LaToyia and Eucild Williams Shelly Williams Sherry Williams

Circle of Blue

Circle of Blue is an alliance of champions dedicated to supporting diabetes treatment and prevention programs that alter the cycle of diabetes within our Native American community. Dr. and Mrs. Akberali Brent Allison, CPA, CMA Michael and Heidi Dawson

Dr. Jose and Mrs. Cheryl Echevarria Karen Payne Drs. Emmanuel and Divina Roman

Mr. David Krapff and Dr. Geeta Silas

Thank you to our donors and supporters. Accurate donor recognition is important to us. Please accept our apology and contact us if there has been an exclusion or inaccuracy. Contact Debbie Starnes, Development Director at dstarnes@ihcrc.org or 918-382-1203 so corrections can be made in future publications.

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Providing Strength Continuous Quality Improvement Studies By: Nancy O'Banion, Quality Improvement Director

Lean Six Sigma 101 Training 2019

Foot Exam Study It is important for patients with diabetes to receive an annual, comprehensive foot exam. Patients with diabetes are at risk for nerve and vascular damage, which can result in poor circulation and healing. The foot exam helps prevent foot ulcers and amputations. From June 10 – October 2, the number of foot exams was tracked. During the first four weeks, 69% of patients who were due for a foot exam received one. The providers set a goal of 80%. Nurses and Medical Assistants started having patients remove their shoes and socks before the provider entered the room. This is how the provider knew the patient was due for the foot exam. In the final four weeks of the study, 89% of patients received a foot exam when it was due.

Patient Centered Medical Home The Patient Centered Medical Home is designed to provide patients with a specific medical provider and care team. IHCRC monitors patient visits with their Primary Care Provider (PCP) as a quality measure. Ideally, patients see the same provider for all of their medical care. When their assigned PCP is not available, we try to schedule patients with another member of that medical care team. This is to enhance continuity of care for the patients.

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In 2019, there were 13,971 individual patients seen in the IHCRC medical clinic. Last year, 89% of patients saw their PCP at least once. An average of 87% of all visits were with the PCP. Ninety percent of patient visits were with the PCP or a member of that medical team.

Diabetes Education Completion Study The Diabetes Education department wanted to increase to 75%, the percentage of patients who completed all four sessions of their initial diabetes education. In the effort to reach the goal, a spreadsheet was created to track each patient's visits. All scheduled sessions were listed in red and changed to black when the patient attended the session. Each time a patient did not keep an appointment and did not reschedule on their own, a phone call to the patient was made to encourage them to reschedule. Two phone call attempts were made to get the patient rescheduled. If no appointment is scheduled at that time and the patient did not refuse services, a letter was mailed to the patient in a final attempt to get the patient to reschedule. At the end of the study, they achieved a completion rate of just 65%. The staff plans to continue the study into 2021, with additional actions designed to help the patient understand the importance of attending the program. Results of the second study will be available in the fall of 2021.

Surveys Completed Due to the pandemic, IHCRC conducted several surveys regarding changes that were made in response to COVID-19. IHCRC conducted surveys of Behavioral Health and Medical patients to determine their response to Telehealth visits. Overall, the visits were well received by the patients, and patients were interested in keeping the visits as an option for the future. For our Pharmacy Department, IHCRC surveyed our patients to determine their response to use of the drivethrough, since we had to close our pharmacy waiting room. In an overwhelming response, patients said they enjoyed using the drive-through, and would continue to use it even when the pandemic was over.

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Providing Strength Board Officers

Brandon Caruso President, Cherokee

Jim Cameron

Secretary, Cherokee 28

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Janice Edmiston Choctaw/Sac and Fox

David Spring

Treasurer, Choctaw


Board Members

Brent Allison Chickasaw

Goldie Phillips Comanche

Dr. Jay Anderson Elizabeth Battiest Choctaw

Joyce Roberts Choctaw

Kiowa

Bob Biting Cherokee

Madeline Teague Mary Ann Vassar Cherokee

Cherokee

Dr. Matt Wilkett Choctaw

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Providing Harmony Recognizing Success and Service

Tanya Cain, RN

Heidi Dawson, PA-C

Dr. Jesicah Gilmore

Kelly Henderson

Timi Pitts

Detoneya Warrior

Leadership of the Year

Shining Star of the Year

Lorrie Pinkston, RN Employee of the Year Clinical

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Provider of the Year

"Lift My Spirits" Award

Opal Price

Employee of the Year Non-Clinical

Physician of the Year

Shining Star of the Year


Organization Awards

Area Director Awards

Best Places to Work in Oklahoma 2020 Tulsa People's A-List Dance of the Two Moons

AAAHC Medical Home Recertification

Psychiatric Team

Exceptional Group Performance Award Clinical

MSPI Team

Exceptional Group Performance Award Non-Clinical

Certified Healthy Oklahoma Business Category Excellence Level

Tenure Awards 5 Years of Service

Dr. Melissa Hudmon Merit Award Urban

Timi Pitts

Individual Excellence in Customer Service Urban

Christie Davis-Spencer Kathryn Jones Mary Revels Becky Sheofee Aly Speers Treece Sutton

10 Years of Service Deni Fholer Kelly Henderson Miranda Kohut Ryann Richey

15 Years of Service Stacey Wilson

Virginia Cox

Peer Recognition Award Urban

25 Years of Service Margaret McIntosh IHCRC 2020

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Heal n a C e Ou W r r e


IHCRC Administration

Carmelita Skeeter, Chief Executive Officer Deanna Holman, Chief Financial Officer Michael Scott, MD, Medical Director Stacie Nutt, Chief Human Resource Officer Tanya Cain, RN, Chief Operating Officer

IHCRC Department Heads Carmelita Skeeter, Chief Executive Officer Deanna Holman, Chief Financial Officer Stacie Nutt, Chief Human Resource Officer Tanya Cain, RN, Chief Operating Officer Jason Menting, PsyD, Director of Behavioral Health Nancy O’Banion, Director of Quality Improvement Debbie Starnes, Development Director Michael Scott, MD, Medical Director

Leadership Team

Carmelita Skeeter, Chief Executive Officer Deanna Holman, Chief Financial Officer Stacie Nutt, Chief Human Resource Officer Tanya Cain, RN, Chief Operating Officer Arthur Holleman, DDS, Dental Director Jennifer Jones, OD, Optometrist Miranda Kohut, PharmD, Pharmacy Director Jason Menting, PsyD, Director of Behavioral Health Nancy O’Banion, Director of Quality Improvement Debbie Starnes, Development Director Michael Scott, MD, Medical Director Jesicah Gilmore, MD, Associate Medical Director Stacy Berg, LPC, Health & Wellness Director David Bright, PsyD, Director of Clinical Training Jenifer Hamma, Patient Business Services Director Kristi Brown, Accounting Supervisor Darryl Hurley, Facilities Manager Kelly Mounce, LPC, Systems of Care Project Director Edward Rogers, Credentialing, Privileging, Accreditation Director Aly Speers, LCSW, SASP/DVP Project Director Mitchell Dodd, Network Systems Supervisor Julie Taylor, Accounts Receivable Supervisor Shannon Woodstock, LPN, Nursing Supervisor

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550 S Peoria Ave, Tulsa OK 74120


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