Home | Classifieds | Place an Ad | Public Notices | Galleries | Milestones | Contact Us | Subscribe | e-newsletter | RSS | GrandCanyonTourGuide.com
Navajo-Hopi Observer | Flagstaff, Arizona

home : opinions : opinions July 23, 2016


1/14/2014 10:40:00 AM
Letter to the editor: Healthcare legislation too vague, creates more bureaucracy

To the editor:

I would like to introduce myself to the honorable council members and delegates of the Navajo Nation. I am a registered nurse currently employed at Tuba City Regional Healthcare. I come to Tuba with 32 years' experience. My training was at Indiana University School of Nursing and my practice background is the delivery of critical care and emergency nursing as well as 20 years as a manager of both ED and ICU/CCU. I am currently Lead Application Specialist and Acting Clinical Education manager here at Tuba City Regional Health Care Corporation.

I am writing to express my concern for legislation posted for public review on Wednesday, November 13, 2014.

Overall I find this proposed resolution to be too vague while creating duplication of services and disciplines. Terms are general, broad, and lacking any specific plan. Many terms such as "fragmentation of healthcare systems" and "stated results of loss of coverage and reimbursement" are too general to readily verify for accuracy and fact.

As a nurse working in both inpatient and outpatient settings, I find that medical providers, mid-level providers, and therapists who do bill for service are quite familiar with both surrounding state and federal guidelines based on the current Medicare and Medicaid regulations. Creating another layer of complexity to me does not seem to be a fiscal or rational use of resource or healthcare dollars in a time when those dollars are shrinking.

In the proposed resolution is the implication that current providers do not provide culturally relevant or quality healthcare. I personally and professionally find this quite inflammatory and unfounded. Following this logic then to establish another level of bureaucracy responsible for the broad oversight capacity proposed would seem to worsen this allegation. I do not believe the welfare of the Navajo people is at the core of this resolution.

While I am not Navajo, I am of native descent and have a deep and abiding respect for this nation's first people. I am well educated and somewhat politically savvy which increases my sense of obligation to our customers. Proposing more layered and potentially conflicting oversight to any level of provider does not equate to improving quality or enhancing culturally relevant care.

To reference line 23 on page 2 of 7, I find this so broad that I wonder what is the proposed timeframe to establish a functional oversight group that is educated and with the level of expertise it takes to collect, integrate, analyze, interpret, and disseminate data on health care, behavioral risk factor surveillance (takes at least a doctoral level), morbidity and mortality indicators, and health and human research. This group would also be appointed to "serve at the pleasure of the President of the Navajo Nation." This seems to subject the entire effort to critical potential for accusations of impropriety.

To reference lines 1-17 of page 5 of 7, I would like to ask the very pointed question of how any item let alone all items mentioned at issue would be established within the constraints of current federal meaningful use mandates as well as ICD-10 billing regulations that will affect all healthcare payers and providers whether private or government?

When reviewing the resolution I also find no provision for how the entity would provide knowledgeable oversight of licensure for healthcare providers. Minimally, all professionally licensed providers have licensing boards in all 50 states and in many states those licensing boards have established reciprocity for practice. These boards monitor minimal practice standards and provide direct due process for complaints or legal actions involving licensed personnel. There is established monitoring and reporting that also follows established state laws. How does another entity propose to operationalize efforts that at best duplicate these established licensing agencies? Due process implies that all peoples have a legal way for appeals, burden of proof for allegations or denials, or safeguards from prejudice to be adjudicated. To have an oversight committee or counsel with the all-encompassing power implied in this resolution would be subject to questionable motives when rendering any decisions.

Fundamentally allowing any agency or entity to self proclaim such broad power as is suggested at all phases of this resolution, is to bring the very idea of sovereignty under question.

There is no clear infrastructure to perform any of the proposed actions of a newly created Office of Medicaid or Department of Health specific to the Navajo Nation nor have they made a clear argument based on known fact or research statistic that would support such endeavors.

I would implore those who currently represent the lives they have sworn an oath to protect and serve by serving in any branch of Navajo government to carefully review this proposal with clear vision to purpose and potential. Many laws have some measure of good intention yet all voters must rely on the gravity imposed on elected and appointed officials to maintain their constituents' best interest in governing their decisions and actions. I could not make that argument to our patients if I were asked if this resolution were in any way in their best interests.

Judy Clanin, RN

Tuba City Arizona



    Recently Commented     Most Viewed
Mapmaker continues quest to document indigenous cultures
New documentary focuses on Native American veterans on Navajo Nation
Letter to the editor: Where do children learn to speak fluent Navajo?
Delegate Edmund Yazzie continues work for Thoreau, N.M. clinic
Pirates of the Navajo Nation under attack




Article Comment Submission Form
Comments are not posted immediately. Submissions must adhere to our Use of Service Terms of Use agreement. The email and phone info you provide will not be visible to the public. Rambling or nonsensical comments may not be posted. Comments are limited to 1300 characters or less. In order for us to reasonably manage this feature we may limit your comment entries to five(5) per day.
Submit an Article Comment
First Name:
Required
Last Name:
Required
Telephone:
Required
Email:
Required
Comment:
Required
Passcode:
Required
Anti-SPAM Passcode Click here to see a new mix of characters.
This is an anti-SPAM device. It is not case sensitive.
   


Advanced Search

HSE - We want to hear from you
Find more about Weather in Flagstaff, AZ
Click for weather forecast


Submission links
 •  Submit site feedback or questions

Find It Opinions Features Submit Extras Other Publications
Home | Classifieds | Place an Ad | Public Notices | Galleries | Milestones | Contact Us | Subscribe | e-newsletter | RSS | Site Map
© Copyright 2016 Western News&Info, Inc.® The Navajo-Hopi Observer is the information source for the Navajo and Hopi Nations and Winslow area communities in Northern Arizona. Original content may not be reprinted or distributed without the written permission of Western News&Info, Inc.® Navajo-Hopi Observer Online is a service of WNI. By using the Site, nhonews.com ®, you agree to abide and be bound by the site's Terms of Use and Privacy Policy, which prohibit commercial use of any information on the site. Click here to submit your questions, comments or suggestions. Navajo-Hopi Observer Online is a proud publication of Western News&Info Inc.® All Rights Reserved.

Software © 1998-2016 1up! Software, All Rights Reserved