Move Will Keep Nurses and Doctors on the Job at Tribal Health Centers

SAULT STE. MARIE, Mich. — The Sault Tribe has taken action to keep direct health care providers that includes Physicians, Nurses, Dentists, Optometrists, Nurse Practitioners, Physician Assistants, Behavioral Health counselors on the job in Tribal health centers, a move that will protect access to medical care for Tribal children, elders and other members.

The Sault Tribe Board of Directors approved the first Market based compensation system for the direct care health providers in more than a decade after a recent analysis found that compensation for the medical staffs at Tribal health centers was not competitive. The Tribe has been losing health care providers since 2008 and has been unable to fill open medical practitioner positions for several years. This compensation analysis may serve as a model for other areas of the organization and began with the Tribe’s number one priority – health care.

The action will help the Tribe recruit and retain providers and nurses and ensure Tribal families, children and elders can get medical care when they need it.

“If we want to recruit and retain good, quality health care providers, we need to offer a benefit package that is competitive for our area,” said Bonnie Culfa, Sault Tribe Health Director. “We’ve been losing physicians and nurses at an alarming rate. We must rebuild our medical staff and fill our vacancies so we can provide the care our members need and deserve.”

Over the past two years, the Sault Tribe has lost 27 health care providers and nurses. As a result, the Tribe’s health division was unable to provide care to thousands of patients because it did not have the medical staff to provide treatment.

“Tribal members, their families and our employees are relying on our health department for important medical treatments,” Culfa said. “Our inability to attract and retain direct care provider staff is hurting our ability to provide medical, dental, behavioral and optical services to our membership, including children and elders, and our employees.”

Under the Board's plan, only direct care providers in the following disciplines - physicians, dentists, optometrists, physician assistants, nurse practitioners, behavioral health therapists and counselors and all nursing positions - are eligible for placement in the market based compensation system.

“This is the first market based compensation system adjustment for our medical provider staff in a decade,” Culfa said. “It was necessary to protect access to medical care for our children, our elders, and all other Tribal members.”

In the Manistique and St. Ignace areas, the position of chief solo dentist was vacant for nearly two years. During this time, not only were dental services not met in the area, support staffers were also laid off. “The affects of not having the number of providers we need not only hurts the number of patients we can see, but the number of staff employed and the amount of third-party revenues we can collect,” Culfa said.

Having an adequate and stable staff of providers and nurses also helps the Sault Tribe Health Centers maintain accreditation.

“Being an accredited medical facility in Indian Country is very rare, and we are very fortunate to have this accolade,” Culfa said. “Having stable, constant staff is one of the reasons we are accredited. Losing accreditation would not only harm our reputation, it would jeopardize our ability to collect third-party revenue.”

Tribal Chairman Joe McCoy said the medical staff compensation increases were approved after careful consideration by the Board and is only a starting point for similar analysis throughout the organization to ensure all employees are receiving fair and competitive market compensation.

“We understand no other Tribal staff, including in our government programs and at our casinos, have seen wage increases in recent years,” McCoy said. “But health care is and always has been our number one priority. If a Tribal member needs medical care, we must be able to provide it, especially at a time when the state and federal governments continue to make deep cuts to Medicaid and Medicare and a record number of Michigan residents have no health insurance.”

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Photo by Ken Bosma / CC BY