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Southcentral Foundation History
Southcentral Foundation is an Alaska Native-owned, nonprofit health care organization serving nearly 65,000 Alaska Native and American Indian people living in Anchorage, Matanuska-Susitna Valley, and 55 rural villages in the Anchorage Service Unit.
Incorporated in 1982 under the tribal authority of Cook Inlet Region, Inc., Southcentral Foundation is the largest of the CIRI nonprofits, employing more than 2,000 people in more than 80 programs.
SCF’s vision is a Native Community that enjoys physical, mental, emotional and spiritual wellness; the mission is to work together with the Native Community to achieve wellness through health and related services. The organization has developed and implemented comprehensive health-related services to meet the changing needs of the Native Community, enhance culture and empower individuals and families to take charge of their lives.
SCF’s first compact agreement, per Public Law 92-638 Bureau of Indian Affairs Alaska Area Native Health Service, began in 1984. The compact agreement provided dentistry, optometry, community health representatives and injury control services. A funding request to provide substance abuse treatment service was added in 1987.
Gradually, SCF increased its compact agreement capacity within the Anchorage Service Unit so that by late 1994 it was administering nearly half the primary care services for Alaska Native people.
The Alaska Native Medical Center opened its doors in May 1997. Earlier that year, Congress had passed Public
Law 105-83, which included a section that enabled Alaska Native people to obtain ownership and
management of all Alaska Native health care services.
In 1998, SCF completed the assumption of ownership and management of primary
care and other programs located in the Anchorage Native Primary Care Center. Since the beginning of the assumption of services, SCF instituted significant philosophical changes and other changes in the design and administration of these programs. SCF instituted a total system-wide transformation of care, increasing the
quality and adaptability of programs–and more importantly–the accountability of
providers and customers alike. Alaska Native people are in charge of designing and
delivering health care.
INTRODUCTION METHODS R E S U LT S
Organizational Infastructure for Successful Behavioral Health Integration in Primary CareShane Coleman, MD, MPH, Division Director of Behavioral Services
VISION A Native Community that enjoys physical, mental, emotional and spiritual wellness
MISSIONWorking together with the Native Community to
achieve wellness through health and related services
elationships between customer-owner, family and provider must be fostered and supported
mphasis on wellness of the whole person, family and community (physical, mental, emotional and spiritual wellness)
ocations convenient for customer-owners with minimal stops to get all their needs addressed
ccess optimized and waiting times limited
ogether with the customer-owner as an active partner
ntentional whole-system design to maximize coordination and minimize duplication
utcome and process measures continuously evaluated and improved
ot complicated but simple and easy to use
ervices financially sustainable and viable
ub of the system is the family
nterests of customer-owners drive the system to determine what we do and how we do it
opulation-Based systems and services
ervices and systems build on the strengths of Alaska Native cultures
RELATIONSHIPS
ork together in re lat ionship to learn and growncourage understanding i sten with an open mind augh and enjoy humor throughout the dayotice the dignity and value of ourselves and othersngage others with compassion hare our stor ies and our hearts tr ive to honor and respect ourselves and others
WELLNESS
How Southcentral Foundation is Different
Customer Ownership - Alaska Native people took ownership over their healthcare
Relationships are the core of our healthcare system
MULTIDIMENSIONAL WELLNESS• Mind and body• Family wellness
Leadership
Merging of Cultures
Team Based Care
SCF is owned by the people it serves – customer-owners. Our culture is lived out through our operational principles. We have always lived our lives in community, in relationship, sharing and carrying one another. We enjoy life, finding humor even in the worst case scenarios, respecting each other regardless of station of life. We believe a human being is made up of more than just the body- we have souls, minds and spirits. We want to address the entire being.
Operational Principals
Core Concepts are the guiding principles each employee should use in every interaction in order to create healthy relationships. These principles guide interactions wiith Customer-owners and employees. Core Conepts is a part or SCF’s onboarding.
Core Concepts
Leadership support was key for creating an integrated, culturally informed, whole person approach to primary care that includes Alaska Native people’s with lived experience. From the CEO to
our VP’s to clinical Directors, SCF is dedicated to our operational principles
We focus on the relationship with our customers
WHOLE PERSON CARE• Increased access• Reduction of stigma• Improve overal health
Beahvioral Health integration is a part of Primary Care
INTEGRATED CARE TEAMS• Behavioral Health Consultants• Integrated Psychiatry
Combing primary care and behavioral health cultures can be difficult. Primary care is efficiency focused, short interactions, focused exams without attention paid to intentional use of
boundaries while behavioral health is relation focused with in depth review, longer interactions and intentional use of boundaries to facilitate sharing and treatment.
• Needs help NOW • Brief and to the point (efficient and effective)• Decreased awareness of transference or
sharing energy• Less skilled with boundaries • Accepts use of antidepressants and
traditional mood stabilizers
The customerowner needs help now!
It’s not urgent. Lets schedule something.
• It’s not urgent• Have to have comprehensive picture• Very aware of transference• All about boundaries• Comfortable with all psychotropic
Primary Care Provider Behavioral Health Services
Relationship is at the heart of our interaction with CO’s as well as among employees. In order to facilitate healthy, productive relationships SCF requires all employees attend Core Concepts. Core concepts is a 3 day training that teaches the basics of safe listening, safe sharing, and encourages one to engage in
relationship through the telling of story. SCF has also learned over time that not everyone is a good match for integrated team based care and that the best match requires a dynamic employee that enjoys working closely with others.
Fit is everything. Let a prospective applicant see the clinic and give an example of a typical day. Not every Behavioral Health
professional is cut out to be a BHC. The “process oriented” clinician will struggle to be able to provide good “customer service”.
Customer Owner satisfation rate of 96%
of behavioral health services are provided in Primary Care
Support from leadership
is required to succeed
Start small and grow changes
over time
Be open to learning from your mistakes
Customer ownership
is invaluable in ensuring alignment
of incentives to provide good care
An emphasis on relationship is a valuable asset in the context of
organizational change
10% of mental health services are provided directly by the primary care physicians.
70% of services and provided by master’s level, brief intervention based behavioral health
consultants (BHC’s) and approximately 20% of behavioral health services are provided by
traditional behavioral health programs. In all, we reach approximately 32% of our active empaneled
primary care population with mental health services.
80%
20%Psychiatrists20%
Traditional behavioral health
services
10%Primary Care
Providers
10%Primary Care
Providers
70%Behavioral Health
Consultants
70%Behavioral Health
Consultants
Purpose
Conculsions
Same day access is an essential element of our system
©2016. Southcentral Foundation. All rights reserved.
For further information, please contact the Nuka Institute | 907-729-8608 | www.southcentral foundation.com | SCF [email protected]