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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 NukaInstitute@SCF.cc