Donna Singer, RDMS & CEO
UNHS was incorporated and began management of the Montezuma Creek Clinic on January 1,
2000. The community has since been involved in its progression, and has insured the success of UNHS.
UNHS now operates four Federally Qualified 330e Community Health Centers (CHC) and the
Blue Mountain Hospital (Critical Access).
2

As a private, non-profit 501 (c)(3) corporation, UNHS provides medical, dental, and behavioral health services, and is directed by a Navajo Board of Directors representative of all communities in which our clinics are located.
Wilfred Jones
Board Chair - Red Mesa
Robert Whitehorse
Vice Chair - Aneth
Lorrissa Jackson
Secretary - Oljato
Melinda Farley
Treasurer –TeecNosPos
Gloria Begaye
Blanding
Jamie Harvey
Aneth
Edward Tapaha
Red Mesa
Harriet Lansing
Aneth
Kenneth Miles
Navajo Mountain
Cassandra Beletso
Mexican Water

Goal 1: UNHS wants to bring excellent quality healthcare to local communities in the Utah Strip and increase patient access to care.
Goal 2: To teach and train Navajos to fully understand the daily operating functionalities of the facilities while offering quality patient care.
Goal 3: To expand levels of service increasing access to specialty services locally.
Goal 4: Expand access thru assumptions of other local health care facilities to coordinate and collaborate in improving healthcare.

20%
Patient Demographics
1%
Native American
White
Other
79%

24,62%
2,35%
17,95%
Revenue Source Ratios
32,65% IHS
Medicaid
Medicare
Self Pay
Third Party
22,43%

Fig. 1. As UNHS becomes more accessible and improves the quality of health services, the number of patients seen has increased dramatically.
133,325














Accreditation by Joint Commission and Patient Centered Medical Home certification
Blue Mountain Hospital Joint Commission Accreditation
Clinical Pharmacy services for UNHS patients
Behavioral Health Program expansion
Tomosynthesis Mammography Units
Patient Navigation Program
Case Management
Information Technology
Patient Transportation program expansion
EMS Services
Navasew Building lease
Financial support for UNHS employees and local students for higher education
Board approval for acquisition of Dental facility and expansion of dental services to Blanding community
9



Blue Mountain Hospital (BMH) is managed by UNHS and a collaborative effort and is intended to make hospital services and renal dialysis more accessible to communities located in the Utah portion of the Navajo
Reservation.
Located in Blanding, Utah, Blue Mountain Hospital is a private, nonprofit corporation developed and owned by the Ute Tribe and UNHS.


Challenges
Disparate base or per capita funding
Lack of funding and services for public health services
Navajo Nation police security
Maintaining IHS and
Tribal communication
Historical nonpayment by IHS of
Contract Support cost


Goals
Evaluate healthcare needs and develop needed services
Improve collaboration with other state, federal, and tribal health agencies
Complete process for approval of operation of Four Corners
Regional Health
Center (Red Mesa)
Improve access and quality of drinking water through system development
Daycare center for the children of employee’s and local workers



Value Statement:
UNHS is customer focused, responsive, respectful, honest and committed to excellence through teamwork in delivering healthcare.
Current Staff:
Stephen Hiatt, MS APRN
Nicole Olsen, CMHC
Roselyn Maryboy, LCSW
Jessica Stubbs, LMFT
Rex Harvey Sr., PSS

Services Offered:
1. Depression/ Sadness
2. Anxiety/ Fear
3. Grief
4. Alcohol or Drug Abuse
5. Emotional Problems
6. Thoughts of Death
7. Anger
8. Stress
9. Co- Dependency
10. Medication Evaluation
11. Evaluation for Inpatient treatment for Life Threatening problems
12. Court Ordered Services
13. Etc.

Family Counseling
(Clinical/ Traditional Prospectives)
1. Marital Conflicts
2. Family Problems
3. Domestic Violence
4. Alcohol/ Drug Abuse

Counseling for Children and Teenagers
(Clinical/ Traditional Prospectives)
1. Relationship Problems
2. Parenting
3. Drugs and Alcohol
4. Depression
5. Anxiety
6. Physical/ Sexual Abuse

Group Counseling (Clinical/ Traditional)
1. Healthy Relationships/ Substance Abuse Education
2. Domestic Violence
2. Parenting Skills
3. Parent Support Group
4. Peer Support Group with Chronic illness diabetes

Other Services
1. Referral to other agencies when needed.
2. Consultation services to agencies, including Medical
Facilities, Schools, Law Enforcement, Social Services,
Substance Abuse programs and other that may need our assistance.
3. Educational services to organizations.
4. All services meet the needs of our community members in both languages, English and Dine Language.


20

The Methamphetamine and Suicide Prevention Initiative
(MSPI) was implemented as an initiative to combat violent and gang-related crime in Native American Country
UNHS Behavioral Health Staff continue to work hard each year to provide interventions, assistance, awareness, classes and outreach programs that inspire and educate our community members.
Positive programs include our youth organization, Native
Youth Designs, and the annual Venture Utah Summer Camp
21

The department was created to:
- Provide education & increase community involvement in prevention goals
-
- Reduce methamphetamine abuse
Reduce suicidal ideations and activity
-
-
MSPI Goals
Enhance community awareness, collaboration, and response to drugs and suicidal related activities
Increase number of youth participating in educational and therapeutic groups.
22

Find healing and promoting constructive behavior through science and culture based teachings that encourage balance and self-awareness.
Learning to celebrate self and cope with life’s challenges
“Trust yourself, create the kind of self that you will be happy to live with all your life. Make the most of yourself by fanning the tiny, inner sparks of possibility into flames of achievement.”
23

a two week, soft nature experience designed to put at-riskyouth in touch with the nature world, accomplished counselors, native artists, native traditions, including food & youth counselors who have also been at risk and have overcome personal obstacles to be able to mentor the process of creating resilience & personal accountability with their peers.
-
-
St. Christopher’s Mission at Bluff, UT
At risk youth are served by a large group of experienced licensed counselors, therapists and medical personnel
(also Alternative Therapist)
24

Physical activities include: kayaking, swimming, hiking, horseback riding, volleyball, bear dancing, dancing, ballroom dancing lessons, service projects such as planting & clearing.
Regular counseling from licensed clinical social workers, medical workers, native traditions, personal power practitioners, holistic health workers, music therapist & team building exercises.
25

Activities include: Native Arts, Navajo basket making, rug weaving, beading, gourd painting and flute making.
Other traditions are also explored such as sheep shearing, the butchering of a goat, and the process of preparing the animal to eat along with traditional bread, ash bread, and fry bread.
26

A. Byron Clarke, J.D.

Motivated
Excellent
Performance
Appreciated
Employees
Guidance and
Administration
Quality
Patient Care
Improved Results to
Customers
28

Goals and Compliance
UNHS hires according to the NPEA
Long-term employment as a goal and upward mobility improves efficiency.
Encourage education and maintain a scholarship fund for employees
Paid time off and tuition payments to conferences and CME courses
Community Involvement
Continuous Quality Improvement and regular performance reviews
29

Upward Mobility: On-the-Job training and advancement
UNHS employees can request school scholarships in exchange for service commitment. To date, UNHS has paid over
$211,000.00 to employee Education Costs
Last Name
Bitsinnie
Holly
Juan
Oshley
Benn
Mose
Miller
Department
Finance & Accounting
Finance & Accounting
Finance & Accounting
Finance & Accounting
MCC - Dental
MVC - Dental
Administration
Atene
Dance
Bennallie
Diabetes Control Project
Diabetes Control Project
MCC - Business Office
Slim MCC - Nursing
Smallcanyon NMC - Business Office
Harrison
Cleveland
Finance & Accounting
Administration
Blackgoat Medicaid Transport
Smallcanyon NMC - Nursing
Fox
Sagg
BFP - Nursing
Finance & Accounting
Begaye
Holliday
Frazier
Todachinnie
MCC - Dental
BFP - Business Office
Diabetes Control Project
MCC - Facility
Lee
Brown
Harvey
Harvey
Yanito
Redhouse
Administration
MCC - Nursing
Administration
Behavioral Health
Pharmacy
Nursing
Current Employees
Year Hired First started as...
2007 A/R Data Entry
2002 A/R Data Entry
2002 A/R Data Entry
Currently Employed As...
Accounts Receivable Technician
A/R Manager
Billing Supervisor
2000 A/R Data Entry
2004 A/R Data Entry
Referrals Representative
Dental Patient Registration
2010 A/R Data Entry Billing Technician
2006 Administrative Assistant Human Resources Manager
2009 Americorp Volunteer
2008 Americorp Volunteer
Diabetes Control Outreach
Diabetes Control Outreach
2004 Behavioral Health Secretary Medical Records Technician
2010 Dental Assistant
2010 Eligibility Specialist
2004 Finance Staff
2007 Front Desk
Medical Assistant- Public Health
Patient Registration
Accounting Manager
Veteran's Affairs Coordinator
2011
2011
2006
2006
2008
2006
2009
2011
Housekeeper
Intern
LPN
Maintenance
Oral Health Educator
Patient Registration
Patient Registration
Patient Transport
2003 Safety Personnel
2008 Screener
2006 Women's Health
2007 Lifeguard
2001 Housekeeping
2005 LPN
Patient Transport
Medical Assistant
Clinical Nursing Director
Facilities Manager
Dental Hygienist
Licensed Practical Nurse
Registered Nurse
Mechanic
Public Relations and Emergency Response
Medical Assistant
Policy Development and Special Event Organizer
Domestic Violence/Traditional Counseling
Pharmacy Technician
Working Toward Registered Nurse
30

100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Departmental Percentages
Caucasian %
Native American %
31 Department

Departmental Numbers
30
25
20
15
10
5
0
Caucasian
Caucasian
Native American
Total Employees: 217, 73.5% Native American
32

Redhouse, L.
Piotrowski, D.
Hurst, A.
Sheeran, G.
Dowell, S.
Oliver, L.
Hammond, D.
Lawrence, A.
Filfred, C.
Thomas, E.
Martin, S.
Vijil, B.
Dowell, H.
Thompson, B.
Jones, G.
Larsen, A.
Bryant, O.
Capitan, C.
Jones, R.
King, Y.
Poyer, C.
Yazzie, H.
Dayish, A.
Nielson, B.
Haycock, R.
Malan, A.
Tom, K.
Hanley, E.
Todecheene, Y.
Dan, P.
Administration
Behavioral Health
BFP - Business Office
BFP - Nursing
BFP - Pharmacy
CHIPRA
Voluntary
Voluntary
Involuntary
Voluntary
Voluntary
Voluntary
Finance & Accounting Involuntary
Information Technology Voluntary
MCC - Business Office
MCC - Facility
MCC - Nursing
Involuntary
Involuntary
Involuntary
MCC - Nursing
MCC - Pharmacy
MCC - Providers
MCC - Radiology
MCC - Radiology
Medicaid Transport
Medicaid Transport
Medicaid Transport
Medicaid Transport
Medicaid Transport
Medicaid Transport
MSPI
MSPI
MVC - Dental
MVC - Dental
MVC - Dental
MVC - Facility
MVC - Facility
NMC - Dental
Involuntary
Voluntary
Voluntary
Retired
Involuntary
Layoff
School
Voluntary
Voluntary
School
Layoff
School
Voluntary
Retired
Voluntary
Involuntary
Involuntary
Involuntary
Involuntary
Total Separations: 31
Total Employees: 217
Total Involuntary: 11
Total Voluntary: 12
Total School: 3
Total Program End: 2
Total Retired: 2
33

Bandis, K.
Whitehorse, T.
Denny, W.
Blackhorse, T.
Billie, T.
Stewart, J.
Talker, R.
Benally, T.
Capitan, A.
Clark, C.
Cly, E.
Etsitty, E.
Juan, L.
Mose, N.
Yazzie, E.
Yellowman, C.
Gilson, T.
Hunter, E.
Morgan, N.
Bonds, J.
Singer, S.
Yanito, B.
Nakai, M.
Employee
Nakai, B.
Nakai, L.
Ahtsosie, K.
Dickson, D.
Tortalita, K.
Begay, S.
Pemberton, R.
Fowler, J.
Tsosie, C.
Tallman, R.
Sampson, Y.
Tolth, D.
Sloan, S.
Crank, S.
Simpson, K.
Olsen, N.
Judy, M.
Atene, L.
Greyeyes, B.
Torres, A.
Blackwater, K.
Mammo Tech
Med Lab Tech
Medical Assistant
MSPI
Navigator
PA
PA
Patient Transport
Patient Transport
Patient Transport
Patient Transport
Patient Transport
Patient Transport
Patient Transport
Patient Transport
Patient Transport
Pharmacist
Pharmacist
Pharmacy Tech
Physician
Radiology Tech
Speciality Services
Speciality Services
Job Title
Accounts Receivable
Accounts Receivable
Admin Assistant
Behavioral Health
Case Management
Clinic Manager- MV
Data Technology
Dental Assistant
Dental Assistant
Dental Assistant
Diabetes Control
Eligibility
Front Desk
Front Office
Front Office
Hourly Worker
Housekeeper
Housekeeper
Housekeeper
IT
Maintenance
Hire Date
9/26/2012
12/11/2012
12/3/2012
10/16/2012
5/28/2013
11/7/2012
10/1/2012
5/8/2013
10/24/2012
10/3/2012
10/3/2012
5/1/2013
1/28/2013
1/28/2013
11/5/2012
10/24/2012
5/1/2013
6/3/2013
3/25/2013
3/18/2013
11/26/2012
3/26/2013
10/24/2012
12/26/2012
12/10/2012
12/17/2012
12/26/2012
6/24/2013
6/3/2013
2/11/2013
3/4/2013
12/10/2012
3/6/2013
6/11/2013
4/29/2013
9/4/2012
6/3/2013
3/25/2013
4/15/2013
4/17/2013
5/29/2013
3/11/2013
9/24/2012
5/2/2013
Total Separations: 30
Total Hires: 44
Total Employees: 217
Turnover 2013: 16%
Turnover 2012: 11%
Turnover 2011: 15%
U.S. RN turnover rate: 14%*
¼ of Hospitals had 20% turnover
*Am. Org. of Nurse Execs.
One ONLR investigations for the past 25 months.
Zero ONLR violations in UNHS history.
34

Investing in Employees – Local Economic Impact
• Every Full-time employee is eligible for benefits –
• 5% gross income to retirement 403b
• Full Premiums for Health Insurance
• Eye and Dental coverage
• Salaries aligned with the
-
National Association of Community Health Centers Survey
2,000+ similarly situated clinics
-State, Regional, & Market Demand
• PTO, Vacation, Bereavement, CME, Bonuses
• Largest private employer in San Juan County
35

UNHS Hiring Practices are governed by the NPEA, EEOC & Title
VII, ULC, FLSA, ADA, ICPFVP, FMLA, VPA, ADEA, USERRA
Credentialing Standards established by HRSA and JCAHO

2012 &2013 Interns and Training sessions
B. Kirk
R. Nielson
A Miller
S. Kelly
S. Haycock
S. Phillips
L. Edwards
M. Morton
O. Pierce
B. Miller
T. Martin
P. Rogers
M. Parrish
T. Warren
B. Palmer
A. Redhouse
N. Whitehorse
B. Palmer
T. Warren
N. Dance
A. Taylor
J. Yowell
S. Bettwiseser
M. Stewart
D. Hamilton
A. Shaw
J. Adams
E. Holiday
D. Atene
C. Benally
J. Harvey
C. Nypaver
K. James
J. Marble
H. Parker
K. Holly
L. Hadley
K. Hiatt
M. John
C. Low
B. Harmon
R. Miguel
S. Vowles
D. Pratt
R. Yanito
J. Wilson
D. Jones
S. Harvey
P. Drake
P. Little
V. Hicks
W. Begaye
J. Allmon
V. Ketchum
D. Yazzie
C. Benally
K. Rivera
Easter Seals
NNDWD
NNDWD
NNDWD
Volunteer
M.A. Student
M.A. Student
M.A. Student
M.A. Student
M.A. Student
M.A. Student
M.A. Student
X-Ray Student
M.A. Student
M.A. Student
M.A. Student
CNM
M.A. Student
M.A. Student
M.A. Student
M.A. Student
General
General
IT intern
General
M.A. Student
M.A. Student
General
M.A. Student
M.A. Student
X-Ray Student
Dental student
General
CHS
M.A. Student
Phys Therapy
General
BH
General
General
General
M.A. Student
M.A. Student
M.A. Student
General
General
M.A. Student
M.A. Student
M.A. Student
M.A. Student
M.A. Student
M.A. Student
M.A. Student
M.A. Student
M.A. Student
M.A. Student
General
Local education system collaboration
Whitehorse High School & Elementary
Monument Valley High School & Elementary
Navajo Mountain High School
San Juan High School & Elementary
College of Eastern Utah
University of Utah
Other Universities

"The mission of The Joint Commission is to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations."

•
Founded in 1951
•
Nonprofit organization
•
Establish standards to address a facility’s level of performance in areas such as patient rights, patient treatment, and infection control.

Benefits of Joint Commission accreditation and certification
•
Strengthens community confidence in the quality and safety of care, treatment and services
•
Provides a competitive edge in the marketplace
•
Improves risk management and risk reduction
•
Provides education on good practices to improve business operations
•
Provides professional advice and counsel, enhancing staff education
•
Recognized by select insurers and other third parties
•
Fulfills regulatory requirements for UNHS

•
Conducts onsite evaluations of facilities
“Accreditation Surveys”
•
Issues a certificate of accreditation valid for 3 years
•
Also provides ‘unannounced surveys’ to encourage a system of continuous quality improvement rather than preparation focused specifically on a site visit

•
2 Patient Identifiers
•
“Time Outs”
•
Read Back of Orders
•
Do not Use Lists
•
Reporting of Problems
•
Look Alike/ Sound Alike Drugs
•
Complete List of Medications

Have You Ever Been Confused While Getting
Healthcare?
 You Didn’t Know What Your Medications Were For?
 You Didn’t Know What the Next Steps Were to Get
You Healthier?
 Felt as Though Your Provider was Telling You What to Do? Felt as Though You Didn’t Have any Say?
 Wished Someone Would “Hold Your Hand”
Through the Process?

What is the PCMH?
A PCMH puts patients at the center of the health care system, and provides primary care that is
“accessible, continuous, comprehensive, familycentered, coordinated, compassionate, and culturally effective.”
(American Academy of Pediatrics)

Joint Principles of the PCMH

Personal Physician (Empanelment)

Physician Directed Medical Practice (Team
Approach with Patient at its Center)

Whole Person Orientation (Many support services: Clinical pharmacy, Nutrition, Specialty
Services, Preventive Screenings, Dental,
Behavioral Health, etc.)

Joint Principles of the PCMH

Care is Coordinated and Integrated o
(Many support services: Patient Navigation, Referral Specialists,
Chronic Care Team)

Quality and Safety are Hallmarks o
(Data supported patient care: Electronic Health Records,
Population Based Care)

Enhanced Access o
(Extended hours and weekends, 24/7 access to clinical advice,
24/7 access to the patients medical record)

Road Map to
Best Practice in
Health Care

Patient Navigation & Case Management

Next Presenter - End of Section

Goals: o
To ensure that our patients have access to the best comprehensive health care services available to them, especially those who may not have a strong family support system.

Patient Navigation & Case Management
RESPONSIBILITIES:


Help patients and their families navigate thru health care system (Dr. office, hospitals, payment systems, support groups, etc.)
Identify possible barriers that could hinder treatment







Facilitate communication among patient, family members and health care providers
Coordinate care among providers
Ensuring that appropriate medical records are available at medical appointments.
Facilitate follow up appointments
Provide emotional support
Help patient and their families understand their diagnosis.
Help arrange language translation/interpretation services

Patient Navigation & Case Management

Patient Rights: o
Accurate and easy to understand health information o
Know their treatment options and make informed decision about their care

Patient Responsibilities: o o o
Be responsible for their own health care (exercise, no smoking, etc.)
Provide accurate information about their health
Be respectful

Patient Navigation & Case Management

Examples of Barriers: o
No established PCP o o o o o o o o o o o
Transportation
System problem with coordinating care
Lack of access to a specialist
System culture and practice/staff belief and attitudes
Difficult to access appropriate food
Unable to care for self at home
Cost of supplies and equipment
Anxiety of patient
Habitual unhealthy lifestyle
Health literacy/lack of information
Language

Patient Navigation & Case Management

CLINICAL PHARMACY

Presented By Andrew Bayless

Dr. Andy Bayless, PharmD, BC-ADM
UNHS Clinical Pharmacist






Dr. C. Albert Noyes, PharmD, BC-ADM
Dr. Andy Bayless, PharmD, BC-ADM
Dr. Tyler Gilson, PharmD
Dr. Emily Hunter, PharmD
Plus 9 University of Utah College of Pharmacy doctoral students trained in the past year, with an additional 12 doctoral students scheduled this year.


Diabetes care
 Patient education


Treatment selection
Follow-up care and monitoring

High risk medication management


Anticoagulation Clinic
Chemotherapy coordination

Medication Consults

Professional education

Formulary management

Clinical Pharmacy
Meaningful progress...

Clinical case: o o o
A 60 year old Navajo woman
Diabetes for many years with prescriptions for pills
Her diabetes remained out of control and she refused to change medicines

Clinical Pharmacy
Meaningful progress...
Clinical Pharmacy Contribution o
Education: “What options do we have?” o o o
Clarified misunderstandings about insulin and other medications
Explained the goals of treatment
Helped patient gain understanding of her power to control her health

Clinical Pharmacy
Meaningful progress...
Follow-up o
Started insulin therapy o o o
2 days later her blood sugar was the lowest it had been in years
The patient is excited for and proud of her new success
Her clinical inertia is in the productive direction

CONTRACT SUPPORT COSTS

Presented By Ron Demaray

Contract Support Costs



Section 106(a)(1) of the ISDEAA authorizes Tribes to contract for all programs, or portions thereof, that the IHS would have otherwise provided.
Sections 106(a) (2) & (3) authorize Tribes to recover additional “contract support costs.”
UNHS has historically negotiated with the Navajo Area
IHS, an amount for direct and indirect-type contract support costs.

Contract Support Costs



Historically, the IHS has not fully funded UNHS CSC due to inadequate appropriations for that purpose.
In June of 2012, the U.S. Supreme Court, in Ramah
Navajo Chapter v. Salazar, ruled for the Tribes indicating that the BIA and IHS must fully fund all Tribal CSC.
The Navajo Nation, UNHS and hundreds of Tribal contractors across the country are pursuing claims against the IHS for full funding of past CSC.

Contract Support Costs



For FY 2014, IHS has proposed language in the 2014
Appropriations Bill to limit CSC to an amount identified on a table listing all Tribes contracting with the IHS.
For UNHS, the amount identified is $3.1 million yet the IHS’s own 2012 CSC Shortfall Report data shows UNHS’s total CSC need to be $3.7 million.
For 2014, the IHS and UNHS will negotiate compact language that identifies UNHS’s full CSC need and the amount the IHS says is available.
o That compact language will preserve the right for UNHS to pursue a claim against the IHS for any deficiency.

William Harrison, Finance Manage r

AS A 638 CONTRACTOR UNHS QUALIFIES FOR ADDITIONAL FUNDING
FROM FEDERAL AND STATE GOVERNMENTS:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Association for Utah Community Health Center Grants
Outreach and Enrollment Primary Care Grant
Community Health Center Primary Care Grant
Community Health Center Mental Health Collaboration
Congressional Earmark Grants
Center for Disease Control Emergency Preparedness
Emergency Management Performance Grant
Medicaid Transportation Program
Meth and Suicide Prevention Initiative
Radiation Exposure Screening and Education Program
Special Diabetes Program for Indians
State Cardiovascular, DCP, and Oral Health Grants
Veterans Administration Contract Services
Patient Navigator Program

133,325

FINANCIAL
CLASS
COMMERCIAL
MEDICAID
MEDICARE
PRIVATE PAY
TOTALS
CURRENT
206,976 33%
UTAH NAVAJO HEALTH SYSTEM
ACCOUNTS RECEIVABLE ANALYSIS
As of June 30, 2013
31-90 DAYS 91-150 DAYS
151-180
DAYS
157,019 25% 76,617 12% 29,013 5%
180+ DAYS
241,608 39%
145,973 39%
17,702 11%
612,259 34%
154,793 25%
58,366 16%
35,346 22%
405,525 23%
33,147 5%
42,508 11%
22,846 14%
175,117 10%
18,788 3%
10,269 3%
13,927 9%
71,997 4%
TOTAL
149,503 24%
169,886 27%
118,849 32%
71,793 44%
510,031 29%
619,128 100%
-
618,221 100%
-
375,965 100%
-
161,614 100%
-
1,774,929 100%

Chart represents ratio of current assets to current liabilities
Industry Recommendation- at least 1:0
UNHS is > than 3:1





INCREASED STAFFING AND SERVICES HAVE CREATED A SHORTAGE OF
SPACE AND RESOURCES. MODIFICATION, RENOVATION AND EXPANSION OF
SPACE IS MUCH NEEDED WITHIN THE UNHS SYSTEM.
THE COST OF PROVIDING COMPETITIVE HEALTH BENEFITS TO EMPLOYEES
IS INCREASING – 20% INCREASE IN PREMIUMS FOR 2012-13
GOVERNMENT PROGRAMS AND REGULATIONS SUCH AS MEANINFUL USE,
PATIENT CENTERED MEDICAL HOME, THE JOINT COMMISION, AND ICD-10,
TO NAME A FEW, REQUIRES CONTINUAL TRAINING TO HEALTHCARE
PROFESSIONAL AND SUPPORT STAFF.
UNCERTAIN POLITICAL ENVIRONMENT AS IT RELATES TO HEALTH CARE
REFORM AND THE CENTER FOR MEDICARE AND MEDICAID MAKE FINANCIAL
FORECASTS AND PREPRATIONS DIFFICULT
UNHS FY 2011-12 AUDITED FINANCIALS AND 990’S ATTACHED

Emergency Medical Services
Presenter:
Dustin A. Coggeshell
Patient Transport Director

Utah Navajo Health System (UNHS) and
San Juan County (SJC) officials met several times in 2008 and 2009 to discuss the status of Emergency
Medical Services on the Utah portion of the Navajo Nation. During the discussion it was made aware that certain areas of EMS needed improvements, UNHS was requested by
SJC to assume EMS for the Montezuma
Creek and Monument Valley areas.

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Response time for 911 and interfaculty calls.
EMS staffing
Response time:
Current ambulance response time of 30 mins to 1 hr for
911 emergencies.
Ambulance response time of 45 mins to 1hr 30 mins for interfaculty transports.
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EMS staffing: Short staffed with volunteer paid EMT’s and no increase in EMT/ EMS staffing due to students not passing SJC EMS courses.

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UNHS agreed to assume EMS with certain conditions in place.
Transfer ownership of three ambulances with equipment's.
Continue dispatching services from San Juan Sheriffs office.
UNHS provide inter-facility medical transports.

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UNHS and Mt Nebo Training of Provo, Utah provided two
EMT courses with one course each at Montezuma Creek and Monument Valley site.
Mt Nebo changed teaching methods such as more hands on and visual teachings. This helped with visual learners and increased the passing rate for EMS courses in
Montezuma Creek and Monument Valley.
Montezuma Creek EMS gained 9 EMT’s
Monument Valley EMS gained 6 EMT’s

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UNHS has submitted application for state ALS and BLS EMS license with support from the Utah Bureau of EMS. 08/14/13
Staffing of EMS being established or in place consisting of EMT’s, ambulance drivers, training officer, course coordinator, instructors, off-line medical director and EMS director.
UNHS purchased two additional ambulances making five ambulances available for UNHS EMS for 911 and interfaculty transports.
Mutual aid agreement’s in place with nearby EMS agencies.
Dispatch agreement in place with San Juan County Sheriffs office.

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UNHS will provide 24/7 ambulance coverage for the Montezuma
Creek, Aneth, Hovenweep, Hatch, Red Mesa, UT, Halchita,
Monument Valley and Oljeto areas.
Several EMT’s and paramedic currently are employed by UNHS making response time faster during normal business hours including nights and weekends.
UNHS has a fulltime mechanic to repair any ambulance in a moments notice.
Monthly training and EMT courses will be provided for continuing education and to advance EMT certification to provide higher level of care.
24/7 Emergency dispatching from SJC Sheriffs Office
Provide and educate community members of EMS updates, injury prevention and access of 911 services.

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Wilfred Jones, Board Chair