It’s nice to hear from an expert. The Navajo nation took over running their hospital under “Title 698” (I may have the numbers wrong). The ensuing chaos I walked into was inevitable, but sad.
Close, its Tribal 638. And yes, for the most part, they run their healthcare facilities ok, but funding is the big bugaboo. Members still do not trust the process of enrolling into a program run by the federal government, and continually question why they should even enroll when they were promised free healthcare. So we have to explain to them that funding has to come from somewhere, and IHS could use the federal matching that Medicaid and CHIP provide.
What you witnessed breaks my heart but doesn’t surprise me. When I visit, they know I am coming and the place is scrubbed and all hands on deck. But we talk to the members and we know how frustrated they are.