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Sleep Health for Apaches

Troy Sebastian, MSHCA, RPSGT, RST
Sleep Disorders Center – Director
San Carlos Apache Healthcare Corporation

Established in August 2017, San Carlos Apache Healthcare Corporation is a tribally owned and operated organization serving members of the San Carlos Apache Tribe in Eastern Arizona. Fully accredited by the AASM, this sleep center is located on a Self-Determination Native American Reservation and serves approximately 16,000 Apache Tribal Members.

When and how was the SCAHC sleep center established?
The Grand Opening of our Sleep Center was on August 22, 2017. We are very proud to say that we are the first fully accredited sleep center by the American Academy of Sleep Medicine (AASM) that is located on a 638, a Self Determination Native American Reservation.

Why is AASM accreditation important for your facility?
Accreditation inspires a high level of confidence for our patients and referring physicians from San Carlos Apache Healthcare Corporation and the Clarence Wesley Medical Center of Bylas, Arizona.

The reason we decided to attain accreditation by the American Academy of Sleep Medicine (AASM) was really two-fold for me. First, being accredited by the AASM exemplifies to the healthcare providers as well as to the general public, that we strive for excellence in performing polysomnograms (sleep studies) for our patients of the San Carlos Apache Tribe.

Secondly, working in the sleep medicine industry for two decades now, I am trusted by our Native American population in performing the highest quality of polysomnograms to our patients. It is a great responsibility and honor for me, so there was no other alternative than to go with the highest accrediting standard – the AASM.

How would you describe the patient population that SCAHC serves?
We are located on the San Carlos Apache Reservation in San Carlos, Arizona. Our patient population is Apache Native Americans. The San Carlos Reservation has approximately 16,000 Apache Tribal Members in Eastern Arizona.

Are there any ways in which business operations (e.g., insurance reimbursement) are different at a tribally owned facility?
Yes, because San Carlos Apache Healthcare Corporation is a 638 – Self Determination Reservation, it has the right to assume the responsibility, and associated funding, to carry out programs, functions, services and activities that the United States government would otherwise be obliged to provide to Native Americans. In doing so, the facility provides better governmental services to their own members than those provided by distant federal bureaucracies.

This Self-Determination Policy has proven so successful that today more than 50 percent of all federal Indian programs are carried out by tribes rather than federal agencies. Our primary insurance provider for our Apache patients is Medicaid, specifically American Indian Health Plan. There is a contract in place in which we are paid a flat rate per encounter.

The SCAHC mission is “to heal, serve and empower the In-deh (Apache people) while honoring the traditions.” Is sleep respected as a healing force in Apache traditions?
The Mission of Izee’Baa’ Gowah is to bring Gozhoo to our people through principles of goodness, balance, harmony and beauty. Izee’ Baa’ Gowah is Apache healing Apaches. By performing high quality polysomnograms, enabling people to reach restorative sleep for current and future generations, we will create a strong and healthy community.

How does SCAHC’s emphasis on providing “holistic health care” impact your work at the sleep center?
A central belief in the Apache Way is Gozhoo. In the Apache value system, revelation came to the Holy people through the Creator and through them to the Apache people. This belief creates well-being through the feelings of goodness, balance, harmony and beauty. Izze’Baa” Gowah opens a pathway of Gozhoo and Healing. Our CEO, Victoria Began, of San Carlos Apache Healthcare, is a true innovator, she believes in treating patients through holistic health care, treating the person as a whole. without Mrs. Began’s astute leadership and innovation, the sleep center would not have become a reality.

What sleep problems are prevalent in your patient population?
To date, we have performed 274 polysomnograms (sleep studies) of which 78 percent of our patients have been diagnosed with severe (AHI >30) obstructive sleep apnea.

Are there unique challenges involved with providing sleep care to a Native American population?
Our sleep center has approximately a 35 percent no-show rate. Although our sleep center is located directly on the reservation of San Carlos, transportation can still be a challenge. Many of our patients that reside on the reservation live multiple miles from the hospital and have found it challenging to travel to our sleep center, as well as other departments of San Carlos Apache Healthcare Corporation. To help remedy our transportation challenges, a multiple passenger van has recently been purchased by San Carlos Apache Healthcare Corporation. Due to the purchase of this van, we now are optimistic that our patients will now have a much easier way to access their healthcare.

What is most rewarding about working at a sleep center on Native American lands?
The rewarding factors in opening the sleep center and the continued work at San Carlos Apache Healthcare Corporation are immeasurable. I am extremely honored to work for the Apache people of San Carlos; my work in the sleep medicine industry spans more than two decades and I have not had a more rewarding experience than working with the Apaches at San Carlos Apache Healthcare Corporation.

Working with the staff of San Carlos Apache Healthcare is also extremely rewarding; the personnel are well-seasoned in their trades and bring with them multiple years of specialized training. In my opinion, of working in various arenas in the health care industry for over 35 years, the entire personnel at San Carlos Apache Healthcare Corporation are unparalleled in the service they give to the Apache people of San Carlos.

“We are proud of our accreditation by the American Academy of Sleep Medicine (AASM).”

“Our Sleep Technicians, Kristine James and Loren Victor, they are both Apache Tribal Members.”

“Our Administrative Assistant, Alicia Moses, performing the majority of our patient scheduling.”

This content was published in the Fall 2018 issue of Montage, the official membership publication of the American Academy of Sleep Medicine (AASM). To read more content from this issue, click the button below!

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Sleep Health for Apaches
Source: Sleep Study News