1. Rural Healthcare Delivery: Bringing care to the people Warm Springs Indian Health Services And The Confederated Tribes of Warm Springs Joint Health Commission

2. Background Collaborative effort with Joint Health Commission Warm Springs is located on 644,000 acres Access to data connectivity is limited in many areas of the reservation Wanting to take services to the people Taking a modern clinic to the medical mobile unit

3. Background Primary Healthcare on the reservation is currently provided by Indian Health Service Local service unit serves roughly 6,500 people 5 family practice physicians, 4 mid-level providers, 1 Podiatrist Dental, Optometry, Lab imagery, Pharmacy 6 exam rooms, 2 ancillary rooms and 1 two- bed treatment area Space to see patients is an issue

4. Project History 2011- Project Planning began Joint project between I.H.S. and Tribal staff 2012- Farber Specialty Vehicles out of Ohio was selected as the design & build contractor 2012- Initial contract completed 2013- Unit Delivered in September

5. Project History cont…… 2013 ground breaking ceremony – Blessing, Tribal Council, community invited – Flu clinic 2013 – Flu clinic at Fire Safety 2013 – Flu clinic at Fire Management 2013 – Diabetes Awareness, HEP C screening and flu clinic ECE (Early Childhood Education), WS Elementary school

6. Mobile Medical Unit

7. Care Delivery Objectives Deliver care to community members who may defer primary care or who have limited access to care Provide routine and preventive services in the community Alleviate congestion in the clinic setting

8. Planned Clinics General medical Senior Dental Diabetes Community Health School Health – New School K-8 th, ECE Podiatry

9. Benefits Access to care Alternative site Expanding services with current space issues Creates two more exam rooms Delivery of care close to home Use fire houses as central places Moving service outside of center Driver is an EMT, can provide triage

10. Challenges Electronic Health Record Connectivity Process and procedure development Supplies and equipment Developing an appropriate staffing model Establishing regular hours Culture issues Social marketing – How to sell ourselves

11. Wishes Expand access to care to all without barriers Integrated system Caroline.cruz@wstribes.org Tammy.wilson@wstribes.org Dwight.carpen@ihs.gov

12. Thank You and Create A Good Day