American Indian and Alaska Native (AI/AN) communities face numerous health disparities compared with other populations, including higher rates of chronic diseases, lower life expectancy, and limited access to health care services.

As an organization dedicated to improving health outcomes for all populations, CHPW is committed to supporting the health care delivery systems for Washington State’s 29 federally recognized Tribes.

Rooted in a deep respect for the history, traditions, and self-determination of Indigenous peoples, CHPW aims to foster culturally responsive care and improve access to health services in AI/AN communities by partnering with Tribal and community organizations.

“CHPW’s steadfast support for Tribal health care is a fundamental aspect of our overarching mission to deliver accessible and high-quality health care services. We prioritize meeting our members in their own environments, ensuring that health care is not only available but also culturally relevant and responsive to their needs,” said Theresa Hattori, CHPW’s Tribal Affairs Administrator and an enrolled citizen of the Muscogee Nation.

“For those who identify as Native American or Alaska Native, we offer comprehensive coverage for their health care services, whether they choose to visit a Tribal Health provider or one of our other extensive network providers,” Hattori said.

Addressing health disparities

In the Greater Columbia region, CHPW’s regionally based care team worked on an initiative to address health disparities among Apple Health (Medicaid) recipients who identify as American Indians or Alaska Natives.

The project sought to understand why our health care system has not been effective in supporting AI/AN members with controlling their A1C levels, which are a key indicator of blood glucose (sugar) levels and a crucial test for diagnosing and managing diabetes.

The team reviewed existing programs and resources and met with staff from Yakima Valley Farm Workers Clinic, which is one of CHPW’s partner Community Health Centers, to better understand potential barriers to care.

Importance of ‘culturally inclusive’ materials

The team identified opportunities to leverage culturally inclusive educational materials, clinical trainings, and local community resources available through the Indian Health Service, the federal agency providing health care services to Native American and Alaska Native people, as well as other partners.

The team also developed an educational toolkit for internal and external providers to use when working with American Indian and Alaska Native communities.

“We learned that utilizing culturally inclusive educational material with the American Indian and Alaska Native population plays a key role in improving health outcomes,” said Damaris Warfield, then-CHPW Regional Case Manager for the Greater Columbia Region, who was the lead for the project.

“This initiative also highlighted the importance of addressing whole-person care to support our American Indian and Alaska Native members.”

Investing in communities

CHPW also partnered with several Tribal and community organizations to support their events, programs, and services as a sponsor:

• Seattle Indian Health Board
  • Adeline Garcia Community Service Awards
  • Indigenous Peoples Festival
  • SpiritWalk & Warrior Run
• Unkitawa
  • Missing & Murdered Indigenous Women & People - Family Gathering
  • Re-entry Support Services
  • Veterans Luncheon
• Yakama Nation Health Heart Powwow

We also awarded $10,000 grants, provided to community organizations serving historically marginalized populations, to each of four Tribal-affiliated organizations in recognition of their work and impact on reducing barriers to care:

• Tahoma Indian Center
• Unkitawa
• United Indians of All Tribes
• Urban Native Education Alliance

Enhancing knowledge and skill

Other initiatives we undertook in 2024 as part of our commitment to upholding Tribal sovereignty and collaborating with Tribal communities to improve health outcomes:

Partnering with our Community Health Centers (CHCs): We offered trainings to CHC staff to enhance their understanding of Tribal sovereignty, the structure of Tribal government, traditional Indian medicine, and the unique challenges and strengths of the Indian health care system.

Provider orientation: We created a provider orientation presentation tailored specifically for Indian health care providers and staff, highlighting the various health plans, benefits, and services offered by CHPW. This presentation was delivered in person at several Tribal clinics to ensure direct engagement and understanding.

Improved billing process: We implemented an updated Tribal Billing Guide and we improved Tribal access to claims resources. This resulted in a dramatic reduction in the backlog of claims and better overall efficiency in our billing practices.

Staff training: We provided training for all our staff focusing on community, cultural awareness, Tribal sovereignty, Tribal government operations in Washington State, and the Indian Health Care System.