COMMUNITY DESCRIPTION

 

Laguna Pueblo is the name for reservation lands now considered home for many members of the Laguna Tribe.  Laguna Pueblo is located in West Central New Mexico and consists of six villages, whose population represents Laguna tribal members and their relatives.  Tribal business is handled through a 21-member Tribal Council.  Each village, regardless of size, is assured equal representation in decisions affecting the Laguna Tribe.  The tribe occupies a large geographic area bordered by Navajo reservation lands and the Acoma Pueblo.

 

Additionally, there are four Tribal colonies.  One colony is located in each of the following cities: Albuquerque, New Mexico; Barstow and Richmond California; and Winslow, Arizona.  Members of the Laguna tribal colonies seek assistance for health care services for their elders through the Laguna Rainbow Corp. located on the reservation at Casa Blanca, New Mexico.  Elderly individuals living in the Laguna colonies and needing residential health care services can seek placement in the tribal nursing home located in Casa Blanca, New Mexico. 

 

BACKGROUND HISTORY

 

The Laguna Rainbow Corporation was chartered in 1979 by the Laguna Pueblo Tribal Council for the purpose of providing comprehensive services to the elderly population of Laguna Pueblo.  Also in 1979, the Department of Housing and Urban Development appropriated funds to build a 40-unit complex where social and support services could be provided to "at risk" elderly living within Laguna Pueblo.

 

The 40-unit complex, funded through HUD funding (CHSP Program), appropriated financial assistance for the social and support services geared toward the elderly.  When this funding was discontinued, the personnel of the Laguna Elderly Care Center found it difficult to provide medical services to the elderly people living in the complex. This resulted in the discontinuation of the individualized care. 

 

More recently, low-income and single- parent families have been allowed to reside in the complex to boost occupancy.  However, even with the addition of this segment of the population, the complex is not fully occupied.

 

In 1981, the Laguna Pueblo tribe built a 25-bed nursing facility to provide health care to their elderly population.  The facility is currently staffed and managed by the Laguna Rainbow Corporation.

 

The Indian Health Service maintains a hospital on the nearby Acoma Pueblo reservation, providing services to not only the Laguna, but also to the Acoma and Canoncito communities.  The Acoma-Canoncito-Laguna (ACL) Hospital is funded and staffed by the IHS.  However, Congressional actions aimed at down­sizing the Public Health Service have left the ACL Hospital deficient on the funding that has traditionally supported hospital-based health services.  Without adequate Indian Health Services (IHS) funding and support, it is likely that the only hospital available to members of the three tribes will be unable to continue providing care.

PROJECT INITIATION

 

The Native American communities have historically depended on government assistance to provide funding for health care services, as well as mechanisms to provide the services.  Recent government policy is encouraging Native American Tribes to provide health services to tribal members, with less support from government subsidies. 

 

This recent change in policy places Native American Tribes in the position of becoming the primary provider of tribal health services,  without sufficient guidance or a resource network to develop a health care initiative.  Many tribal councils are not familiar with the processes by which such initiatives are developed and implemented.

 

FUNDING

 

Funding through the state Indian Area Agency on Aging and Title VI supports the Meals-on-Wheels program for congregate and homebound meals and the transportation to medical appointments.  These programs are managed by the nursing facility, which receives payment for the nursing home clients through Medicaid.  However, the Laguna Tribal Council must provide additional monies each year to subsidize the operation of the nursing facility.

 

CHALLENGES

 

It is important to the Laguna Rainbow Board of Directors, as well as to the Executive Director of the Corporation, that the Laguna Tribal cultures are preserved.  Tribal culture is incorporated into services and activities offered to the elderly population in the nursing facility.  One of the results of this effort has been a high participation rate among the elderly and their families within the Laguna Pueblo and surrounding areas in combined activities, which are largely culture-specific and of interest to the community being served. 

 

The concept of incorporating tribal culture into activities and services includes the manner in which food is prepared for the congregate meals program.  The dietary staff is supported by the executive director, program director and staff as they apply tribal culture in the preparation of food for the meals. 

 

This effort to validate and show respect for the culture of the population being served has resulted in the formation of a bond of trust between the executive director, board of directors, tribal council and elders.  This has been evidenced in the tribal council's follow-through in applying to HUD to have the 40-unit HUD complex turned over to the Laguna Rainbow Corporation.  The application must be submitted through the Governor and Tribal Council in order to be considered by HUD. 

 

PLANS FOR FUTURE GROWTH

 

The Laguna Elder Care Center

 

The Laguna Rainbow Corporation currently operates the Laguna Elder Care Center and plans to include the 40-unit complex.  Application has been made through the Governor and Laguna Tribal Council to have HUD turn the 40-unit com­plex over to the Laguna Rainbow Corporation.  This facility will be used for assisted living for Indian elders.

 

With the addition of the complex to the Laguna Rainbow Corporation, the elderly individuals living in the assisted living units will receive health care from the newly formed home health agency.  Currently, elderly persons living in the 40-unit build­ing do not receive basic health services from the nursing home staff due to regulations restricting the delivery of services to individuals outside the regulation parameters.  There are also plans to restructure a portion of the 40-unit complex to provide an adult day care facility.  With the inclusion of assisted living units and an adult day care, the Laguna Rainbow Corporation will be able to provide essential broad-based housing and health care services.

 

In an attempt to better care for elderly tribal members, the Laguna Rainbow Cor­poration is adding 25 beds to the current 25-bed nursing facility.  The availability of assisted living, adult day care, and a nursing home will also allow selective placement of the many elders who are cur­­­rently on the waiting list for nursing home placement.

 

The Laguna Home Health Care Agency

 

The Laguna Rainbow Corporation re­­­cently received licensure for a home health care agency serving communities within a 50-mile radius of Laguna Pueblo.  Other Native American tribes represented within the area would be welcome to services outlined by the Laguna Rainbow Corporation.  Since these tribal communities are geographically isolated, a multi-tribal service area serves the needs of all the people in the area. 

The Laguna Rainbow Corporation will employ and train individuals from within the tribal community who are aware of tribal belief systems, customs and language.  This will help assure that the services are offered in a manner acceptable to the population being served.  It is ex­tremely important that the individuals providing the home health   care services are able to communicate with the population in their own language in order to develop the acceptance and trust needed to foster utilization of available services.

 

A Multi-Organizational Approach to Health Care

 

The Executive Director of Laguna Rainbow Corporation has initiated a multi-organizational approach to providing health care services to the elderly population of Laguna Pueblo.  Key individuals currently employed by various health care service providers will be pulled together in a collaborative effort, hosted by the Laguna Rainbow Corporation, to discuss the formation of a multi-tribal, multi-organizational comprehensive health care system.  In the face of severely decreased government funding and an increased need to develop internally structured health care services, the Laguna Corporation is facing the future of health care with creativity, sensitivity, and collaboration.