Economic and community impacts of tribal health care enterprises  

“Behavioral health is just one aspect where they need some healing but there are other underlying conditions,” Kirk said. He noted that people coming in for addiction treatment may also need services for unaddressed dental issues, diabetes, or hypertension, among other concerns. “With IHS right across the street, we can help get clients reacclimated with the IHS system so they can get their prescriptions and other medical care.” 

Tribal health care facilities largely serve only Native Americans—including citizens of the tribe running the facility and citizens of other federally recognized tribes. Depending on the facilities’ financing and the tribal nation’s policies, some facilities and services may also be available to non-Native clients.  

“Though our facility is owned by the Pawnee Nation, any tribal member is welcome,” said Richard Failla, executive and clinical director at Pawnee Nation Behavioral Health. “Any non-tribal member also is welcome, but when you come here you’re going to be exposed to culture, and we’re proud of that. There are so many members of the tribe here that give willingly to help people in recovery.” 

In addition to patient care responsibilities, tribal nations’ health care systems and other neighboring hospital systems in Oklahoma often share resources, facilities, and training opportunities. 

“In Ada, we have two hospitals. There’s Mercy Hospital and there’s us,” said Chickasaw Nation’s RADM Meeks. “We partner together and support each other. I think Mercy is stronger because Chickasaw Nation is here, and Chickasaw Nation is stronger because Mercy is there. It’s not competition because, for the most part, we don’t serve non-Indians; patients have to meet certain eligibility requirements. So, we take the edge off of those community hospitals so they can focus on the people who need to see them there.” 

Tribal enterprises in health care and beyond help fuel the state’s overall workforce growth. A recent Kansas City Fed report found that in 2023, Native Americans drove Oklahoma’s labor force participation rate beyond the US average for the first time in over 30 years. Native American workers were responsible for more than two-thirds of that growth since 2021. This growth included 15,000 Native American workers in hospital jobs. 

“In some regions, including Oklahoma in the Federal Reserve’s 10^th District, the tribal economy plays an important role in the overall economy,” said Joe Gruber, executive vice president and director of research at the Kansas City Fed. “In setting monetary policy, the Fed must understand economic conditions in the varied industries, communities, and geographies that make up the United States. By increasing our fluency in the tribal economy, we’re able to engage in important conversations with district residents about their economic lives.” 

Tribal nations also invest in needed rural infrastructure projects. Chief Batton noted that the Choctaw Nation contributed and awarded funding in recent years for broadband internet, water, septic, and road infrastructure projects within the boundaries of the Choctaw Nation, benefiting both Native and non-Native communities. 

“You can’t just build a hospital and hope it does some good. There’s a lot more to it than that,” said Chief Batton. “Health care might be the end goal, but you’ve got to have infrastructure, technology, people, and education systems to get there.”