TSE BONITO, New Mexico – Executive leaders from Sage Memorial Hospital (SMH), representing the Association of Indians for Self-Determination in Healthcare (638 Association), participated in the Navajo Nation Council’s Health Education and Human Services Committee (HEHSC) work session on Mar. 23.
The session focused on advancing tribal self-determination in healthcare delivery, with in-depth discussions on long-term contracts under the Indian Self-Determination and Education Assistance Act (ISDEAA, Public Law 93-638) and the Purchased/Referred Care (PRC) program.
The meeting featured presentations from Indian Health Service (IHS) Navajo Area Office staff and representatives from Title I contracting and Title V compacting organizations. Melinda White, Chief Executive Officer of SMH, presented on behalf of the 638 Association. She highlighted how tribally managed facilities deliver essential specialty, emergency, and referred care services not always available at direct IHS sites.
A major focus of the meeting was the PRC program, which helps cover medically necessary services when direct care is unavailable. Key topics included:
• Eligibility rules, including “He Who Refers Pays” and “Home of Record” guidelines
• Appeals processes for denied services
• Medical priorities and how tribal organizations can adapt them based on funding
• Patient education and challenges with cross-border referrals and notification timelines
Additional discussion addressed Non-Emergent Medical Transport (NEMT) regulations, including permitting processes, safety standards for drivers and vehicles, complaint resolution, and enforcement mechanisms.
The HEHSC expressed appreciation for the collaborative presentations and indicated plans to explore legislative options for standardizing contract terms, improving PRC coordination across facilities, and updating NEMT regulations. Further technical assistance sessions and stakeholder work sessions are expected in the coming months.
MEDIA CONTACT:
Christian Bigwater,
Chief Patient Experience Officer
christian.bigwater@sagememorial.com
Office – (928) 755-4532 | Cell – (928) 221-4205
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