Impact Unfiltered

Welcome to another episode of Impact Unfiltered, where we're diving deep into real stories of leadership and impact in healthcare and community development. In this episode, we sit down with Cameron Chase, the health director for the Tunica-Biloxi Tribe of Louisiana. Cameron shares his journey from global health work to tribal leadership, highlighting the unique challenges and triumphs of building resilient healthcare systems in rural and Native communities.

1. Introduction to the Podcast and Episode

• Introduction of guest: Cameron Chase, Health Director, Tunica Biloxi Tribe of Louisiana.

2. Cameron Chase’s Role and Daily Responsibilities

• Overview of Cameron’s position as Health Director.

• Description of proactive vs. reactive approaches in healthcare.

• The public health approach beyond clinical care.

• Emphasis on prevention, education, and enabling the community to actualize their goals.

3. Background of the Tunica Biloxi Tribe

• History and federal recognition of the Tunica Biloxi Tribe.

• Discussion of fragmentation and merging of multiple bands/tribes.

• Historical context: forced removal and the impact of colonization.

• Gaining federal recognition through the “Tunica Treasure” artifacts.

• Commitment to nation-building and serving the broader Central Louisiana community.

4. Cameron Chase’s Background and Pathway into Tribal Health Leadership

• Personal background: non-Native, broad international and healthcare experience.

• Inspiration from working with indigenous communities in Guatemala.

• Experience at the tribal epidemiology center and transition to Tunica Biloxi.

• Building new health services and clinics for the tribe.

• Focus on services beyond healthcare: social services, justice, housing, and reentry programs.

• Leadership style rooted in collaboration and teamwork.

5. Understanding and Defining Impact in Tribal Healthcare

• Broader definition of impact—extending beyond the present and considering legacy.

• The concept of “seventh generation” thinking and planning for future generations.

• Importance of creating resilient systems rooted in public health approaches.

• The unique resilience of Native American communities.

6. Community-Driven Initiatives and Long-Term Projects

• Emphasis on resilience within both the tribe and the state of Louisiana.

• Inclusive services for both tribal citizens and the wider local community.

• Addressing chronic diseases, diabetes, and access to expensive medications (GLP-1s).

• Use of federal programs (340B) to increase access for the uninsured and underinsured.

• Development of programs: homeless shelter, juvenile healing, wellness, domestic violence, and substance abuse initiatives.

• Evaluation of impact through community health needs assessments and ongoing measurement.

7. Current State of Tribal Healthcare & Vision for the Future

• Acknowledgement of challenges due to historical and systemic oppression.

• Impacts of federal and state budget cuts and the importance of resilience and strategic planning.

• Rural healthcare challenges and disparities in access.

• Collaboration with the state to serve underserved populations, especially Medicaid recipients.

• Commitment to not reducing services for Native citizens while expanding access to non-citizens.

• Innovative partnerships and leveraging state resources.

8. Legacy Leadership and Advice for Emerging Leaders

• The power of collaboration and teamwork in leadership.

• Importance of patience and understanding that meaningful change takes time.

• Personal anecdotes about the slow pace of progress in healthcare and research.

• Encouragement to young leaders to view their work as a long-term quest.

9. Ways to Get Involved and Learn More

• Recommendation to look for local opportunities to support change.

• The importance of self-education about Native American history and the ongoing impact of colonization.

• Information on how to contact and support the Tunica Biloxi Tribe, including visiting their website and engaging with local initiatives.

Welcome to another episode of Impact Unfiltered, where we spotlight voices making real change. In this special “Tribal Impact” series, host Philippe sits down with Dr. Setu Vora, Chief Medical Officer for the Mashantucket Pequot Tribal Nation in Connecticut. Dr. Vora shines a light on the tribe’s innovative, holistic approach to healthcare a journey that spans over three decades. He walks us through the evolution of Pequot Healthcare, a tribally owned system that not only serves its own community with independent health plans and in-house pharmacy services, but also extends support to other small businesses and tribal nations. Together, Philippe and Dr. Vora discuss the impact of accessible, quality care, the power of self-governance, and what it means to create lasting value in healthcare, both for the tribe and beyond. Whether you’re interested in health innovation, tribal self-determination, or building systems that put people first, this episode delivers inspiring insights on making an impact where it matters most.

1-Introduction and Podcast Overview
  - Dr. Setu Vora's professional role as Chief Medical Officer of Mashantucket Pequot Healthcare.
2. Background on the Mashantucket Pequot Tribal Nation and Its Healthcare System
  - The tribe as innovators in both gaming and non-gaming enterprises.
  - The tribe’s strategic objective: prioritizing health for tribal families and communities.
  - Establishment and evolution of Pequot Healthcare over 30+ years.
      - Independent, tribally-owned third-party administration for self-funded health plans.
3. Dr. Setu Vora’s Role and Mission
  - Responsibilities as Chief Medical Officer: steward and resource for the tribal council’s health objectives.
  - Focus on delivering better value health and applying this mission to both tribal and non-tribal clients.
  - Emphasis on delivering quality, safety, and a better experience at a lower total cost.
4. Pharmacy Services and Pandemic Response
  - Explanation of PBM Solutions' offerings (by Phillippe) related to pharmacy programs, assistance programs, TPA setup, and pharmacy buildouts.
  - Mashantucket Pequot’s large in-house pharmacy team (10+ pharmacists).
  - Key role of the clinical pharmacy team during the COVID-19 pandemic:
      - Leading vaccination programs across the tribal nation.
      - Establishment and operation of one of Connecticut’s largest mass vaccination sites in partnership with state and local healthcare systems.
5. Engagement at the Tribal Self-Governance Conference
  - Explanation of the tribe becoming a Title V tribal nation and transition from Title I contracting.
  - Self-governance compact with the Indian Health Service achieved in October 2022.
  - Greater engagement at the national level, including sponsorship and leadership at the conference.
  - Councilor Michelle Scott’s role in health and human services and her contribution as an opening speaker.
  - Importance of legal counsel in unlocking self-governance advantages.
6. Conference Takeaways and Reflections
  - Value of networking and meeting other innovators at the conference.
  - Recognition of entrenched healthcare systems and the challenge of delivering value in those systems.
7. Meaning of Impact in Tribal Health Context
  - Dr. Vora’s vision for impact: improving tribal community access to care, empowerment, and leadership in health solutions.
  - Extending services and solutions to other tribal nations and self-funded American businesses.
8. Measuring Success: Return on Health (RoH) vs. Return on Investment (ROI)
  - First focus is on RoH: patient well-being, outcomes, and experience.
  - Designing systems to achieve RoH typically brings ROI, achieving better care at lower cost.
9. Closing and Final Thoughts
  - Dr. Vora’s call to action: Find and collaborate with likeminded individuals to tackle healthcare cost drivers and barriers to care.
  - Emphasis on partnerships and alliances for sustained progress.