The federal Centers for Medicare and Medicaid Services last fall gave Arizona permission to offer traditional healing services for Medicaid patients through the Indian Health Service. That came after about a decade's worth of work to make it happen. But, with cuts potentially coming to Medicaid, the change could be short-lived.
Charles James Parker, chaplain director for the Phoenix Indian Medical Center, joined The Show to talk about the kinds of services patients who are part of the Arizona Health Care Cost Containment System, or AHCCCS, can now get.
Full conversation
CHARLES JAMES PARKER: Well, I, I will honestly say that much of our processes has remained the same, mostly because we do not have an employed traditional practitioner on staff. When the changes came down, the HCPCS codes that were put in place, the, the Healthcare Common Procedure Coding System, they created these, these codes that allowed for CMS reimbursement for traditional healing services.
MARK BRODIE: So, when that was introduced, that allowed for Arizona's Indian Health Services, tribally operated health facilities to be able to provide traditional healing services and be reimbursed for that.
PARKER: However, my program for the spiritual care department here at PIMC, we have volunteers. These are individuals from the community that volunteer their skills to provide care, on a traditional healing site. So, what will ultimately happen is that once we have employed a traditional healer onto our staff, then we'll be able to, to apply for reimbursement of those services.
BRODIE: Would that person be in addition to the, the volunteers that you've had or or instead of them?
PARKER: Yes. Absolutely, that our, our volunteer program is not going to change. A strong care department always has a strong volunteer program behind it. We're, we're talking a great number, you know, of tribes that we support all, all throughout the community, you know, about 574 federally recognized tribes. So that, that is a lot of people.
BRODIE: Well, so I'm curious, you know, you mentioned the number of different tribes, you know, who have patients that could be coming to, to your facility. How do you try to find a person or even enough volunteers who are proficient in the, the healing practices?
I would imagine that there's at least some amount of variability between different tribes, even if sort of the, the idea or the the sort of the tenet of, of them is the same between different tribes. I'm assuming that there's some, some very important specific differences.
PARKER: There are, and I have to be clear in saying that there's a difference between chaplaincy and traditional healing practices. As a professional chaplain, I, I'm not trained as a traditional healer, so I couldn't, I couldn't speak to that in its totality. But I will tell you that what I've observed to this point, is that there are some things that are done, generalized in some areas.
Because of the amount of patients that we're serving, we're talking about well over 174,000 patients. I mean, just the, the Yavapai Nation, Tohono O'odham Nation, Yavapai Apache Indian tribe. I mean, the list goes on. It's a large health care area between Arizona, Nevada, California and Utah. So, many of those patients come in, but the largest group is, is the Navajo, Navajo tribe.
So, Navajos have, they have medicine men, and, and they have specialized requirements, whereas the Tohono O'odham, they might have another process, but if you're outside of that system, you're, you're not gonna know what it is. So, ideally, what I'm trying to do is get something in place that is more generalized so that more tribes can be supported.
BRODIE: What kind of demand do you see from patients for this, these kinds of services?
PARKER: Well, I will tell you that for spiritual care as a whole, it varies because many of the patients, they were brought up with a specific religious tradition. And many of them do maintain that religious tradition, while others have gravitated into a more spiritual non-religious track, which is more traditionally based.
And so, of the 1,000 or so patients that we had and admitted last year, about 30% of those admissions were visited by a spiritual care provider and then about 42% of those visits were based on consults. So that means that the patient was admitted and then specifically requested for spiritual care.
That, that has gone up and we're just talking about fiscal year 2024, but, the, the beginning of fiscal year 2024 consults were at about maybe two to three a month. And as of now, I mean, we're up to 24 consults a month, and climbing.
BRODIE: Well, so I've got to ask, given sort of where we are, in this country right now, you just received approval to do this not that long ago. Are you concerned that the funding for this position might be eliminated and you might not actually be able to bring somebody on?
PARKER: No, I, I really don't, I'm not too concerned about it because, like I said, a strong spiritual care department has a strong volunteer system. The, the work that we do, in the health care system as spiritual care providers, we're not like many other disciplines.
We are clinically, clinically trained. However, we are so focused on holistic care and so focused on ameliorating the suffering of others, that my job at its core is to meet the need, to provide a way. So whether the position gets funded or not, there will always be people in the community that are willing to step up and, and help someone in need.
BRODIE: One way or the other, if, if not a paid employee, you'll just continue with the volunteers that you have.
PARKER: Correct.
