The Fourth of July is a great time to get together with family and friends, fire up the grill, and celebrate our nation’s independence. It’s also a great opportunity to get outside and get active. There are plenty of activities to choose from, so there’s no excuse not to get up and move! If you’re looking for something low-key, take a leisurely stroll around your neighborhood or go for a swim at your local pool. If you’re feeling more adventurous, head to the nearest park for a game of frisbee or go hiking/biking on one of the many trails available in Tulsa (Turkey Mountain is our favorite!). So, whether you’re looking to burn some calories or simply want to enjoy the outdoors, make the most of this holiday and get moving! As you’re planning July 4th adventures, be sure to account for ample water and skin protection. It’s important to stay safe and protect your skin from the intense summer heat. Applying sunscreen BEFORE heading outdoors will protect your skin from burns and harmful UV rays. Have a safe and hydrated Fourth of July! Resources: Oklahoma Outdoor Activities Red Cross Fireworks Safety Tips CDC Fourth of July Blog

Tucked away in a hallway rarely traveled by patients or staff are the hard working staff known as Patient Benefit Coordinators. We prefer to call them our unsung heroes. These individuals battle daily to ensure our patients have the health care, services, and insurance they need. A fallacy about Indian health care is that it is "insurance." While health care is free for tribal citizens, the availability of specialty care (and primary care for that matter) is very limited. In Oklahoma, having a tribal card or CDIB card does not mean you can present at the nearest emergency room for care and have it paid for by the tribe or government. Neither does it mean you can see that wonderful cardiologist your co-worker recommended. Every day IHCRC's physicians refer patients for specialty care services such as an MRI, a visit with a cardiologist, or a biopsy. That referral passes to an IHCRC Patient Benefit Coordinator. These unsung "contract health" or "purchased referred care" dollars are simply no longer available. It is at this point the Patient Benefit Coordinators come alive. Their job? To find the referred service for the patient whether or not funding is available and to keep track of that referral from beginning to end. The unsung heroes of IHCRC are also the experts on health insurance, especially SoonerCare, Medicaid, and Medicare. Being able to cover IHCRC patients with a third party payer source is just another way to ensure they receive the health care they deserve. If anyone asks you why IHCRC is different, an answer must always be, "Because our Patient Benefit Coordinators are the absolute best at what they do!"

Ten percent of IHCRC's annual patient population are ages 65 and up. Another 1,500 are ages 55 to 64. According to the U.S. Census, 14.2% or 6,387 of Tulsa County's population are Native American ages 65+. Elders in Native American societies play a vital role in the preservation of Indian culture. Elders teach younger generations about spirituality and history. They are considered to "wisdom-keepers" and are held in the highest regard. Unfortunately, these same American Indian and Alaska Native elders comprise the most economically disadvantaged group in the nation and are at increasing risk of health disparities, financial exploitation, and neglect. Additionally, this group is often responsible for the raising of grandchildren. During 2020, IHCRC received an invitation to apply for a grant from the United Health Foundation. The United Health Foundation is the philanthropic arm of UnitedHealth Group, a diversified health care company dedicated to helping people live healthier lives and helping to make the health system work better for everyone. It is an honor to be invited to apply for a grant. IHCRC submitted a project with the goal of reducing health disparities and disease complications in Tulsa County's Native American community ages 65 and over. The proposed project consists of five patient community ages 65+: (1) comprehensive medical care; (2) behavioral health services; (3) fitness activities; (4) medical social work services; and (5) health education for individuals ages 65+ and their caregivers. In September United Health Care announced that IHCRC has been awarded a $1.8 million grant for its Protecting Our Elders program. IHCRC is honored and humbled to be partnering with United Health Foundation.

When part of a routine, children can develop relationships with those they interact with during those activities, and it can help support a sense of belonging and self-confidence. As they grow, they will be able to follow routines, begin to demonstrate independence, and more easily adjust to change. Create a schedule and routine for your family does not have to be hard; you can keep it simple. Think of the things you do each day and break those down into steps. You can review this schedule daily with your children and have it in a place they can easily see. It's important to remain flexible and let your child know that sometimes plans do change, but also try to give them a warming if you know something will be different. .........See more

The last two years have been all about separating ourselves from… you know… people. Other people. Those people. Them. As much as I want to believe, still, that pre-pandemic normalcy is surely right around the corner, I struggle with a pragmatic belief that we probably are living our new normal and must adapt. I miss the people. And I know you do too. I think the biggest change every single one of us people had to adapt to was the isolation and separation from other people. This was required of us all. All ages. Globally. In both physical and psychological ways, it’s taken a toll and impacted our lives and relationships. We need to get our peopling opportunities back. The energy created, the understanding achieved, the motivation sustained, the respect appreciated, all feed off our ability to be present with our people. We have an amazing group of 161 people. (That active staff number is as of the writing of this piece.) As we progress through the new year, let’s prioritize putting other people first, taking care of our people, serving other people, and appreciate our need for peopling. If not for our people, our 161 amazing healthcare-providing people we have at IHCRC, we wouldn’t be where we are today…45 years into an amazing existence. An existence excitedly on the edge of second expansion and an existence only attributable to the people who come to IHCRC every day and care about other people. Let’s get to know each other, let’s get to know our people again. This is what the people at IHCRC are made of. Enjoy the demographics! Of the 161 employees who are active this day, 135 of those are women. We are an organization who truly appreciates and strives for diversity and appreciation of women in the workforce, in healthcare! 84% of our workforce are made up of amazing women! One of which has been with IHCRC for our entire 45 years of service to Indian people, Carmelita Skeeter. Carmelita started with IHCRC in August of 1976 and has dedicated her life to the mission of providing healthcare services to Indian people in the Tulsa area. Carmelita has provided leadership to our IHCRC community, to our people, for 45 amazing years that have been full of growth and achievement. In her 45 years, in the clinics 45 years, we’ve seen the workforce, the people, grow to a staff of 161 and growing. We have all 5 generations represented with our largest being Generation X. Generation X represents 43% of our workforce, followed by our Millennials at 37%, and Baby Boomers making up 17% of our people. Interestingly, the remaining 3 percent belong to 3 young IHCRC professionals in the newest generation, Generation Z, and one amazing leader of the Traditionalist Generation, also known as the Greatest Generation and for good reason. Demographically, today our workforce people are comprised of 57% salaried professionals and 43% hourly professionals. 97% are considered full time status. 32% of our current staff have advanced education and are Licensed to perform the health services we provide to our patient population, with an additional 18% having training Certifications to either assist in or perform certain other health services. The remaining staff is comprised of both management and support staff whose function is to support the service providers by maintaining the infrastructure and leading the people. Our workforce people are made up of many tenured individuals who have more stories and memories of the growth and development of our organization than we could ever capture in entirety. Thank goodness for a trove of old photo negatives and slides we have kept safely in administration all these years. Interestingly 32% of our people have worked for IHCRC between 1 and 4 years with an additional 19% of our current staff having been with us for under one year. That means half of our staff, due to both healthy turnover and adding new positions, have a history of less than 5 years with IHCRC and bring so many new, creative, ideas and experiences with them to add to our talents. 29% of our staff have a tenure between 5 and 9 years and 17% have been with our organization between 10 and 19 years. We have a total of 4 people who have been with us between 20 and 29 years, with one person having dedicated the last 37 years of their career to IHCRC, and one other, 45. In the last year and a half that we have been avoiding people, we have had amazing and incredible stories of resilience and tragedy and celebration among our people. Many of these experiences need to be shared in person to be truly respected and appreciated with the compassion and empathy we people need. We’ve had marriages and divorces, births and deaths…too many deaths. We’ve had promotions, terminations, office moves, and Plexiglas grooves. We had program growth and facility expansion hopes, and we’ve again run out of office space. And we had a really amazing street party. In all of it, remember the most important part, are the people. On a purely entertaining side, 44%, almost half of our staff, prefer the Fall season, with both Spring and Summer seasons each being preferred by 22% of staff. Winter is the preferred season of only 3% of our staff and 9% of our staff fell into another season category by answering with new seasons including Hunting, My Birthday, Vacation, and Monsoon season. Very funny people, very funny.

Carmelita began her career at IHCRC in 1976 when she helped survey residents to assess health needs of the local urban Indian population. Survey results showed medical needs of Tulsa’s Native Americans were not being met. When she was hired as one of IHCRC’s original four employees, the agency provided referral services only. Within a year, the first medical services were offered. During her tenure with IHCRC, Carmelita has worn many hats, including Clinic Administrator and, since 1989, Chief Executive Officer. During the past 45 years she has been the recipient of many awards, including (1) “Outstanding Community Leadership of the Year,” presented by the Oklahoma Native American Business Development Center, 1998; (2) an award for significant contributions in improving the health of American Indian and Alaska Natives presented by the National Indian Health Board, 1999; (3) the national Council of Urban Indian Health “Outstanding Program of the Year” award, 2002; (4) Maxine Cissel Horner Spirit of Community Excellence Award, 2003: (5) a Women in Communication Annual Newsmaker, 2011; (6) a Women of the Year Pinnacle Award winner; (7) a YWCA 100 Women of Moxie, 2014; (8) a Dan Allen Social Justice Award Winner, 2016; (9) City of Tulsa “Carmelita Skeeter Day” Proclamation, 2019; and (10) Kenneth Anquoe Lifetime Achievement Dream Keeper Award, 2021. Carmelita has dedicated her life to the issues affecting Native Americans. She is never without drive and determination to add to and enhance the many services already provided by Indian Health Care Resource Center. She is admired and respected by the IHCRC patients, former and current staff, and the Board of Trustees. Indian Health Care would not be such a vital resource to the Tulsa community without the vision and leadership of Carmelita Skeeter.

With COVID-19 here to stay for the foreseeable future, many parents are left wondering how to protect their children. Schools are returning to in-person learning which can increase a child’s risk for potential exposure, and many parents are hopeful that vaccination can be an additional line of defense. The FDA has approved 3 COVID-19 vaccines for adults (ages 18 years and older) including Pfizer, Moderna, and Johnson & Johnson. At this time, only Pfizer has been approved for older teens ages 16 years and up. IHCRC does not currently offer Pfizer and therefore we are unable to vaccinate anyone who is not yet 18 years old. However, Pfizer is offered at select facilities and we would encourage families to contact their tribe and other local IHS entities to determine if their 16 or 17 year old teen can receive the Pfizer vaccine elsewhere. The public health community is hopeful that the FDA will be expanding the approved age brackets for COVID-19 vaccines to eventually include younger teens and older children as the year progresses.Please check with your child’s doctor or our IHCRC Facebook page frequently for the most up to date information regarding when your child can be vaccinated against COVID-19.

IHCRC will be closed February 16th due to weather. Stay safe and warm!

Going into 2020, none of us knew what it was going to be like. Maybe you had plans like a vacation or graduation, a new job or a wedding. Or maybe you were looking forward to spending quality time with family that you don't get to see very often. Whatever you were hoping to do in 2020, COVID-19 probably changed your plans somehow, and you may even be mourning a loved one this year. I'm a family practice doctor, and like most other healthcare workers, I was thrilled to hear that the coronavirus vaccines had been made, and that they work so well. Everyone should talk to their own doctor about whether the vaccine is a good choice for them, and I made sure to read everything I could find about the Pfizer and Moderna vaccines, so I could help my patients decide what they wanted to do when given the chance to get one. Many people wonder how they will feel after a shot, and if the shots are safe. The possible side effects are the same as for most other vaccines: arm pain where the shot is given, body aches, fatigue, fever, headache, etc. Side effects usually only last a couple of days, and go away on their own. The vaccine is very safe, and definitely safer than getting an infection. A lot of people - 25 million Americans! - have already gotten a shot, and nobody has died because of the vaccine. On the other hand, 26 million Americans have had COVID-19, and over 400,000 people have died because of those infections. Most people who get infected will be sick for days or weeks. We are also learning that ~1 in 10 people will have symptoms or signs of organ damage for months after they get COVID-19. I've had patients and friends who still can't taste or smell, or who have cough, fatigue, shortness of breath, headaches, brain fog - the list is long! Most people who get COVID-19 will survive and probably be just fine in the long run. But this virus is unpredictable, and can hurt people in many ways. I wear a mask and got the vaccine because I don't want to take chances with my family's health. I got my shot so that someday I can hug my parents and in-laws and baby niece again. I got my shot so that someday I can hold my grandparents' hands, and tell them how much I missed them in 2020. I got my shot because I love my family so much, and I never want to be the reason that they got sick. The vaccines are giving us a chance to beat this virus, so I'm not throwing away my shot!

While the fear of confirmed cases of COVID-19 continues to rise, there is fear that cases of domestic violence will also be on the rise. While residents of Oklahoma are being asked or issued to practice social distancing and remain within their homes, which is crucial in reducing the spread of COVID-19, this could also strike fear in many vulnerable individuals. Senator Amy Klobuchar and the National Coalition Against Domestic Violence spoke about these elevated risks during a public conference call this week. “Think about what we say to victims when they call and ask for help on the hotline. We say, ‘leave the house, leave the house.’ And the opposite message—for good public health reasons—is being conveyed right now,” said Senator Klobuchar. Now is the time to be mindful of potential risk factors that increase the likelihood of domestic violence occurring, how to reduce risk factors, or ultimately how to get help and know your community resources. It is well known that as emotional or life stressors increase, the likelihood of negative outcomes may increase as well, such as domestic violence related situations. Stressors such as food insecurity, lack of childcare, church and school closures, job loss, the inability to seek face-to-face care in some businesses- especially in rural areas, and lack of community interactions combined with isolation within the home for long periods of time can increase the risk to victims of domestic violence. But the most important message for anyone reading this is..YOU ARE NOT ALONE IN THIS. It is important to not let hopelessness take over during this time. There are resources within the community and people that are here to help. Now is the time to become creative and think outside of the box if you are with your family within the home. When safety planning with an individual a large focus is placed on harm reduction. So how do we cope during these times? We focus on the here and now. We focus on how to change our daily routines during these changing times. Examples of this could be taking breaks from schoolwork, serious conversations, or during a stressful moment and refocus on something else, such as spending time outside meditating, taking a walk, playing silly games with your children such as tag. Now is the time to focus on healthier ways to take care of ourselves, which can be as simple as taking a shower, having a meal, writing our feelings or thoughts. But when all else fails, there are resources and teams that are available to provide emergency relief. Domestic violence victims are used to adapting to new situations to rebuild their lives. You have not been forgotten and we are here to help.

A diagnosis of pre-diabetes can be confusing and scary but what is pre-Diabetes? A diagnosis of pre-diabetes means that your blood sugar levels are higher than what your doctor considers normal. This is usually diagnosed with an A1C reading. An A1C is a representation of a 2-3 month average of blood sugars. Normal A1C values are less than 5.7%, Pre-diabetes range is 5.7-6.4%, and diabetes is diagnosed with an A1C of 6.5% and above. There are many things that increase our risk for diagnosis of pre-diabetes including but not limited to: increasing age, being overweight or physically inactive, having a parent or sibling with diabetes, being Native American, for women being diagnosed with poly cystic ovarian syndrome (PCOS), or a dark velvety rash on the back of the neck or elbows. If you have been diagnosed with pre-diabetes there is hope! A referral from your doctor to see a Registered Dietitian Nutritionist (RDN) can help you understand your diagnosis, prevent a progression to diabetes, and help you to make small lifestyle changes to lose weight and prioritize your health. RDNs are specially trained to help you set and meet lifestyle goals to help you lead your healthiest life. The RDNs at Indian Health Care Resource Center of Tulsa look forward to meeting with you!

At First Nations, we always put Native communities first – every day and with every opportunity. But for many people outside Indian Country, thoughts about Native Americans and Native communities can be fleeting, and come to the forefront only on certain occasions. For many, those occasions happen in November when attention turns to Native American Heritage Month and Thanksgiving. Here, we offer four reasons to rethink these annual celebrations to truly make a difference for Native Americans. Celebrate year-round. In 1990, President George Bush declared the month of November as Native American Indian Heritage Month, which later became Native American Heritage Month. The month is designed to provide a platform for Native people to share their culture and traditions and for non-Native people to learn about Native American history and rights in order to improve awareness. The month builds on the initial proclamation of American Indian Week, and while a month is longer than a week, we have to ask: Why just November? At First Nations, we believe any time of the year is the appropriate time to celebrate the contributions of American Indians. Remember the roots of Thanksgiving. Another way to “rethink” at this time of year is to grasp a greater understanding of Thanksgiving. The myth of Thanksgiving suggests that Native people and pilgrims came together to celebrate the survival of the fragile Plymouth colony. In reality, there was indeed a “First Thanksgiving” in 1621, but Native people were not invited. Instead, Wampanoag soldiers showed up on their own after hearing celebratory gunshots and screams from pilgrim settlements. The Wampanoag soldiers thought the pilgrims were under attack and arrived as part of a diplomatic treaty of mutual defense between the Wampanoag nation and pilgrims. Ultimately, it wasn’t until after the formation of the United States that narratives of a harmonious celebration between pilgrims and Wampanoag were created to justify westward expansion and “manifest destiny.” Our purpose here is not to erase Thanksgiving as a celebration of gratitude and family, but to ensure people know and honor the real story of how this holiday came to be. Help reclaim Native truth. In November and all year, another way to make a difference for Native communities is to recognize the myths and misconceptions surrounding Native Americans and take active steps to gain a more accurate understanding and share that truth with others. In Changing the Narrative About Native Americans, A Guide for Allies, part of First Nations’ 2016 groundbreaking research Reclaiming Native Truth, we wrote: What most people in this country know — or think they know — about Native Americans is rooted in myths, stereotypes and half-truths. Information they have received since birth from movies, television, the media and school lessons has created a false narrative (or commonly accepted story) about historic and contemporary Native Americans and tribes. From a young age, most people in the United States have been immersed in the current dominant narrative about Native peoples. It is a largely false and deficit-based narrative, meaning it focuses on challenges and weaknesses — real, assumed or exaggerated — rather than being based on strengths and opportunities. These narratives are almost always created by non-Native people, often with the intention to oppress Native nations, peoples and cultures. By recognizing these existing narratives, people can enact strategies to shift these beliefs in everything from how stories are told and how people are portrayed, to how children are taught and how decision-makers are informed. The result: Greater social justice and increased collaboration with Native American peoples in all aspects of society. Invest in Native communities. Finally, a great way to make a difference this season is to learn about and support the amazing work that’s taking place throughout Indian Country when it comes to Native food sovereignty, language preservation, youth programs, and community building and asset building. Our grantee directory details hundreds of grassroots Native-led initiatives across the U.S. that First Nations has invested in. You can support these organizations directly, or support First Nations overall and designate your gift to our Native Youth & Culture Fund, to our COVID-19 Emergency Response efforts, or to where funding is needed most. Your support is always valued – during Native American Heritage Month, Thanksgiving, and beyond. Native Americans are still here in November and always. As the holidays and promotions pass, remember it’s always the right time to appreciate Native cultures and remember and honor the role of Native Americans in this country and in our lives. About First Nations Development Institute For 40 years, using a three-pronged strategy of educating grassroots practitioners, advocating for systemic change, and capitalizing Indian communities, First Nations has been working to restore Native American control and culturally-compatible stewardship of the assets they own – be they land, human potential, cultural heritage or natural resources – and to establish new assets for ensuring the long-term vitality of Native American communities. First Nations serves Native American communities throughout the United States. For more information, visit www.firstnations.org.

The Encyclopedia of Britannica states that the instinct and enthusiasm people share for gardening occurs all over the world and over all periods of human history with the earliest known garden plan from Egypt in 1400 BC. The encyclopedia goes on to say that the shared human desire to garden is from a “response to nature…a wish to produce growth and harmony in a creative partnership with it”. With this knowledge, it is no great shock that many people have turned to gardening in today’s time of uncertainty. I feel an internal shift as winter starts to fade into spring each year, a growing wonder in my soul. A need to dig deep into the soil that surrounds me and plant a seed to bring nourishment and joy in the coming weeks and months. Each new sign of life grows my enthusiasm to plant another so that I may watch and learn from the way it develops. Every season of gardening my knowledge heightens as each flower, bush, and vegetable brings with it new insight on how to use the land around me. In this way, we are all growing together. Harmony is found as I leave behind all other expectations and worries of today to step into the garden, where both my hands and mind are busy caring for the life around me. I open the gate and look in on the kale, radish, lettuce, onions and others, greeting them as both new and old friends. I wander to the hydrangeas and irises to see new leaf and bud has sprung overnight. Before any time has passed, the sun is setting and it is once again time for us all to rest. Each visit to the garden, I am taught something new, small kernels of detail on how to care for the world around me. As I care for the garden, it gives back the certainty that I can change and alter my surroundings in a beautiful way. A deal is made, though not spoken, that if I come and care for the earth around me, I will learn and be nourished in return. National Gardening Day is April 14th, and my hope for all of us is that we find and nourish growth and harmony through a partnership with the world around us.

We all struggle with life’s problems: relationship problems, money problems, job problems, car problems. Bottom line is we all have problems. Many of us have friends or family who do their best to help. Sometime, even a stranger has advice to help with our problem. This is especially true in today’s world of social media. Post a problem to your page or feed and see how many people tell you how to solve your problem. Or not. Because we all have problems, we are often too quick to offer our help when someone has a problem. We may be the ones commenting on the post or sending a personal message or maybe, just maybe, sitting down over a cup of coffee to talk. Whether you are receiving or giving help for a problem, one must be careful to understand that helping someone with a life problem is not the same as providing therapy. Offering assistance or advice is being a friend or a colleague, but it is not therapy. After all, you have probably taken aspirin to relieve a headache but did not begin to view yourself as a medical doctor People often minimize the value of training received by behavioral health providers because they have helped other people. Helping someone does not make you a therapist, any more than picking up cold medicine for a sick friend makes you a doctor. There is value in the training that counselors, social workers, psychologists, and psychiatrists receive, otherwise they would not receive training. Just like physicians, behavioral health providers are trained to recognize and evaluate problems. They are also trained to provide assistance that causes no harm. Behavioral health providers have expertise in this area. It is important to trust that expertise in treatment just as you would with a medical provider.

Parties. Family. Money problems. Lack of time. All of these things cause stress and anxiety during the holidays. Often times we think simply avoiding something will relieve all that stress and anxiety. Anxious about seeing family who criticize you? Just don't attend the family holiday party. After all, Aunt Bea should be there again next year. Anxious about having no money this year? Have a drink (or two or three), spend the money you have and simply avoid the bills that need to be paid. Anxious about going to a party where too many people will be there? Then just stay home and miss out on the all the fun. Anxiety is your body’s natural response to stress. It’s a feeling of fear or apprehension about what’s to come. The office holiday party, going to a family function, or being in a crowd of people you don't know may cause you to be fearful and nervous. These are feelings we don't like so we simply avoid situations that frighten us. Did you know that avoiding that situation will most likely NOT relieve your anxiety? In fact, scary situations become scarier when you avoid them. And as they become scarier, our anxiety actually increases over time. Avoidance has become our way to cope. So, now what do we do? 1. Recognize that avoidance doesn't work. 2. Recognize the cost of avoidance. (Being alone, not seeing loved ones) 3. Learn to understand, accept, and handle the feelings and situations that make you anxious. Anxiety is not just about the holidays. Many things in life cause us extreme stress and anxiety. If you find yourself constantly avoiding life situations on a regular basis or find that your avoidance is causing issues in your daily life (not leaving home or not going to the store, for example), reach out and get some help. Effectively treating anxiety often requires facing those frightening situations. The IHCRC Behavioral Health Team is here to help when anxiety and avoidance take over your life. In the meantime, during this time of holiday stress, find a friend to attend that party with you. You just might have a merry time.