Sanford Health is working to address health disparities for the Native American population in Minnesota, and people like Rebekah Fineday are helping make that happen.
Fineday is an enrolled member of the Leech Lake Band of Ojibwe and serves as Sanford Health’s Native American community advocate in Bemidji, Minnesota. In that role, Fineday is helping Sanford continue to develop and deliver culturally appropriate services to Native American patients.
The Sanford Native American community advocacy effort also includes Tabitha Chilton, a citizen of the White Earth Nation who works on behalf of cancer patients at the Sanford Joe Lueken Cancer Center in Bemidji.
“Sanford has made it a documented priority to improve meaningful delivery of services for the Native American population,” Fineday said. “I’m happy to be able to go out to our communities and share the things that Sanford is doing.”
Fineday seeks out community resources for Native Americans in Bemidji and within the White Earth Nation, Red Lake Nation and her own Leech Lake Band of Ojibwe.
Navigating health care systems
Navigating the different health systems in the Bemidji area can be challenging, Fineday said. Indian Health Services are government-run entities located on reservations and have been established as part of treaties between the U.S. government and the tribes. There are also health care facilities owned and operated by the tribes themselves.
“I meet with tribal leadership throughout the three reservations and let them know the role Sanford has in the area,” Fineday said. “I try to build on these relationships and in some cases try to repair some of these relationships by letting people know the kinds of things that Sanford can help with. Because I’m a Native American sometimes I can open a few more doors and present more opportunities on the reservations and in the communities themselves.”
Fineday, who took her position at Sanford in May, is an Air Force veteran who went on to become a registered nurse and has since served in multiple capacities for both Cass Lake and Red Lake Indian Health Services.
Her roles within the military and health care have always gravitated toward leadership. She will often help at the facilities she visits by working in a case management role or in a patient advocate role, all the while utilizing her background in nursing to provide expertise. In those capacities she gets a close-up view of the contributions being made by colleagues to the overall delivery of health care.
“The case management team is absolutely phenomenal here in Bemidji in what they can accomplish,” Fineday said. “They do so much in such a short time. They work tirelessly and go above and beyond for all our patients.”
Making all feel welcome
Sanford Health’s commitment to the Native American population got a boost recently when its efforts in substance abuse disorder services became certified in a program called Wellbriety. As such, Sanford was added as the 12th program in the nation to receive approval from an organization that promotes a culturally-based approach to dealing with substance abuse.
Mindie Bird, a licensed addiction counselor at Sanford of Northern Minnesota, served a vital role in bringing about the certification from Wellbriety. Bird is a member of Black Feet Nation located in Montana but has spent most of her life in Bemidji. Like Fineday, her Native American background, coupled with her training, has made her a valuable asset as Sanford continues to make inroads in providing quality care in the Bemidji area.
“Wellbriety is a program that is for Natives in recovery, by Natives in recovery,” Bird said. “It’s a community approach to recovery, much like AA, but it’s Native American-specific. It’s a big deal for Sanford because we are one of the very first agencies to pursue care within behavioral health programs on what Native American recovery could look like.”
Earning the certification is a success story that reflects positively on Bird and her colleagues’ efforts to complete the process. The benefits of that recognition may be felt throughout the region.
“It says a lot not only for Mindie Bird with all her efforts and knowledge that she poured into this but also for Sanford supporting her and her culturally appropriate programs,” Fineday said. “Sanford has been supportive of her and her department in getting the accreditation because they realize how important it is to have culturally geared appropriate programming for patients.”
Delivering culturally appropriate care
What does it mean to deliver culturally appropriate health care? Fineday offered an example:
“One of the biggest things Sanford has delivered on so far is the ability to address some of our cultural and spiritual needs with what we call ‘smudging,’” Fineday said. “Smudging entails burning certain herbs. It’s not an open flame but it is burned and the smoke is the end result of that. The point is to keep the flame going while you smudge and cover yourself with the smoke from head to toe.”
With counsel from Native American spiritual leaders and Sanford’s willingness, they have found ways to get past some of the obstacles that would stand in the way of providing this spiritual opportunity.
“For a long time, facilities were not allowed to do it,” Fineday said. “Now they’ve taken the proper fire safety precautions while also taking into consideration patient surroundings.”
Sanford now offers smudge kits that include all the appropriate items needed for smudging with fire precautions in mind. With considerations for patients’ rights and hospital rules, smudge kits include use of a high efficiency particulate air (HEPA) filter, smoke detector cones that prevent alarms from going off during ceremonies and instructions to clinical staff for safe operation in the presence of oxygen delivery devices.
Training health care providers
Educating and training providers on Native American culture is an important piece of the effort, Fineday said. To that end, Sanford has created committees that explore ways of eliminating inequities.
“We ask ourselves: What are some things we can look at to be more culturally sensitive, to be more culturally aware and make the patients aware that we really are here to help?” Fineday said. “It might not be health-care specific but it’s specific to their healing process.”
In her role with Sanford, Fineday has tapped into a philosophy held by her father, who was a pastor at the Leech Lake Reservation. You have to take your message to the people, he told her. Meet them where they are.
“We did a lot of traveling around the reservation visiting with people,” she said. “That’s what I’ve taken with me all these years. We have to go to the people. It shouldn’t be an email that says, ‘Hey, come to my conference room and meet with me.’ It has to be ‘Hey, I want to meet with you and speak with you. Where would you like to meet?’”
Developing familiarity and a comfort level has become a very important part of the job. It has become a smoother process, Fineday said, thanks to the spirited dedication of her predecessors.
“I’d like to recognize and thank the previous Native American patient advocates that Sanford has hired over the years, including Joseph Beaudreau (currently a peer recovery specialist for Sanford Behavioral Health),” she said. “Although my current role is a little different than the previous patient advocate roles, those people helped to pave the way for my current role to be established. They laid the groundwork and relationships between the community and Sanford, and initiated some of the events that Sanford still does today. I’m grateful Sanford has had these roles throughout the years to assist Native American patients, and recognizes the continued need, and importance for such roles.”
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