# Presentation: 124466

## Presented at the Indian Health Service
General Staff Meeting
By 
RADM Gary J. Hartz, P.E.
Director, Office of Environmental
Health and Engineering
November 3, 2005

**General Staff Meeting**
**By **
**RADM Gary J. Hartz, P.E.**
**Director, Office of Environmental**
**Health and Engineering**
**November 3, 2005**

- 50 Years in Indian HealthOffice of Environmental Health and Engineering

## FIFTY YEARS Environmental Health and Engineering:Prevention, Environmental Health, Safety and Support of Clinical Healthcare Delivery

- Environmental Health
- Injury Prevention
- Construction
- Sanitation Facilities
- Health Care Facilities
- Maintenance and Improvement
- Facilities Operations
- Equipment and Clinical Engineering
- Facilities Management
- Realty

## The Way it Was

- Facility Waiting Area

- 20th Century Equipment

- Community Sanitation

**Notes:**
Facility Waiting Area. Sign reads “Clinic Hours 1st and 3rd Wednesday of Each Month 9AM to Noon”

## Supporting Indian Health from the beginning

- Pest Control

- Sanitation

- Fort Defiance – Old BIA Facility

**Notes:**
Oldest Building where IHS provides Health Care:  Part of the Naytahwaush Clinic in Minnesota is 105 years old.  The interior has been modernized and upgraded.  
Riverhaven (Ft. Yuma) California is the oldest building (146 Years) where we have people working—The old building is being used for office space.

## Transition and Development

- PIMC -1970s

- Sharing Plans

- Calibrating Equipment

- Sells 1961

- Public Health

- Water to the Home

## Getting Water: How much it has changed.

## Progress in Sanitation

- In 1959, Potable water in 20% of AI/AN Homes
- Currently 88% have potable water
- compared to 99% of the general US population
- Goal: 94% by 2010
- OEHE Part of IHS Strategic Plan to achieve parity in access

**Notes:**
SFC defines homes with potable water as any home that has access to running water in the home, whether through a community water system or an indivdual cistern.

##  Gastroenteric and Postneonatal Mortality Rates 

**0 **

**5 **

**10 **

**15 **

**20 **

**25 **

**20 **

**30 **

**40 **

**50 **

**60 **

**70 **

**80 **

**90 **

** **

**1967**

** **

** **

**1970**

** **

** **

** **

** **

**1975**

** **

** **

** **

** **

**1980**

** **

** **

** **

** **

**1985**

** **

** **

** **

** **

**1990**

**2000**

**Calendar Year**

- % Homes with Sanitation Facilities

- Gastroenteric Mortality

-  Rate Per 100,000 Population

-            (Age-Adjusted)

- Postneonatal Mortality Rate
- Per 1000 Live Births

** ****Gastroenteric and Postneonatal Mortality Rates **
**Compared with Percent of Homes with Sanitation **
**Facilities for American Indians and Alaskan Natives**

## Progress in Providing Access

- Pinon Health Center opened October 3, 2005

- Then

- And Now

**Notes:**
Old building is a modular unit that has been in use for several years.

## Section 301 Priority System
Winnebago, Nebraska, Hospital
Pawnee, Oklahoma, Health Center
Pinon, Arizona, Health Center
Red Mesa, Arizona, Health Center
Sisseton, South Dakota, Health Center
Clinton, Oklahoma, Health Center

**Winnebago, Nebraska, Hospital**
**Pawnee, Oklahoma, Health Center**
**Pinon, Arizona, Health Center**
**Red Mesa, Arizona, Health Center**
**Sisseton, South Dakota, Health Center**
**Clinton, Oklahoma, Health Center**

**Joint Venture**
**San Simon, AZ, Health Center**
**Dulce, New Mexico, Health Center**
**Idabel, Oklahoma, Health Center**
**Lake County, California, Health Center**
**Coweta, Oklahoma, Health Center**
**Cherokee, Oklahoma, Health Center**

- 21st Century Health Care Facilities

## 21st Century Health Care Facilities

**Ho-Chunk Health Care Center, WI**
**Pueblo of Jemez Health and Dental Clinic, NM**
**Yreka Clinic (Karuk Tribe), CA**
**Mariposa Indian Health Clinic, CA**
**Stigler Satellite Clinic, OK**
**Bois Forte Health Clinic, MN**
**Pechanga Health Clinic, CA****	**
**Las Vegas Paiute Colony Health Care, NV**
**Roger Saux Health Center, WA**
**Toksook Bay Sub-Regional Clinic, AK**
**Reno-Sparks Indian Colony Clinic, NV**

**White Swan Health Clinic (Yakama Nation), WA**
**Chenega Bay Health Clinic, AK**
**Narragansett Indian Health Center, RI**
**Chippewa Cree Health Center, MT**
**Purcell Clinic, OK**
**Tribal Clinic, OR**
**Santa Ysabel Health Care Facility, CA**
**Inchelium Health Care Facility, WA**
**Campo Clinic, CA**

- 21st Century Health Care Facilities

## Operate and Maintain IHS and Tribal Facilities

**48 Hospitals**
**44 Government Owned**
**4 Tribally Owned**
**244 Health Centers (Including school health centers)**
**62 Government Owned**
**182 Tribally Owned**
**167 Health Stations**
**50 Government Owned**
**117 Tribally Owned**
**180 Village Built Clinics in Alaska**

**Data on this table are current to October 1, 2003**

## Swinomish Dental Clinic LaConner, Washington

## Clinical Engineering and New Technologies

**Notes:**
Showed this picture of the ear to Dr. O., who thought t first it might have been a picture from a colonoscopy but then indicated it was probably an ear.

## Progress in Environmental Health

**Notes:**
Top left, Clockwise: Pest Control spraying, medical x-ray survey, Mosquito trapping, Rabies Clinic, Seat belt safety, Hanta Virus Survey, testing for contamination and remediation prior to closing down BIA maintenance yard, Seminole Reservation, Florida, 

## Sleep Safe Fire Safety Project

- Fond du Lac
- Head Start Center
- Bemidji Area, October 2003

## Equipment

**Sells 1961**

- Facility Operations

- Facilities

- Water to the Home

- Environmental Health and Safety

**Notes:**
Trailer and truck is labeled in IHS “Environmental Health Trailer”  First line on side of Truck is “Here is the Story”

## Facilities

- Equipment

- Environmental Health and Safety

- Water to the Home

- Facility Operations

- Winnebago

- Close