In October 2018, the Billings Urban Indian Health and Wellness Center (BUIHWC) opened to provide free health care to American Indians eligible for services through the U.S. Department of Health and Human Services’ Indian Health Service. The clinic filled a gap in service after a previous Indian-focused health care clinic in Billings, Montana, closed during spring 2017.
The clinic’s vision, in part, is to increase life expectancy through accessible, culturally appropriate health and wellness services that address disparities in health outcomes between American Indians and the population as a whole. In Montana, American Indians and Alaska Natives born in 2009 have a life expectancy of 69.2 years compared with 79.1 years for whites.1
About 6,400 American Indians live in Billings, 6 percent of the total population, according to data from the American Community Survey. The clinic also connects with residents of the Crow Reservation, just southeast of Billings, where about 6,000 American Indians live. For example, the clinic has a bus driver who transports clients and pharmaceuticals to and from the Crow Reservation.
“The Health and Wellness Center is a welcome addition to the community,” said Leonard Smith, interim executive director of the clinic and executive director of Native American Development Corporation (NADC). “We are looking forward to not only filling gaps left by the old clinic’s departure, but to advance a vision of what health might look like in the future.”
The health clinic was NADC’s first foray into heath care. As a Native American community development financial institution,2 NADC plays a significant role in American Indian community development in Montana and several surrounding states, including financing and providing technical assistance to Native-owned businesses, and collaborating with tribal governments and other organizations on economic development projects and initiatives. NADC renovated the second floor of an empty building in downtown Billings’s “hospital corridor” and plans to renovate another floor for the clinic’s expansion.
Funds for operations come from the Indian Health Service, which is supplemented by funding from the Montana Health Care Foundation and other sources. BUIHWC is seeking a designation as a Federally Qualified Health Care Center, which will enable it to receive Medicare and Medicaid reimbursement.
In terms of services, the clinic provides primary medical care along with behavioral health, which includes substance abuse and mental health treatment. Smith noted that the clinic plans to expand mental health services and offer a physical therapy program, a pharmacy, and dentistry. “Our vision is aimed not only at treatment but also at prevention, including health education classes, suicide prevention programs, and youth programs.”
Developing partnerships is a key strategy for providing services. “The clinic is already partnering with other health and human service providers in Billings and is actively engaging in cross-referrals,” Smith said. For example, the clinic may do an initial patient intake screening and then send the patient out for lab work, X-rays, or major surgery. The clinic is also seeking to coordinate care with the two major hospitals in Billings.
Almost all the staff at the clinic are American Indian and the clinic has been a sought-after employer for individuals wishing to move to Billings. Smith hopes to see the clinic become an important source of jobs for American Indians; the clinic plans to hire another 10 to 12 people in the near future.