Osage Strong: Kirk Shaw on how WahZhaZhe Health Center works to transform access and wellness

Indigenous Peoples Day is not only an opportunity to celebrate the rich cultures and histories of Native American communities, but also to reflect on the crucial issues affecting their well-being.

Health disparities remain a significant challenge among tribal populations, where access to healthcare, culturally sensitive services and adequate funding are often lacking.¹ Native Americans experience higher rates of disease than the national average, thereby creating a compounding crisis where limited access to healthcare and high rates of disease exacerbate poor health outcomes, further entrenching disparities and preventing many Native communities from receiving the timely and comprehensive care they need.

For healthcare leaders like Kirk Shaw, chief operating officer at WahZhaZhe Health Center (WZZHC) in the Osage Nation Health System, addressing these issues is essential to ensuring these communities can thrive. Shaw’s work in expanding healthcare services for the Osage Nation highlights the ongoing efforts to overcome systemic barriers, improve health outcomes and integrate cultural practices into modern medical care.

Addressing underfunding and expanding resources

One of Shaw's primary challenges lies in the chronic underfunding of the Indian Health Service (IHS).However, in the past fiscal year, Shaw had the opportunity to serve on the IHS Tribal Budget Formulation team for the Oklahoma City area, and reports progress on these key challenges, including the federal approval of advanced appropriations for IHS and a shift toward mandatory funding  beginning in FY2026, ensuring consistent, uninterrupted funding moving forward.

To further address funding limitations, Shaw emphasizes the need to maximize third-party revenue, treating tribal facilities like private healthcare providers. “The funding received through our Compact/Multi Year Funding Agreement (MYFA) with IHS only spreads so far,” he explains, “and in order to provide unique and above-and-beyond services, we must collect as much revenue as we can to pay for those services.”

Transportation challenges for patients “spread far and wide” across Osage County — an area roughly the size of Rhode Island — are significant, Shaw says, noting that the health center’s mobile medical unit makes weekly, routine stops for acute clinics in Fairfax, Hominy and Skiatook, Oklahoma. WZZHC also has community health representatives (CHRs) who handle most of the patient transportation for those who qualify in the center’s service area.

Elder care is another focus, with the Elder Services Pathway grant addressing the same need as the CHRs but for their older patients.

Much of Shaw’s work involves advocating for consistent funding. “In delivering services to our community, stable and guaranteed funding is imperative in taking care of our Native American families,” he says.

Chronic conditions among Native Americans, and addressing mental healthcare

To combat the high prevalence of chronic conditions such as diabetes and heart disease in Native American communities, WZZHC launched the “Osage Strong” program.

“It is a holistic approach that will include consultations with a dietitian, fitness specialist, behavioral health (if needed) as well as with their primary care provider,” Shaw explains. “This clinic is in partnership with our diabetes and behavioral health programs, and the Osage Nation’s fitness center.”

To address growing needs for mental healthcare, WZZHC recently opened a $20 million, five-building Substance Abuse and Primary Residential Treatment (PRT) facility. Onsite, “there will be an outpatient counseling center, adult PRT with 12 beds each, adolescent facility with 16 beds (eight for boys, eight for girls), and a Transitional Living Facility,” Shaw explains.

The facilities welcome all Native Americans, not just Osage members, with a strong focus on cultural integration by “doing Osage craft classes, sweat lodge every week and taking them to our cultural events in and around Osage County,” Shaw explains.

Expanding the patient base and planning for the future

At the WZZHC, improving patient care starts with addressing accessibility and wait times. Kirk Shaw emphasizes the importance of ensuring timely access to healthcare services: “At the forefront, we recognize that we must improve upon the services we provide inside our four walls,” he says. “We have increased the number of providers to address patients feeling like they have to wait weeks at a time in order to be seen.”

 Staffing, like in the broader U.S. healthcare industry, is another significant area of concern. “Our patient registration supervisor has played an important role in ensuring that all patients have all of the necessary resources and the outlet to voice their opinions when needed,” he explains. “She and her staff serve as a quasi-patient advocate team.” These efforts have paid off, with WZZHC adding about 780 new patient charts in the last fiscal year, not including reactivated charts.

Despite these successes, Shaw explains that “retaining high-performing employees has proven to be difficult and ultimately is negative for patient experience and outcomes.” He suggests that federally funded programs to boost employee morale and retention to address the center’s constant turnover would be a good start.

Strengthening cultural integration and tribal sovereignty in healthcare

Beyond expanding services, integrating cultural practices into healthcare remains a priority. “We attempt to incorporate our culture into the health system as much as possible whether it be our language throughout the new clinic, supporting our cultural events with our mobile medical units or hosting cultural craft nights through our counseling center,” Shaw says. This cultural integration, he believes, is essential to the center’s identity. “I understand that we would not be here without our tribe and our culture, which guides what we do.”

Tribal sovereignty plays a crucial role in the autonomy of WZZHC. Shaw explains, “Our sovereignty and treaties are what allow us to compact our healthcare services away from the federal government and run our health system.”

Shaw continues, “It is important for tribes to consider compacting their services, as you are able to provide services above and beyond what the federal government can provide.”

What’s next for Osage Nation healthcare

With his recent promotion to Chief Operating Officer, Shaw’s focus remains on expanding services for the increasing patient base at WZZHC. The center received a $3.5 million small ambulatory program (SAP) grant through IHS to construct a satellite clinic in Skiatook, which sits on the southern edge of the county closest to Tulsa. “Tulsa County has a large Native American presence, and urban areas generally have a higher level of insured patients, so we are hoping to capture that demographic,” he says.

Shaw also shares progress for Osage Nation’s new 60,000 square foot clinic, expected to be completed by early summer of 2025, offering expanded services, including the addition of physical therapy, which will greatly benefit patients. The clinic is also focusing on expanding community outreach programs, such as diabetes, public health, community health representatives, and elder services to meet the needs of a large rural service area. 

“We’re trying to reach patients where they are,” Shaw explains, noting that the clinic’s Mobile Medical Unit makes weekly stops in three heavily populated towns for walk-in acute appointments, staffed by an APRN and LPN every day.

Shaw also has long-term plans for further expansion: “The mid- to long-term plan is to go past clinical operations to a hospital – we are not sure how that looks at the moment, but we are looking at different avenues to address this.”

Indigenous healthcare: reflecting on progress and looking ahead

On this Indigenous Peoples Day, Shaw reflects on the future of tribal healthcare. “My hope is that tribal healthcare continues to grow, and tribes recognize that running their own health system is attainable,” he says. He adds that balancing culturally sensitive care with the economic realities of the healthcare system will be key to success: “The name of the game is to bill and collect as much as possible so that you can put that back into your health system to purchase more services.”

Kirk Shaw’s leadership at WZZHC highlights the importance of culturally sensitive, comprehensive care for Native American communities. As the health center continues to expand and innovate, Shaw’s commitment to improving healthcare access and outcomes for the Osage Nation sets an example for tribal healthcare systems across the country.

Notes

1. Indian Health Service. “Indian Health Disparities.” Indian Health Service Fact Sheets, U.S. Department of Health and Human Services, 2019. Available from: https://bit.ly/4dNHgwB .