Native American community advocate meets people where they are


Sanford Health works to address health disparities for Minnesota’s Native American population, and people like Rebekah Fineday are helping to make that happen.

Fineday is an enrolled member of the Leech Lake Ojibwe Band and is the Native American Community Advocate for Sanford Health in Bemidji, Minnesota. In this role, Fineday helps Sanford continue to develop and provide culturally appropriate services to Native American patients.

Sanford’s Native American community advocacy effort also includes Tabitha Chilton, a White Earth Nation citizen who works on behalf of cancer patients at the Sanford Joe Lueken Cancer Center in Bemidji.

Improving access to health care: Native American Community Outreach at Sanford Health

“Sanford has made this a documented priority to improve the delivery of meaningful services to the Native American population,” Fineday said. “I’m happy to be able to go out into our communities and share the things that Sanford does.”

Fineday seeks community resources for Native Americans in Bemidji and within the White Earth Nation, Red Lake Nation and his own Leech Lake Band of Ojibwe.

Navigating Health Care Systems

Navigating the different health systems in the Bemidji region can be difficult, Fineday said. Indian Health Services are government-run entities located on reservations and were established through treaties between the U.S. government and the tribes. There are also health care facilities owned and run by the tribes themselves.

“I meet with tribal leaders on all three reservations and let them know about Sanford’s role in the area,” Fineday said. “I try to build on those relationships and in some cases try to mend some of those relationships by letting people know the kinds of things that Sanford can help with. Because I’m a Native American, I can sometimes open a few more doors and present more opportunities on reserves and in the communities themselves.

Fineday, who took up her post at Sanford in May, is an Air Force veteran who became a registered nurse and has since held several positions with the Cass Lake and Red Lake Indian Health Services.

His roles in the military and health care have always been about leadership. She will often assist in the facilities she visits by working in a case management role or in a patient advocate role, while using her nursing background to provide her expertise. In this capacity, she gets an up-close view of the contributions made by her colleagues to the overall delivery of healthcare.

“The case management team is absolutely phenomenal here at Bemidji in what they can accomplish,” Fineday said. “They do so much in so little time. They work tirelessly and go above and beyond for all of our patients.

Make everyone feel welcome

Sanford Health’s commitment to the Native American population was recently strengthened when its efforts in substance abuse disorder treatment services were certified in a program called Wellbriety. As such, Sanford was added as 12e program in the country to receive endorsement from an organization that promotes a cultural approach to tackling substance abuse.

Mindie Bird, a licensed addiction counselor in Sanford, northern Minnesota, was instrumental in getting Wellbriety certified. Bird is a member of the Black Feet Nation located in Montana but has spent most of his life in Bemidji. Like Fineday, her Native American background, coupled with her education, has made her a valuable asset as Sanford continues to make inroads in providing quality care in the Bemidji area.

“Wellbriety is a program for natives in recovery, by natives in recovery,” Bird said. “It’s a community approach to recovery, much like AA, but it’s specific to Native Americans. This is a big deal for Sanford because we are one of the very first agencies to pursue care in behavioral health programs about what Native American recovery might look like.

Obtaining certification is an achievement that positively reflects the efforts of Bird and his colleagues to complete the process. The benefits of this recognition can be felt throughout the region.

“It speaks volumes not only for Mindie Bird with all the effort and knowledge she has put into this, but also for Sanford who supports her and her culturally appropriate programs,” Fineday said. “Sanford supported her and her department in achieving accreditation because they realize how important it is to have culturally appropriate programs for patients.”

Provide culturally appropriate care

What does it mean to provide culturally appropriate health care? Fineday gave an example:

“One of the biggest things Sanford has achieved so far is the ability to meet some of our cultural and spiritual needs with what we call ‘purification,'” Fineday said. “Smudging is burning certain herbs. It is not an open flame but is burned and smoke is the end result. The goal is to keep the flame alight as you smudge and cover yourself head-to-toe in smoke.

With the guidance of Native American spiritual leaders and the will of Sanford, they found ways to overcome some of the obstacles that would prevent them from providing this spiritual opportunity.

“For a long time, facilities weren’t allowed to do that,” Fineday said. “Now they have taken the proper fire safety precautions while considering the patient’s environment.”

Sanford now offers smudging kits that include all the proper items needed for smudging with fire precautions in mind. Considering patient rights and hospital rules, smudge kits include the use of a High Efficiency Particulate Filter (HEPA), smoke detector cones that prevent alarms from going off during ceremonies and instructions to clinical staff for safe operation in the presence of oxygen-supplied devices.

Train health care providers

Educating and training vendors on Native American culture is an important part of the effort, Fineday said. To that end, Sanford has established committees that explore ways to eliminate inequities.

“We ask ourselves: what are the things that we can look at to be more culturally sensitive, to be more culturally aware and to make patients aware that we are really there to help them? said Fineday. “It may not be specific to healthcare, but it is specific to their healing process.”

Related: Sanford Health supports and celebrates Native American cultures

In his role with Sanford, Fineday tapped into a philosophy of his 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 traveled a lot on the reserve to visit people,” she said. “That’s what I took with me all these years. We have to go to the people. It shouldn’t be an email saying, “Hey, come to my conference room and meet me.” It should be ‘Hey, I want to meet you and talk to you’. Where would you like to meet?'”

Developing familiarity and a level of comfort has become a very important part of the job. The process has become smoother, Fineday said, thanks to the fiery dedication of his predecessors.

“I would like to acknowledge and thank the former Native American patient advocates Sanford has hired over the years, including Joseph Beaudreau (currently Peer Recovery Specialist for Sanford Behavioral Health),” she said. “Although my current role is a little different from previous patient advocate roles, these people helped pave the way for the establishment of my current role. They laid the foundation and relationship between the community and Sanford, and started some of the events that Sanford still hosts today. I am grateful to Sanford for playing these roles over the years in helping Native American patients, and I recognize the continued need and importance of these roles.

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Posted in Bemidji, Community, Here for all. Here for Good., Inclusion at Sanford, People & Culture

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