Muscogee (Creek) Nation 2017 Economic Impact & Legislative Luncheon

1. Muscogee (Creek) Nation 2017 Economic Impact & Legislative Luncheon

2. MCN at a Glance 4th largest Federally Recognized Tribe in the United States with more than 87,000 citizens.  75% reside within Oklahoma Headquartered in Okmulgee Jurisdiction covers 11 counties in east central Oklahoma A permanent and committed partner and economic driver in Oklahoma. Provides critical services such as health care and housing to citizens through tribal government operations. Operates diverse entities that benefit all Oklahomans Cultural tourism, hospitality and gaming, other diversified businesses and educational institutions.

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4. Committed Partners MCN is a significant contributor to the regional and state economy. Using 2017 audited numbers, MCN commissioned an economic impact report through an independent economist.  The results from the report include:  $866 million is the impact on Oklahoma in 2017. Nationwide, that number grows to $1.4 billion. An estimated 8,700 jobs statewide can be attributed to the MCN and its activities. More than $12 million was directly contributed in state and local support. .

5. Department of Health

6. Department of Health MCN Department of Health is responsible for providing inpatient, outpatient and referred care to all Native Americans that reside inside the Creek Nation boundaries. The Department of Health provides 176,815 annual visits through six outpatient clinics, two community hospitals, one physical rehabilitation service and one skilled nursing inpatient facility. The Department of Health generates $207,600,819 in Gross Revenue each year of which $4,330,204 is Non-Native Self Pay and $42,822,320 is Native Private Pay. The Department of Health has over 42,000 registered patients that are served by the department’s 10 facilities and 900+ FTE’s.

7. Health Programs • In addition to the hospitals and primary care facilities, MCNH operates many other services, grants and programs such as: • Behavioral Health • Special Diabetes Programs • Contract Health • Public Health Nursing • Community Health Representatives • SANE Program

8. Medical Center The Medical Center is a 66-bed acute care hospital located in Okmulgee and includes a 16-bed geriatric psychiatry unit and extensive diagnostic services. The facility has more than 14,000 emergency visits, 1,300 outpatient surgeries and more than 700 admissions each year. Over 50% of the OP visits and 35% of the admissions are Native American patients. .

9. Creek Nation Community Hospital Creek Nation Community Hospital is a 25-bed Critical Access Hospital located in Okemah. The hospital was replaced with a new $55,000,000 facility. The facility serves both Native and Non-native patients and has more than 10,000 emergency visits, and nearly 200 admissions each year. More than 80% of the ER visits and 74% of the admissions are Native American patients.

10. Physical Rehabilitation Center • The PRC houses a 4-bed LTAC, 8-bed SNF and extensive outpatient services including an aquatic program. • The Department has filed with the State of Oklahoma to expand the LTAC to 16 beds. • The facility has over 20,000 outpatient visits, and more than 200 admissions each year. • Over 65% of the outpatient visits and 36% of the admissions are Native American patients.

11. Koweta Clinic The Koweta Indian Health Center is an 80,000 square foot facility located in Coweta. The facility houses 10 providers and has more than 32,000 patient visits per year. The facility provides primary care, behavioral health, diabetes care, podiatry, pharmacy, radiology and laboratory services.

12. Eufaula Clinic The Eufaula Indian Health Center is a new 80,000 square foot facility located in Eufaula. The facility houses 9 providers and has nearly 14,000 patient visits per year. The facility provides primary care, pediatric care, behavioral health, diabetes care, podiatry, pharmacy, radiology, laboratory and audiology services.

13. Okemah Clinic • The Okemah Indian Health Center is a new 60,000 square foot facility located in Okemah. • The facility houses 6 providers and has more than 17,000 patient visits per year. • The facility provides primary care, behavioral health, diabetes care, pharmacy, radiology and laboratory services.

14. Okmulgee Clinic • The Okmulgee Indian Health Center is a 50,000 square foot facility located in Okmulgee. • The facility houses 11 providers and has more than 34,000 patient visits per year. • The facility provides primary care, pediatric care, behavioral health, diabetes care, urgent care pharmacy, radiology and laboratory services.

15. Sapulpa Clinic • The Sapulpa Indian Health Center is a 40,000 square foot facility located in Sapulpa. • The facility houses 7 providers and has more than 21,000 patient visits per year. • The facility provides primary care, pediatric care, behavioral health, diabetes care, pharmacy, radiology and laboratory services.

16. Wetumka Clinic • The Wetumka Indian Health Center is a 10,000 square foot facility located in Wetumka. • The facility houses a nurse practitioner, behavioral health, diabetes care, pharmacy and radiology services.

17. Contract Health • Contract Health covers services not provide in our facilities and is provided by physicians and hospitals outside of the Department of Health. • Contract Health provides more than $13,000,000 of care annually. $7,000,000 of this care is funded by gaming revenue and $6,000,000 is provided by the Indian Health Service. • Contract Health drives more than $39,000,000 of care of which 75% is provided in Tulsa and 25% is provided in Oklahoma City markets. • Referrals for elective inpatient or outpatient care are typically driven by a clinic physician order and arranged by a Contract Health staff member. • Referrals are driven by referring physician preference or contract arrangements depending on the tribe.

18. Contract Health - Payment • Hospital and physician services are usually paid at Medicare like rates by Contract Health. • Patients treated by the hospital or provider should be registered as a self pay patient unless Contract Health has issued a purchase order. • Always ensure that no other means of payment is available as Contract Health by law is considered the payor of last resort. • Billing for services rendered is completed when the bill is dropped including PO number and provided to the Contract Health department of the referring facility or tribe.

19. Department of Education & Training

20. Education The MCN Department of Education & Training provides oversight of comprehensive programs that deliver quality educational opportunities for MCN citizens from early childhood through college.  More than $12 million in state and local education support. $8.4 million in higher education scholarships

21. Department of Interior Affairs:  Transportation and Infrastructure

24. Contributor to State & Local Economy • MCN is a significant contributor to the regional and state economy. • MCN contracts with local businesses. (For example - McGuire Brothers, Ellsworth Construction, APAC, B&S Construction and Glover Construction) • In the past 5 years, $35 million have been invested in Oklahoma transportation projects.

26. Current Projects Under Construction

27. New Projects for FY2020 • Duck Creek Casino Smoke Shop Parking & Drive • Little Coweta Road • Lamar Road • Teel Road • Duck Creek Casino Road

28. Concharty Bridge “We were fortunate to donate this project for the benefit of the community and members of Concharty United Methodist Church” – Principal Chief James R. Floyd

29. For more information visit: www.mcnimpact.com Questions?