The Tunica-Biloxi Tribe’s Rural Clinic Safeguards Louisiana Health

Today, a clinic founded by the Tunica-Biloxi Tribe of Louisiana 's Health Department serves 1,700 tribal members and more than 250 non-tribal patients. Wraparound services connect patients to nutrition assistance, case management, behavioral health services, and medical referrals, among other support.

Cameron Chase, the Tribe's health director, described an ambitious plan that tribal leaders worked painstakingly to bring to life over time.

"The Tunica-Biloxi Rural Health Clinic was modeled after a wraparound care model where needs were identified while services are administered," he explained to Direct Relief. "Warm handoffs and coordinated care teams were carefully developed between many staff and departments over more than a decade to get the policies, infrastructure, and staff in place to be able to administer this care."

At first, health services on the reservation focused on a Special Diabetes for Indians program that allowed a part-time nurse to provide community care and outreach to tribal patients with diabetes.

But by November of 2020, in the midst of the Covid-19 pandemic, the tribe had a fully-fledged clinic that offered ambulatory care, behavioral health services, elder-specific care, and telehealth.

Clinic director Doug Phillips described the process of developing an ambulatory clinic from the ground up with Chase: outfitting exam rooms, setting up electronic medical records, securing credentials, connecting to community partners.

"I've always walked into something that was already put together," he said. "What we were doing was building the clinic from the ground up."

From the Beginning

The clinic staff immediately noted extraordinarily high mental health needs - just at the time when the Covid-19 pandemic drew attention to widespread shortages in mental healthcare across the U.S.

"Covid really unearthed a lot of problems that not only tribal communities were dealing with, but nationally people were really able to recognize, 'Hey, there was a problem here,'" Phillips recalled.

And from the beginning, Chase noted, kidney disease care, suicide prevention, and treatment for non-communicable diseases like diabetes and hypertension were an urgent priority.

While these health issues are widespread, they are compounded in Native American communities, which have historically struggled to access health care and experience disproportionately high levels of poverty, food and housing insecurity, intergenerational trauma, and other systemic barriers to health.

Chase explained that this lack of access has had profound consequences for both mental health issues like depression, anxiety, and substance use disorders, and physical health conditions like diabetes, obesity, and chronic kidney diseases.

These "play a tremendous role in reducing quality of life and life expectancy," he said. "In turn, these issues burden and steal the life of [tribal] citizens and families."

No "Break in the Hand Clasp"

At the clinic, building better health outcomes means understanding each patient's needs, beyond the immediate reason they're there. If a patient comes in for a sick visit, but needs support with accessing insurance, employment, clothes, or even diapers, the clinic staff figure out what programs patients can access, and help them navigate the process. If a patient is referred out to other facilities, staff provide a warm handoff and follow up after.

Internally, this includes both care coordination and referrals between departments, such as Social Services, Housing, Tribal Court, Culture, Education, and the Police Department.

"I like to not have any break in the hand clasp," is how Phillips puts it.

These measures don't just help that patient and their family, according to Chase. Greater awareness benefits the larger community and helps bring issues to light that other patients may be confronting.

"Our citizens and their families are all connected," he said. "When one part of the community is hurting, all of the community can feel that pain. So we address it together… Even when no solution is there, the community awareness of an issue grows."

That focus on increasing the entire tribe's health has been key to the clinic's success, said health and human services manager Ashley Kinman.

"You're ultimately battling for your tribal organization, so you've got a scope, and it's achievable," she said. "I have seen over the last three years the faith and the trust" that the clinic has gained.

That trust, Kinman and Phillips said, was earned.

"The community is small," Phillips explained, and many tribal members are wary of services provided by non-members. (Chase, Phillips, and Kinman work for the Tunica-Biloxi Tribe but are not tribal members.) Privacy was a serious concern.

Staff assured tribal members that their privacy was protected by law, that clinicians would care for them ethically and be liable for missteps. But it was being able to care for patients - and put those promises into action - that made the biggest difference, Phillips noted.

"Words are one thing, actions are another," he said.

New Goals, Growing Partnership

What began as a mission focused on tribal members is now open to the larger public.

Foster children in the area have begun receiving their pediatric checkups there - "That's a huge need in the state," Phillips said - and clinicians evaluate kids for mental health concerns like anxiety and ADHD, treat respiratory infections, and draw labs for walk-in patients.

The clinic has even opened a second clinic facility, off the reservation.

Direct Relief has partnered with the Tunica-Biloxi Tribe of Louisiana since 2024, supporting the Rural Health Clinic with a grant of $157,000 to install a resilient solar power system at the reservation facility that's designed to protect healthcare access even in the event of a hurricane. The clinic also received a $300,000 award from Direct Relief's Innovation Awards in Community Health: Addressing Infectious Disease in Underserved Communities, supported by Pfizer, which clinicians are using to reduce transmission and increase awareness of respiratory disease among community members.

In addition, Direct Relief has supported the tribe's health department with medicine and medical items, including field medic packs, respirators, and over-the-counter medications.

Chase said the partnership has been a new model for the Tunica-Biloxi Tribe's Health Department.

"The Power for Health project is a tremendous capital outlay that I would otherwise be unable to take on or afford. The Pfizer grant is even more immediately impactful in that it allows us to expand our care to the need and population that we most need to address," he explained.

But he said the ongoing collaboration and conversation have meant the most to the Tunica-Biloxi Tribe:

"It is the expertise and partnership in knowing that if we need help implementing a program, support will be offered to help advance our objectives."