Pueblo of Acoma: Lessons Learned about Reservation Healthcare in a Post-COVID-19 World

In the face of the ongoing COVID-19 pandemic, we all too often hear of the devastation faced by small, rural communities. Recently though, we heard from the Pueblo of Acoma about their successful response to COVID-19. This summary of lessons learned, shared by Tonya Ortiz-Louis, executive director of the Pueblo of Acoma (POA) Health and Human Services, may be helpful to other tribes:  

On Dec. 31, 2019, the World Health Organization (WHO) reported an abnormal viral pneumonia in Wuhan, China that was later found to be a novel coronavirus labeled COVID-19. Less than two months later, on Feb. 26, 2020, the first U.S. case was confirmed. These events soon snowballed, with 7.1 million U.S. cases and 204,328 deaths by Sept. 28, 2020. Researchers have found that only 6% of those deaths were a result of COVID-19 alone – the remaining 94% of individuals had preexisting conditions.

On average, rural populations are older, poorer and suffer from higher rates of chronic illness than their urban peers. Since 80% of older Americans have at least one chronic disease and 77% have at least two or more chronic illnesses, rural populations are at a significantly higher risk of mortality from COVID-19 than urban populations.

The Pueblo of Acoma (Acoma) in New Mexico’s Cibola County is home to 2,784 citizens, with 18% over the age of 50, and 20% of senior citizens living below the poverty line. Fortunately, the tribe’s response efforts have helped to significantly slow the spread – even when compared to the rate of cases in the surrounding county.

Acoma took early measures to deter outside citizens from visiting, enacted universal testing across their population to isolate potential infections and hotspots, and issued orders for social distancing and facial coverings to inhibit the spread. The community cooperated.

POA Health and Human Services also adopted novel healthcare strategies, such as telehealth clinics to limit travel while expanding healthcare access for citizens. By partnering the clinics with a firm that identifies early cases of COVID, treatment by clinicians, hospital staff and primary care physicians could protect the most vulnerable before spread begins. Medical data was shared through mobile and wearable devices for trend analysis through HIPPA-compliant clouds.

This allowed citizens to stay at home, reduced the burden on healthcare providers and lowered costs for patients, providers, local government and Medicare/Medicaid reimbursements.

The U.S. had 2,103 cases per 100,000 people by Sept. 28, 2020 and Cibola County saw about 1,544 cases per 100,000 people. Meanwhile, Acoma had only 1,364 cases per 100,000 – 12% less than the surrounding county.

Acoma ultimately learned it is critical to stay ahead of the curve with telehealth and medical technologies and be proactive in protecting those most vulnerable. The community has established a dedicated, preventative care clinic focused on the vulnerable population – patients with multiple chronic conditions – to proactively monitor and track health changes. They also leveraged the federally funded Centers for Medicare & Medicaid Services (CMS) to sustain the clinic even after the CARES funding was exhausted. 

While Acoma was unable to escape the pandemic unscathed, their innovative and proactive approach combatted their rural demographics and lack of healthcare access. If you would like to learn more about what’s working for Acoma Pueblo, feel free to contact Tonya by email at: TLouis@poamail.org.