Cherokee Nation health leaders report rising surgical volume, measles response and pharmacy mail delays

Cherokee Nation health leaders told a committee meeting in Tahlequah that surgical clinic changes have produced a sharp rise in procedures, that the system is actively responding to a local measles outbreak, and that mail-order prescription delays tied to the U.S. Postal Service are affecting some patients.

Commander Murray, a hospital operations leader, said clinic scheduling changes — including 10-hour clinic days and expanded access — led to a 67 percent increase in patients in March 2025 compared with March 2024 and produced “the highest number of patients scoped in a month since December of 2016,” and “the highest number of total scopes and procedures in a month since October of 2018.” He said the added clinic hours have filled the operating room more often and helped increase procedures.

The committee heard that staffing changes are occurring. Commander Murray said the system has offered early-retirement packages and that “we've lost eight employees” who elected to take the early-retirement option; their last days were expected within a few weeks. He also told the committee that some on-site services have been restructured: chiropractic care has been moved from an on-site clinic into a purchase-referred-care (PRC) model to align with Cherokee Nation practices, and some orthodontic services were discontinued as a routine offering.

Dr. Steven Jones, introduced as representing Cherokee Nation Health Services, said Cherokee Nation is monitoring several external risks that could affect operations and revenue. Jones told the committee that the system was “ahead of schedule on revenue” and expected to surpass last year’s revenue if trends continue. He said negotiators had recently spent several days on campus negotiating a funding agreement with the Indian Health Service (IHS) and described those talks as “getting very close” to being wrapped up.

Jones and others said the system is watching federal and state changes closely. Jones said there has been “a lot of talk about grants being stopped” and that some auxiliary specialty-care grants affecting hepatitis C and HIV services had been pulled back. He also flagged potential changes at the Oklahoma Health Care Authority related to Medicaid expansion and eligibility, telling the committee that changes to eligibility could reduce the number of patients eligible for Medicaid and therefore reduce third-party revenue the health system relies on.

On public health, the committee heard a focused briefing on measles. Dr. Harp (presented to the committee to brief on measles) described measles as “a very highly contagious virus” and emphasized vaccination and clinic mitigation steps. She said a single MMR dose provides “about 93 percent” immunity and “it’s going to go up to 97 percent with the second dose.” Dr. Harp said the system is offering an early MMR dose for children ages 6 months to 11 when parents request it, and that Cherokee Nation is coordinating case investigations with state epidemiology and internal public-health staff.

Dr. Harp explained operational steps for clinics: identifying suspected measles in front-desk triage, directing symptomatic patients to negative-pressure rooms, masking patients who call ahead and ensuring staff PPE and employee titers. She noted that MMR is not given to pregnant patients, so prenatal patients who lack immunity would be offered immunization after delivery. She also urged committee members to act as “trusted messengers” to help counter misinformation in the community.

Committee members asked about special risks for children and pregnant people. Dr. Harp said children under 5, adults 20 and older and immunocompromised people face higher risk of complications, including pneumonia and rare encephalitis. She also noted historical vulnerabilities in Native communities and urged vaccination outreach to reservation communities.

The committee raised questions about mail-order prescriptions after a constituent reported repeated delays. Dr. Jones said the system dispenses a very large volume of prescriptions and that “186,000 prescriptions [were filled] the month of February,” which underscores the scale of mailings. He said the health system uses bulk postage and that once prescriptions leave the clinic and enter the postal system they are subject to postal routing and delays; staff perform audits and work with Postal Service investigators when individual shipments go missing. Committee members asked staff to assess postage options and costs, but Dr. Jones cautioned that budgets and regulatory limits on mailing certain temperature-sensitive medications constrain options.

Other operational items discussed included a new radiology residency partnership with Oklahoma State University that matched two residents this year, and modular clinic buildings being moved into position in Nowata to add physical and occupational therapy services in early summer. The committee was also told that some outpatient services previously offered on-site were moved or wound down to align with Cherokee Nation practices.

Hospital leadership changes were announced: Commander Murray said he had accepted a new position and would start in Pawnee in May; he introduced Mr. Deckard as the hospital chief operating officer who will provide hospital updates going forward. Jones said negotiators and legal staff were continuing work on funding agreements that he said would reduce barriers once finalized.

Committee members and staff said the system will continue close monitoring of grants, Medicaid eligibility developments and public-health data, and will pursue outreach and vaccination campaigns while auditing individual prescription-delivery complaints to identify any internal process fixes.

The meeting adjourned after a brief motion and voice vote.