Janice Jordan assumed her new role as CEO of Marimn Health earlier this month after about five years in leadership roles for the Coeur d’Alene Tribe-owned health care organization based in Plummer, Idaho.
Having first joing Marimn in 2017, Jordan had served as the center’s medical director of operations and chief clinical officer before ascending to her new post in March. She replaced Helo Hancock, who left Marimn to take a position with Beacon Cancer Care PLLC, of Coeur d’Alene.
Marimn is a rural medical center with 236 employees and was the first tribally owned clinic in the U.S. to serve Native Americans and non-Natives. Jordan is a Coeur d’Alene tribal member and has a long career in the medical field, including 16 years of experience as a registered nurse working in emergency care, intensive care, and acute care, and 12 years working as a physician’s assistant in urgent and emergency care. She received her MBA from the University of Idaho in 2010 and was the co-owner of a family medicine practice in Spokane, in addition to serving as the vice president of operations for the Community Health Association of Spokane before joining Marimn.
The Journal sat down with Jordan to discuss her experience in the medical field and working in rural communities and what she hopes to accomplish before she retires.
What attracted you to the medical field?
You know, I was always interested in the medical field, and I wanted to be a doctor. But I decided I wanted to have kids and be a mom more than a doctor, so I became an RN first. I have eight children, the oldest is 42 and the youngest is 18 and just started her freshman year at Washington State University. I was a single mom most of the time, but my children were really helpful.
Then I decided I did want more, so I became a physician’s assistant. My first job was in the Alaska Bush for two years. I was supposed to be one of five, but when I got there, everybody else had left, so I was by myself as a new PA. Where I was, you could only get there by plane. There were nine villages with health aides, but I was the only PA, so I was the one they came to. I had a moment of panic, but it helped me learn like crazy. I learned to X-ray and run my own labs. And there was no telehealth back then. When I needed to talk to the doctors back in Fairbanks, it was all landline telephones.
Can you tell me about Marimn Health’s integrated approach to medicine? What does that mean?
We’ve always been a forerunner on new and emerging models of medicine. Behavioral health is one of those integrated models. We do this thing where we have behavioral health consultants and coaches on the floor.
So, for example, if we have a patient come in with high blood sugar, staff will pull in the behavioral health consultant to talk about lifestyle changes, but in a motivational interview kind of way. They’re integrated into the visit.
We also do the same with our nutritionist, and we’ve integrated pharmacy in the past two to three years and have a pharmacist on the floor at all times, who handles medication reconciliation.
We’ve seen increased compliance in lifestyle changes based on their ability to integrate with a medical provider. We have a robust medication-assisted treatment program and substance abuse disorder treatment program. We also have lots of groups for counseling for pregnant women. We have a whole program for trying to help mothers keep their children by getting them what they need, helping them with substance abuse. We are not critical of our patients; we want to meet them where they are.
We also have a whole separate program for people with substance abuse disorders who are reentering society. We offer them apprenticeships throughout the wellness center that allow them to gain confidence and gain respect and work a job. We give them a lot of flexibility for court dates and other needs, but it works out really well. A lot of them become full time.
What does the transition from director to CEO look like for you?
Financially, we are really healthy. COVID really helped too. There was a lot of money poured into community health centers. But even before COVID, we’ve always been financially healthy and financially cautious. There hasn’t been much stress, and I’m glad I’ll be inheriting that. It helps that medical is the bread and butter of any medical center and that when I was the director, I was in that realm too. I never told my providers I was looking at numbers, but I did focus on revenue—how much they were bringing in and making sure we were getting the funds we are entitled to. Probably three years before COVID, we saw a steady increase in our revenue and our new programs. We didn’t take a loan out for our $19 million Coeur Center, a 32,000-square-foot facility that offers access to fitness areas like indoor basketball and pickleball, in addition to community programs like a teen center and the Boys & Girls Club of the Coeur d’Alene Tribe. We paid for it out of pocket.
How did you fare during COVID?
You know, we did amazing. Because of that community connection.
In 2020, we saw our first positive case the Friday before Memorial Day. We had a COVID testing site up and running that weekend and stayed open the entire weekend too. Within a week, we could see that we were better at contact tracing our own people than Panhandle Health was. So, we collaborated with them and said, how about we take over contact tracing for our own people? If we had a positive, we had every direct contact tested before the end of the day. We hardly had any outbreaks, and, if we did, we contained them really quickly. We did really good the first two years and then with the omicron variant. That was the first big outbreak for us.
We did have to have some creative strategies. For instance, we had a tribal ordinance where, if you are a tribal member and you didn’t follow through with quarantine, you would be jailed. We had elders we were trying to protect, and we thought we can’t compromise at all on that.
One of the problems we ran into was that our first outbreak was among the substance-abuse community. A lot of them were couch surfing or homeless, Natives and non-Natives alike. So, we collaborated with the city of Coeur d’Alene and the Salvation Army, which had commandeered a motel during this time. We were able to work with them and pay them to keep our people who didn’t have a place to stay until they finished quarantine and were able to safely reenter the community.
This crowd, they tend to hide and not come in for help. But during this time, it allowed us to show them how much compassion we have and that we will help them, regardless of what stage they are in, if they are in withdrawal or need to (go through) withdrawal. It was great because it allowed everybody to shine and for the community to see us more.
I can see how you would want to come back here and work after all these years.
I signed a contract for five years and I’ll probably retire after that. But I’ve always thought to myself, where is the one place I can make the most impact in the time I have left to work?
I didn’t want to be CEO; I’ll tell you that right now. I loved my job. And when Helo (Hancock) said he was going to leave and wanted me to take over, I said no way. I loved what I did, and I saw that it was a lot of responsibility, not that I’ve ever shied away from responsibility. But I was seeing the light at the end of the tunnel for retirement thinking, I know where I am going. And Helo had really empowered me in my position to create a lot of programs, and I thought my job was to make him look good. But the more I thought about it, I said yes, I’ll do it.
What do you wish to accomplish before you retire?
We’re doing some expansion, and I want to hire one more chiropractor. We are getting a PEMF, that’s a pulse electromagnetic field, this huge magnet that realigns cells and helps with healing and depression too. I would love to get an acupuncturist, and we’re talking about therapeutic massage.
But my biggest wish is to expand our dental to include a very robust pediatric dentistry. There is nothing in the community health centers. We are expanding to include six chairs and four of them will go to pediatric. I want to make it fun, with TVs on the ceiling and fun colorful things on the walls. Make it a place where kids can get their dental care here.
This interview has been edited for length and clarity.
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