FDL human services director retires, but his legacy lives on

Jan. 20--It is impossible to completely know the difference Phil Norrgard made over nearly four decades of working for the Fond du Lac Band of Lake Superior Chippewa, but the numbers alone tell part of the tale.

When he started in 1979 as a graduate student volunteer, there were five staff members in the Human Services Division. On Wednesday, nearly 38 years later, Norrgard officially retired from his position as Human Services director after shepherding the division into an award-winning organization of more than 325 employees and an annual budget of over $43 million.

[Phil Norrgard] has had a huge impact "on not only the health of American Indians in this state but on the overall health of Minnesotans," said Dr. Ed Ehlingher, Minnesota Commissioner of Health. "His impact and legacy is nothing short of incredible."

Sometimes called the "Dean of Tribal Health Directors," Norrgard's work at Fond du Lac has been hailed by many as the best American Indian health and social service delivery system in the country. Tribes from across the country have come to Fond du Lac to learn more about the model programs operated by the Human Services Division, and staff are often asked to speak at trainings and conferences and have won numerous and prestigious awards, including five from the Kennedy School of Government at Harvard University.

Although he declined an interview with the Pine Journal the day before his retirement -- "too busy" -- Norrgard pointed to the stable leadership of the Fond du Lac government as the basis for continued success over the years.

"I've been fortunate to work for some of the most highly-regarded, elected leaders in Indian Country," he said in the press release issued by his division. "They led by example and I tried to learn as much as I could from each of them."

Today, the Fond du Lac Health and Human Services division operates two health clinics, three pharmacies, numerous public health and social services programs, one assisted living residence, two outpatient substance use disorder treatment centers, numerous prevention/intervention programs for youth and one dental clinic. It manages six beautiful, modern facilities that have been recognized for their patient-centered focus and American Indian artwork.

The list of "firsts" that happened under Norrgard's watch is extensive and impressive, and too lengthy to be included in its entirety. But a few of those "first" highlights follow:

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First to provide targeted case management;

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First tribe in Minnesota to provide transitional housing for Indian women;

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First to provide a group home for American Indian children;

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First to provide direct services to an urban population outside of its service area;

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First to license American Indian foster homes outside of the reservation;

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First to organize and operate summer youth and family camps;

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First to offer methamphetamine and prescription drug treatment in Indian Country;

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First to sponsor Medicare Part B premiums for seniors, and first to sponsor Medicare Part D premiums for seniors,

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First to provide mental health case management;

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Firstto provide nurse midwife and doula services;

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First to sponsor individual health insurance for nearly all tribal members residing in the service area.

"As we discuss healthcare reform in the U.S. in the year 2016, I can't help but think how [Phil Norrgard] was a pioneer of support, facilitating innovative healthcare delivery at its highest level 15 years ago -- well before the current health reform movement," wrote Scott Giberson, deputy director of human capital at the centers for Medicaid and Medicare.

In letters of recommendation, Norrgard's peers also talk about him as a person.

"Phil is a great health service director, in part, because he is humble and does not think he knows it all," wrote Edward Fox, tribal health director of Washington's Skokomish Indian Tribe. "He has always been willing to learn."

In the press release, Norrgard said he is most proud of the work he did in the mid-1990s, regarding the state's newly awarded authority to regulate payment for various types of health and human services. Those policies created the business foundation that helped tribes and Indian Health Service (IHS) facilities operate more like other health care providers as the technical and medical improvements in the healthcare landscape started to explode.

Fox understands as much as anyone what Norrgard and others did in terms of health care for American Indians and Alaska natives. In a letter, Fox detailed how they both argued for a liberal interpretation of an agreement that expanded how Indian health programs would be paid by Medicaid, noting that, since 1995, the payments by Medicaid to Indian people has risen from under $500 million to over $4 billion annually.

Advancing the strategy of sponsoring individuals into the individual health insurance market -- Fond du Lac paid for health insurance premiums for eligible American Indians -- was another hallmark achievement. Tribes across the country are now sponsoring individuals and families and even the IHS has encouraged sponsoring for American Indians who use its facilities.

Norrgard is recognized as a key policy expert for Indian Country regarding health care reform. In 2013, he was appointed by Governor Dayton to serve on the MNsure Board of Directors. In that same year, he also wrote, produced and directed three critical training films about the Affordable Care Act for the Tribal Education and Outreach Consortium that were used at training events across the country.

In the press release, Norrgard said he is really excited about the future of the division.

"The three associate directors (Jennifer DuPuis, Marilyn Grover and Nate Sandman) who have had years of training and leadership experience are sure to do an excellent job," he said. "I'm sure they will continue to win the support of the elected officials and the patients."

Norrgard recently said the strength of the Human Services Division lies in its excellent employees, most of whom are American Indian. High quality services require high quality staff and the division has been able to recruit and retain some of the best. Norrgard always credits his staff for division success, especially Chuck Walt -- his long-time associate director who is now the executive director of programs at FDL, which includes human services.

Understanding that health care financing may be in for some significant changes with the Trump administration, Norrgard said he is sure Fond du Lac will be able to compete with other providers because it has never taken its eye off high-quality, patient-centered care.

"We know our patients and clients better than other providers and we have done a better job in serving their needs," he said. "Thirty-seven years ago, there was a lot of skepticism about the tribe's ability to build and operate an effective health and social service delivery system. Today, there is no doubt about it. The role and function of services directed by tribal government have been firmly established and are here to stay!"

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