Pawnee Nation Uses Capital Stacking to Fund Needed Tribal Health Center
Overview of The Project
Overview of The Project
The Pawnee Nation of Oklahoma known as Chaticks-si-Chaticks conducted the Pawnee Nation Needs Assessment and identified an intense need to address behavioral health issues in the community. Pawnee County, Oklahoma is a rural region struck with a 20% mental illness rate opioid addiction, suicide and inaccessible medical care. Capacity issues has created a five-week wait time for appointments and community members had to travel over 40 miles to seek quality behavioral and mental health treatment according to Tribal Business News and a Baker Tilly case study.
Despite initial funding gaps, the Pawnee Nation has utilized capital stacking along with EDA grants to fund new estimated $22 million 22,000-square-foot health facility on tribal land. This facility will provide high demand behavioral health treatment and enhance economic development opportunities in the area.
“It's going to make a huge impact on the community,” Brian Kirk, executive affairs director for the Pawnee Nation, told Tribal Business News. “We have a medical facility that does a lot, but with mental health, it was a big gap. And then looking at the economic development side of it, there are going to be some great jobs promoting the health care industry. It was a win-win for us.”
The Impact of the Pawnee Nation Behavioral Health Center
The Impact of the Pawnee Nation Behavioral Health Center
Photo from Clearinghouse CDFI
The Pawnee Nation Behavioral Health Center is a top priority of the Pawnee Nation Comprehensive Economic Development Plan. The health center will enhance local accessible treatment for the predominately rural five-county service area designated as medically underserved for both Tribal and non-Tribal Members.
The center will serve as a crucial referral source for the Tribe’s primary care center, which otherwise is unable to provide the necessary mental health treatment.
The 22,000-square-foot health facility will:
Serve 2,040 unique patients annually: Over 75% of them classified as low-income persons, more than 50% Medicaid insured coverage and over 90% of Native American descent.
Create 47 construction jobs (60% accessible to Native, 70% accessible to Low-Income) with benefits and training opportunities.
Create 53 permanent jobs: Over 37% filled by low-income persons and over 25% filled by Native Americans with benefits and training opportunities.
Provide solutions to the needs identified in letters of support provided by the City of Pawnee, Oklahoma Congress and Senate leaders, the Oklahoma Department of Mental Health and Substance Abuse Services, local healthcare groups and area not-for-profits.
According to New Market Tax Credit Coalition (NMTC Coalition) summary, Clearinghouse CDFI impact story, and Baker Tilly.
The Pawnee Nation partnered with Ascension Recovery Services, an industry leader in developing comprehensive behavioral health systems for vulnerable populations who are uninsured or underinsured. They entered a contract to design the facility’s welcoming, accommodating programming, and tailored the plan for the diverse Tribal community. The health facility is estimated to be open in Spring/Summer 2025.
What is Capital Stacking? Funding the Project
What is Capital Stacking? Funding the Project
Photo from Clearinghouse CDFI
Capital stacking is using a ‘stack’ capital such as loans, grants, tax credits, or other debt and equity to purchase, build or develop a piece of real estate.
This innovative way of funding can break the barriers found by rural low-income tribal communities to complete costly high demand fundamental projects.
The Baker Tilly Capital team helped the Pawnee Nation receive a $3 million grant from the EDA’s CARES Act Recovery Assistance, $1 million grant from Rural Development USDA, $14 million financing of New Markets Tax Credit (NMTC) through Clearinghouse CDFI, and a $12.4 million USDA guaranteed loan from Native American Bank.
The behavioral health facility has been five years in the making. The tribe spent much of that time assembling a capital stack when a consultant pointed the tribe toward the NMTC system. This was the a viable way to secure the multi-million dollar fragment still missing from the stack, Brian Kirk, executive affairs director for nation, said to Tribal Business News.
“It was time consuming, but it wasn’t too complex,” Krik said “[Clearinghouse] was excited to know we were coming to them about the NMT program, because CDFIs have been trying to get this information out to tribes. They aren’t used much and I’m not sure what the barrier is, or what side it’s on.”
Capital stacking and the NMTC system were new the nation and Krik did not know anyone who has complete it until the consultant pointed it their way. To compile appropriate paperwork and complete an estimated 19-page checklist provided by Clearinghouse CDFI, which included an economic feasibility study, took roughly nine months. Despite the time it took the nation was glad to fix bridge the gap in funding for the highly needed healthcare center.
“I highly recommend looking into it,” Kirk said. “This is beneficial to smaller or less fortunate tribes. The tribes with a lot of revenue might be able to get a business loan or start something on their own, but for smaller tribes without that revenue, this is a way they can start looking into funding for large projects.”
Learn more about this project from CoP Event with Brian Kirk and Matthew Pugh:
Learn more about this project from CoP Event with Brian Kirk and Matthew Pugh:
Subject Matter Experts related to this blog:
Sources used in this blog:
Pawnee Nation of Oklahoma utilizes NMTCs to construct new behavioral healthcare center - Baker Tilly
Pawnee Nation Behavioral Health Center - New Market Tax Credit Coalition.
Pawnee Nation Behavioral Health – Pawnee, OK - Clearinghouse CDFI
Pawnee Nation Breaks Ground on Behavioral Health Facility - Rural Development USDA
Brian Kirk, MPH
Click to learn more about the Executive Affairs Director of Pawnee Nation
Matthew Pugh
Click to learn more about the Senior Manager with Baker Tilly Capital
The Pawnee nation utilized an innovative way of funding to break the barriers found by rural low-income tribal communities to complete costly high demand fundamental projects. The health center will enhance local accessible treatment for the rural service area designated as medically underserved.