In 1987, the Coeur d’Alene Tribe began to search for ways to improve the health care services at their small Indian Health Service (IHS) satellite clinic. It was located at the Tribal Headquarters, several miles from the City of Plummer, Idaho. Many tribal members were dissatisfied with 15 years of fragmented care delivered in a semi-condemned building and with poor continuity of care. Due to the non-payment of medical bills by the IHS, tribal members were often turned over to collection agencies. Their plight became intolerable to the point that the only feasible solution was to develop their own health care delivery system.
Access to affordable health care services for non-Indian residents in the local region were very similar to those of the Tribal community. Distance to the closest health care service was between a 45 minute and 2-hour drive over dangerous curved roads, particularly during the winter months. None of the ambulatory care facilities in the four surrounding counties of the Northern Idaho town were providing services to the medically underserved on a sliding fee basis.