My name is Jacquelyn Robinson and I am a member of the Hopi Tribe. I am Water Clan in Hopi, so most of my teachings growing up had to do with water. My grandparents taught me the importance of saving water, blessing ourselves with water, and continually praying for rain. Rain is a great blessing. Always be respectful of water. My grandmother would take me out to our family’s ranch to show me about the springs. She taught me that water is living, that water is life. As I’ve grown older, I have learned that these principles taught me about stewardship. Accounting rules, reimbursement rates, or financial statements are how we normally think about expressing Tribal sovereignty but I’d like to discuss it through the lens of stewardship based in traditional Native teachings.
I think about the word sovereignty a lot and the many different definitions that exist. To many, it means authority and self-governance. As a Hopi, I was taught something a little different. I was taught that responsibility comes before sovereignty. We have a responsibility to care for resources, to think about our actions as they impact future generations, and to leave our world stronger than we found it.
These teachings apply to healthcare finance and that may sound foreign but hear me out.
Let’s consider the Great Iroquois teaching, “In every deliberation, we must consider the impact of our decisions on the next seven generations.” With this teaching we can ask, will this decision benefit the community for generations to come?
Framing healthcare financial architecture from this lens is important because:
• A clinic that cannot sustain itself financially cannot serve future generations
• A building without a strong operating model does not provide the ability to exercise sovereignty
• A construction grant without a financial sustainability plan does not allow a Tribe to exercise self-governance
In Hopi, Village Criers used to play an important role in coordinating action and support for the community. They would stand on top of the roof and “cry” out when someone needed help with their houses, fields, or other necessities of life.
Thinking about this concept in accounting and finance we can find similarities because accounting is communication and financial information tells a story. They function a lot like the Village Crier. It tells leadership what is happening, where help is needed, what risks are emerging, and where resources should be focused.
If we use our healthcare systems to create real wealth in terms of long-term wellbeing, then we can redefine wealth as:
• Healthy Native people
• Healthy Native communities
• Healthy Native systems
• Healthy Native balance sheets
• Healthy Native governance systems
This isn’t to misconstrue the pursuit of wealth for its own sake, but wealth as a tool for regrowing Native communities that are healthy and well.
The Four Pillars of Financial Stewardship
To build a practical framework for financial architecture grounded in stewardship, I use a simple model called The Four Pillars of Financial Stewardship. Over the years I’ve learned that Tribal healthcare stewardship requires four things.
1. We must see clearly
Financial stewardship begins with visibility.
Sound reconciliations, timely reporting, accurate data, and transparent financial information empower Tribal leaders to understand where risks lie, where opportunities exist, and where resources can be used to improve the health and wellbeing of communities.
Without reliable financial information, it becomes difficult to exercise sovereignty because decisions are made under chaotic conditions and without a clear understanding of balance sheet health.
2. We must stand firm
Financial stewardship requires stability.
Strong cash flow, effective internal controls, compliance systems, and documented processes develop organizations that can grow and change as necessary, effectively allowing Tribes to meet Tribal Members where they need help the most.
Throughout my career, I have witnessed Tribal programs struggle not because of lack of commitment, but because critical knowledge existed only in the minds of a few employees. When those employees left, important processes collapsed within the system.
Well documented, strong systems create continuity and consistency. They allow Tribes to weather staff turnover, maintain internal controls, and continue to serve their communities regardless of who currently works for the organization.
I have found that this is key to building and maintaining trustworthy financial reporting that Tribes can stand firm on.
3. We must choose intentionally
Financial stewardship requires thoughtful planning.
Financial modeling, expansion analysis, workforce planning, and capital forecasting help Tribes understand the long-term effects of decisions before resources are committed.
Every Tribal Nation has a unique history of survival, cultural preservation, and relationship to healing and wellbeing. Because of these factors, no financial model should begin with assumptions alone. It should begin with listening, researching, and understanding to learn about the story of the community.
When we combine Tribal wisdom with sound financial analysis, we create plans that are not only financially sustainable, but grounded and responsive to the needs of Tribal people.
4. We must leave something stronger behind
Financial stewardship ultimately concerns legacy.
I define strength for the future as building reserves, preserving community memory, mentoring future Tribal leaders, and creating culturally significant opportunities for future generations.
One of the most powerful lessons I have learned is that systems alone do not create financial sustainability. People connected to traditional knowledge do.
Accounting tracks resources. Financial models forecast growth. Policies guide decisions. Traditional knowledge teaches why caring for resources matters, who they should serve, and how to operate in consideration of future generations.
My grandfather told me, “Education is the way we will survive in this world.”
Back then, I understood education to be schooling. Over time, I have come to understand education includes mentorship, leadership development, cultural knowledge, technical expertise, and the wisdom we share with one another.
For more than twenty years, I have worked alongside Tribal leaders, finance professionals, healthcare administrators, and community members who have dedicated themselves to building healthy, prosperous, and resilient community foundations.
Whenever possible, I weave mentorship, training, and knowledge-sharing into my work because leadership development is an investment in sovereignty.
Our ancestors shared knowledge to make our communities stronger. When future leaders are prepared, sovereignty becomes achievable. When opportunities are created for our children, prosperity extends well beyond a single generation.
The strongest healthcare systems are not those that simply focus on today’s needs. They are ones that prepare future generations to lead tomorrow.
Stewardship Across Generations
When my grandmother taught me that water is life, she was teaching me about stewardship. Stewardship means caring for our community’s resources in the present so that they will be available for our children tomorrow.
This concept is true for Tribal healthcare systems. Financial architecture is not ultimately about accounting systems, financial reports, or audits. They are important tools that lead to purpose. The purpose is ensuring that the systems we build today continue serving our people long into the future.
My mother once told me that the prayers of our ancestors are reaching us today. Those prayers helped create the opportunities, resources, and healthcare systems that we are blessed with today.
Years later, a Native OB-GYN physician shared another teaching with me. He said that when we look at our children, we must remember that they carry the future within them. This taught me that the future is already here, and it is our responsibility to protect it.
Thinking about those teachings together, our ancestors prayed for us before we were born, and today we hold responsibility for generations to come. The healthcare systems we inherit today exist because previous generations invested in our wellbeing. In a similar way, the systems we create today should serve generations who we may only know in spirit and whose lives are already connected to ours.
When we strengthen our financial systems, preserve Tribal knowledge, grow reserves, mentor future leaders, and plan responsibly for growth, we are doing more than just operating healthcare organizations. We are protecting the future that already exists within our communities. This is stewardship.
Perhaps this is one of the most important expressions of sovereignty: accepting responsibility not only for ourselves, but for the generations who will follow us.