Tultxʷ · Confluence of waters

Native nurses,
answering the call.

A 24/7, Native-led nurse advice line for Indian Health Service beneficiaries — licensed RNs, evidence-based triage, and care that honors who you are.

Status
The line is open. 24 hours, 7 days a week.
What we do

Triage that knows your story.

Tulq operates a HIPAA-compliant, 24/7 telephone triage line staffed by U.S. state-licensed registered nurses, working from established clinical decision protocols and grounded in indigenous-informed care.

/ 01

24/7 RN telephone triage

Live, licensed registered nurses on the line — every hour, every day. No bots, no chat queues that go cold at night.

/ 02

Medical, dental & behavioral health

A single line that can triage chest pain, a worsening tooth abscess, and a behavioral health crisis with the same calm and clinical rigor.

/ 03

Evidence-based clinical protocols

Schmitt-Thompson-aligned decision support paired with culturally informed clinical judgment. Defensible. Auditable. Documented.

/ 04

HIPAA-compliant infrastructure

Encrypted call handling, role-based access, full disposition documentation, and audit trails ready for IHS, OIG, or tribal health authority review.

/ 05

Indigenous-informed care

Triage that understands what walks in the door — historical trauma, multigenerational caregiving, mistrust of systems, and the long way home.

/ 06

Warm hand-offs into the system

Care navigation back into IHS, Tribal, and Urban Indian Health Programs. We don't leave anyone holding the line.

Who we serve

Where care is needed most.

Tulq is built for the populations that mainstream telehealth has consistently underserved — the patients the system loses track of, the families who have learned to be careful with care.

"The first nurse who picks up should already know who you are."
/ 01

IHS beneficiaries, nationwide

Eligible American Indian and Alaska Native patients across the 12 IHS Areas — from urban centers to the most remote service units.

/ 02

Tribal nations & 638 facilities

Tribal health programs operating under the Indian Self-Determination and Education Assistance Act looking to extend after-hours and surge capacity.

/ 03

Urban Native communities

Urban Indian Organizations (UIOs) and the AI/AN populations they serve in cities, where access falls through cracks between federal and state systems.

/ 04

Underserved & rural populations

Communities where the nearest emergency department is a long, expensive drive — and a phone call to a competent nurse changes what happens next.

Why Tulq

Native-owned. Sovereignty-aligned. Built for the contract.

Tulq is structurally and culturally aligned with how Indian Country actually works — not retrofitted to look the part.

/ Pillar 01

Buy Indian Act qualified

Tulq is wholly owned by Michael Chavez Ross, an enrolled citizen of the Snoqualmie Indian Tribe — eligible to compete as an Indian Economic Enterprise under 25 U.S.C. § 47.

/ Pillar 02

Cross-system clinical depth

Eleven-plus years of Level 1–2 trauma center ICU, Kaiser Hospital-at-Home telehealth, supermax corrections triage, and 142-bed SNF leadership — staffed by a director who has actually carried the pager.

/ Pillar 03

Indigenous-informed by design

Cultural competency built in at the protocol level, not bolted on at training — informed by tribal governance experience, lineage, and lived understanding of what care has and hasn't looked like.

Leadership

Who's on the line.

A tribally-rooted operator and a multi-state ICU veteran — built to satisfy both the contracting officer and the patient at the other end of the call.

MR
Founder · CEO · President

Michael Chavez Ross

Snoqualmie Tribal Citizen · Government & Tribal Enterprise Leader

Michael is the sole founder, CEO, and President of Tulq. He is an enrolled citizen of the Snoqualmie Indian Tribe and currently serves as the Tribe's Deputy Executive Director of External Affairs — leading public outreach, government relations, cultural and natural resource stewardship, and engagement across Tribal enterprises including Salish Lodge & Spa and Eighth Generation.

Earlier in his career he served four years on the Snoqualmie Tribal Council, including two terms as the youngest ever Snoqualmie Tribal Council Vice Chair. As a member of the Federal Affairs Working Group, he helped advocate for the reaffirmation of the Violence Against Women Act, Savannah's Act, and the $8 billion tribal allocation under the CARES Act during the COVID-19 pandemic.

He chaired the Tribe's Investment Committee, more than quadrupling its portfolio in two years, and founded Cozy Camperz LLC, returning a portion of profit to organizations protecting sacred sites and public lands. He brings to Tulq the rare combination of tribal governance fluency, federal advocacy experience, and operating-business discipline.

Education
BBA, Seattle University · Harvard Business School Exec Ed (NCAI joint)
Citizenship
Enrolled, Snoqualmie Indian Tribe
Contact
JM
Clinical Director · RN, BSN

Jayson Minagawa

Multi-State ICU Veteran · MDS Coordinator · 11+ Years Acute & Telehealth

Jayson is the Clinical Director of Tulq, responsible for clinical protocols, RN staffing, evidence-based decision support, and quality assurance. He is a Registered Nurse holding active licensure in California, Oregon, and Washington with eleven-plus years of progressive experience spanning critical care, telehealth, corrections, behavioral health, and skilled nursing facility leadership.

His critical care experience includes Level 1–2 trauma center ICUs (Erlanger Baroness, Enloe Medical Center, Tacoma General, Kadlec, CHI St. Vincent, Sunrise Las Vegas), with deep proficiency in vasoactive titration, IABP management, continuous EEG, and post-cardiac-surgical care. As a Telehealth RN with Medically Home, he delivered hospital-level care remotely to Kaiser Northern California patients — directly relevant experience for running a triage line.

He currently serves as RN Unit Manager and MDS Coordinator at a 142-bed SNF in Seattle, leading CMS survey preparation, PDPM optimization, and interdisciplinary care planning. He has supported a major facility-wide EMR conversion (Meditech → Epic) and is certified in BLS, ACLS, and Advanced Wilderness & Expedition Provider (AWEP).

Licensure
RN — Washington · California · Oregon
Education
BSN — Bachelor of Science in Nursing
Our story · in brief

The name comes from the confluence.

Tulq is an anglicization of tultxʷ — the Lushootseed name used by the Snoqualmie people for the place where the Tolt and Snoqualmie rivers come together. It is a word about meeting. Two currents, one water.

Michael's great-grandmother, Ollie Moses, was a direct descendant of signers of the 1855 Point Elliott Treaty. As a child she was taken to Chemawa Indian Boarding School — one of the federal institutions designed to sever Native children from language, family, and care. Tulq exists, in part, because of what it took to survive that. The line we answer today is part of how that gets repaired.

Read the full story
Contact

Let's build it together.

For contracting, partnerships, or clinical inquiries, reach out directly.

Founder · CEO & President

Michael Chavez Ross

Government & Partnerships
BasedSnoqualmie, WA
Clinical Director · RN, BSN

Jayson Minagawa

Clinical Protocols & Operations
LinkedIn/in/jayson-m
LicensesRN — WA · CA · OR

Capability statement available on request

NAICS & UEI registered. SAM.gov ready. Buy Indian Act qualification documentation furnished on contracting officer request.

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© 2026 Tulq · A Snoqualmie-citizen-owned enterprise
Tultxʷ · The confluence of the Tolt & Snoqualmie rivers