Urban Indian health clinics are a lifeline for tribal members who live in cities off reservations. The Bush administration has proposed to sever that lifeline.
Bush's proposed budget would eliminate the Urban Indian Health Program, which funds primary, preventive and behavioral health care for the 60% of American Indians and Alaska Natives that reside in urban areas, for savings of $33 million.
The funding provides services to 34 Indian clinics across the country, and if they are closed, many American Indians would have to seek care from reservation clinics which are not exactly down the street.
At the seventh annual Montana-Wyoming Tribal Leaders Council Health Conference in Billings, Mont., Darryl Red Eagle, a council member of the Fort Peck Assiniboine-Sioux Tribes, said reservation health care services are underfunded. He added that dental care is available only on an emergency basis and that patients in need of orthodontic services will not be able to be seen by a doctor until 2017. Anthony Addison, co-chair of the Northern Arapaho Tribe on the Wind River Reservation in Wyoming, said diseases such as cancer, diabetes and cardiovascular problems, as well as illicit drug and alcohol use, are prevalent among American Indians, and he attributed lack of immediate care as part of the problem. "We need to come together in a unified, collaborative effort to do our best to address these issues. Even though money is not allocated at levels we need ... it never has been funded at [the proposed] levels," Addison said.
If those clinics are closed, tribal members likely would have to return to their home reservations to receive health care. But the reservation clinics and hospitals are barely able to provide services for those people eligible for care, let alone an influx of others, Montana and Wyoming tribal leaders said.
Urban Indian health programs report that such a cut would result in bankruptcies, lease defaults, elimination of services to tens of thousands of Indians who may not seek care elsewhere, an increase in the health care disparity for American Indians and Alaska Natives and the near annihilation of a body of medical and cultural knowledge addressing the unique cultural and medical needs of the urban Indian population held almost exclusively by these programs. According to the 2000 Census, nearly 70% of Americans identifying themselves as of American Indian or Alaska Native heritage live in urban areas.
Darryl Red Eagle, a council member of the Fort Peck Assiniboine-Sioux Tribes, said there are already medical “horror stories” because of not enough funding for health care services to his tribe.Dental care is available only on an emergency basis, Red Eagle said, and if someone needs braces the system is backed up until 2017. A tribal elder recently rode to Billings in the back of a pickup to get her medical care, Red Eagle said. A man’s gallstones were not considered a matter of “life and limb,” so he could be referred off-reservation for care until a duct ruptured and he became infected. The man is in Billings recovering but had to have part of his pancreas removed and is on dialysis, Red Eagle said.
Red Eagle held up his left arm and rubbed the elbow where bone chips float, a condition that sometimes hampers use of his arm but that isn’t critical enough to make him eligible for IHS treatment.
“There are solutions, but it takes a community to gather our funding,” Red Eagle said. “There is strength in numbers. We’re bringing all of our resources and numbers together.”
Addison said there is a requirement in treaties between the government and tribes for federal funding to provide health care.
“We need to come together in a unified, collaborative effort to do our best to address these issues,” Addison said. “Even though money is not allocated at levels we need … it never has been funded at those levels.”
Diabetes, heart disease, drug and alcohol abuse and cancer are debilitating young and old alike, Addison said. Those are ailments that don’t stop at reservation boundaries but, in most cases, are more prevalent in Indian Country. Part of the problem, he said, is that too often people have to wait until a condition is advanced before health care is available.
“There are preventative measures that can be done,” Addison said. “But there’s just not enough money to do it.”
The following article is from the Santa Fe New Mexican.
Native American health: Marchers demand Bush restore funds for urban clinics
SALT LAKE CITY — To chanting and the pounding of drums, hundreds of people marched Friday against $33 million in proposed federal cutbacks that could shut down some urban health clinics for American Indians.
“We’re upset that our center is being threatened, and we’re here to send a message that you don’t mess with a federal obligation,” said Dena Ned, executive director of the Indian Walk-In Center in Salt Lake City. “Just because we live off the reservation doesn’t mean we’re not in need of health care.”
About 400 people marched peacefully almost two miles from the clinic to the Wallace F. Bennett Federal Building for a rally, police Sgt. Lamar Ewell said.
President Bush’s 2007 budget proposal says urban Indians could use regular community-health centers. His budget calls for adding more and larger health centers for poor people under a $182 million funding increase. The budget also would increase funding for clinics on Indian reservations by about 4 percent over the 2006 fiscal year, said Scott Milburn, a spokesman for the Office of Management and Budget.
Salt Lake City Mayor Rocky Anderson said those programs would do little to serve American Indians in urban areas, where the clinics double as social-service networks and cultural centers. He said 83 percent of the clients at the city’s walk-in center have no health-insurance coverage. The clinic serves about 4,000 people a year.
Anderson, a Democrat, likened the proposed cut to the government’s “shameful” history of violating tribal treaties. “What is happening now is just part of that pattern of betrayal of Native Americans,” he said.
Sen. Orrin Hatch, R-Utah, said he also opposed the cut. “This health care delivery system has taken decades to create, and if it were to disappear, it would increase the health care disparities and barriers to care for American Indians from that of the general population,” Hatch said in a statement.
Sen. Bob Bennett, R-Utah, a member of the powerful Senate Appropriations Committee, said he would work to restore the funding.
Half the country’s 34 urban Indian clinics might have to close if Bush’s proposal stands, Ned said. The remaining clinics would have to cut services, charge clients or raise money through private donations to stay open, she said.
“If these things are cut off, then we’ll have to go back to the reservation with our tails between our legs,” Eleanor Iron Lightning told the crowd. A member of the Cheyenne River Sioux Tribe from Eagle Butte, S.D., she said she’s used the clinic since she moved to Utah in June 2002.
Community health centers aren’t designed to meet the needs of urban Indians, according to the National Association for Community Centers. The centers are for people without health insurance.
In Utah, Community Health Centers Inc. has a $200,000 contract to provide medical care for the Indian Walk-in Center.
But that’s just a fraction of the clinic’s $1.5 million annual operating budget, Ned said. If the center were to lose its $1.1 million in federal contracts, it would also lose grant funding, effectively cutting about 90 percent of its budget.
The center provides diabetes education, immunizations, substance-abuse treatment, mental-health counseling, holistic care, HIV testing and youth programs. It also operates a food pantry for the United Way that handed out some 5,200 boxes of food to Indians and non-Indians last year.
Nationally, some 60 percent of American Indians and Alaska natives live in urban areas, according to the Census Bureau.
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