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Some health clinics deny care to urban Indians

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  • Some health clinics deny care to urban Indians

    Some health clinics deny care to urban Indians
    by Garance Burke
    The Associated Press - 7 March 2007

    FRESNO, Calif. - American Indians say they are being illegally denied care at taxpayer-funded clinics that have long served all people of native ancestry but recently began excluding members of tribes that lack formal recognition by the U.S. government.

    Federal officials deny that qualified patients are being turned away and say they're doing all they can to ensure a health program for urban Indians isn't shut down entirely. The Indian Health Service oversees 33 clinics nationwide that provide free or discounted, culturally sensitive medical services to city-dwelling Indians.

    Native groups say federal law requires the clinics to serve all patients of Indian ancestry, but some have recently stopped admitting those who can't document their federal tribal status, patients and clinic officials told The Associated Press.

    "They said if you don't have federal paperwork you can't get service anymore," said Vera Quiroga, a Yaqui elder who was turned away from a clinic she helped found in Santa Barbara and now has to drive to a far-off reservation to get her teeth cleaned.

    The U.S. Bureau of Indian Affairs doesn't recognize the 82-year-old as Yaqui, even though her children and grandchildren have tribal documentation.

    Another former Santa Barbara patient, Janet Darlene Garcia, 50, is a member of the Coastal Band of the Chumash Nation, which does not have federal status. She relied on the clinic for her diabetes counseling sessions.

    Martin Young, chairman of the clinic's board, says it received a letter last fall from the IHS regional office in Sacramento instructing it to stop offering free health services to patients from unrecognized tribes or who don't have a BIA identification card.

    It has since turned away about 200 patients, he said.

    An IHS spokesman said the letter explained who was eligible for care, but denied the agency instructed Santa Barbara to withhold services. However, clinic managers in Tucson, Ariz., Wichita, Kan., and Boston reported getting similar directives.

    "IHS is suddenly saying that you can't serve this Indian even though he looks Indian, and his family says he's Indian and has all of this history of being Indian, but he doesn't have this piece of paper," said Susette Schwartz, director of the Hunter Health Clinic in Wichita. "We need some consistency."

    The question of who is entitled to free health care will likely be discussed Thursday during a hearing of the Senate Indian Affairs Committee.

    Under the American Indian Health Care Improvement Act of 1976, Congress funds health care programs for members of tribes recognized by states or the federal government, as well as their descendants. Many states recognize tribes the federal government does not.

    In California, the right to government-sanctioned medical care is extended a step further, to those whose ancestors lived here in 1852 and are "regarded as an Indian by the community."

    Phyllis Wolfe, who oversees urban Indian programs at the U.S. Department of Health and Human Services, said clinics that are granted federal dollars must follow those guidelines. Program officials did not answer requests to clarify any possible exceptions.

    Wolfe could not explain why the clinics would have changed their policies.

    "I don't believe they would do that, but I can't say that that's not been done," Wolfe said.

    Nationwide, more than 60 percent of American Indians and Alaska natives live in urban areas, according to the U.S. Census. For the poorest of them, the clinics are a lifeline, a place to get diabetes treatment or alcohol counseling delivered by doctors well-versed in native culture.

    Urban Indians have higher rates of infant mortality and deaths attributed to diabetes and alcohol consumption than city dwellers of all other races, according to a 2006 report in the American Journal of Public Health.

    The urban clinics are managed by local contractors with funding from IHS, a division of Health and Human Services. But President Bush's 2008 budget proposal would eliminate the program's $32.7 million annual allocation altogether.

    Under the circumstances, federal officials say, the cash-strapped clinics are doing everything they can to care for all patients in need.

    "We recognize that the urban Indian population is in need of care and we don't want to disenfranchise any native Americans who are living in urban areas," said Paul Redeagle, deputy director of the IHS office in Sacramento. "We're currently working with the urban programs in California to resolve their problems."

    Another California clinic, the Fresno Native American Health Center, closed its doors in January. Clinic officials there said they were asked why they were treating patients from tribes the BIA didn't recognize.

    Redeagle said the Fresno clinic was closed because it was seeing too few patients and did not hire qualified staff, violations of its contract with the federal government.

    In Boston, workers at the North American Indian Center said they were told not to treat the Mashpee Wampanoag of Cape Cod, whose ancestors shared Thanksgiving dinner with the Pilgrims. But they were allowed to keep offering free health services to the tribe's members after they read the text of the 1976 law to their federal funders.

    "We actually got requests from IHS to deny service to the Mashpees," said Barbara Namias, who oversees community health programs at the Boston clinic. "We had to refer them back to the legislation."

    Throughout American history, defining who is Indian - through tracing family trees or calculating a person's percentage of Indian blood - has always been political.

    Each tribe defines its membership differently. In California, just 12 percent of the state's 433,000 American Indians belong to BIA-recognized tribes.

    The Santa Barbara clinic removed most of its board members in September and replaced them with members of federally recognized tribes. Nonnative staffers who were let go the year before are suing over the alleged bias.

    Redeagle said his office had looked into questions about the management of the Santa Barbara clinic and had found no proof of wrongdoing.

    But that's no consolation to Vera Quiroga, who helped start the clinic in the 1970s, long before it moved to its current home in a shopping center. She said her already limited finances are taxed by regular 40-mile trips to the tribal lands of the Santa Ynez Band of Mission Indians.

    "Now I have to go up to the rez to get seen," said Quiroga, who lives on $1,600 a month from her pension and social security checks.

    The clinic where she now receives dental work is run by a federally recognized tribe whose members each get sizable checks in casino revenue, but they still qualify for free care from the Santa Barbara facility.

    Many urban clinics are already trying to make do with less by following the example set by Oakland's Native American Health Center. The clinic has applied for grants from other funders and opened its doors to all urban dwellers to bring in new sources of revenue.

    "We just want to do what we're here for, which is to help the working poor," executive director Martin Waukazoo said.

    But Lisa Flores, an environmental planner and documented Pascua-Yaqui member who attended diabetes counseling classes at the now-defunct Fresno clinic, has given up on getting native-focused care in her area.

    "From a tribal perspective we're all supposed to take care of each other," she said. "Now that they closed it, the question then becomes: Are you unworthy of health care?"

    "Be good, be kind, help each other."
    "Respect the ground, respect the drum, respect each other."

    --Abe Conklin, Ponca/Osage (1926-1995)

  • #2
    Remember tomorrow is get over it Day, I am sure those people being denied will get over be denied medical help


    • #3
      I guess today is oversimplify the issues day...

      To celebrate this day it helps to be totaly lacking in human compassion.
      I feel something for Vera Quiroga who was denied care at a clinic she helped to found because of some BS government trickery. I feel something for every person who needs care and is denied care. There is just something very wrong with a society that will not care for it's citizens in need. I guess we should all be used to that by now and just "get over it." I think that is just more blaming the victim which the government has been doing to us for centuries.


      • #4
        Originally posted by rvrsdwilliam View Post
        Remember tomorrow is get over it Day, I am sure those people being denied will get over be denied medical help
        as long as they don't die from what's wrong with them... sure.
        There is only one success; to be able to live your life in your own way.


        • #5
          Originally posted by rvrsdwilliam View Post
          Remember tomorrow is get over it Day, I am sure those people being denied will get over be denied medical help

          Thats a cold view brother...


          • #6
            denial of treatment

            how very sad , to need what amounts to a federal dog liscence to get care. i know of only ONE indian clinic that does not require enrollment. others wont even talk to you on the phone if you cant give them a roll number.what a bunch of horse****! the real solution is to just do away with all this enrollment crap I HAVE NEVER BEEN ENROLLED AND I HAVE NOT SUFFERED FOR IT, I DONT NEED GOVT CHEESE EITHER. I think the time has come that native people be treated just like any other etnic group.beleive me,you will get better care at the county hospital than at some ihs clinic.


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