Duke City Indians face health care crisis

By Pamela G. Dempsey
Diné Bureau

WINDOW ROCK — The some 40,000 Urban Native Americans living in Albuquerque will face further health care shortages if the Albuquerque Service Unit does not receive the $5 million it needs to make up this year's funding shortage.

This includes the more than 18,000 Navajo residents of Albuquerque and Bernalillo County.

"The worst case scenario is, with no additional funding, we'll be down to at least two physicians, working Monday through Friday," said Maria Rickert, acting chief executive officer for the Albuquerque Service Unit.

Six pueblos and tribes, under the service unit, receive contract health care funding under the Indian Self-Determination Act.

Because funding is divided among the contracted tribes, little or no health care dollars remain for those who are not part of those tribes. The urban Native Americans not members of the pueblos and tribes are served by the Albuquerque Service Unit

The users have increased, Rickert said, and topped 25,000 in 2004.

Rickert said that jobs and, subsequently, services are already on the chopping block.

By February, 40 positions are expected to be eliminated and a proposal to close the hospital's urgent care clinic and reduce services to appointment only is on the table. Three years ago, the Albuquerque Service Unit closed down its inpatient services.

"We're a huge, outpatient facility," Rickert said. "This is the third year we've run deficits. We can't keep doing this."

The decision now, Rickert said, may be to reduce personnel in order to get down to the facility's $5 million operating budget.

Of the $23 million given to the Albuquerque Service Unit, $13 million is contracted out to the six pueblos and tribes. The remaining $10 million is split between earmarked funds and hospital operating causes. The service unit needs $10 million for operations.

As a last-ditch effort, a letter was sent in December to Dr. Charles W. Grim, director of the Indian Health Service, by New Mexico congressional representation to request additional funding from within Indian Health Service or the Department of Health and Human Services as well as recurring funds.

Rickert said, as of yet, no response has been received; however, the Navajo Nation's Health and Human Services Committee as well as the Inter-Governmental Relations Committee passed legislation requesting its own Navajo Area Indian Health Service to assist the Albuquerque Service Unit with its funding shortages as long "no recurring funds intended to serve the Navajo Area Indian Health Service user population ... are diverted to the Albuquerque Area Indian Health Service."

In 2002, the Navajo Area Indian Health Service gave $100,000 to the Albuquerque Service Unit for pharmaceuticals and supplies.

But rising costs of health care, decreases in federal health care dollars, and the service unit's allocation methodology has resulted in the recurring problem.

"If the Navajo Area Indian Health Service gave the needed $5 million to the Albuquerque Service Unit, then other service units, such as Phoenix and Salt Lake City, which serve more users, will request funding too," said Peterson Yazzie, a member of the Navajo Nation's Health and Social Services Committee and sponsor of the legislation.

Under the Indian Self-Determination Act, it is the responsibility of the Department of Health and Human Services Secretary to provide services to tribes not served by the contract.

"Nothing in the Indian Self-Determination Act is to limit or reduce in any funding for any program, project, or activity serving a tribe," the act states.

— To contact reporter Pam Dempsey call (505) 879-1707 or email pamelagdempsey@msn.com