[Hpn] Bush Wants To Eliminate Funding To Indian Clinics~OT~

William Charles Tinker wtinker@verizon.net
Fri, 24 Mar 2006 11:28:31 -0500


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Bush Wants To Eliminate Funding To Indian Clinics

March 24, 2006

When Jennifer Carter moved from her reservation to Pierre, S.D., a few =
years ago, she went from seeing Indians like her every day to barely =
seeing any. But the first time she visited the South Dakota Urban Indian =
Health clinic, she knew she had found her place.=20

There, she met Indians just like her, people she could relate to and who =
made her feel comfortable. They were from various tribes. They no =
longer, or never did, live on a reservation.=20

"When you all get together, it's like home," said Carter, a single =
mother of four who used to live on the Cheyenne River Sioux Reservation =
in Eagle Butte. "It makes me feel like home."=20

To urban Indians, that connection to their culture often means as much =
as the medicine they are prescribed.=20

But now that relationship is threatened by President Bush's 2007 budget =
proposal to zero out the $33 million allocation for urban Indian health =
clinics. At least 17 of the 34 clinics across the country may have to =
close their doors, while the rest would be forced to cut services.=20

Some 60 percent of American Indians and Alaska natives live in urban =
areas, according to the Census Bureau. And for years - decades in some =
cities - they have been receiving health care at clinics in or near the =
cities where they live. Providing health care to all Indians has been =
part of the government's trust responsibility.=20

"Many tribes are viewing this as an assault on trust responsibility," =
said Geoffrey Roth, executive director of the National Council of Urban =
Indian Health.=20

Sen. John McCain, R-Ariz., noted during a Senate Indian Affairs =
Committee hearing last month that even though the proposed cuts could be =
restored, "I think some of these cuts ... clearly sends out the wrong =
signal to Indian Country as to what our belief and our fulfillment of =
our obligation to Native Americans is all about."=20

Urban Indian health care clinics, located in 21 states, are funded by =
the Indian Health Service, but operate as private clinics under contract =
with the government. Whether a city has an urban clinic depends on the =
population, health status and poverty level of Indians. They are located =
in cities as large as New York and as small as Butte, Mont.=20

Clinics differ in their services -- some offer primary care, others just =
referrals -- but most have programs vital to Indians. Many offer =
comprehensive medical care ranging from dental and vision to mental =
health. Most have alcohol addiction and diabetes programs, because of =
the prevalence of those diseases among Indians.=20

The amount patients pay for services varies from clinic to clinic. Some =
are free; others have a sliding fee schedule. Last year, the clinics =
treated more than 106,000 Indians.=20

Compared to the U.S. population as a whole, urban Indians have a 178 =
percent higher death rate from alcohol abuse and a 54 percent higher =
death rate from diabetes, according to a 2004 study by the Seattle =
Indian Health Board's Urban Indian Health Institute.=20

At the Hunter Health Clinic in Wichita, Kan., outreach workers who help =
diabetics with exercise, diet and foot care would lose their jobs, and =
mental health and alcohol and substance abuse programs would be cut, =
said Susette Schwartz, clinic chief executive officer.=20

Isabelle Gyongyossy, a 78-year-old Oglala Sioux patient at the Hunter =
clinic, has diabetes and heart disease. She takes eight pills a day, =
uses a walker and isn't sure how she will cope if she can no longer use =
the clinic's programs.=20

"If they take the funding away, I'll have to pay for a lot of things. I =
won't have any food," she said.=20

Urban clinics also offer services many other clinics don't, such as =
transporting patients to and from appointments, something many older =
patients need.=20

In Bush's 2007 budget proposal, it is suggested that urban Indians can =
go to community health centers instead, since those centers are slated =
to receive a $181 million increase that would build or expand 300 sites. =


Alex Conant, spokesman for the White House Office of Management and =
Budget, noted the increase and said: "Urban Indians, like all Americans, =
continue to benefit from the president's initiatives to make health care =
more affordable and available."=20

But clinic directors and urban Indians say increasing community health =
center funding doesn't solve the problem.=20

Urban Indians may be reluctant to seek care from a non-Indian clinic. =
Instead, those patients will likely wait to receive medical attention =
until their condition deteriorates, and then they will fill emergency =
rooms. Many urban Indians are too far away from reservations to return =
there for medical care through the Indian Health Service.=20

"They just won't get primary care because they're not going to drive =
those kinds of miles," Schwartz said. "They don't have money for gas. A =
lot of them are disabled and unable to get around."=20

Community health centers are already "stretched to the limit," said Amy =
Simmons, spokeswoman for the National Association for Community Health =
Centers. The proposed program expansion isn't designed to meet the needs =
of urban Indians, Daniel Hawkins, the association's vice president for =
federal, state and public affairs, said in a recent letter to Bush.=20

"My fear is losing our Indian identity," said Schwartz, the Wichita =
clinic CEO. "We would be able to stay open, but would lose our Native =
American programs."=20

At the Wichita clinic, which also operates as a community health clinic, =
urban Indians receive free services and prescriptions. Some 2,700 =
Indians visited the clinic last year.=20

If the funding is dropped, urban Indians there could get health care =
from the community clinic. But they would miss the cultural connection =
they enjoy now because most Indian workers would lose their jobs, =
Schwartz said.=20

"We have so many people who don't know exactly why they're so messed up =
and out drinking and abusing until they talk to someone who understands =
Indian history. There's generations of anger that only someone who =
understands can connect the dots," Schwartz said.=20

Marjorie Bear Don't Walk, executive director of the Indian Health Board =
of Billings, Mont., said if Bush's proposal is approved, her clinic will =
be out of business.=20

"We don't turn away anybody. All of the chairs are filled in the lobby =
and we only have clinic from 1 to 5," she said. "Most of them will have =
nowhere to go."=20

Cynthia Jurosek, who is both a patient and a temporary employee at the =
Billings clinic, wonders what will happen to all the people who rely on =
the clinic for transportation, and to the patients in mental health and =
substance abuse programs.=20

"All these urban clinics, they belong to the Indians," said Jurosek, a =
Crow Indian. "It's where they can go and feel good about themselves. =
They're treated with respect. And that's what I will lose here.=20

"I will lose people who are truly interested in helping me get well."
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<H1 class=3DHeadline>Bush Wants To Eliminate Funding To Indian =
Clinics</H1>
<P>
<DIV class=3Dposted>March 24, 2006</DIV>
<P></P>
<DIV class=3DStoryBody><!--startindex-->When Jennifer Carter moved from =
her=20
reservation to Pierre, S.D., a few years ago, she went from seeing =
Indians like=20
her every day to barely seeing any. But the first time she visited the =
South=20
Dakota Urban Indian Health clinic, she knew she had found her place.=20
<P></P>There, she met Indians just like her, people she could relate to =
and who=20
made her feel comfortable. They were from various tribes. They no =
longer, or=20
never did, live on a reservation.=20
<P></P>"When you all get together, it's like home," said Carter, a =
single mother=20
of four who used to live on the Cheyenne River Sioux Reservation in =
Eagle Butte.=20
"It makes me feel like home."=20
<P></P>To urban Indians, that connection to their culture often means as =
much as=20
the medicine they are prescribed.=20
<P></P>But now that relationship is threatened by President Bush's 2007 =
budget=20
proposal to zero out the $33 million allocation for urban Indian health =
clinics.=20
At least 17 of the 34 clinics across the country may have to close their =
doors,=20
while the rest would be forced to cut services.=20
<P></P>Some 60 percent of American Indians and Alaska natives live in =
urban=20
areas, according to the Census Bureau. And for years - decades in some =
cities -=20
they have been receiving health care at clinics in or near the cities =
where they=20
live. Providing health care to all Indians has been part of the =
government's=20
trust responsibility.=20
<P></P>"Many tribes are viewing this as an assault on trust =
responsibility,"=20
said Geoffrey Roth, executive director of the National Council of Urban =
Indian=20
Health.=20
<P></P>Sen. John McCain, R-Ariz., noted during a Senate Indian Affairs =
Committee=20
hearing last month that even though the proposed cuts could be restored, =
"I=20
think some of these cuts ... clearly sends out the wrong signal to =
Indian=20
Country as to what our belief and our fulfillment of our obligation to =
Native=20
Americans is all about."=20
<P></P>Urban Indian health care clinics, located in 21 states, are =
funded by the=20
Indian Health Service, but operate as private clinics under contract =
with the=20
government. Whether a city has an urban clinic depends on the =
population, health=20
status and poverty level of Indians. They are located in cities as large =
as New=20
York and as small as Butte, Mont.=20
<P></P>Clinics differ in their services -- some offer primary care, =
others just=20
referrals -- but most have programs vital to Indians. Many offer =
comprehensive=20
medical care ranging from dental and vision to mental health. Most have =
alcohol=20
addiction and diabetes programs, because of the prevalence of those =
diseases=20
among Indians.=20
<P></P>The amount patients pay for services varies from clinic to =
clinic. Some=20
are free; others have a sliding fee schedule. Last year, the clinics =
treated=20
more than 106,000 Indians.=20
<P></P>Compared to the U.S. population as a whole, urban Indians have a =
178=20
percent higher death rate from alcohol abuse and a 54 percent higher =
death rate=20
from diabetes, according to a 2004 study by the Seattle Indian Health =
Board's=20
Urban Indian Health Institute.=20
<P></P>At the Hunter Health Clinic in Wichita, Kan., outreach workers =
who help=20
diabetics with exercise, diet and foot care would lose their jobs, and =
mental=20
health and alcohol and substance abuse programs would be cut, said =
Susette=20
Schwartz, clinic chief executive officer.=20
<P></P>Isabelle Gyongyossy, a 78-year-old Oglala Sioux patient at the =
Hunter=20
clinic, has diabetes and heart disease. She takes eight pills a day, =
uses a=20
walker and isn't sure how she will cope if she can no longer use the =
clinic's=20
programs.=20
<P></P>"If they take the funding away, I'll have to pay for a lot of =
things. I=20
won't have any food," she said.=20
<P></P>Urban clinics also offer services many other clinics don't, such =
as=20
transporting patients to and from appointments, something many older =
patients=20
need.=20
<P></P>In Bush's 2007 budget proposal, it is suggested that urban =
Indians can go=20
to community health centers instead, since those centers are slated to =
receive a=20
$181 million increase that would build or expand 300 sites.=20
<P></P>Alex Conant, spokesman for the White House Office of Management =
and=20
Budget, noted the increase and said: "Urban Indians, like all Americans, =

continue to benefit from the president's initiatives to make health care =
more=20
affordable and available."=20
<P></P>But clinic directors and urban Indians say increasing community =
health=20
center funding doesn't solve the problem.=20
<P></P>Urban Indians may be reluctant to seek care from a non-Indian =
clinic.=20
Instead, those patients will likely wait to receive medical attention =
until=20
their condition deteriorates, and then they will fill emergency rooms. =
Many=20
urban Indians are too far away from reservations to return there for =
medical=20
care through the Indian Health Service.=20
<P></P>"They just won't get primary care because they're not going to =
drive=20
those kinds of miles," Schwartz said. "They don't have money for gas. A =
lot of=20
them are disabled and unable to get around."=20
<P></P>Community health centers are already "stretched to the limit," =
said Amy=20
Simmons, spokeswoman for the National Association for Community Health =
Centers.=20
The proposed program expansion isn't designed to meet the needs of urban =

Indians, Daniel Hawkins, the association's vice president for federal, =
state and=20
public affairs, said in a recent letter to Bush.=20
<P></P>"My fear is losing our Indian identity," said Schwartz, the =
Wichita=20
clinic CEO. "We would be able to stay open, but would lose our Native =
American=20
programs."=20
<P></P>At the Wichita clinic, which also operates as a community health =
clinic,=20
urban Indians receive free services and prescriptions. Some 2,700 =
Indians=20
visited the clinic last year.=20
<P></P>If the funding is dropped, urban Indians there could get health =
care from=20
the community clinic. But they would miss the cultural connection they =
enjoy now=20
because most Indian workers would lose their jobs, Schwartz said.=20
<P></P>"We have so many people who don't know exactly why they're so =
messed up=20
and out drinking and abusing until they talk to someone who understands =
Indian=20
history. There's generations of anger that only someone who understands =
can=20
connect the dots," Schwartz said.=20
<P></P>Marjorie Bear Don't Walk, executive director of the Indian Health =
Board=20
of Billings, Mont., said if Bush's proposal is approved, her clinic will =
be out=20
of business.=20
<P></P>"We don't turn away anybody. All of the chairs are filled in the =
lobby=20
and we only have clinic from 1 to 5," she said. "Most of them will have =
nowhere=20
to go."=20
<P></P>Cynthia Jurosek, who is both a patient and a temporary employee =
at the=20
Billings clinic, wonders what will happen to all the people who rely on =
the=20
clinic for transportation, and to the patients in mental health and =
substance=20
abuse programs.=20
<P></P>"All these urban clinics, they belong to the Indians," said =
Jurosek, a=20
Crow Indian. "It's where they can go and feel good about themselves. =
They're=20
treated with respect. And that's what I will lose here.=20
<P></P>"I will lose people who are truly interested in helping me get=20
well."</DIV></DIV></DIV></DIV></BODY></HTML>

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---
avast! Antivirus: Outbound message clean.
Virus Database (VPS): 0612-3, 03/24/2006
Tested on: 3/24/2006 11:28:32 AM
avast! - copyright (c) 1988-2005 ALWIL Software.
http://www.avast.com




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<BR><BR>
<TABLE width=3D400><HR>
<P style=3D"FONT: 9pt/11pt verdana"><a href=3D"http://www.avast.com">avast!=
 Antivirus</a>: Outbound message clean.
<P style=3D"FONT: 8pt/11pt verdana">Virus Database (VPS): 0612-3, 03/24/200=
6<BR>Tested on: 3/24/2006 11:28:32 AM<BR><FONT color=3Dgray>avast! - copyri=
ght (c) 1988-2005 ALWIL Software.</FONT></P>
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