Tribe to operate health clinic despite a lag in IHS approval

IGNACIO, Colo. – A lengthy battle by the Southern Ute Indian Tribe ended with a win Oct. 1 as the tribe prepared to take over operation of the Southern Ute Health Center, a former IHS facility that provides health care to Southern Ute tribal members and other local American Indians.

“The tribe has been looking forward to this date for a long time and many tribal leaders, including previous chairmen, members of prior tribal councils, and numerous tribal members committed to improving our health care have brought us to this point,” said Matthew Box, Southern Ute tribal chairman.

When the tribe wanted to run the clinic itself nearly five years ago, IHS balked, contending that funding shortages from diminished congressional appropriations and increased tribal applications to operate clinics conflicted with mandates favoring tribal control under the Indian Self-Determination and Education Assistance Act and other legislation.

But a federal court ruled IHS didn’t have the discretion to decline the Southern Ute clinic proposal “on the basis of insufficient Congressional appropriations to pay CSC (contract support costs)”or to require funding waivers or other contract modifications by the tribe.

Now, additional federal money has been allocated to help tribes with costs of running programs themselves – the contract support costs – which were cut in 2008, despite the fact that more and more tribes wanted to take over federally-administered programs.

IHS and the Southern Ute Indian Tribe agreed to a contract under the act that allowed the tribe to begin management of the health center “while still allowing for the resolution of the issues that led to the litigation,” the tribe’s press release states. The contract is under an order from federal court in New Mexico.

“Unfortunately, it has taken us longer to get here than we had hoped, but we are excited that we can now move forward with our plans for providing quality health care to our members and other Indians in the community,” Box said.

He said health care is a top priority for the Southern Ute Indian tribal council, and that taking over management of the health center helped meet that priority. “Although changes may not immediately be seen, the tribe’s management of the health center will ultimately mean we can be more responsive to the health care needs of our members rather than relying on the IHS.”

The Southern Ute Health Center had formerly been one of two IHS centers at Ignacio and Towaoc, Colo. and a field health station in White Mesa, Utah, serving Southern Ute and Ute Mountain Ute members. The health centers were among eight service units administered by IHS’ Albuquerque Area office.

The center’s services include medical, nursing, dental, optometry, nutrition, community health nursing, mental health, social services, substance abuse, and others, along with general clinics.

The tribe had initially proposed such a transfer to IHS as early as 2005 under the Indian Self-Determination Act, which advocates for tribes to have maximum participation in directing federal services to Indian communities “so as to render such services more responsive to the needs and desires of those communities.”

“Tribal programs have clearly increased the quality and level of services in their health systems fairly significantly over direct service programs,” notes the National Congress of American Indians, and failing to adequately fund contract support costs “is defeating the very programs that appear to be helping improve health conditions” for Native people.

The Southern Ute reservation covers more than 1,000 square miles in southwest Colorado along the northern border of New Mexico. Population in the area is about 11,000, of whom about 1,400 are tribal members.