Indian Country Today
A federally run health care facility on tribal land in New Mexico has scaled back many of its services during the COVID-19 pandemic, and those decisions are being questioned by elected officials, including the state's governor and the leader of the pueblo most affected.
The Acoma-Canoncito-Laguna Service Unit, an Indian Health Service facility on the northern edge of the Acoma Pueblo, no longer offers in-patient and emergency care services. It’s unclear when or if these services will be offered again. Hospital hours have been cut, but limited urgent care services remain.
Acoma Pueblo Gov. Brian Vallo said Indian Health Service’s decision to shutter services at the hospital came “without any meaningful consultation with me, my administration or my tribal council.”
“The closure of the ACL hospital and the abrupt termination of health care and emergency medical services during an ongoing global pandemic defies sound public health policy, constitutes a fundamentally flawed course of action and an abdication of the trust responsibility by the Indian Health Service,” Vallo said.
Indian Health Service Director Michael Weahkee said during a Monday news conference that he’s been in contact with Vallo and there has been a “robust dialogue” between his department and Acoma Pueblo for “quite some time.”
The hospital changes, Weahkee said, are related to self-governance and self-determination. Laguna Pueblo, he said, requested in July that a health care facility be built on its pueblo with the federal funding allocated for Laguna. That money is usually designated for the Acoma-Canoncito-Laguna Service Unit, he said. Laguna is nearby and northeast of Acoma.
In late September, Indian Health Service Albuquerque Area entered an agreement with the Laguna Health Corporation on behalf of Laguna Pueblo to provide services that were offered at the Acoma hospital, Weahkee said. The facility is scheduled to open in February.
“With the reduction in federally operated programs, functions, services and activities, and accompanying funds, the IHS will redesign programs and services provided at the service unit,” Weahkee said. “This redesign will be done in consultation with all affected tribes, including the Pueblo of Acoma.”
Acoma-Canoncito-Laguna is near Interstate 40 and about 60 miles west of Albuquerque. It has 25 in-patient beds and serves around 9,100 tribal citizens from multiple tribes, according to the Indian Health Service website. It has 126,000 patient visits each year.
The hospital has been in operation since the mid-1970s and provided in-patient and out-patient care, along with dental, optometry, pharmaceutical and medical emergency services, Vallo said.
The Acoma Pueblo, of about 3,000 citizens, has seen a recent spike in coronavirus cases, including 100 in early November after reporting zero cases in September.
A county hospital in Grants, a small town along the interstate, about 20 miles west of Acoma, and hospitals in Albuquerque are now the only options for Acoma citizens in need of emergency medical care, Vallo said.
Indian Health Service, which falls under Health and Human Services, is working on a redesign of programs and services offered at the Acoma hospital. A timeline for the redesign isn’t known.
The third tribe connected to the hospital, Cañoncito Band of Navajos, pulled its allocated funding a few years ago, Weahkee said. Laguna is the largest shareholder of the hospital with allocation funds of 47 percent of the hospital budget, he said.
“With a major shareholder pulling their funds out of the program, it’s basically leaving about 33 percent of the original budget for operations,” Weahkee said.
Recent Indian Health Service coverage:
New Mexico Gov. Michelle Lujan Grisham, U.S. Sen. Tom Udall and U.S. Rep. Deb Haaland each issued recent statements of support for the Acoma Pueblo.
“My administration will do everything it can do to address this situation with the federal government and work with the Pueblo of Acoma to get people the care they need,” Grisham said.
Grisham recently implemented a statewide shelter-in-place order for two weeks as coronavirus cases increase in the Southwest and across the country.
In a letter dated Nov. 14 and addressed to Weahkee, New Mexico Rep. Patricia Roybal Caballero asked him to “immediately reverse your decision and reinstate full IHS emergency room medical services and in-patient services” at the hospital.
Haaland, Laguna and Jemez Pueblo, said she will be looking into the decision to shutter services and is expecting answers from Health and Human Services.
“This pandemic does not discriminate, and its toll in communities of color has revealed the longstanding disparities that exist in Indian Country,” she said. “This administration is putting lives in danger and needlessly increasing patients’ and families’ distress.”
Vallo is asking Indian Health Service to allocate money it received from the Coronavirus Aid, Relief and Economic Security Act to fund the Acoma hospital. A little more than $1 billion of the CARES Act was set aside for Indian Health Service.
Weahkee said they are looking at all available resources and legal requirements for the use of those funds. He said his department is looking at CARES Act funding to potentially “alleviate the stress of this transition.”
Vallo said he’s asked Congress to keep the hospital open for full service by providing legislative relief and funding.
“I simply say to all of you today, this situation has become a serious matter of life or death here at Acoma and is one that cries out for resolution especially now when COVID-19 is out of control,” Vallo said. “I ask that the Indian Health Service honor and uphold its obligations and reinstate the health care my people deserve.”
Dalton Walker, Red Lake Anishinaabe, is a national correspondent at Indian Country Today. Follow him on Twitter: @daltonwalker Walker is based in Phoenix and enjoys Arizona winters.
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