Post by Okwes on Mar 17, 2006 12:12:03 GMT -5
Clinic is facing grim prognosis; Federal budget would slash Indian health center funding
His medical problem wasn't serious, but in other ways, the young Navajo was in
critical condition.
A new arrival to San Diego from the sprawling Arizona reservation where he'd
lived all of his 20-some years, he was overwhelmed. The city seemed so large, so
loud, so bustling. So alienating.
At the San Diego American Indian Health Center – which is now facing a crisis of
its own – he told Dr. Richard Tew he had been going up to the roof of his
apartment building, because only there, closer to the sky, did his heart stop
racing.
Most physicians might not grasp what that young man was describing three years
ago, or what it had to do with health care. But after seven years at San Diego's
only clinic for “urban Indians” – those from non-local tribes – Tew knew what
the patient needed. He sent him to pray in a sweat lodge on the Viejas
reservation.
“I recognized something about his anxiety,” Tew said. “I let him know there are
people in this city that he could connect with.”
Since 1979, the small outpatient clinic has been providing mainstream and
culturally tailored medical, dental and behavioral-health care to the region's
large and diverse urban Indian population.
A looming federal budget cut could force its closure.
“We are much more than just a health center,” executive director Crystal Tetrick
said. “We provide unique, unduplicated services for the American Indians that
the community health centers will not be able to provide.”
The Bush Administration's proposed fiscal 2007 budget earmarks $3.2 billion for
the U.S. Indian Health Service – an overall increase of 4 percent – but
eliminates all funding for the service's urban health program on which the San
Diego clinic and 33 others nationwide depend. Cutting the $33 million in urban
program funding shaves about 1 percent from the Indian health budget.
The clinic at First Avenue and Maple Street in Midtown, one of 10 statewide,
relies on the urban health funds for 47 percent of its $1.8 million budget,
Tetrick said. The rest comes from grants, insurance payments, Medicare and
Medi-Cal.
As Congress prepares to debate the budget over the next three to four months,
Tetrick and other urban Indian clinic administrators are pleading for help.
“I don't think we would be able to provide health care services,” without the
federal funds, Tetrick said. “We would just be a referral service.”
The urban program is being eliminated to preserve the Indian Health Service's
primary focus – reservation hospitals and clinics, an agency spokeswoman said.
“We mostly serve rural and reservation-based Indians,” said Dianne Dawson of the
health service. “Fifty-four percent of our budget goes to tribes to manage their
own health programs.”
Tetrick said about 70 percent of the nation's American Indians live in cities,
not on reservations. That's largely because of a federal push in the 1950s to
assimilate Indians by relocating them to urban areas.
Tetrick said census figures show 60 percent of the 24,000 American Indians in
San Diego County belong to non-local tribes – Navajo, Lakota and dozens of
others. The local urban Indian population swells to 43,000 when those of mixed
ancestry, who aren't officially enrolled in tribes, are included, she said.
The San Diego clinic treats patients of any ethnicity, but its focus is on
American Indians. Tetrick and most of her staff have native backgrounds and are
especially attuned to afflictions prevalent among Indians, such as diabetes and
alcoholism.
The clinic has outreach workers for homebound patients and talking circles for
recovering addicts. It also runs “family wellness” meetings, exercise groups and
culture camps for troubled teens.
Besides dispensing health care, the clinic provides a referral network and a
sense of community for urban Indians, Tetrick said.
“There's not an American Indian neighborhood (in San Diego). They're dispersed,”
she said. “We're bringing American Indian people together.”
The clinic sees 6,000 patients a year, most of whom are low-income. They pay as
little as $10 per visit on a sliding scale based on their income and insurance.
Juan Castellanos, executive director of San Diego's Indian Human Resource
Center, an employment and social-services agency for urban Indians, said his
office refers patients to the clinic almost daily.
“There is no other agency that could fill the void that would be created if they
were to be de-funded,” he said. “American Indians need some kind of a place . .
. where they feel people understand them, understand their culture.”
In the waiting room one morning last week, patient Randolph Hood was dozing in
an armchair, waiting for his diabetes checkup. The Shawnee Indian, 49, had
gotten up at 5:30 a.m. to ride a bus from San Marcos for his 10:30 a.m.
appointment.
Hood, a part-time librarian with no health insurance, said he's been a patient
at the clinic for 10 years.
“I'm coming here because that's what I can afford,” he said. “It's the only
clinic I go to.”
<http://www.kumeyaay.com/news/news_detail.html?id=3708>
Material appearing here is distributed without profit or monitory gain to
those
who have expressed an interest in receiving the material for research and
educational purposes. This is in accordance with Title 17 U. S. C. section 107.
www4.law.cornell.edu/uscode/17/107.html
His medical problem wasn't serious, but in other ways, the young Navajo was in
critical condition.
A new arrival to San Diego from the sprawling Arizona reservation where he'd
lived all of his 20-some years, he was overwhelmed. The city seemed so large, so
loud, so bustling. So alienating.
At the San Diego American Indian Health Center – which is now facing a crisis of
its own – he told Dr. Richard Tew he had been going up to the roof of his
apartment building, because only there, closer to the sky, did his heart stop
racing.
Most physicians might not grasp what that young man was describing three years
ago, or what it had to do with health care. But after seven years at San Diego's
only clinic for “urban Indians” – those from non-local tribes – Tew knew what
the patient needed. He sent him to pray in a sweat lodge on the Viejas
reservation.
“I recognized something about his anxiety,” Tew said. “I let him know there are
people in this city that he could connect with.”
Since 1979, the small outpatient clinic has been providing mainstream and
culturally tailored medical, dental and behavioral-health care to the region's
large and diverse urban Indian population.
A looming federal budget cut could force its closure.
“We are much more than just a health center,” executive director Crystal Tetrick
said. “We provide unique, unduplicated services for the American Indians that
the community health centers will not be able to provide.”
The Bush Administration's proposed fiscal 2007 budget earmarks $3.2 billion for
the U.S. Indian Health Service – an overall increase of 4 percent – but
eliminates all funding for the service's urban health program on which the San
Diego clinic and 33 others nationwide depend. Cutting the $33 million in urban
program funding shaves about 1 percent from the Indian health budget.
The clinic at First Avenue and Maple Street in Midtown, one of 10 statewide,
relies on the urban health funds for 47 percent of its $1.8 million budget,
Tetrick said. The rest comes from grants, insurance payments, Medicare and
Medi-Cal.
As Congress prepares to debate the budget over the next three to four months,
Tetrick and other urban Indian clinic administrators are pleading for help.
“I don't think we would be able to provide health care services,” without the
federal funds, Tetrick said. “We would just be a referral service.”
The urban program is being eliminated to preserve the Indian Health Service's
primary focus – reservation hospitals and clinics, an agency spokeswoman said.
“We mostly serve rural and reservation-based Indians,” said Dianne Dawson of the
health service. “Fifty-four percent of our budget goes to tribes to manage their
own health programs.”
Tetrick said about 70 percent of the nation's American Indians live in cities,
not on reservations. That's largely because of a federal push in the 1950s to
assimilate Indians by relocating them to urban areas.
Tetrick said census figures show 60 percent of the 24,000 American Indians in
San Diego County belong to non-local tribes – Navajo, Lakota and dozens of
others. The local urban Indian population swells to 43,000 when those of mixed
ancestry, who aren't officially enrolled in tribes, are included, she said.
The San Diego clinic treats patients of any ethnicity, but its focus is on
American Indians. Tetrick and most of her staff have native backgrounds and are
especially attuned to afflictions prevalent among Indians, such as diabetes and
alcoholism.
The clinic has outreach workers for homebound patients and talking circles for
recovering addicts. It also runs “family wellness” meetings, exercise groups and
culture camps for troubled teens.
Besides dispensing health care, the clinic provides a referral network and a
sense of community for urban Indians, Tetrick said.
“There's not an American Indian neighborhood (in San Diego). They're dispersed,”
she said. “We're bringing American Indian people together.”
The clinic sees 6,000 patients a year, most of whom are low-income. They pay as
little as $10 per visit on a sliding scale based on their income and insurance.
Juan Castellanos, executive director of San Diego's Indian Human Resource
Center, an employment and social-services agency for urban Indians, said his
office refers patients to the clinic almost daily.
“There is no other agency that could fill the void that would be created if they
were to be de-funded,” he said. “American Indians need some kind of a place . .
. where they feel people understand them, understand their culture.”
In the waiting room one morning last week, patient Randolph Hood was dozing in
an armchair, waiting for his diabetes checkup. The Shawnee Indian, 49, had
gotten up at 5:30 a.m. to ride a bus from San Marcos for his 10:30 a.m.
appointment.
Hood, a part-time librarian with no health insurance, said he's been a patient
at the clinic for 10 years.
“I'm coming here because that's what I can afford,” he said. “It's the only
clinic I go to.”
<http://www.kumeyaay.com/news/news_detail.html?id=3708>
Material appearing here is distributed without profit or monitory gain to
those
who have expressed an interest in receiving the material for research and
educational purposes. This is in accordance with Title 17 U. S. C. section 107.
www4.law.cornell.edu/uscode/17/107.html