Post by Okwes on Jun 6, 2007 8:39:41 GMT -5
Alaska tribal health groups join suit
CLASS-ACTION: Nearly a third of a $950 billion shortfall in federal aid should have gone to help Natives, says lawyer.
By ALEX DEMARBAN
Anchorage Daily News
Published: February 14, 2007
Last Modified: February 15, 2007 at 01:44 AM
More than 300 tribal health organizations, including 40 in Alaska, are suing the Indian Health Service for nearly $1 billion.
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They say the agency, responsible for providing health care to American Indians and Alaska Natives, has knowingly and annually shortchanged them since the early 1990s. They are pursuing class-action status for their lawsuit in a federal court in New Mexico.
The 334 tribal organizations, such as Anchorage-based Southcentral Foundation, contract with the agency to deliver health care.
The massive shortfall, representatives say, has hurt a population facing medical crises on many fronts, including soaring rates of diabetes, heart disease, suicide and alcoholism.
Officials with the Indian Health Service in Washington, D.C., acknowledge there's a huge shortfall, but say they've paid out all that Congress allows.
In similar cases in recent years, the U.S. Supreme Court, other federal courts and a federal appeals board have ruled in favor of tribal contractors.
The federal government isn't fully paying tribal contractors, said Dan Winkelman, general counsel for the Yukon-Kuskokwim Health Corp. It doesn't shortchange other contractors, he said.
"We shouldn't be treated as second-class citizens when it comes to health care," he said.
The Bethel-based health corporation, providing care to about 30,000 Natives in 50 Southwest Alaska villages, has been underpaid $50 million since 1992, Winkelman said.
As a result, the hospital can't meet the "enormous" health care needs of the region. The region has cancer rates that are the highest of any ethnicity in the nation, he said. Dental decay rates are more than twice the national average, he said. The hospital employs only six dentists, half what the region needs.
The Indian Health Service, through tribal contractors and direct services, provided health care to 1.9 million Alaska Natives and American Indians last year, said Ron Demaray, who oversees contract support costs at the agency's headquarters in Rockville, Md.
Alaska is divided into 12 regions, where nonprofits such as Yukon-Kuskokwim and the Southcentral Foundation provide health care to Natives. Smaller tribal contractors also provide health care in some villages.
American Indians and Alaska Natives die of alcoholism five times more often than other Americans, according to agency figures. They're more than twice as likely to die from diabetes and 60 percent more likely to commit suicide.
The agency's responsibility to serve Indians and Natives stems from laws as well as treaties between the federal government and tribes, Demaray said.
The fight isn't over what the agency pays contractors for doctors, nurses and needles. It's over the administrative costs required to deliver health care.
At issue is just how much of those administrative costs the agency must pay for, said Demaray. Those administrative costs include such things as insurance, building maintenance and auditing services.
"(The agency believes) we're contracted to provide what Congress provides to us. Others feel it's an entitlement that should be paid regardless," he said.
Last year, the agency paid its tribal contractors about $1.6 billion, Demaray said. Of that, about $264 million went for administrative costs.
But the contractors actually incurred another $70 million in administrative costs, he said. Congress, however, didn't appropriate that extra money so his agency couldn't pay it, he said.
"We can only pay what Congress authorizes us to pay," he said.
Lloyd Miller, an attorney representing tribal organizations, said Congress' decision, made in 1998, might have limited what the agency can pay for administrative costs. But it doesn't change the fact that the federal government still owes that money because it must honor its contracts, he said.
The agency also owes tribal governments for underpaying support costs before 1998, he said.
In 15 years, according to the agency's documents, they've shortchanged the tribal groups more than $950 million, Miller said. Alaska tribal organizations are owed more than $300 million, he estimated.
Southcentral Foundation, providing Native health care in Anchorage and the surrounding region, wants to recover $18 million for a five-year period in the mid- to late-1990s, said Lee Olson, vice president of finance. The agency was underfunded after 2000, and will likely file claims for that money as well, he said.
Southcentral co-manages the Alaska Native Medical Center that serves Natives across the state. It could have hired more doctors and dentists with the money, Olson said, reducing long waiting times in dentistry and optometry.
Southcentral might also have been able to expand health care for Natives in the rapidly growing Mat-Su area, where about 5,000 Natives live, he said. The corporation is responsible for emergency room care at Mat-Su Regional Medical Center and operates a clinic in a Wasilla strip mall.
"Beyond that, all the Alaska Natives must come to Anchorage to receive their health care, unless they go to private providers and pay for it themselves," he said.
There's a very good chance the tribal health contractors will win, said Miller, attorney for the class-action suit.
The suit, originally filed in federal court in 2001 by the Zuni Pueblo in Albuquerque, N.M., was put on hold pending the outcome of a similar case that went to the U.S. Supreme Court, he said. It hasn't been certified as a class-action, he said.
In 2005, the Supreme Court unanimously ruled in favor of two Lower 48 tribes in a "look-alike" case argued by Miller, he said. Federal courts in Portland and Washington, D.C., as well as the federal civilian contract appeals board, also said the agency must fully pay contractors, Miller said.
CLASS-ACTION: Nearly a third of a $950 billion shortfall in federal aid should have gone to help Natives, says lawyer.
By ALEX DEMARBAN
Anchorage Daily News
Published: February 14, 2007
Last Modified: February 15, 2007 at 01:44 AM
More than 300 tribal health organizations, including 40 in Alaska, are suing the Indian Health Service for nearly $1 billion.
Story tools
E-mail a friend
Digg this
Seed Newsvine
Send link via AIM
Font size : A | A | A
They say the agency, responsible for providing health care to American Indians and Alaska Natives, has knowingly and annually shortchanged them since the early 1990s. They are pursuing class-action status for their lawsuit in a federal court in New Mexico.
The 334 tribal organizations, such as Anchorage-based Southcentral Foundation, contract with the agency to deliver health care.
The massive shortfall, representatives say, has hurt a population facing medical crises on many fronts, including soaring rates of diabetes, heart disease, suicide and alcoholism.
Officials with the Indian Health Service in Washington, D.C., acknowledge there's a huge shortfall, but say they've paid out all that Congress allows.
In similar cases in recent years, the U.S. Supreme Court, other federal courts and a federal appeals board have ruled in favor of tribal contractors.
The federal government isn't fully paying tribal contractors, said Dan Winkelman, general counsel for the Yukon-Kuskokwim Health Corp. It doesn't shortchange other contractors, he said.
"We shouldn't be treated as second-class citizens when it comes to health care," he said.
The Bethel-based health corporation, providing care to about 30,000 Natives in 50 Southwest Alaska villages, has been underpaid $50 million since 1992, Winkelman said.
As a result, the hospital can't meet the "enormous" health care needs of the region. The region has cancer rates that are the highest of any ethnicity in the nation, he said. Dental decay rates are more than twice the national average, he said. The hospital employs only six dentists, half what the region needs.
The Indian Health Service, through tribal contractors and direct services, provided health care to 1.9 million Alaska Natives and American Indians last year, said Ron Demaray, who oversees contract support costs at the agency's headquarters in Rockville, Md.
Alaska is divided into 12 regions, where nonprofits such as Yukon-Kuskokwim and the Southcentral Foundation provide health care to Natives. Smaller tribal contractors also provide health care in some villages.
American Indians and Alaska Natives die of alcoholism five times more often than other Americans, according to agency figures. They're more than twice as likely to die from diabetes and 60 percent more likely to commit suicide.
The agency's responsibility to serve Indians and Natives stems from laws as well as treaties between the federal government and tribes, Demaray said.
The fight isn't over what the agency pays contractors for doctors, nurses and needles. It's over the administrative costs required to deliver health care.
At issue is just how much of those administrative costs the agency must pay for, said Demaray. Those administrative costs include such things as insurance, building maintenance and auditing services.
"(The agency believes) we're contracted to provide what Congress provides to us. Others feel it's an entitlement that should be paid regardless," he said.
Last year, the agency paid its tribal contractors about $1.6 billion, Demaray said. Of that, about $264 million went for administrative costs.
But the contractors actually incurred another $70 million in administrative costs, he said. Congress, however, didn't appropriate that extra money so his agency couldn't pay it, he said.
"We can only pay what Congress authorizes us to pay," he said.
Lloyd Miller, an attorney representing tribal organizations, said Congress' decision, made in 1998, might have limited what the agency can pay for administrative costs. But it doesn't change the fact that the federal government still owes that money because it must honor its contracts, he said.
The agency also owes tribal governments for underpaying support costs before 1998, he said.
In 15 years, according to the agency's documents, they've shortchanged the tribal groups more than $950 million, Miller said. Alaska tribal organizations are owed more than $300 million, he estimated.
Southcentral Foundation, providing Native health care in Anchorage and the surrounding region, wants to recover $18 million for a five-year period in the mid- to late-1990s, said Lee Olson, vice president of finance. The agency was underfunded after 2000, and will likely file claims for that money as well, he said.
Southcentral co-manages the Alaska Native Medical Center that serves Natives across the state. It could have hired more doctors and dentists with the money, Olson said, reducing long waiting times in dentistry and optometry.
Southcentral might also have been able to expand health care for Natives in the rapidly growing Mat-Su area, where about 5,000 Natives live, he said. The corporation is responsible for emergency room care at Mat-Su Regional Medical Center and operates a clinic in a Wasilla strip mall.
"Beyond that, all the Alaska Natives must come to Anchorage to receive their health care, unless they go to private providers and pay for it themselves," he said.
There's a very good chance the tribal health contractors will win, said Miller, attorney for the class-action suit.
The suit, originally filed in federal court in 2001 by the Zuni Pueblo in Albuquerque, N.M., was put on hold pending the outcome of a similar case that went to the U.S. Supreme Court, he said. It hasn't been certified as a class-action, he said.
In 2005, the Supreme Court unanimously ruled in favor of two Lower 48 tribes in a "look-alike" case argued by Miller, he said. Federal courts in Portland and Washington, D.C., as well as the federal civilian contract appeals board, also said the agency must fully pay contractors, Miller said.