Bush administration seeks to eliminate urban Indian health care

In a widely anticipated move, the Bush Administration has proposed to eliminate Urban Indian Health Program (UIHP) funding (Title V) in the FY 2008 budget. It is the assertion of the Administration that the medical services offered by Urban Indian Health Programs are a duplication of services already provided by the nationwide network of Community Health Centers.

"This is an outrage," said National Council of Urban Indian Health (NCUIH) Executive Director Geoffrey Roth immediately after learning of the budget cut. "While the elimination comes as no shock to Indian Country, the Administration's continued disregard of the urgent health care needs of the urban Indian population and Tribes' rights to self-determination is nevertheless disconcerting."

The unique and non-duplicative nature of the Urban Indian Health Program has been long recognized by national community and health partners. For instance, in response to last year's elimination proposal, the National Association of Community Health Centers, Inc. indicated in strong terms that Community Health Centers have neither the means nor the capacity to take on a significant urban Indian patient load, which would occur if the NACA Family Health Center no longer received Title V funding. Similarly, sending the urban Indian population back to the Tribal Health Clinics is not a viable option since the Indian Health Service's system of care is already under-funded and stretched to the limit, and many urban Indians cannot afford the transportation costs and time away from work involved in making the trips to the tribal clinics.

The three Urban Indian Health Programs in Arizona, providing primary health care, counseling, outreach and referral services to growing urban Indian populations, operate in Flagstaff, Phoenix and Tucson. Dana Russell, CEO for Native Americans for Community Action, Inc. (NACA), based in Flagstaff an Urban Indian Health Program, which has served the community since 1991, finds the President's issue with UIHP support ($32.7 million) is risking the health of urban American Indians across the nation. This is particularly disappointing and ironic in light of the fact that many millions more dollars are directed to other countries like Iraq to establish a network of hospitals and clinics. Mr. Russell states, "This only perpetuates the thinking that health care (and other) issues for the First Americans seem to take a back seat to international relief and conflict."

Today, as many as 65 percent of Americans identifying themselves as American Indians and Alaska Natives live in urban areas. There are only 34 Urban Indian health program clinics to provide culturally relevant medical services to this population. As reported by many of the clinics, losing Title V funding would result in discontinuation of well over half of the clinics providing services to approximately 120,000 urban Indian patients annually, as well as bankruptcies and defaults on leases on buildings used for those purposes. In sum, lack of services would force many urban Indians to be unable to seek needed health care, thus increasing - not decreasing - the gross health care disparities and acute care costs for American Indians and Alaska Natives.

This is the second year in a row that the Urban Indian Health Program has been initially zeroed out. The first time was in the FY 2007 budget. Last year's proposal, however, was resoundingly rejected by Congress, which fully restored funding in the current federal budget.

NCUIH is launching a nation-wide advocacy campaign in support of the restoration of UIHP funding in FY 2008. Petition letters can be submitted online at www.ncuih.org. With questions or for further information about the Title V elimination, feel free to contact NACA at (928) 526-2968 or visit the website at www.nacainc.org.

Dana Russell, CEO

Native Americans for Community Action

Flagstaff