State trying to make up for health care cuts

By Kristen Davenport
For The Independent

SANTA FE — State lawmakers say they are scrambling to find money to make up for huge federal cuts to the Indian Health Service.

And, they say, Santa Fe plans to send a message to Washington this year: Money must be restored to the nation's Native health care system.

Gov. Bill Richardson said Tuesday he is asking the federal congressional delegation to restore funding for health care on reservations and to reauthorize the federal Indian Health Care Improvement Act.

"In several meetings with New Mexico's 22 federally recognized Indian Pueblos, Tribes and Nations, one issue came across loud and clear: we must improve Native American health care," Richardson said. An even steeper cut recommended by George Bush's proposed 2008 budget $33 million less for the IHS will have a "devastating effect" on New Mexico, Richardson said.

In the meantime, however, the New Mexico State Legislature has been forced to find money to fill in some of the gaps in Native health care special funding requests for items such as behavioral health services or $2 million needed for a new dialysis center at the hospital in Gallup.

Disparities
And, Speaker of the House Ben Lujan, who has requested $10 million from the legislature this year to cover the costs of his Native American Health Care Act, HB 784, cites the federal government's failure to meet its trust responsibility to tribes, saying the federal government "continues to withdraw support from the Indian Health Service, and this lack of support for health care services for Native Americans results in severe disparities" in health care between Native and non-Native peoples.

The $10 million in Lujan's bill would go toward finding ways to reduce those disparities by increasing access and working relationships between health care providers on the reservation and those off site.

Rep. Ray Begaye, D-Shiprock, agrees that the state is being forced to make up the difference.

"This is the worst I've ever seen it," Begaye said. "I think a lot of the Indian people have suffered major health consequences because of the cuts to Indian Health Service."

Begaye said reservations have also lost many doctors and health care providers from surgeons to midwives because of IHS cuts.

Begaye said he successfully inserted a $2 million appropriation for health care for Native children checkups, immunizations and other basic health care items the IHS can no longer handle into the state's general budget, which passed the House Tuesday by a vote along party lines.

War vs. welfare
Sen. Lynda Lovejoy, D-Crownpoint, said she is also introducing bills to fund behavioral health care, but nothing specifically to fill gaps left behind by IHS.

"But I agree that the federal government is sending all the money into military operations and that is leaving a lot of health and human services with shortfalls including the Indian Health Service," Lovejoy said. Lovejoy said she is thinking of introducing a memorial into the Senate asking the federal government to restore funding to the IHS.

"This is a prime time to really send a strong message to Congress that this is not acceptable," she said. "In some ways the state can pick up some of these services for the IHS. But the state Indian health care law should not be a substitute for their negligence in keeping IHS underfunded."

In particular, Lovejoy said, she believes diabetes programs are terribly underfunded, as well as prescription drug programs and contract services.

Dialysis center
In Gallup, the dialysis center at the Rehoboth McKinley hospital has been filled to capacity for several years, as the IHS is not providing dialysis treatment for patients mostly those with end-stage diabetes.

The dialysis center now sends patients to another clinic in Zuni, and soon will have to send them to Albuquerque when Zuni is full. The Gallup-area congressional delegation plans to fund a $2 million dialysis center in Gallup to fill that gap so patients from the reservation don't end up driving to Albuquerque for kidney treatments.

"The dialysis center is definitely part of that trend," said Patty Lundstrom, D-Gallup. "In particular with diabetes, it's almost epidemic here."

Although not all of it can be attributed to health care gaps, Lundstrom said much of the 11 percent increase in this year's state budget which came in over $5 billion was due to "unfunded mandates" from the federal government. Some of those are in health care, and others in education such as unfunded requirements of the No Child Left Behind law.

But, there's no way the state can make up for all the disparities in native health care, lawmakers say.

Richardson said in a press release Tuesday that an extensive state study found that Native Americans experienced the highest rates of death for diabetes, pneumonia, alcoholism and cirrhosis. Richardson said many tribal members believe they don't need insurance because they have direct access to health care through the IHS when, in fact, "these services had either eroded or are grossly underfunded."

HB 784, the Native Health Care Act, passed its first committee last week and will likely be put to a vote by the House soon.

Richardson said he is also calling for the federal government to reauthorize the Indian Health Care Improvement Act in Congress. The act was first passed in 1976 and has been reauthorized four times since. But since 2000, the act which authorizes and expands all types of Native health care has been expired.