Future hazy for Indian clinic

Federal funds may end, force S.L. health center to close

Published: Saturday, March 25 2006 12:00 a.m. MST

Rad Cuch sorts food for a client at the Food Pantry in the Indian Walk-in Center Friday. Proposed budget cuts target urban Indian health clinics.

Laura Seitz, Deseret Morning News

Since she moved to Salt Lake City from the Navajo Indian Reservation, Priscilla Harvey has relied on the Indian Walk-in Center for health care and occasional food assistance.

But for Harvey, 37, the center is more than a clinic. It also provides a social network, helping her stay connected to her culture through activities such as powwows. That's critical for Harvey, who lived her entire life in the Four Corners area until she moved here about a year ago.

"We're out in the middle of the white man's world," Harvey said. "It's nice to keep tradition."

But now, Utah's only urban Indian health clinic is threatened by President Bush's 2007 budget proposal to erase the $33 million federal allocation for urban Indian health clinics. At least 17 of the 34 clinics across the country, including Salt Lake's, may have to close their doors, while the rest would be forced to cut services.

If the center were closed, Harvey said she doesn't know where she'd go for the same services.

"I'd probably move back" to the reservation, she said.

Dena Ned, executive director of the Indian Walk-in Center, 120 W. 1300 South, said the center serves an estimated 4,000 urban Indians each year, most of whom are uninsured and at or below the poverty level.

"If we were closed, I don't know where they'd go," Ned said. "The only viable solution to this is that the dollars are fully restored."

In Bush's 2007 budget proposal, it is suggested that urban Indians can go to community health centers instead, since those centers are slated to receive a $181 million increase that would build or expand 300 sites.

Alex Conant, spokesman for the White House Office of Management and Budget, noted the increase and said: "Urban Indians, like all Americans, continue to benefit from the president's initiatives to make health care more affordable and available."

But clinic directors and urban Indians say increasing community health center funding doesn't solve the problem.

"Many tribes are viewing this as an assault on trust responsibility," said Geoffrey Roth, executive director of the National Council of Urban Indian Health.

Community health centers are already "stretched to the limit," said Amy Simmons, spokeswoman for the National Association for Community Health Centers. The proposed program expansion isn't designed to meet the needs of urban Indians, said Daniel Hawkins, the association's vice president for federal, state and public affairs, in a recent letter to Bush.

In Utah, Dexter Pearce, deputy director of Community Health Centers Inc., said he wasn't sure about the current proposal, but a federal funding increase of $1 million over the past five years all went to rural areas.

Community Health Centers has a $200,000 contract to provide primary care for the Indian Walk-in Center.

"If there's not a dollar-for-dollar exchange, we would have to make that up somehow," he said. "Someone would go without services."

Ned said she's optimistic that Congress won't let the budget cut stand. However, if the center were to lose its $1.1 million in federal contracts, it would also lose grant funding, effectively cutting 90 percent of the center's $1.5 million budget, she said.

The Indian Walk-in Center's free health and behavioral health services include diabetes education, immunizations, substance abuse treatment, mental health counseling, holistic care, HIV testing and counseling, and youth programs. It also operates a United Way-funded food pantry, which handed out some 5,200 boxes of food to both Indians and non-Indians last year.

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