Clinic for Indians faces cut in funds

More than 7,000 Native Americans in the Seattle area would see cuts in their health care under President Bush's budget proposal, according to an Indian health official.

Bush has proposed cutting all of the $33 million that had been requested for the national Urban Indian Health Program, including about $3.5 million for the Seattle Indian Health Board.

That would be a 40 percent cut for the Seattle program, the largest of 34 such clinics in the nation, and would cause reductions in services for general medical and dental care, diabetes, mental health, chemical dependency, immunizations and the homeless, said Rebecca Corpuz, associate director of the Seattle Indian Health Board.

"I think a lot of people would end up in hospital emergency rooms or receive no care at all," she said. "This doesn't feel good."

Bush administration officials said the cuts would be compensated for by a proposed $181 million increase in funds for 1,200 expanded or new community health centers nationwide that serve mostly low-income patients. But federal budget officials said the increase is intended for poor or rural communities with limited health-care access, and Seattle has dozens of clinics for the poor.

Kay Garvey, a spokeswoman for the Health Resources and Services Administration, said "it's not likely" any Seattle clinics would qualify for the new funds.

Corpuz said the city's Indians and Alaska Natives have many special medical, psychological and cultural needs that should be served by the Indian Health Board, at 12th Avenue South and South Weller Street.

"We have a lot of patients who won't go anywhere else," she said. "They worry about finances, what they see as racism, and they're intimidated by the health-care system."

Corpuz said about half the clinic's 2,000 dental patients could lose their care, many of them children. The care begins at age 1, including tooth sealants to prevent cavities, and parental education about oral hygiene. Many adults need dentures.

"We see some teenagers [who haven't had care] who have lost all their permanent teeth by age 16," Corpuz said.

Diabetes, which affects more than 15 percent of American Indians and Alaska Natives, is also a focus of the clinic. A program for about 300 diabetics emphasizes education, diet, exercise and close monitoring of blood-sugar levels. About 200 of the patients who regularly visit the clinic now have the disease under control, Corpuz said.

Many mothers and children also depend on the clinic. About 200 women a year receive pregnancy tests, and about 100 babies are delivered through the program. It includes prenatal care and continuing care and nutrition for the mothers and their infants.

The infant-mortality rate for Indians and Native Alaskans in King County is 14.9 per 1,000 live births; for all races combined, it's 4.9 per 1,000.

"We're trying to make strides in decreasing this rate in Native populations," Corpuz said.

Also at the clinic, a mental-health program helps hundreds who suffer from depression or post-traumatic stress disorder. The clinic treats a variety of medical problems of homeless patients. And it operates the Thunderbird Treatment Center for 96 patients with alcohol and drug addiction, including about 16 chronic street alcoholics at any given time.

Overall, the clinic logs about 40,000 patient visits a year for its variety of services. More than 70 percent of the patients live at or below the federal poverty level. Often, their efforts to get care elsewhere have been difficult experiences, Corpuz said.

"They don't understand where these people are coming from," she said. "The doctor says go get this or that for your kids, but they don't because they can't afford it, and then they don't go back. It makes them feel hopeless, helpless and depressed."

In a U.S. House Ways and Means Committee hearing Wednesday, U.S. Rep. Jim McDermott, D-Seattle, pointedly questioned Department of Health and Human Services Secretary Mike Leavitt about elimination of the urban Indian clinics.

McDermott said the cutback would force patients to "go from a culturally sensitive clinic that has been dealing with urban Indian problems, and you're going to throw them out ... to compete with other uninsured in the community. There is no justice in that."

U.S. Rep. Norm Dicks, D-Bremerton, said he successfully fought off a partial cut to the Urban Indian Health Program last year and vowed to do the same this year.

"This is one of those mindless cuts this administration makes because they're spending all this money on defense, on the war," Dicks said. "I think this [cut] would be a tragedy not only in Seattle but all across the country."

Congressional committee meetings and budget deliberations could take until fall before a final decision is make on funds for the clinics.

Warren King: 206-464-2247 or wking@seattletimes.com