FRESNO, Calif. – After tribal elder Vera Quiroga was turned away from the very clinic she had helped to found, she had little choice but to drive to a far-off reservation for her dental work.
The reason, she said, is that the U.S. Bureau of Indian Affairs doesn’t recognize her as a Yaqui, even though her children and grandchildren have tribal documentation.
“They said if you don’t have federal paperwork you can’t get service anymore,” said Quiroga, 82.
While federal law requires taxpayer-funded tribal clinics to serve all patients of Indian ancestry, some have recently stopped admitting those who can’t document their federal tribal status, patients and clinic officials say.
Federal officials deny that qualified patients are being turned away and say they’re doing all they can to ensure a health program for urban Indians isn’t shut down entirely. The Indian Health Service oversees 33 clinics nationwide that provide free or discounted medical services to city-dwelling Indians.
But Martin Young, chairman of the board of the Santa Barbara clinic where Quiroga was turned away, said it received a letter last fall from the Bureau of Indian Affairs instructing it to stop offering free health services to patients from unrecognized tribes or who don’t have a bureau identification card.
It has since turned away about 200 patients, he said.
An Indian Health Service spokesman said the letter explained who was eligible for care, but denied that the agency instructed Santa Barbara to withhold services. However, clinic managers in Tucson, Ariz.; Wichita, Kan.; and Boston reported getting similar directives.
“IHS is suddenly saying that you can’t serve this Indian even though he looks Indian, and his family says he’s Indian and has all of this history of being Indian, but he doesn’t have this piece of paper,” said Susette Schwartz, director of the Hunter Health Clinic in Wichita. “We need some consistency.”
Under the American Indian Health Care Improvement Act of 1976, Congress funds health care programs for members of tribes recognized by states or the federal government, as well as their descendants. Many states recognize tribes the federal government does not.
In California, the right to government-supported medical care is extended a step further, to those whose ancestors lived there in 1852 and are “regarded as an Indian by the community.”
Phyllis Wolfe, who oversees urban Indian programs at the U.S. Department of Health and Human Services, said clinics that are granted federal dollars must follow federal guidelines. Program officials did not answer requests to clarify any possible exceptions.
Lisa Flores, an environmental planner and documented Pascua-Yaqui member who attended diabetes counseling classes at a now-defunct Fresno clinic, has given up on getting native-focused care in her area.
“From a tribal perspective we’re all supposed to take care of each other,” she said. “Now that they closed it, the question then becomes: Are you unworthy of health care?”
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