Tulalips to move pharmacy to limit who gets free drugs

TULALIP – A pharmacy in the Tulalip Tribes’ health clinic that has served American Indians free of charge for 14 years will close in May.

A new pharmacy will open then in Quil Ceda Village. It will be open to the general public as well as Indians.

The change will save the tribes nearly $1 million every year, said Steve Gobin, former health and human services director for the tribes.

Gobin is now deputy general manager for Quil Ceda Village.

“Since (the pharmacy) is in the Indian Health Clinic, we were required to provide pharmaceuticals to anyone of Native American descent free of charge,” he said.

By removing the pharmacy from the clinic, the tribes can limit distribution of the free medication to Tulalip members only.

The Indian Health Service, the federal agency that handles funding for tribal health services, doesn’t fully reimburse the Tulalip Tribes for the cost of providing medications free, Gobin said.

“We’ve had several meetings with Indian Health Service to try to solve the situation – unsuccessfully,” he said.

Denise Imholt, the Portland, Ore.-based Indian Health Service agent who handles funding for the Tulalip Tribes, did not respond to requests for comment.

The tribes opened their first clinic in 1979 in a collection of trailer homes totaling 6,000 square feet. When the clinic moved to a new 26,000-square-foot building in 2003, Indians from around the region and beyond were attracted to it.

The clinic’s caseload grew by nearly 50 percent, to about 6,000 patients, clinic manager Karen Fryberg said.

Only about 2,000 of those patients are Tulalip tribal members, Gobin said. The rest are Indians from other tribes who can receive free prescription drugs from the pharmacy.

“We’re losing about $800,000 a year,” Gobin said. “Because of economics, I’m forced to close the pharmacy.”

Tulalip tribal members will continue to get free prescription drugs at the new pharmacy, but everyone else will have to pay in full or use an outside insurance plan, he said. The pharmacy will hire couriers to deliver prescription drugs to Tulalip tribal elders.

The Tulalip Tribes negotiated with the Indian Health Service for a “self-governance grant” to serve 1,600 people in 1993, Gobin said. Since then, the tribes have received $3.8 million each year from the agency.

That amount hasn’t grown, even though the number of people the clinic serves has.

“That’s not even half of what our total operating budget is,” Fryberg said. “We’re not getting what Indian Health Service is supposed to give to run our base. The tribe is subsidizing the rest.”

Western Washington’s Indian tribes were promised continued medical care when they ceded what is now about a fifth of the state to the federal government in 1855. Fryberg, Gobin and others believe the Indian Health Service is violating that agreement by failing to fully subsidize tribal health clinics.

“We hardly get squat from (Indian Health Service,)” said Shawn Yannity, chairman of the Stillaguamish Tribe.

The Stillaguamish Tribe owns land scattered throughout the Arlington area. Most of the tribes’ 200 members don’t live in Snohomish County.

Some Stillaguamish tribal members travel to Tulalip for health care, Yannity said.

“We try to take care of our tribal members,” he said. “If our members come to our (Stillaguamish) clinic, Indian Health should be covering it. If Indian Health can’t cover it, we try to take care of it.”

But if a tribal member needs specialty care, it’s unlikely that the tribe will be able to foot the bill, Yannity said.

“The federal government is not holding up to its responsibility,” he said.

As prescription drug costs rose, Tulalip officials said, they had no choice but to reopen the pharmacy as a for-profit business.

“The cost of pharmaceuticals has absolutely gone through the roof,” Gobin said.

Reporter Krista J. Kapralos: 425-339-3422 or kkapralos@ heraldnet.com.