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Jonathan Sims is a media producer and former appointed official at the Pueblo of Acoma. He covers news and Indigenous People's issues for The Paper.

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Native Leaders Decry “Immoral” Closure of Regional Indian Medical Services Mid-Pandemic in New Mexico

It’s the only medical facility around for 24 miles, and the federal government is shutting its doors. Just as New Mexico sees a record surge in COVID-19 cases across the state, the federal Indian Health Service (IHS) has decided to shut down all emergency and in-patient services for the Acoma, Laguna, Canoncito (ACL) hospital. The hospital is located on Acoma tribal lands but is intended to serve all three pueblo communities.

IHS said they have made the decision to shutter the only medical facility that provides critical emergency medical services due to lack of funding. It’s also the only hospital in that long stretch of I-40 that can treat patients with emergency needs due to COVID-19. Pueblo residents from all three tribal communities (Canoncito is now To’hajiilee) will have to travel into Albuquerque adding more strain on an already strained hospital system. For many residents, this drive can take up to an hour. In an emergency, that is often an hour they can’t afford.

“The decision to close ACL hospital is not only reckless but immoral,” said Acoma Governor Brian Vallo. “It is a complete abandonment by the Indian Health Service of its legal responsibilities to the People of Acoma during this global pandemic. Why the IHS made this decision at this time and under these conditions is baffling.”

ACL Hospital, Acoma Pueblo, New Mexico. The Paper staff photo

Acoma is a small Pueblo community of 3,000 and has seen a spike in COVID positive cases.  They have already recorded 100 cases in the first two weeks of November. Over the past year, medical providers, nurses, and staff at the ACL hospital have been severely cut, laid off, or have left seeking work elsewhere, according to local officials. With an operating budget of $8 million for 2020, ACL was equipped to accommodate 25 emergency in-patient beds. That was reduced to a small urgent care unit earlier this year with limited hours for funding reasons, and will now cease to exist altogether. Without an emergency room or the necessary ER staff, the hospital will no longer provide emergency medical services to the traveling public along Interstate 40.

“When every minute counts and every critical moment is a matter of life or death, this is not the time to shut down a full-service hospital, especially during this out-of-control pandemic. The Indian Health Service carried out its underhanded actions without any meaningful consultation with the Pueblo. It also failed to adequately inform Congress, a federal requirement,” said Vallo.

Governor Michelle Lujan Grisham and State Representative Patricia Roybal Caballero (D-Bernalillo) have submitted letters of support, asking for IHS to reconsider. Governor Lujan Grisham says the federal government needs to honor its legal obligations to maintain and increase support for healthcare on tribal lands. “The federal government’s sudden decision to close the ACL hospital in the midst of a nationwide pandemic makes no sense and flies in the face of decency. Closing the hospital when people rely on this facility for their healthcare is unconscionable. It not only compromises their health and wellbeing but creates uncertainty, anxiety and fear at the worst possible time,” Lujan Grisham said in a statement.

$1 Billion For Indian Health

In April, Congress appropriated $1 billion through The Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, to the Indian Health Services to assist with pandemic-related response. In a statement at the time, US Health & Human Services Secretary Alex Azar said the funding represented a priority for the Trump administration. “The funding secured by President Trump to combat the coronavirus is delivering significant investments in the Indian Health Service and tribal communities’ ability to respond to the COVID-19 public health emergency,” says Azar.

But that funding has been slow to arrive and failed to meet the need. By May, the Navajo Nation, which includes the tiny community of To’Hajiilee served by the closing clinics, had recorded the highest rates of infection in the country. As statewide infection rates began to slow, roughly half of New Mexico’s COVID cases involved Native Americans, according to a report from the non-profit news organization NM In Depth.

In a letter published by the Washington Post, US Senator Elizabeth Warren (D-MA) and Congresswoman Deb Haaland (D-NM), an enrolled member of the Laguna Pueblo, wrote that “More than a month after the Cares Act was enacted, Native nations still hadn’t received a penny of the $8 billion the law provided to them.” Even when funds and supplies were available, “bureaucratic obstacles forced the Navajo Nation to wait for desperately needed funds as infections multiplied among its citizens. The IHS, tribal health authorities and urban Indian health organizations have struggled to access the Strategic National Stockpile, a federal repository of drugs and medical supplies for public health emergencies,” they wrote.

In early October, the US House of Representatives passed a new COVID-19 relief bill dubbed the HEROES Act. It included $3 billion in new funding to assist Native communities with COVID-related health care. Senate Leader Mitch McConnell has, so far, refused to schedule a vote on the bill.

Update: Including a statement from US Senator Tom Udall (D-NM)

US Senator Tom Udall:

“IHS needs to provide clear, direct answers about where the people of Acoma, Laguna, and To’hajiilee are going to be able to access emergency and hospital care during this public health crisis.”

“Throughout this pandemic, I’ve heard directly from Tribes about their urgent and ongoing needs for healthcare and economic resources to combat the virus. That’s why I worked so hard to make sure we included $10 billion in relief funds for Tribal governments in the CARES Act. Yet, I continue to hear how existing federal policies, practices, and program structures have left Native communities particularly exposed to severe and long-lasting impacts. This pandemic is not over, and the call to live up to our trust and treaty responsibilities is still paramount. We must continue the work to build a stronger, better Indian Health Service system so that health disparities that already exist in Indian Country are not further exacerbated.”

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