Fresno Health Center for Urban American Indians to Close
By Barbara Anderson, The Fresno Bee, Calif.
Jan. 25–A health center serving urban American Indians in Fresno has lost funding from the federal Indian Health Service and will close Friday.
The Fresno Native American Health Center at First Street and Shields Avenue was notified Friday that its contract was not being renewed.
The center provides referrals to doctors and counsels American Indians on diabetes, substance abuse, nutrition and other health issues.
An Indian Health Service official said the center was not complying with its contract because it was seeing too few people and did not have a public health nurse available for patients.
Executive Director Virginia Sutter said the center was seeing a sufficient number of patients and had attempted to hire a nurse and medical director, but the Indian Health Service decided to end the center’s contract.
Indian Health Service is the federal health program for American Indians and Alaska natives.
The Fresno center incorporated in 2003 and opened under a contract from the Indian Health Service to fill medical, emotional and social needs of urban American Indians living in Fresno. The nearest urban health centers are in San Francisco and Los Angeles.
The Fresno center estimates 13,000 urban American Indians live in Fresno County.
Paul Redeagle, deputy director of the Indian Health Service in California, said his agency found the center’s “performance was unsatisfactory and [we] made the decision not to renew the contract.”
The center received about $330,000 a year to operate, he said.
Redeagle said Indian Health Service expected the center to serve 10 to 15 patients a day, but records showed they saw far fewer.
The center also failed to use money provided to pay for laboratory work, he said. And the center only sporadically had a public health nurse on hand to monitor patients.
Sutter said the center saw 5,000 clients in 2006 and part of 2005, and had documents to prove it.
The center attempted to hire a medical director to approve orders for lab work, but Indian Health Service staff did not approve the hire, she said. A public health nurse, hired by the center, also was rejected by the agency.
Louise Appodaca, a member of the Chumash tribe and chairwoman of the center’s board of directors, said the closure was retaliation for a conflict the center has had with the Indian Health Service.
The center contracted for medical services with Fresno-based Sequoia Community Health Centers in 2005. It later had an agreement with a Bay Area provider. The center subsequently dismissed the health-care providers at the request of Indian Health Service officials, Sutter said.
Providing direct medical services is outside the scope of the center’s contract with the agency, Redeagle said.
Dr. John Maffeo, chief executive officer at Sequoia Community Health Centers, said the center’s closure will be “a shame.”
“The urban Native American residents in Fresno County will no longer have this culturally competent, culturally sensitive resource center.”
Redeagle said it’s the responsibility of the Fresno center staff to notify patients of the closure and to direct them to other sources of care.
His agency will begin immediately to look for alternatives to serve the urban American Indian population in Fresno, he said. “We are hopeful we can re-establish a program,” he said.
Redeagle said he expected the center to operate until the contract ends Feb.28. But Sutter said there was no money to stay open.
Eligible patients can be seen at Central Valley Indian Health Inc., a tribal clinic in Clovis, Redeagle said.
The Clovis clinic should be able to absorb patients from the center, administrator Chuck Fowler said.
Onehawk Hirajeta, director of substance abuse and anger management programs at the center, said some of his clients may not be eligible for services and others will have trouble getting to the Clovis clinic.
One of Hirajeta’s clients, April Reihm, 53, of Fresno, was at the center Wednesday. She said she relies on the center for mental-health counseling.
A member of the Arapaho and Western Shoshone tribes, Reihm said: “I feel like I’ve been stabbed in the back — and this time, it’s by Indians. How dare they do this? We need this clinic.”
The reporter can be reached at banderson@fresnobee.com or (559) 441-6310.
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Copyright (c) 2007, The Fresno Bee, Calif.
Distributed by McClatchy-Tribune Business News.
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