ACL to undergo redesign; Hospital to remain open

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  • Acoma-Canoncito-Laguna Service Unit will be undergoing a redesign phase after facing budgetary issues. The U.S. Indian Health Services say that the hospital will remain open but with limited operations. File photo
    Acoma-Canoncito-Laguna Service Unit will be undergoing a redesign phase after facing budgetary issues. The U.S. Indian Health Services say that the hospital will remain open but with limited operations. File photo
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ACOMA, NEW MEXICO — AcomaCanoncito-Laguna Service Unit, a 25-bed medical facility, is facing a budget crisis, forcing the hospital to look at its financials. While the service unit is not shutting down, some of its services will be affected by the shortfall as ACL staff have already began leaving their employment. “With the reduction in federally operated programs, functions, services, and activities, and accompanying funds, the [federal Indian Health Services] will redesign programs and services provided at the service unit. This redesign will be done in consultation with all affected tribes, including the Pueblo of Acoma,” said United States Indian Health Services Director Rear Admiral Michael Weahkee.

ACL Service Unit provides services for more than 9,100 tribal citizens and has around 126,000 visits per year, according to federal hospital data.

Budget shortfall

Rear Adm. Weahkee said that ACL’s funding had been affected greatly this year; in the spring the Canoncito shareholders decided to withdraw from the agreement to help fund the hospital, and on July 1 the Pueblo of Laguna informed the IHS that they planned to build their own hospital; Weahkee said this action would remove about 33 percent of the service unit’s full budget.

The new Laguna facility should be finished in February, but the services they offer will depend fully on staffing.

With the changes to ACL’s funding, the service unit will be left with about 33 percent of its entire budget with which to operate. Director Weahkee said that due to this, the hospital will be forced to redesign their operation, but that it is not shutting down.

The IHS team acknowledged rumors they had heard of ACL shutting down and wanted to put the rumor to rest. Until at least Feb. 1 the service unit will continue to operate, but at a reduced capacity.

Services lost

Staff retention has become an issue at ACL, according to the IHS director. Several contract medical professionals and other staff have decided to leave the facility once they heard of the looming budget crisis.

“As a result,” Director Rear Adm. Weahkee said, “the Acoma-Canoncito-Laguna Service Unit does not currently have sufficient staffing to provide inpatient and emergency department services. During the ongoing pandemic, there is a nationwide shortage of healthcare providers making it difficult to fill these positions. Primary care and urgent care services will continue to be provided at the service unit.”

For emergency or inpatient services people will have to choose between Cibola General Hospital in Grants, New Mexico or a hospital in Albuquerque, New Mexico.

Barbara Felipe, acting CEO of ACL, was asked about the services that will continue and how the effects of redesign might affect the service unit.

“I don’t have a comment,” she said, explaining that she is not authorized to about the transition.

What will Acoma do?

Around 66 percent of ACL’s budget is gone and Acoma stands alone funding the service unit, the pueblo had a scheduled meeting with IHS in Albuquerque on Nov. 16 to discuss what’s next for the service unit but that meeting was cancelled by IHS.

IHS officials maintain that the intent of the cancellation was not actually to cancel, but rather to gather more information so the Albuquerque IHS office would be ready to answer all questions from the pueblo. Officials said that they were hoping to reschedule for later in the week of November 18.

“It is a complete abandonment by the Indian Health Service of its legal responsibilities to the People of Acoma during this global pandemic,” said Pueblo of Acoma Governor Brian D. Vallo in a statement on Friday. “Why the IHS made this decision at this time and under these conditions is baffling.”

Vallo claims that IHS made an order to close the hospital without ever consulting the tribe, which would be a violation of federal law.

Director Rear Adm. Weahkee said that IHS respects tribal sovereignty and that it is important to IHS.

Vallo said that he recognizes the issues at ACL come after a decision to build a new urgent care facility in Laguna, and said that IHS should use CARES Act funding (COVID-19 relief funding passed by the U.S. Congress) to keep ACL running.

According to federal documents IHS received $1 billion from the CARES Act.

Director Rear Adm. Weahkee said that IHS is looking at all funding options to keep the hospital going.

Congress responds

New Mexico’s Senior U.S. Senator Tom Udall said, “This pandemic has strained Native health systems, disrupted Tribal economies, and taken a disproportionate toll on Native families. Tribes across the country have met this crisis with resilience, but their federal partners aren’t rising to the challenge. Cutting essential services, like the closure of IRS’s ACL service unit, while New Mexico is experiencing a dangerous surge in COVID-19 cases statewide, is a threat to public health — for Native families and for the entire state. It’s wrong. It’s dangerous. And, it’s a complete dereliction of duty. 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 longlasting 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.”

New Mexico’s U.S. House District 1 Representative Debra Haaland said, “Healthcare services need to be accessible for every community, especially during a global pandemic, but this Administration made an irresponsible decision to close a healthcare center in Acoma. This pandemic does not discriminate and its toll in communities of color has revealed the longstanding disparities that exist in Indian Country. This Administration is putting lives in danger and needlessly increasing patients’ and families’ distress. I’ll be looking into this decision and expecting answers from HEIS.”

New Mexico’s Junior U.S. Senator Martin Heinrich, current U.S. Representative Xochitl Torres Small, Cibola County representative, Senator-Elect and current Assistant Speaker of the U.S. House of Representatives Ben Ray Lujan, and Cibola’s Representative-Elect Yvette Herrell, Cibola County representative, had not released on a statement on the current status of ACL before press time.