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Health | Opinion
Mark Trahant: IHCIA brings hope for urban Indian health

"American Indian Health and Family Services helps the 57,000 Native Americans living in the greater Detroit area. Services are delivered at an old church and rectory donated by the Detroit Archdiocese in 1993. Jerilyn Church is the executive director of AIHFS. She’s Minnecoujou Lakota, born and raised on the Cheyenne River Sioux reservation in South Dakota. When she moved to Detroit she says she “wasn’t prepared” for the same type of unemployment as back home on the reservation.

“Yet despite our surroundings, we get a lot done with little resources,” Church says. “We could write a book about it.”

That book would detail the logistics of serving people who are mostly uninsured – and too often ineligible for safety net programs like Medicaid. Among the AIHFS clients only about a third have full-time employment. So when a patient requires health services beyond the basics of the clinic, the health provider – a doctor or a practical nurse – spends hours on the phone looking for a doctor or hospital that will provide “uncompensated care.” So instead of treating people, these health professionals must act as brokers, looking for someone, anyone, in the health care system to help.

The paradox that is urban Indian health is that more than two-thirds of American Indians and Alaska Natives live in cities and yet receive only about one percent of the Indian Health Service budget. There is hope, however, because of health reform and the Indian Health Care Improvement Act. The new law, Church says, should make it possible to hire at least one more health professional for the clinic. Another possibility down the road is to qualify American Indian Health and Family Services as a “Federally Qualified Health Center.” This is a designation that opens up the potential for additional federal funds, as well as better malpractice protections."

Get the Story:
Detroit’s geography of despair include many seeds of hope (Mark Trahant 4/19)

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