UNM Hospital and the 1952 Contract

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UNM Hospital and the 1952 Contract

• Homer Robinson
• NM Center on Law and Poverty
• Norman Ration
• National Indian Youth Council

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1927 100 of patients are Indian
1954
2007 4 of patients are Indian
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Albuquerque Indian Hospital
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Albuquerque Indian Hospital

• 1925 - 60 bed inpatient facility built on 12th
  Street at the Albuquerque Indian School
• General medicine surgery
• OB-GYN, 10 bed nursery
• Urology
• Orthopedics
• Ambulatory care

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Indian Health Service Sanatorium

• 100 bed facility, built in 1930s
• Tuberculosis rehab
• Became Albuquerque Indian Health Center located
  on Lomas adjacent to UNMH

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Bernalillo County Indian Hospital
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Bernalillo County Indian Hospital

• 1949 Congress authorizes Department of Interior
  to transfer 5.33 acres of BIA-controlled land to
  Bernalillo County
• Intention is to build a regional hospital to
  serve surrounding reservations
• But the hospital would be open to Indians from
  any part of the southwest, and for that matter,
  to Indians from any part of the United State and
  would not be limited to Pueblo Indians
  (Congressional testimony in 1949)
• At no time was any distinction made based on
  residency or tribal affiliation.

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1952 Federal Contract

• 1952 - Bernalillo County signs contract with the
  United States for the operation and maintenance
  of the hospital
• Final construction cost is 3.25 with 1.5
  million from BIA and 1.75 million from County
• 1954 Hospital opens with mission to serve
  Indian and indigent patients

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1952 Federal Contract

• At least 100 beds for Pueblo patients
• At least one Pueblo Indian is a member of the
  Board of Trustees
• Perpetually binding upon the County, the Trustees
  and their successors, and any authorized
  successor operator of the hospital
• assure that adequate medical treatment for
  qualified Indians is properly provided.

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Timeline

• 1968 Bernalillo County Medical Center
• 1969- UNM assumes operation as a teaching
  hospital
• 1978 UNM assumes full control through 20 year
  lease
• 1978 AIPC becomes representative party
• 1987 University of New Mexico Hospital
• 1999 Language change to also serve Native
  Americans of New Mexico
• Subsequent lease amendments, esp. 2004

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UNM Hospital Today
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UNM Hospital Today

• 1952 contract has been amended several times, but
  the spirit of it remains the same
• UNMH is obligated to provide high quality health
  care services to Indian people and the federal
  government is obligated to pay for them.
• UNMH mission is now to become a premier research
  and learning institution
• Federal funding for Indian health care services
  is minimal
• Current practice is to encourage Indian patients
  to enroll in UNM Care

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Current Issues

• Federal policy changes, e.g. contract health
• 2004 Lease Agreement
• Payment policy
• Native Americans treated the same as all
  Bernalillo County residents
• Charity care
• AIPC as entity of record without inclusion of
  off-reservation representatives
• IHS as payer of last resort with AIPC approval
• Elimination of urgent care at IHS in 2005

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1952 Contract Enforcement

• Breach of contract?
• Negative impacts to 3rd party beneficiaries, i.e.
  off-reservation Indians
• Fiscal impacts to UNMH as it tries to absorb
  costs that should be incurred by the federal
  government

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Conclusion

• UNMH exists due to the 1952 contract and was
  created to provide health care services to
  Indians and County indigent
• Federal government is obligated to reimburse UNMH
  for services
• Contract has been modified many times in the last
  50 years to the detriment of Native Americans
• Contract is still in force and should be enforced
  to provide care