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UNM Hospital Disputes Indian Care

By Olivier Uyttebrouck
Journal Staff Writer
    A dispute between the Indian Health Service and the University of New Mexico is threatening the multimillion-dollar expansion of the university's hospital, the head of the UNM regents says.
    "If it doesn't get resolved, (UNM) won't build the hospital," Regents president Jamie Koch said this week.
    The two sides even disagree about what is in dispute.
    Koch said in an interview that the Indian Health Service wants University of New Mexico Hospital to provide indigent care for Indians throughout the state.
    Koch estimated the cost at several million dollars, which he said the university can't afford.
    Indian Health Service officials in Albuquerque contend that the disagreement is about coverage for indigent Indians in Bernalillo County only and that the cost to UNMH would be less than $1 million.
    Koch said the standoff has already delayed the bidding deadline for the $183 million project. UNM initially set a May 18 deadline to receive bids but postponed the date to July 1 because it needs time to resolve the dispute, he said.
    "Two weeks ago, we realized this is a huge problem," Koch said. "Everybody thought this was going to be a slam dunk. It isn't a slam dunk."
    A university official earlier said the deadline was postponed because the price of steel had stabilized, eliminating the need to rush the bidding process.
    Sen. Pete Domenici, R-N.M., waded into the issue by sending a letter to Tommy Thompson, secretary of the Department of Health and Human Services, asking him to "look into this matter and urge IHS to work more closely with UNMH."
    Domenici wrote in the April 22 letter that changes demanded by the federal agency "would make UNMH financially liable for all medically indigent Native American patients living in New Mexico."
    UNMH needs approval from the Indian Health Service to move forward with the construction project because of a complex legal agreement among the federal agency, UNM and Bernalillo County.
    The Indian Health Service has a decadeslong agreement with Bernalillo County that says the county must provide some medical services for Indians.
    UNMH, which fills that obligation, gets about $59 million a year in county property taxes and leases the hospital from the county for $1 a year.
    That lease must now be renegotiated to obtain financing for the hospital project, and all three parties— the county, UNMH and Indian Health Service— must sign off on it.
    James Toya, director of the Albuquerque Area Indian Health Service, said the agency wants UNMH to pay for all urban Indians who qualify for UNM Care— a program for indigent patients funded by a county property tax.
    Indian Health Service pays for medical care for about 23,000 Bernalillo County Indians, but it wants to become a "payer of last resort" for indigent Indians in Bernalillo County, Toya said.
    He said only a portion of its Bernalillo County clients would qualify for indigent funding, although he didn't have an exact number. He estimated that UNMH would pay no more than $1 million a year to provide treatment for them.
    Maria Rickert, acting chief executive officer of the Albuquerque Service Unit of Indian Health Service, said the agency's costs are growing because of rising medical costs and a growing population of "urban Indians."
    "The Indian Health Service would like UNM to pick up more Bernalillo County Indians that qualify for UNM Care," Rickert said.
    Negotiations between the agency and UNMH are moving slowly, she said.
    UNM plans to build a six-story expansion to house its Children's Hospital, emergency and maternity units. It will be among the state's largest public construction projects.
    Steve McKernan, chief executive officer of UNMH, declined to comment on the negotiations.
    "It's a complex transaction that we're trying to move along on a time schedule," McKernan said Monday.