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According to its director, Lucy Harrison, the American Indian Health and Family Services of Southeast Michigan has nearly 15,000 encounters a year with sick and needy American Indians.
But under President Bush's fiscal year 2007 budget, funding would be eliminated for the southwest Detroit clinic and 33 others like it in urban settings throughout the country.
"There is a large population of American Indians out there who would just be devastated if we were to close," Harrison said. "A lot of them fall between the gaps. The welfare system doesn't really exist any more. The adults don't qualify. A lot of the indigent Indians are homeless and have been out of work for years. Those are the ones who are of the most concern."
Harrison, who has been associated with the clinic since it opened 21 years ago, said that the clinic serves needs far beyond the obvious primary health care.
"There is a huge unmet need for behavioral health and mental illness," she said. "We're seeing increasing numbers of Indians with mental illness, depression, schizophrenia, personality disorders, etc. And we're seeing more children and adolescents."
The nonprofit clinic operates with an annual budget of about $1.2 million provided by the federal government. About $180,000 is devoted to behavior health services such as psychotherapy, on-site psychological assessment, therapy and clinical counseling for such issues as alcohol dependence.
Closing the centers would put further weight on the already overburdened urban health care system, Harrison said.
"They're going to have to turn to the local health care centers that provide free or affordable health care, which are already overloaded," she said. "The current health care centers aren't going to be able to pick up this load."
Harrison is seeking a political solution to the funding problem.
"It's a hard fight right now," she said. "We've recently been able to get Sen. Debbie Stabenow (D-Michigan) to sign on. We're trying to get this information out to representatives in our state and what I'm finding out is that they are unaware of a lot of what we do and how we're funded."
There is a good chance that the $33 million in cuts to the 34 clinics will be restored during the budget process. Sen. John McCain (R-Ariz.) indicated that he would work toward that end during a Senate Indian Affairs Committee hearing in February. But McCain noted the kind of message being sent by the federal government by proposing the elimination of funding.
"I think some of these cuts . . . clearly send out the wrong signal to Indian Country as to what our belief and our fulfillment of our obligation to Native Americans is all about," McCain said.
Freelancer Tom Schram is co-chair of the National Writers Union of Southeast Michigan. Send comments to firstname.lastname@example.org.