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Claremore, OK - If the Indian Health Service doesn't come through with additional funding, there will be a few more empty offices at Claremore Indian Hospital. Due to a projected budget shortfall of nearly $1.5 million, the hospital is expected to cut at least 13 jobs next week. "We'll lose some good people out of this," said John Daugherty, the service unit director.

The situation isn't any better in Tahlequah, where W.W. Hastings Indian Hospital faces a shortfall of more than $1.8 million. "We're already down to a bare bones staff," said Hickory Starr, director of the Tahlequah service unit. "Our next step is to cut services. "On the chopping block at Hastings are diagnostic services like ultrasound testing, and some prescription drugs. Claremore will be phasing out some of their pharmaceutical offerings as well. "Some of the newest, most costly drugs to treat diabetes, hypertension, and heart disease will be the first to go," said Daugherty. "Those patients will still be treated with other effective medications, but it's not what we want to do."

The root of the problem lies in the way that the Indian Health Service funds Oklahoma tribes. IHS allots an average of $1,351 per Indian patient per year nationwide, but Oklahoma averages just $856 per Indian patient per year. "Our funding level is $500-$600 per patient per year," said Daugherty. "We've never had enough money. Our staff has learned how to do more with less, but we've finally hit the wall."

The current crisis results from a flat IHS budget over the last 3 years that must be stretched to cover growing health care and prescription drug costs. "Our pharmaceutical costs have increased by 25% a year each of the last two years," Starr said. "The government gave our employees a cost of living raise, but didn't make up for it in our budget. That cost us $375,000 right there."

Daugherty says Claremore Indian Hospital employs 50 fewer people than they did two years ago, but those cuts have come primarily from support staff. "We've got more patients than we can see," he said.

The hospitals have requested additional funds from the Cherokee tribal council. Without committing money, the Cherokee Nation has agreed to help the Hastings and Claremore hospitals with their funding problems. "This is an IHS funding problem, but it affects our people," said Principal Chief Chad Smith. "IHS needs to understand that the lives and health of Cherokees are just as valuable and just as precious as the lives and health of the other Indian tribes they fund."

On behalf of the hospitals, Chief Smith has met with the Deputy Director of HIS Mike Lincoln and requested an additional $3.3 million appropriation to cover this year's projected shortfall. The Nation has also appealed to Oklahoma's congressional delegation to look into the funding inequities and help them in their request to IHS for the additional allocation, which would save jobs and ensure services.

The Nation also has requested that IHS release its Level of Need Funded report, which is expected to help alleviate some of the funding inequities faced by Oklahoma tribes. "If we were just funded as much as other IHS regions, we'd be fine," said tribal councilwoman Barbara Starr-Scott.