By James T. Mulder | jmulder@syracuse.com
Syracuse.com
Onondaga Nation — Onondaga Nation residents used to be able to walk in and get medical care quickly at the nation’s health center.
Now they wait months to get appointments at the state-funded medical and dental clinic on Route 11A on the Onondaga Nation.
The center is so short-staffed and strapped for cash it is sending many patients to Syracuse hospital emergency rooms where they wait for hours and sometimes leave without getting care.
“It’s a beautiful building,” said Tadodaho Sid Hill, the nation’s spiritual leader, of the two-story, Haudenosaunee-style longhouse the Onondagas built in 1997. “But if you don’t have enough staff what good is it?”
Health care staffing shortages are causing delays in care for many in Central New York. On the nation, there’s an additional hurdle – the state has frozen funding for the Onondaga clinic for more than a decade.
The state has not increased the health center’s $1.3 million annual budget in 13 years, payments that are required as part of a treaty. As a result, the center can’t pay the going rate to nurses and other health providers. It’s at a competitive disadvantage with hospitals and other medical facilities, which have increased wages to fill job vacancies in a tight labor market.
The center is struggling to fill three vacancies for nurse practitioners and a dental hygienist because it cannot afford to pay as much as other medical and dental providers in the Syracuse area, according to its medical director. The center also cannot afford to make plumbing repairs and other necessary improvements to its building.
“The health and well-being of our people is at risk because New York is failing to meet its human rights obligations,” Hill said in a recent letter to Dr. James McDonald, the state’s health commissioner.
This year, the nation is asking for more help. The Onondagas are asking the state for $5 million to help make up for the lack of increases over 13 years. Going forward, the nation is asking for $2.3 million a year out of the state’s $227 billion budget.
Readily available primary care is sorely needed on the Onondaga Nation, where diabetes and other chronic illnesses are rampant, said Dr. Eva Gregory, the center’s medical director. Gregory is on the staff of Upstate University Hospital which has a state contract to operate the center.
About four of every 10 Onondagas die before age 65, the highest premature death rate in Onondaga County.
New York is required by state law to “administer to the medical health needs of the ambulant sick and needy Indians on the reservations.”
The state Health Department budget contains $25 million for health care services for indigenous populations at eight Indian nations throughout New York, including the Onondagas. The $25 million is for clinics and for health care services provided off the reservations to patients referred by the clinics.
When asked why funding for the Onondaga Nation’s health center has been held flat so long, a Health Department official said the clinic’s patients are free to go elsewhere for care.
“As sovereign nations, please note that while each clinic can provide assistance, it is not mandatory for members to participate in these state supported programs,” said Cadence Acquaviva of the state Health Department.
But most of the center’s patients have no other options for primary care, according to Gregory.
“Sending them to the emergency room is not good for patients,” she said.
Sen. Rachel May, D-Syracuse, supports Hill’s request for more state money.
May said the lack of funding is part of a “pattern of neglect” in the state’s dealings with the Onondaga Nation.
“It’s a high poverty area where the health outcomes are far worse than elsewhere so it makes sense that we put more resources there,” she said.
In addition to the one-time $5 million payment and an additional $1 million each year, Hill is also asking the state for similar increases for two other health clinics at the Tonawanda-Seneca and Tuscarora nations in Western New York. Those nations, like the Onondaga Nation, are part of the Haudenosaunee.