The Southern Utes have gained control of the health center in Ignacio, seen on Thursday.
The tribe could take over the Ignacio clinic from the Indian Health Service by next week, said IHS spokesman Russ Pederson.
"It's ongoing right now. They're planning on having a contract in place by Oct. 1, so it's pretty hectic right now," he said.
The nearly five-year-long legal battle ended with a settlement last week in federal court in New Mexico. The Sept. 16 court order requires the government to sign a contract and funding agreement with the Southern Ute tribe.
The tribe sued in January 2005 after the IHS refused to turn over control of the clinic under the Indian Self-Determination and Educational Assistance Act. By running their own clinic, tribal leaders would be able to choose what kind of medical care to deliver.
Under the act, the federal government is supposed to let willing tribes take over their own services. The Southern Utes run their own law enforcement under the act. But in practice, the Indian Health Service has been unwilling to let tribes across the country run their own clinics, often balking over the price of the contract.
In Ignacio, the major dispute was about how much money the federal government would pay the tribe for administrative costs, known as "contract support costs." When the federal government runs a clinic, it can rely on other agencies to provide functions such as human resources, said Steven Boos, the Durango lawyer who filed the lawsuit for the Southern Ute tribe.
"If (a tribe) takes over a hospital, now you're going to have to hire (a human resources) director, you're going to have to set up a personnel office," Boos said.
The IHS had refused to sign a self-determination contract with the Southern Utes because it didn't have the money to pay contract support costs. But Congress this year plans to add $107 million nationally to the IHS budget for contract support. Indian tribes are expecting to have 80 to 90 percent of the shortfall in contract support costs covered this year, Boos said.
Boos credits a change in presidential administrations with a new willingness of IHS officials to sign self-determination contracts.
"I think the new administration has been better to deal with than the previous administration," Boos said.
Pederson did not know what would happen to clinic staff currently on the federal payroll. Boos referred further questions to the Tribal Council and executive office, which did not return calls from the Herald on Thursday.
The Southern Utes aren't alone in their struggle to get adequate contract support costs. The National Congress of American Indians helped the Cherokee Nation win a favorable Supreme Court ruling against the IHS in 2005. According to the NCAI, the lack of money for contract support is one of the major obstacles to Indian self-determination, forcing tribes to cut their services to pay for items such as property insurance and workers' compensation.
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