Background and History
The NYS Department of Health (DOH) is required by Public Health Law § 201(1)(s) to "administer to the medical and health needs of the ambulant sick and needy Indians on reservations." State funded clinics on Indian reservations have been in existence for more than three decades. In the late 1970's, the St. Regis Mohawk, Seneca and Oneida Nations elected to receive federal funding from Indian Health Service (IHS) as their primary funding source for health services.
DOH provides funds for health care for nine Indian nations in the state:
Federally and New York State recognized Indian Nations:
- Tonawanda-Niagara, Erie and Genesee Counties
- Tuscarora-Niagara County
- Seneca-Cattaraugus, Allegany and Erie Counties
- Onondaga- Onondaga County
- St. Regis Mohawk-Franklin County
- Oneida- six county catchment area-Oneida, Onondaga, Herkimer, Madison, Cortland and Chenango Counties
- Cayuga- receives services through the Seneca Nation clinics
New York State recognized Indian Nations (not federally recognized)
- Shinnecock- Suffolk County
- Unkechaug(Poospatuck)- Suffolk County
Federally recognized Indian Nations may access federal (IHS) monies to support their health care needs, including outpatient and inpatient hospital care.
- St. Regis Mohawk
- Seneca (including Cayuga)
These three nations, which accept federal funding, access federal monies to fund the major operations of their Nation clinics. DOH monies supplement federal funds in order to cover the cost of staffing, eye care, and pharmaceutical care.
Traditional nations are nations which maintain that the state is responsible for their health care according to the treaty signed in the 1700's. Although these nations are federally recognized, they do not access IHS funding to support the operation of their health clinics. The Onondaga Nation does utilize IHS funding to pay for inpatient hospital care only. In 2006 the Tuscarora Nation applied to IHS for inpatient hospital care also.
New York State Recognized Nations
Only the Shinnecock Nation has a health clinic. The Unkechaug Nation has a health care coordinator who provides information and referral so the tribal members can access health care providers.
What NY Covers
Through contracts, NYS pays for all the health care services provided at the Nation clinics, not funded by IHS. Eye care, prescription drugs (following Elderly Pharmaceutical Insurance Coverage (EPIC) guidelines) and specialty medical services are paid for by DOH. A referral from the nation clinic authorizes payment for health care services provided off-site. Each health clinic provides assistance to their members in accessing state-supported programs such as Medicaid, Child Health Plus (CHP), Family Health Plus (FHP), Prenatal Care Assistance Program (PCAP), Women, Infants, Children (WIC), etc.