RENO, Nev. (KOLO) The Nevada Urban Indians Medical Clinic offers health care not only to local tribal members, but also the general public, many of them uninsured or under-insured.
Most of its funding is through the federal Indian Health Services office, one of those agencies affected by the government shutdown. It had been able to maintain its normal four-day-a-week operation. This week that was no longer possible.
"People that were working 40 hours are now working 32. Those who were working 32 are working 24," says Executive Director Janet Reeves. "I have employees here who are living paycheck to paycheck. They need to pay their mortgage, to pay whatever bills they may have, to put food on the table."
One of those employees is already making plans.
"Because of the reality that she's no longer getting a 40-hour paycheck, she's now looking for another part-time job."
But, of course, the impacts don't stop with the caregivers. Fewer days of operations means patients who can't be seen may have difficulty with prescription renewals, or worse, no access to their doctors if their conditions change.
They held off as long as they could and decided on a graduated cutback across the board to lessen the impact. If the shutdown drags on, the cutbacks will have to deepen.
"If it's still going another couple of weeks, we'll probably look for more cutbacks," says the clinic's fiscal officer, Dennis Boyce. "It's a week-to-week process at this point. We just don't know."
"I watch the news and I'm a little bit discouraged," admits Reeves. "We elect these people. One side's blaming the other and though I can see both sides, the reality is, it's the people."
Other urban area clinics--those with substantial revenue sources like the Reno Sparks Indian Colony--are better able to weather the shutdown.
Those in the rural areas may be hit hardest.