On the last day of June, employees at Gallup Indian Medical Center, an Indian Health Service hospital serving residents of the Navajo Nation and nearby areas, received a notice that a key emergency service would be suspended until further notice. The reason given was a new review process implemented in response to an executive order issued by President Trump to “promote efficiency.”
Between 5:30 p.m. and 7 a.m., “there will be NO ultrasound on-call coverage from Monday through Friday,” the email read, citing the “new Presidential Appointee Approver and Departmental Efficiency Review.” The New Mexico hospital hadn’t been able to fill an ultrasound technician vacancy, meaning physicians caring for certain emergency patients overnight wouldn’t be able to immediately diagnose their conditions. In at least one instance, a patient had to be admitted overnight as a safety precaution.
According to former and current IHS employees and emails reviewed by STAT, the loss of overnight ultrasound service at Gallup is just one of numerous service and staffing cuts at IHS facilities nationally caused by the new contract review process. Known by the acronym PAA-DER, the process requires contracts and requisitions to get final approval from a top official at the Department of Health and Human Services, IHS’s parent agency, which employees described as an onerous procedure that can take weeks or longer.
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