By Emma Whitford

Law360 (March 2, 2021, 10:36 PM EST) -- The Pueblo of Laguna tribe on Tuesday opened a new community health center in central New Mexico, the proposal for which prompted the Indian Health Service to seek to downsize a local hospital, a plan currently stalled in federal court.

In a statement issued Monday, acting Indian Health Service Director Elizabeth Fowler said the new Laguna Community Health Center in Paraje, New Mexico, was administering "portions of the programs" previously offered at Acoma-Cañoncito-Laguna Hospital, which nevertheless continues to offer around-the-clock health care.

The move comes partway through a temporary restraining order issued last month and extended through March 19. The order blocked IHS from downsizing the ACL Hospital to a clinic, a planned move that the Pueblo of Acoma, a neighboring western New Mexico tribe, has called particularly dangerous amid the coronavirus pandemic.

ACL Hospital opened in the 1970s and has served the Laguna and Acoma pueblos for decades.

"The Indian Health Service remains committed to providing comprehensive, quality health care to patients at the Acoma-Cañoncito-Laguna Service Unit," Fowler said Monday. "The facility is continuing to provide emergency department services 24 hours per day, seven days per week to any IHS beneficiary, and continuing to provide primary care, behavioral health, dental, radiology, laboratory, pharmacy, and other ancillary services during this transition period."

The Laguna Community Health Center opened Tuesday as part of a contract under the Indian Self-Determination and Education Assistance Act, IHS said. The law allows tribes to enter into federal contracts to administer health care and other services.

The Pueblo of Acoma filed suit in D.C. federal court in January, accusing IHS of failing to provide proper notice and details to Congress before moving to downsize the ACL Hospital. Such notice is required under the Indian Health Care Improvement Act, the tribe claimed.

In February 2020, according to the complaint, the Laguna Health Corp. notified IHS that it wanted to withdraw its funding shares from the hospital and use that money to set up a clinic for its pueblo about 15 miles away.

The Pueblo of Laguna was not expecting this to come at the expense of a fully operating ACL Hospital, according to a letter from Laguna Gov. John E. Antonio Sr. submitted to the court at the time.

Yet in August, IHS allegedly informed the Pueblo of Acoma that the agency planned to enter into a new contract with Laguna, and that services at ACL Hospital would be "dramatically" reduced.

The emergency room subsequently closed temporarily, according to the complaint, after several staffers resigned or retired. The hospital effectively operated as an urgent care clinic until IHS stepped back in to resume more comprehensive care for the month of January.

On Feb. 1, U.S. District Judge Beryl A. Howell granted the Pueblo of Acoma's request for a temporary restraining order, blocking IHS from "closing the [ACL] Hospital or reducing the facility's current services pending the expiration of this temporary restraining order or further order of this court."

That order was recently extended through March 19 as part of an extended filing schedule, court records show.

In a post on its website, the Laguna Community Health Center invited ACL Hospital patients to transfer their medical records over to the new clinic. 

Counsel for the Pueblo of Acoma declined to comment Tuesday. A representative of the Laguna Community Health Center confirmed the center's opening but did not immediately provide further comment. 

--Additional reporting by Diamond Naga Siu. Editing by Peter Rozovsky,

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