Tribal leaders protest plans to close Tucson health care facility

U.S. Rep. Adelita Grijalva, along with U.S. Sens. Mark Kelly and Ruben Gallego, all three Democrats, raised alarms about the closure in a June 1 letter to Clayton W. Fulton, Indian Health Service chief of staff. They said IHS should suspend the proposed consolidation until it fully clarifies the potential impacts on tribal nations in southern Arizona and completes a meaningful, formal tribal consultation process.

"The Tucson Area Office facilitates essential health services for nearly 28,000 patients in coordination with the Pascua Yaqui Tribe and Tohono O’odham Nation," the lawmakers said in the letter. "Merging these offices will require patients and staff to travel as long as two hours to visit the closest area office, exacerbating bureaucratic delays, communication failures, and service disruptions."

The Tucson facility is the only one targeted for closure.

Indian Health Service officials said the agency is undertaking a major modernization effort to align its organizational structure with current needs and requirements. They said the agency has not conducted a comprehensive organizational review in more than 20 years, despite significant changes in the Indian health system during that time.

Why is IHS closing the Tucson facility?

The proposed realignment is designed to modernize the agency’s structure, creating a more agile and responsive organization capable of meeting evolving health care needs and priorities, IHS officials said. In June 2025, IHS sent a letter to tribal leaders to initiate tribal consultation regarding the proposed realignment of the Indian Health Service.

On Nov. 13, 2025, IHS announced the next phase of its proposed realignment.

In their letter to IHS, state leaders said it remains unclear why the Tucson Area Office was selected and whether the full impact of the decision has been adequately evaluated. They requested a comprehensive written response outlining how IHS plans to address potential service disruptions and tribal consultation gaps before moving forward with any additional realignment actions.

Officials said tribal nations and urban Indian organizations have expressed the need for additional engagement opportunities, including more regional in-person sessions and a virtual option, to ensure all voices are meaningfully represented in the discussion.

Tribes and tribal members say staff and tribal members would now require a two- to four-hour trip to Phoenix to obtain support services, depending on where they live.

That would include diabetes services, impacting timely care for the estimated 50% of O'odham people who have diabetes — the highest proportion in the world. The letter from legislators said the Phoenix area agency office may not be able to replicate specialized diabetes care or have the staff to implement the program.

Tohono O'odham leader says closure is 'not necessary'

The two tribes in the Tucson area agency, the Tohono O'odham Nation and the Pascua Yaqui Tribe, operate their own health care programs under a federal law enabling tribes to develop and run their own health care systems.

But tribal leaders said they are concerned about how the removal of their agency office would actually serve their needs for coordination, provide oversight by managers with local institutional knowledge of the region and its people and support specialized services provided by the area office.

Tohono O'odham Nation Chairman Verlon Jose said the "negative impacts of the proposed closure of the Tucson Area Office will be significant for our people and are not necessary."

"Nation members will have to drive two hours simply to access routine care, and it is likely members will lose many local support services for issues like diabetes," Jose said in a statement released June 1. "The Nation has already passed a resolution opposing the closure, and we will work with our congressional delegation to ensure proper consultation takes place before any action is taken to close the office."

Tohono O’odham officials raised concerns about the realignment on Feb. 19. When the potential closure was announced on Dec. 5, 2025, tribes had just 10 days to prepare in advance of consultations.

"This is contrary to IHS' tribal consultation policy, which requires information to be provided at least 30 days prior to the start of consultation," Jose said.

IHS has provided few details on how the closure of the Tucson office and merger of services at the Phoenix office will work.

Tribes would lose $5 million in services, leaders say

At a June 1 press conference in Tucson, Grijalva, along with Jose and Tohono O'odham Vice Chairwoman Carla Johnson, discussed the closure.

Grijalva said the IHS procedures are a "breach of trust responsibilities." She also said removing critical staff such as diabetes consultants from close access to tribal communities would directly jeopardize care for health conditions heavily impacting Native communities.

Johnson said the proposed closure "will not improve or streamline health care services and will not support tribal self-governance, the stated goals of the IHS realignment. The effects of closure would be devastating for the Nation and other tribes, and the impacts would extend far beyond the closure of one office."

IHS posted a statement on its website stating that it would not alter its timeline during the process. It also said in the statement that its current tribal consultation policy does not require consultation in all 12 IHS areas and that tribes that manage their own health care systems have decision-making authority over direct service tribe operational matters. (Direct service tribes are tribes that receive all services directly from IHS, as opposed to self-governance or "93-638" compacts, named after the 1975 legislation.)

However, Johnson pointed out that eliminating the Tucson office would result in a loss of $5 million in services to Tohono O'odham and Pascua Yaqui communities.

"It will not achieve the goals of IHS realignment," Johnson said. "It will not improve or streamline health care services and will not support tribal self-governance.”