The Urban Inter-Tribal Center of Texas opened in 1971 as a result of several years of collaboration among American Indian community leaders and with voluntary, part-time medical providers. Since the late 1970s, funding from Indian Health Service, a branch of the US Department of Health & Human Services, along with other subsequent funding streams, has enabled the Center to expand its services to include dental, pharmacy, job training, employment, education, mental health and substance abuse counseling, emergency assistance services, a food pantry, and HIV outreach/education.

Dallasites may be more familiar with the Center’s previous name, the Dallas Inter-Tribal Center, but the new name more accurately reflects the Center’s reach. By 1999, the Center had experienced an extended growth trend, and management actively was pursuing fund development to enable the Center to provide more health services to American Indians in Tarrant County. Three years ago, the Center opened a collaborative “Community Health Partnership Clinic” with John Peter Smith Hospital and the Salvation Army as Fort Worth partners, which allows the Center to provide tribal citizens in Tarrant County more access to services.

“It was not difficult to see that the old company name—The Dallas Inter-Tribal Center—was not nearly as inclusive for our geographical service area as it needed to be,” according to Keith Overstreet, the Center’s family services director. “For example, as we worked with entities in Tarrant County and Fort Worth to secure funding for an outreach medical clinic, it was clear that having ‘Dallas’ in our name was not necessarily a strength. Hence, we decided on a dba of Urban Inter-Tribal Center of Texas. This name is inclusive and reflects the reality that our organization serves Indians from all parts of the state.”

The 2000 Census indicates 30,000 American Indians in the Metroplex (11 North Central Texas counties) who claimed one race—American Indian, and 50,000 who claimed two races—one being American Indian. The Center’s records show that it serves citizens from about 100 federally recognized tribes.
During the Center’s last fiscal year, it logged about 10,000 “encounters” with its American Indian clients. Of these, about 6000 were for medical/dental services, and most of these were at the clinic’s main location at 209 E. Jefferson Blvd in Dallas. The Fort Worth clinic is at the Salvation Army, 1855 E. Lancaster. Most of the Center’s services are free.

The Center primarily is funded by Indian Health Service, a federal agency that is mandated to provide medical, dental, and other supportive services to Indians enrolled in federally recognized tribes. In order to access the services, clients must provide documentation of their enrollment in one of the nation’s 568 federally-recognized tribes and, in turn, the Center must provide annual compliance documentation to IHS about its successes in providing health care to urban American Indian citizens. Each grant and program of the Center has other eligibility criteria, such as income level or residency.

“Because of this arrangement, we need to recruit and retain medical providers who have demonstrated not only outstanding medical expertise, but specific cultural competence, as well,” according to Mr Overstreet. He says that the center’s medical director, DCMS member Mahmood Panjwani, MD, is an outstanding internist and nephrologist who has served clinic patients with great expertise and sensitivity.

“Trust is a huge issue, and lack of it is a formidable access barrier for Indians who may be eligible for certain mainstream resources, but who tend to stay outside the larger public health delivery system,” Mr Overstreet says.

American Indian communities face a seemingly overwhelming array of concerns, in addition to diabetes, hypertension, obesity, coronary disease, cancer, dental problems, and inadequate food and nutrition resources. Indians also must deal with poverty, unemployment, low educational attainment, lack of health insurance, violent victimization by non-Indians, inadequate housing and other environmental issues, and lack of transportation.

“Additionally,” according to Mr Overstreet, “negative racial stereotypes of American Indians still abound in the mass media, which unfortunately perpetuates an outcome in which Indians are ‘invisible’ to the larger society.” Because many dominant culture citizens retain a stereotype either that Indians are “extinct” or that they all live on the “reservation,” he says they are unaware that about 63% of the nation’s 2.5 million Indian citizens live in urban areas.

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