The Helena Indian Alliance is laying off the medical director of the Leo Pocha Health Clinic in order to cut costs.

The announcement, made at a Friday staff meeting, caught staff and medical director Joe Gassenberg by surprise.

Gassenberg, a physician, will be replaced by a physician assistant or nurse practitioner, said Nicholas Vrooman, HIA executive director.

The board made the decision following some unexpected financial news in April, Vrooman said.

HIA learned that it needs to pay back $36,184 to the Indian Health Service for “unsupported and unauthorized travel expenditures” that occurred when Donald “Louie” Clayborn served as director. Clayborn resigned Feb. 28, 2007, following an audit of the organization.

Bookkeeping records from that period are still being investigated by the Federal Bureau of Investigation and the Helena Police Department, said Vrooman.

HIA is also paying back $117,413 on debts from previous years of deficit spending under Clayborn, he said.

Once 2006 and 2007 audits are completed, HIA could owe additional money, Vrooman said.

HIA is also concerned it faces future deficit spending after learning in April that income from Medicare and Medicaid reimbursements will likely fall short of its projections by $58,334.

The board is being fiscally responsible in making the layoff decision, said Vrooman.

“The key to all this is the organization is attending to its deficit spending and debt load,” he said.

“We’ll save $32,000 by the end of this fiscal year,” Vrooman said. “In the next fiscal year, it’s over $53,000 with hiring a physician’s assistant.

“It (the clinic) will be maintained. We will maintain it at the same level of service as we have in the past.”

The clinic offers approximately 100 medical procedures. Only 30 of these require a physician, and 15 of these are done only once or twice a year.

The clinic’s diabetes physician, Courtnay Crowell, will remain on staff.

“It’s about decisions made for the whole,” said Vrooman. “What’s at stake is health care for the community. ”

By laying off a contractor, HIA prevented any staff layoffs, he said.

However, Gassenberg said he was stunned by the decision and disagrees that it won’t affect the level of care the clinic provides.

“This will hurt the Indian community in Helena,” he said his voice breaking, “there are patients who will be hurt by this and possibly die.”

The two-week notice he was given, he said, is not adequate time to provide care for his patients.

“They gave staff absolutely no warning about my departure or about the decision.

“They’ve continued to say how well they were doing and getting better and better and emerging from this financial situation,” he said.

Vrooman said the notice given Gassenberg may possibly be extended.

Gassenberg estimated there are 500 to 800 “active patients” at the clinic, needing some kind of on-going care.

“I care about my patients,” he said. “They’re my highest priority. I’m not given a chance to care for them.”

Gassenberg said that he has only charged for 28 of the 32 hours he works weekly in order to save the clinic money.

He’s also contributed a $5,000 paycheck to the clinic, he said, and volunteered for community events such as the powwow and Governor’s Cup.

“I feel I’ve volunteered and done a great job for the community and have been repaid in a very harsh way,” he said.

Reporter Marga Lincoln: 447-4074 or marga.lincoln@helenair.com.