Two years ago, a Cortez hospital turned away a Ute Mountain Ute woman who said she had been raped and was seeking treatment. Her case has led to a landmark civil-rights settlement in Colorado. It also has become a catalyst in efforts to bring about better government and tribal cooperation nationwide.

The settlement inked this week between the Colorado Civil Rights Commission and Southwest Health Systems Inc., which operates Southwest Memorial Hospital, establishes new policies to ensure tribal members who come off reservations for medical treatment aren’t discriminated against. The hospital entered into the agreement voluntarily while denying any wrongdoing.

This was the first civil-rights complaint ever initiated by the commission. Usually complaints are taken up at the behest of victims. In this case, the victim did not want to get involved, but investigators were able to document through other sources that the woman was not given the care she sought at the hospital. The investigation also revealed there had been a persistent problem with American Indians being turned away from the hospital for years.

“We’ve heard complaints before, but we just never had an instance where we could document what happened until now,” said former U.S. Attorney Troy Eid, special counsel to the Ute Mountain Ute tribe and chairman of the national Indian Law and Order Commission.

“This settlement is a textbook example of how states and tribes should be working together on tribal rights,” Eid said.

Ernest House Jr., a member of the Ute Mountain Ute tribe and executive secretary of the Colorado Commission on Indian Affairs, concurred that the settlement will have impacts far beyond a single case.

“This is really going to be a pivotal point for how Native Americans access health care,” House said.

Hospital officials agreed to the new anti-discrimination policies, to continued monitoring by the commission and to the training of staff members at the 25-bed hospital in “cultural competency” so they better treat the American Indian population in the Four Corners area. That population, mainly from the nearby Ute Mountain Ute reservation and the Navajo Nation, makes up about 20 percent of patients at Southwest.

“We could have fought this, but really, it’s in our best interest to make sure we have a good relationship with the Indian nations that are so important a part of this corner of the state,” said Southwest chief executive Kent Helwig.

Helwig took the helm at Southwest seven months ago and was not there when the intoxicated woman showed up at the emergency room in March 2010 saying she had been raped and seeking treatment.

According to those familiar with the story, a physician told her to go back to the reservation because Indian Health Services often failed to reimburse the hospital for the care of indigent American Indians.

That is true, according to officials on all sides of this settlement. The Ute Mountain Ute tribe has only about 2,000 members and is often shortchanged on federal funding for medical and other reimbursements that go to larger tribes with more political clout.

Helwig stressed that was no excuse for turning away a patient.

The 12-year-old federal Emergency Medical Treatment and Active Labor Act, commonly known as the Patient Anti-Dumping Law, requires public hospitals to provide emergency treatment, regardless of a patient’s ability to pay.

“That should never enter into any discussion about treating a patient,” Helwig said. “Regardless of ability to pay, we will provide service.”

He said that some staff involved in the incident have received counseling and that hospital officials have had a discussion with tribal officials about how American Indians can expect to be treated at the hospital in the future. Those discussions will continue, he said.

“They (hospital officials) are really trying to do the right thing,” said Steven Chavez, director of the Colorado Civil Rights Division and the man who is credited with shepherding through this unique settlement on a very sensitive issue.

Beyond Colorado’s borders, Eid said he has used this discrimination case as an example when he regularly testifies before Congress about the need for interjurisdictional cooperation between tribes and governmental entities.

“This is a big topic nationally, and when something positive like this happens, it’s a real high point,” Eid said.

Officials with the Ute Mountain Ute tribe and Indian Health Services did not return calls asking for comment.

Nancy Lofholm: 970-256-1957 or nlofholm@denverpost.com