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During the last year, the Niagara Falls Reporter devoted a fair amount of space to two ongoing stories.

One is a success story: the struggle and triumph of Niagara Falls Memorial Medical Center, under the leadership of Joseph Ruffolo and the board of directors there.

The other is a kind of tragedy or horror story, a story of great injustice.

I am referring to human rights abuses the Tuscarora Nation, in Niagara County, suffer under the leadership of three men. The three are Tuscarora themselves -- tribal Clerk Leo Henry, aided and abetted by the father-and-son team of Neil Patterson Sr. and Neil Patterson Jr.

Our Editor in Chief Mike Hudson has uncovered a fascinating amount of detail and shocking abuses told over more than 35 stories on the topic.

In short, the story is this: In 1992, the Bureau of Indian Affairs (BIA) named Henry (a mere tribal clerk) as spokesman for the tribe, in effect altering the age-old form of Tuscarora government, a system where a chief is chosen by the clans who are represented by clan mothers. Because Henry was named by the BIA, the New York Power Authority, the Environmental Protection Agency and National Grid deal exclusively with Henry, who spends much of the year living in Bradenton, Fla.

The ancient custom and tradition of respect and power of the individual clans being upheld by the clan mothers is now virtually no more. Clan mothers have no power to represent their clans and condole a chief. This is because Henry operates by the "golden rule" -- "he who has the gold rules" -- and is in effect de facto chief-for-life.

Asked why NYPA negotiated the $100 million settlement with Henry without the input of the Tuscarora people, NYPA spokesperson Connie M. Cullen said Henry was the designated representative named by the federal BIA.

Checks from NYPA, made payable to the "Tuscarora Nation of Indians," totaling $12,484,752 since 2005, have been delivered to Henry's house and deposited into accounts Henry and the Pattersons control. The three men hold $9,581,690 in mutual funds accounts (there may be more), and not a dime has been distributed among the Tuscarora people, many of whom do not have electricity or safe drinking water.

These mutual funds produce dividends ranging between $350,000 to $560,000 per year on the nearly $10 million. What happens to the dividends is a mystery.

With fewer than 1,000 enrolled members of the Tuscarora Nation, the money collected by NYPA could have amounted to payments of nearly $15,000 to every Tuscarora man, woman and child on the reservation. Or brought the entire reservation safe drinking water.

Henry and the Pattersons will receive an additional $2 million this year, and every year for the remaining 46-year life of the agreement with NYPA.

As part of the settlement, NYPA gives the Nation one megawatt of free power, which is sufficient to provide free electric service to every household on the reservation. The right to determine whether to use the power on the reservation or sell it to National Grid is made by the three men, who so far have chosen to sell most of the power. No one knows what happens to the money.

Two years before the relicensing agreement went into effect, Henry, on behalf of the tribe, signed a waiver that would have otherwise required an expensive environmental impact study for NYPA. Four months later, on Dec. 31, 2005, Henry received his first check from NYPA for $5 million. It was deposited into one of his accounts.

The final NYPA environmental impact statement, issued in December 2006, states, "The Tuscarora Nation (i.e., Henry) has not raised environmental justice concerns, and we assume, by (Henry) signing their agreement with the Power Authority, their concerns about the project have been addressed."

Shockingly, an environmental impact study was waived by Henry, in spite of a complaint filed by the Tuscarora Nation Landholders Coalition (a group Henry does not recognize) describing the impact of the NYPA project on water pollution and the surrounding environment. Known hazardous waste repositories -- including the Lewiston Reservoir -- directly encroach on the Tuscarora Reservation. People on the reservation can't safely drink water that comes from their wells. In fact, doctors prescribe bottled water because of the contaminants in well water there.

In addition to NYPA, National Grid also cut a deal with the aging tribal clerk that says a Tuscarora cannot have electricity on the reservation without Henry's permission. National Grid pays for their power lines crossing all over the reservation. What rent the Nation receives is unknown.

People shiver in the cold with fireplaces, and light homes with inadequate generators or candlelight, because of infractions as small and personal as dating a particular person. Grudges held against families can be generational. An individual can be denied service because of some transgression committed by his grandfather years ago. Seventy-year-old women go out and get wood in the winter to heat their houses.

National Grid spokesman Steve Brady and Patricia Pesaturo, a commercial connections representative with National Grid, both confirmed Henry must approve electrical service before they will provide electrical service on the reservation.

Not only homes, but businesses run on expensive generators, making it difficult to start and hard to continue operating.

You ask why the people tolerate this?

Why do they in Cuba or China?

If you incur the wrath of a Patterson or Henry, you can be denied the issuance of essential Native American identification papers, known informally as a "red card."

Henry and the Pattersons point to the new community building completed last year. They told the people they spent $7 million to build it for them.

An independent appraiser estimated construction costs to be actually around $2 million for the 33,000-square-foot building. Neil Patterson Sr. acted as "consultant" on the construction and was paid $87,000 for his work.

The community center may have wound up costing the three-man "nation" nothing at all. They procured a federal Department of Health and Human Services Community Service Block Grant for $2.2 million for the project.

The 10-acre site of the Nation House is on land owned by Henry, who formerly used it as farm fields and the location of his outhouse. Since the reservation does not record deeds and mortgages with the Niagara County Clerk's Office, it is not known if Henry sold the land (worth perhaps $50,000 on the open market) for millions or is involved in a lucrative land lease arrangement.

Another service the three men provide for their nation is the Tuscarora Environment Program (TEP), which solicits grant monies from the state and federal government.

One such grant is where TEP received $215,640 per year under a two-year agreement with the EPA, plus the Pattersons got $20,000 each per year in "travel expenses," $62,000 for a new Chevy Suburban 4x4, $20,000 for office furniture and $2,000 annually for office supplies. Patterson Jr. paid himself another $39,000-a-year plus benefits in the EPA deal.

When Chew Road was found to have been paved with radioactive metals that for years have been leaching into people's wells, it helped explain why whole families in the neighborhood between Mt. Hope Road and the Tuscarora Baptist Church have been lost to cancer. Patterson Jr., as head of the TEP, when called upon to come up with plans for remediation (some of which would cost the "nation" money) came up with the simplest plan -- start a program to encourage people to drink only bottled water.

Another service the leaders provide is medical care. The Tuscarora health and dentistry clinics deny health care to enrolled Tuscarora members who have run afoul of the Pattersons or Henry. More than 100 enrolled Tuscaroras were denied healthcare services. In one family, Henry allowed a son to go to the clinic, but not the daughter, even though both share the same parentage.

Incidents of child molestation also surfaced. The alleged perpetrators are related by blood to at least one of the three men who dominate most areas of life on the Tuscarora Reservation.

Molestation and rape incidents (and coverup) are traditional with the ruling elite and go back as far as 30 years. A powerful Tuscarora man allegedly raped and abused young girls between the ages of 11 and 16 since the 1970s.

The women waited years before coming forward with their allegations. They had reason to be afraid. At a whim, Henry could have that person or their parents removed from the rolls, seize their property, or deny the family the ability to buy property.

Buffalo attorney Kendra Winkelstein resigned last year as legal counsel to the ruling three, after 18 years, following these allegations of the systematic sexual abuse of young girls on the reservation.

Hard to believe?

It exists today under the leadership of Leo Henry, Neil Patterson Sr. and Neil Patterson Jr., propped up by the U.S. government, not unlike some Third World dictator who supports U.S. policy of convenience, while the people suffer.

The only difference in this case is that these people are your neighbors.

On the other hand, the Memorial Hospital story is an unqualified success story. In spite of the fact that it serves primarily low-income patients, Memorial has evolved into a premier hospital with amenities, technology, services and a staff comparable or better than hospitals in affluent communities.

Funny, too, from 1998-2002, Memorial lost more than $20 million. Averaging a $5 million loss per year, it was on the verge of bankruptcy. Since 2003, it made an almost miraculous turnabout.

One of the elements of the Memorial story is that things started to change precisely when it hired back its old dishwasher and made him president.

Actually, Joseph Ruffolo had done a few other jobs since leaving the hospital in 1972, when he worked in dietary, scrubbing pots and pans for five years working his way through college.

Ruffolo became controller at Sheehan Memorial Hospital in Buffalo for five years. Then Millard Fillmore Health System as Chief Financial Officer for 10. Then CEO of Children's Hospital of Buffalo for another five years.

"That was my real 'Camelot' in terms of helping people," Ruffolo said in an interview. "I was playing a part, albeit a very small part, in helping children become healthier. Seeing kids afflicted with terminally ill disease is tough. Little kids, young, innocent -- they didn't do anything, right? They have cancer. So that was a big part of my career."

Ruffolo and others were the catalyst in Children's merger with Buffalo General and Millard Fillmore that formed Kaleida. He became the COO/EVP of Kaleida for a few years. Then he joined a consulting firm and formed a division that provided interim CEO services to financially distressed hospitals in Pittsburgh and Louisville.

Then one day, by luck or chance, in 2002, at a local event, Ruffolo ran into longtime hospital board member Don King. King recognized what Ruffolo was doing for other communities needed to be done in his hometown too.

There were 1,100 people working there. Ruffolo was not one of those "brightest and best" hired from afar, but a local lad, come back in the full maturity of experience and vision.

He knew probably half the people working there from friends and family, and from the kitchen when he worked there.

The board hired Ruffolo and gave him the charge not just to run a hospital and keep up the best of its 100-plus year-old traditions, but also to stop the massive loss of money.

His philosophy from the start was that this hospital had to make it on its own.

"I always say, 'We eat what we catch,'" Ruffolo said. "We don't catch fish, we don't eat. We catch fish with no insurance we have to care for them, but we don't get paid."

It was a challenge.

Twenty percent of the people in this area are on or below poverty guidelines, and roughly 50 percent are on some form of government assistance. Forty-one percent of patients are Medicare/Elderly, 35 percent are Medicaid, roughly 8 percent is self-pay -- meaning, in most cases, no pay or charity cases.

This environment would be a challenge for the World Health Organization. The area has some of the highest health indicators in terms of mortality, cardiac, stroke and diabetes, a rise in teenage pregnancy, inadequate prenatal care. With the highest health indicators, think about the enormous resource that the people need because of their poor health indicators and the finite number of resources we have in this community. Ruffolo's job was to try to figure out how he could rub a penny into a dollar.

Somehow he did it. He not only paid the bills and continued charity or "safety-net" services, but got the place to go from losing $5 million a year to breaking even. He got capital needs met by grants. Pretty much everything he initiated from building Heart Centers, Endocrinology/Diabetes Centers, and the new Behavioral Health Center was all done through grants.

He securitized future revenue stream and had bonds issued to build the new 54-bed inpatient Behavioral Health Center that replaced one that was 35 years old.

Ruffolo also set out to change the way people got medical services.

It's a big, busy facility. At the ER, Memorial gets perhaps 30,0000 visits per year -- one of the busiest Emergency Rooms in Western New York. The problem is, there are probably 7,000 or 8,000 people who use the Emergency Room as a primary care unit.

Ruffolo arranged to partner with a federally qualified healthcare center, and the Hamilton B. Mizer Primary Care Center increased hours, and Memorial began to redirect people to a more appropriate and cost-effective setting for primary care.

With money raised from a creative bond backed by a union, they built a brand-new Emergency Room three times the size of the old ER with a Heart Center attached, because one-third of the people who use the ER have some kind of heart ailment. Memorial has one of the most modern Heart Centers and Emergency Rooms in all of New York.

Primary Care Facilities, a New York State Designated Stroke Center, the only Endocrinology/Diabetes Center in the area, a Sports Medicine Program and a Cardiac Center with some of the most innovative, noninvasive testing to prevent heart attack, all delivered by a hospital not subsidized by any state, local, or federal agency with respect to sustaining its operations.

The goal to run at a break-even was accomplished, barely. The 2011 operating budget of $85 million had a $126,000.00 operating surplus, less than one-tenth of 1 percent.

If the hospital was owned by a city government, county government or state government -- which, by the way, in most metropolitan areas, is the way an inner-city hospital that's the "safety net" is typically owned -- I suppose they might not need a man like Ruffolo.

Your tax dollars would support the deficit.

Instead, this community hired a man named Joe Ruffolo, a hometown boy to run its hospital, and the taxpayers do not have to chip in.

Of course, Ruffolo is unhappy taking credit.

"Well, it's the 1,100 people here. I mean the average tenure, the average seniority of a nurse here is probably somewhere between 15 and 20 years," he explains. "You don't see that anywhere, not in any other part of the country. This is their 'House.'

"They are loyal to this. I mean, they could go to Buffalo, nurses here could leave tomorrow, go to Buffalo and probably make $3 or $4 more per hour. A nurse that has the skill set from 15 years experience here, they have seen it all and done it all with that continuity and consistency. They are born here, they live here, and they have devoted their life here, and they are wed here.

"You say I keep this place together? Well, God forbid, if I got hit by a car tomorrow, somehow, someway, the people here would figure out a way to keep the doors open and keep it going. I guess it's all about teamwork. It is all about the team. They are thick-skinned, they have been through hell and back more than once, probably half-a-dozen times or more. They have seen it all, they have heard it all, they have done it all, and they are still here.

"That is why the quality of care is so high, because you have such a skill set with such continuity. Our people know our systems, our patients and each other. That is a big thing."

What a contrast of stories between the Tuscarora leadership and Memorial, and yet both needed to be told. And will continue to be told.

Niagara Falls Reporter www.niagarafallsreporter.com Feb. 21 2012