For the second year in a row, Indian Health Service (IHS) leadership is confused how federal sequestration will impact its budget, leading to questions of responsibility and competency from Native-focused health officials.
The latest confusion centers on how the Special Diabetes Program for Indians (SDPI), a program created in 1997 by Congress for the prevention and treatment of diabetes in American Indian and Alaska Natives, will be affected under the new federal budget deal. The December congressional arrangement alleviates sequestration on many so-called discretionary Indian-focused programs, but it leaves cuts in place for some mandatory programs.
SDPI last year was classified as mandatory under White House Office of Management and Budget (OMB) rules, so the program received a 2 percent cut, translating to $3 million. That reduction was able to be absorbed by IHS through an internal reshuffling of funds, according to agency officials last year.
This year, under the budget deal hammered out for 2014 by Democratic and Republicans congressional negotiators in December, mandatory programs would be subject to the same cut. As of December 24, 2013, IHS officials believed that SDPI would face the same cut as last year, and agency leadership was communicating that information to Indian health officials and to the press. An IHS spokeswoman told Indian Country Today Media Network by e-mail on December 24 that “SDPI has been sequestered by 2 percent again as other mandatory health programs.” A question at that time left unanswered was whether IHS would be able to absorb the $3 million shortfall, as it had in 2013.
Fast forward to mid-January, with IHS now telling Indian health officials that it doesn’t know if SDPI will be subject to sequestration in 2014. They also told Indian health officials on January 15 that the agency does not know when they would have more information on this issue.
When asked by ICTMN again on January 16 if SDPI would be subject to sequestration and if so whether IHS would be able to administratively pick up the slack as it did last year, Dianne Dawson, a spokeswoman for IHS, said that the Office of Management and Budget (OMB) should be contacted for details on the 2014 budget.
OMB has not responded to requests for comment, but one thing is for sure: IHS leadership is no stranger to accusations of not knowing how federal sequestration affects their budget. Yvette Roubideaux, acting director of the agency, told Indian health officials at various tribal meetings and in letters throughout 2011 and early 2012 that “the worst-case scenario would be a 2 percent decrease from current funding levels” for IHS under sequestration, rather than the 9 percent that was forecasted for most federal agencies if the sequester went into effect. But that information was a misreading of the law, according to OMB, and IHS ended up being subject to higher levels of sequestration.
Indian health officials were outraged that Roubideaux had fed them wrong information, and they said it cost them the ability to prepare tribal budgets to help make up for the greater shortfall. They were also concerned with OMB’s interpretations of the law.
Questions over this issue and others involving lacking tribal consultation, transparency and funding issues have caused Democratic senators to hold up Roubideaux’ re-nomination to her director position. She has been reduced to acting capacity, which has reduced morale in the agency, according to Indian-focused officials who have discussed the situation with IHS staff.
Given the new confusion surrounding the SDPI program and sequestration in 2014, Indian health officials are again angry with IHS leadership and are demanding clarification.
“I am not sure what IHS is doing anymore; we have hardly any transparency when it comes to IHS budget issues with this director and administration,” said Jim Roberts, a policy analyst with the Northwest Portland Indian Health Board, when asked about the SDPI situation in December. “I’ve never seen budget and administrative transparency worse in the history of the agency despite its mantra and their espousal that this is their priority.”
From Roberts’ own reading of the law, he says that if Congress does its job and stays within the allocation caps reached under the December budget deal, there should not be a two percent reduction to the general IHS appropraition.
National Indian Health Board officials say they are investigating the situation with the agency.
Washington State’s recommended fish consumption rates boil down to just 6.7 grams per day per resident, or one eight-ounce fillet per month.In contrast, Oregon’s rate to determine how much contamination is allowable in its waters assumes a 175-gram-per-day consumption rate, or about 24 eight-ounce fillets per month.
The problems associated with contamination in Northwestern waters are mounting.
For years the many contaminants in Washington State waterways have prompted the state’s Department of Health to issue official warnings against eating Washington fish too frequently. Washington currently has fish consumption advisories issued throughout the state.
“The tribes are not only interested in protecting all the species of fish they eat, but they’re also concerned about protecting their economic interests,” said Ann Seiter, fish consumption rate coordinator for the Northwest Indian Fisheries Commission.
Tribes are calling for major changes in pollution policy. When health officials from Washington and Oregon issued advisories for mid-Columbia River’s resident fish last September due to elevated mercury and PCB levels, tribal leaders were outraged.
“The focus should not be ‘Do not eat’–it should be ‘Clean up’–the Columbia River,” said Yakama Nation Chairman Harry Smiskin in a statement at the time.
The Umatilla, Yakama, Nez Perce and Warm Springs tribes urged the governors of Washington and Idaho to update water quality standards and fish consumption rates.
“The tribes believe that the long-term solution to this problem isn’t keeping people from eating contaminated fish—it’s keeping fish from being contaminated in the first place,” Columbia River Inter-Tribal Fish Commission Chairman Joel Moffett said in a statement. “Armed with higher fish consumption rates and water quality standards, we hope there will be a greater motivation to remove pollutants from the Columbia River and its tributaries.”
Washington has also issued a lower Columbia advisory that warns of PCBs, DDT and Dioxin as well as other compounds. To the state’s east, an advisory has been issued for the Spokane River, which is contaminated with PCBs, lead and other harmful materials. There is also a statewide mercury advisory.
Washington and Idaho are reevaluating their fish consumption rates, which are used to calculate water quality standards that protect human health. The four Oregon tribes urged Washington and Idaho to adopt at least the same rate that Oregon uses to establish water quality standards protective of all fish consumers in the region, according to the White Salmon Enterprise.
Oregon’s 175-grams-per-day suggested consumption is a more accurate representation of how much fish most of Oregon’s residents actually eat. But even that does not go far enough, tribal leaders say. State and federal governments must act to clean the polluted sections of the Columbia River contaminating fish, Smiskin said.
“The fish advisories confirm what the Yakama Nation has known for decades,” Smiskin said. “State and federal governments can no longer ignore the inadequacy of their regulatory efforts and the failure to clean up the Columbia River.”
The Yakama Nation repeatedly identified contaminated sites along the Columbia, expressing concerns for the health and culture of the Yakama people and calling upon the state and federal agencies for cleanup actions that would protect the tribe’s resources, retained by them in the Treaty of 1855.
“The new advisories once again pass the burden of responsibility from industry and government to tribes and people in the region,” Smiskin said. “Rather then addressing the contamination, we are being told to reduce our reliance on the Columbia River’s fish. This is unacceptable.”
Anyone preparing or serving food on the reservation is required to have a current food worker card. Upon completion of the class and a passing test score, a food worker card will be issued which will be valid for three years from the test date. This card is valid for employment on the reservation only.
Please see the attached flyer for the address and further details.
From Darryl Madden, Director of FEMA Ready Campaign
For many, the New Year is a time for setting goals and making new resolutions for the year to come. If you are anything like me, each year you find yourself resolving to achieve a healthier lifestyle – eating right, exercising more, losing a few pounds.
Setting personal health goals in the New Year is great, but improving overall well-being involves taking actions to be prepared. Knowing what to do in an emergency is vital to the health and safety of you and your loved ones.
This year, the Ready Campaign is challenging you to be Prepared in 2014. Start the New Year by connecting with family and friends on the importance of preparedness. Not only can the information shared potentially save a life, connecting with those you love has an added benefit. People who have strong social connections tend to be healthier and more resilient.
I know the hardest part of keeping a resolution is sustaining it after those first few weeks of the year, but you don’t have to do it all at once.
First, start by simply having the conversation: who to call, where to meet and what to pack in an emergency.
Build your family’s emergency supply kit by picking up recommended emergency items over the first month or two of the year.
Create a preparedness checklist. This should include things such as emergency phone numbers and copies of important documents, and information on how to register for programs such as the American Red Cross Safe and Well website.
Set reminders throughout the year to talk about and update your family emergency communication plan. If you have children, include them in conversations and planning activities. The Ready Campaign has age-appropriate tools and resources you can use to introduce disaster preparedness to them. And you can learn more about talking with kids after disasters so you’re ready to help them through tough situations.
Have pets? Make sure they are a part of your planning process. Create a pet go-bag to help keep them safe during an emergency. Find helpful tips from FEMA on how to plan for your furry friends
Older adults often have special needs in a disaster and may depend on medications or other special requirements. If older adults are a part of your social connection, be sure to include them in your preparedness planning efforts.
Emergencies can and will happen, but being ready can minimize the impact they have on the overall well-being of you and your family.
This year, make disaster preparedness part of your New Year’s resolution. On January 1st 2014, join the Resolve To Be Ready Thunderclap to promote a message of preparedness to your social connections on New Year’s Day. Don’t forget to use the hashtag #Prepared2014 whenever you discuss family preparedness on Twitter.
Flu shots work to prevent illness – lots of vaccine available in the county
SNOHOMISH COUNTY, Wash. – Snohomish County’s first confirmed flu death of the 2013-14 season has been reported to the Snohomish Health District. A Bothell, Wash. woman in her thirties died from influenza complications on January 4. She had underlying health conditions, and passed away in a King County hospital.
“This next few months could be a rough start to 2014 for people who do not protect themselves from the flu,” said Nancy Furness, Director of Communicable Disease Division at Snohomish County’s local public health agency. Furness noted that seven county residents died from influenza-related illness in 2013.
A flu shot every year is recommended for everyone age 6 months and older. Different strains of flu circulate each year. So far this year, the most common flu virus has been H1N1, the “swine flu” that hit young adults and children hard in 2009. This year’s flu vaccine includes H1N1, substantially reducing the chances you will get a serious case of the flu or pass it to others.
The state Department of Health reports five flu-related deaths statewide as of Dec. 28. Official statewide cumulative totals about illness activity are issued once a week, and do not include data from the current week. The Jan. 4 Snohomish County death is not reflected in the most recent statewide total.
Two upcoming community clinics in Everett offer flu and whooping cough shots at no cost for uninsured, low-income adults.
·10 a.m. to noon Friday, Jan. 10 at Everett Station, 3201 Smith Ave., Everett, Wash.
·3:30 to 5:30 p.m. Saturday, Jan. 11 at Comcast Arena, 2000 Hewitt Ave., Everett, Wash.
The vaccine for this current flu season is available at medical providers and pharmacies throughout the county and will protect against three or four kinds of influenza virus — including H1N1 — that make people sick.
Washing hands, covering your coughs, and staying home when you are sick are effective ways to reduce spreading and getting diseases. Vaccination is the best way to protect yourself and others.
The Snohomish Health District’s clinics in Everett and Lynnwood have vaccine to protect you against the flu. The cost for an adult flu shot at the Snohomish Health District is $30. A flu shot for a child costs $23. The Health District accepts payment by cash, check, VISA, MasterCard, Provider One (coupons), and Medicare for clients whose primary insurance is not with an HMO. Clients may apply for a reduced fee, based on income and household size.
Snohomish Health District clinic hours – shots by appointment only:
·SHD Everett Immunization Clinic, 3020 Rucker Ave, Suite 108, Everett, WA 98201
425.339.5220 for an appointment: 8 a.m.- 4 p.m., Mon-Wed-Fri; closed on weekends & holidays
425.775.3522 for an appointment: 8 a.m.- 4 p.m., Tue & Thu; closed on weekends & holidays
Established in 1959, the Snohomish Health District works for a safer and healthier Snohomish County through disease prevention, health promotion, and protection from environmental threats. Find more information about the Health Board and the Health District at http://www.snohd.org.
Tulalip Casino & Resort Salmon On a Stick is a traditional preparation method for slow-roasting salmon on iron wood sticks over wood coals. The method is at least several centuries old and is part of a rich tribal heritage for the Pacific Northwest’s Coast Salish peoples.
Long before the “100-mile diet” became the trendy new way to eat, Native American people of the Pacific Northwest were immersed in this way of eating. And little wonder, for they lived in an environment that was astonishingly bountiful. Forests overflowed with deer, elk, berries, flowers, seeds and greens. Seas and rivers teemed with salmon, prawn, crab and other nourishing plant and animal life. Shorelines were rich with clams, oysters and seaweed.
Salmon n’ Bannock Sous Chef Kyle. The fine-dining restaurant serves wild fish; free range, grass fed and/or organic meat; bannock made fresh daily, and other culinary deights inspired by a variety of First Nations traditons. (Hans Tammemagi)
Food was central to traditional life and was especially enjoyed at feasts and potlatches, where platters boasted salmon, oolichan (a small, oily member of the smelt family), venison, bannock, wild berry jams and much more. For Native people, food is what connected them to family, community and even the afterlife.
Then came the white man, and everything changed. In today’s era, food, generally processed, is purchased at supermarkets or fast-food outlets. Nutrition is too often replaced by sugar, salt and glitzy packaging. And, as is well documented, the health of Native peoples has slowly spiralled downward.
But there is good news: traditional foods are making a comeback. Even better, the old dishes are being infused with modern culinary innovations to make tasty, attractive, and of course, healthy cuisine.
I was in the Salmon n’ Bannock Bistro in Vancouver, British Columbia with a Haida canoe suspended from the ceiling and Native art adorning the deep red walls. The server placed an attractive appetizer platter from the ‘Land and Sea Feast’ menu on the table. I popped a spicy game chorizo sausage into my mouth … wonderful! Then I savored Indian candy — smoked salmon covered with a maple syrup glaze. I spread barbequed salmon mousse on bannock and ladled blueberry chutney onto a piece of bison carpaccio.
Inez Cook, Nuxalk Nation, the co-owner and manager of Salmon n’ Bannock in Vancouver (Hans Tammemagi)
With my mouth full, it was hard to speak, so I listened to Inez Cook, Nuxalk Nation, the co-owner and manager of this fine-dining restaurant, which is winning accolades on the hotly competitive Vancouver cuisine scene. “My bistro is unique. It’s the only restaurant in Vancouver that offers 100 percent First Nations’ food, and it’s staffed entirely by Native people,” she said. “I’m very proud of First Nations’ food,” she continued. “It’s great. I want to shout out: ‘Try it! Eat it!’” I acquiesced and speared a piece of musk ox prosciutto. Delightful!
The bistro opened in 2010 and has slowly gained a following. “None of our food contains preservatives or additives,” Cook said. “Nothing is raised in factory farms or is genetically modified. We source all fresh and wild foods so it’s very healthy.”
“The most popular dishes are salmon, barbequed or smoked, and deer shank with red wine gravy,” Cook said. These are paired with wines from Nk’Mip Cellars, a Native-owned and -operated winery in the Okanagan Valley, central British Columbia.”
When I remarked that the menu featured mostly fish and meat, Cook answered with a laugh, “Yes, Natives think that vegetarians are just lousy hunters.”
The “Bounty Bowl” at The Blackfish Salmon Grill (Tulalip Casino & Resort)
At present, unfortunately, eating establishments offering traditional Native food are rare. The Blackfish Salmon Grill at Tulalip Casino & Resort, north of Seattle, Washington, is one of the exceptions. “We are not a strictly Native cuisine restaurant,” explained Chef David Buchanan, “but rather, our style is innovative Pacific Northwest influenced by traditional tribal culture and cuisine.”
Wild salmon cooked on Tulalip hand-carved, ironwood sticks over an alderwood fire is very popular. Other menu items include an appetizer of clam fritters (from a Tulalip tribal elder recipe), local root vegetables, corn cakes and fresh berry soufflé. Typical ingredients include local clams, Alaskan prawns, many varieties of oysters, Alaskan halibut, wild Steelhead, blueberries, blackberries, hazelnuts, wild chanterelle and morel mushrooms.
“We strive to put a little twist on every dish, to make it our own. For instance, our crab cakes have roasted fresh sweet corn and apple-smoked bacon in them and are served with three sauces and an apple-watercress salad,” Buchanan explained.
The Blackfish Salmon Grill is like a Longhouse with large beams accenting the ceiling and a long, beautiful natural wood community table in the center of the room. The focal piece is an open fire pit on which on which the Salmon on a Stick is prepared.
Buchanan said “I am especially intrigued by how in Native culture the entire process of a meal is so holistic. Thanks is given for the return of the salmon each year and for the sustenance it gives. Thanks and a prayer are also given for the wood when it is harvested to carve the Ironwood sticks used for roasting the salmon. Those who prepare the meal should do so with good intent in their hearts. The meal is a time for sharing with friends and family, and being thankful for those who helped catch and prepare the food.”
But those living in the Seattle area don’t need to go to a fancy restaurant to enjoy Native food. Instead, they can use Facebook to track down the current location of Off the Rez, the first Native American food truck in the country. Pale blue in color, the truck serves up a variety of Native fry breads of which the three-taco combo with pork, beef and chicken fillings is reputed to be outstanding.
The ‘Land and Sea Feast’ platter at Salmon n’ Bannock in Vancouver (Hans Tammemagi)
There are two smaller but notable Native eateries. The Riverwalk Café at the Quw’utsun Cultural Centre in Duncan, BC, on Vancouver Island. Situated on the banks of the Cowichan River, a heritage river with three salmon runs each year, the Café features such delicacies as smoked and candied salmon, clams and octopus. The Riverwalk Café is open only for lunch from June to September.
The Thunderbird Café is part of the Squamish Lilwat Cultural Centre in Whistler, BC. It is open year-round but only to 5 p.m. Its Indian Taco with venison chilli and bannock is reputed to be truly man-size. Other favorites are salmon chowder and smokies made of wild boar and bison. They also make a venison pemmican with local berries and nuts.
While waiting for more restaurants to offer traditional Native cuisine, you may decide to cook at home with friends. Thanks to Dolly and Annie Watts, a mother and daughter team, you can do just that, guided by their book, Where People Feast – An Indigenous People’s Cookbook. The cookbook, one of the few that focuses on west coast Native cuisine, appeared in 2007 and was an instant hit, winning rave reviews and the Gourmand Award for best local cuisine book in Canada. Where People Feast is crammed with easy-to-follow traditional and modern aboriginal recipes, from hot buttered halibut to juniper berry sauce to bannock and also includes methods for smoking and drying wild game, preparing seafood and preserving berries.
A champion of traditional Native food is Chef Ben Genaille, a Cree, who moved from Manitoba to the west coast about 20 years ago where he has worked at several top restaurants. He’s passionate about Native dishes, preparing them using contemporary methods and presenting them with modern flair. He established an Aboriginal Culinary Program at Thompson River University, Kamloops, British Columbia, the only one in North America.
The Aboriginal Culinary Arts Certificate Program integrates an understanding and appreciation of the important value food plays in Aboriginal culture. (Thompson Rivers University)
In 2012, Genaille led a team of five young west-coast Native chefs to the World Culinary Olympics in Germany. “I’m very proud of them. They worked hard and trained for five years for the competition,” he said. “We focussed on Pacific Northwest ingredients and showed the world that First Nations cuisine is at the cutting edge of local food.” Dishes that caught the judges’ eyes included oolichan oil in dessert, herring eggs in soup and a platter with five types of salmon, each prepared a different way.
Chef Genaille is an unabashed supporter of Native cuisine. “It all hinges on getting talented young chefs,” he stresses. “We must strive to give them pride and passion. And that’s happening. As these young chefs develop, traditional Native food will grow in popularity.”
Where People Feast – An Indigenous Peoples’ Cookbook
The cover of the book Where People Feast (Arsenal Pulp Press)
Preheat oven to 350°F (180° C). Crush the berries, garlic, cayenne pepper, cumin seeds, and onion flakes in a mortar. Rub the crushed spices onto the roast and then pan-sear the roast in a hot frying pan with the oil to lock in the juices. Put roast in a roasting pan and add the boiling water, then roast for 1 hour, basting at least 4 times. Makes 3 servings.
At the beginning of every year, we read the tea leaves to see what new food trends we’ll be tasting in the coming months. This year, the tea itself is the trend.
Tea leaves will be big in entrees, desserts and, of course, cocktails. Starbucks has opened its first tea shop.
We won’t be just drinking tea; Artisan distilling keeps on growing. This could be the year of gin, made with local botanicals as well as the traditional juniper berry.
New — but still ancient — grains will join the now-common spelt and quinoa. Teff and freekeh may be as familiar to us by the end of next year.
Nuts aren’t new either, but a Harvard study shows that nut eaters live longer and lose weight. Tada: next year’s favorite snack food.
Another study finds we threw out 40 percent of our food last year. Now grocery auctions offer unsold food, and even the former president of Trader Joe’s will open a market selling perfectly good food that’s just past its sell-by date.
Vegetarianism is no longer just for vegetarians. While most Americans still eat meat, 47 percent of the country eats at least one vegetarian meal a week.
Cauliflower, by the way, is the new Brussels sprout.
Eating local is going into overdrive. Restaurants and markets have planted gardens and built farms — on the ground and on the roof.
And if you can’t grow it, you can buy it from professional foragers, who will bring chickweed and chanterelles to chefs and consumers.
Small-scale meat producers will be available as we continue to fret about industrial farming. Expect more goat, rabbit and pigeon — or squab, if that makes you feel better.
The meats may be flavored with za’atar or sumac, which should easier to find as we dig deeper into the foods of the Mideast.
From the Middle East we go to the Middle West for simple, hearty cooking. The Food Network names the Midwestern food movement as the No. 1 trend for 2014. You betcha.
Dessert? Ice cream sandwiches. Probably made with tea leaves.
Bonny Wolf is managing editor of americanfoodroots.com and editor of NPR’s Kitchen Window.
· 2:30 – 5:30 pm free skating for clinic clients and their kids
· 3:30 – 5:30 pm adult-only shots for flu and whooping cough
What: The Everett Public Facilities District and Global Spectrum are putting flu season on ice again in 2014!
On Saturday, January 11, Comcast Arena and the Comcast Community Ice Rink will host a free public skate and vaccination clinic to serve uninsured and lowincome adults in the Snohomish County area. Volunteers and staff from the Snohomish Health District, Mukilteo-South Everett Rotary, and Walgreens will provide adults with flu shots and whooping cough vaccinat ions from 3:30 pm to 5:30 pm.
Guests of the event will skate on the Comcast Arena’s main ice rink where the Everett Silvertips play their home games. Skating is from 2:30 to 5:30 pm. Guests are asked to enter through the Comcast Community Ice Rink entrance (Broadway).
Flu season has begun in Snohomish County. Getting a flu shot every year is the best way to prevent infection. Vaccination is also the best protection against whooping cough. Whooping cough, also known as pertussis, is no longer at epidemic levels in Snohomish County, but cases of it are still being confirmed and it can be deadly to babies. It is especially important that all pregnant women and people who are around newborns – including teens, grandparents, and childcare workers – get the booster shot to protect the infant.
Download vaccine information sheets at http://www.cdc.gov/vaccines/hcp/vis/index.html
