Tribes scramble to avoid $1 million in fines under Affordable Care Act

Diabetes patient Jay Littlewolf says he sought medical help for a diabetic ulcer at a Billings hospital after not receiving "adequate health care through the IHS in Lame Deer." He wants reimbursement from the IHS and sought Sen. Jon Tester's assistance.Photo/Larry Mayer, Gazette staff
Diabetes patient Jay Littlewolf says he sought medical help for a diabetic ulcer at a Billings hospital after not receiving “adequate health care through the IHS in Lame Deer.” He wants reimbursement from the IHS and sought Sen. Jon Tester’s assistance.
Photo/Larry Mayer, Gazette staff

By Tom Lutey, The Missoulian

BILLINGS – Montana’s Indian tribes, which until recently thought the Affordable Care Act would pass them by, could face fines exceeding $1 million for not offering insurance to employees.

Beginning in 2016, businesses with 50 or more full-time workers will have to offer at least a minimum amount of health insurance to employees. Those who don’t comply face tax penalties, and that includes tribal governments.

The requirement has been a surprise to tribes, said George Heavy Runner, Blackfeet Insurance Services health and wellness coordinator. As individuals, American Indians have the option of choosing not to follow Affordable Care Act rules. Many assumed tribal governments, which are sovereign, had that same option.

“We thought this was a ship kind of passing us by,” Heavy Runner said. “But it’s not just a ship passing through the night. We have been identified in this legislation, just not where we thought we would be.”

Tax penalties facing the Blackfeet Tribe for not complying could be as high as $1.1 million. Crow Tribal Chairman Darrin Old Coyote said the size of the fee depends on how many people a tribal government employs.

“If we don’t do the mandate, we’re going to be fined for the number of employees we have, and that number could be up to $1.5 million,” Old Coyote said. “We pay federal tax, and our employees pay federal tax and so we’re part of the large employer mandate.”

The tribes can avoid the fees by offering the insurance to their workers. Old Coyote said the Crow have hired a benefits manager to do just that.


The change caught tribes off-guard because American Indians by treaty receive health care via the Indian Health Service on reservations. IHS is much maligned by tribal members for not providing adequate health care and for not covering services by specialists outside the IHS program.

Because IHS is limited, tribal members who work for their government would benefit from having other health care, Old Coyote said. The challenge is having a health care plan to offer by next year.

Suing to get off the employer mandate has already been tried. In February, Wyoming’s Northern Arapaho Tribe failed to convince a federal judge to block the employer mandate. The Northern Arapaho argued that subjecting tribes to the employer mandate was an oversight that overlooked treaty rights related to Indian health care, while also stating that tax credits and benefits granted to Indians under the Affordable Care Act would be denied.

Earlier this month, U.S. Sen. Steve Daines, R-Mont., and U.S. Rep. Ryan Zinke, R-Mont., announced a bill to exempt tribes from the employer mandate. Daines called the mandate a job killer for tribal governments, who wouldn’t hire as many employees if they had to pay significant penalties.

Other sponsors of the bill, such as Republican Sen. John Thune, of South Dakota, said it was unfair to exempt individual tribal members and not exempt tribal governments as well.

However, exempting tribes from the employer mandate won’t help the nagging problems with Indian health care, said a representative for Sen. Jon Tester, D-Mont.

“This bill does nothing to solve the underlying problem, which is crisis-level health disparities among Native Americans,” said Marnee Banks. “If we are serious about increasing access to quality health care in Indian Country, we will expand Medicaid and adequately fund the Indian Health Service.”


IHS spending on Indian patients was $2,741 per person in 2013, according to the National Congress of American Indians, which asserts that IHS is severely underfunded. Medicaid spending, by comparison was $5,841.

The state of Montana is awaiting federal approval of the state’s plan to begin offering Medicaid to Montanans earning up to 138 percent of the federal poverty level.

Medicaid expansion would extend benefits to as many as 11,000 tribal members over the next four years, said Jon Ebelt of Montana’s Department of Public Health and Human Services. The program would benefit tribal health care in general, Ebelt said.

“Medicaid expansion revenue will be critical for building health infrastructure, expanding the workforce, and keeping health care providers in tribal communities,” Ebelt said. “Medicaid revenues will bring new funds to the programs and further investment in the Indian health system infrastructure and workforce. This is an opportunity to provide more health care services, create more jobs and employ more Native Americans in tribal communities.”

Old Coyote said he’s concerned that state benefits representatives won’t be able to clearly explain the expanded Medicaid program to some Crow Indians who speak Crow as their primary language. He’s asked the state to provide a benefits representative who is fluent in Crow.

Ebelt said the state is able to provide translation assistance if necessary and in determining an outreach plan with members of the Indian Health Service at Crow Agency.

Proposed 2016 budget for Indian Health Services outlined

Noel Lyn Smith, The Daily Times

FARMINGTON — The acting head of the Indian Health Service has highlighted the federal agency’s proposed 2016 funding to provide health care services to Native Americans.

During a teleconference on Thursday, Acting IHS Director Yvette Roubideaux outlined the proposed budget for the agency, which is included in the proposed $4 trillion federal budget announced this week by President Barack Obama.

The IHS is an agency within the U.S. Department of Health and Human Services. It provides health care services to approximately 2.2 million American Indians and Alaska Natives through more than 650 hospitals, clinics and health stations on or near reservation lands.

The proposed budget for the IHS would total $5.1 billion, which is an increase of $461 million from the fiscal year 2015 budget, Roubideaux reported.

Among the funding proposals Roubideaux mentioned is $718 million for contract support costs. She noted that the budget proposes mandatory appropriation for contract support costs starting in 2017.

The budget proposes a $70 million increase to the Purchased/Referred Care Program, which pays for health care services obtained from the private sector or for services not available by the IHS.

A total of $185 million has been requested to provide funding for construction projects listed under the Health Care Facilities Construction Priority List.

Under the proposal, about $20.5 million would be used for the facility design and to start construction of the Dilkon Alternative Rural Health Center in Dilkon, Ariz.

Funding would also be used to complete construction of the Gila River Southeast Health Center in Chandler, Ariz., and to start the construction of the Salt River Northeast Health Center in Scottsdale, Ariz., and the Rapid City Health Center in Rapid City, S.D.

The budget proposes that $115 million be allocated for the Division of Sanitation Facilities Construction, which supplies water, sewage disposal and solid waste disposal facilities to homes.

The budget proposes an annual appropriation of $150 million for the next three years for the Special Diabetes Program for Indians, which started in 1997 and provides diabetes prevention, awareness, education and care programs to IHS, tribal and urban facilities.

Joining Roubideaux for the teleconference was Jodi Gillette, special assistant to the president for Native American Affairs, who said the president’s approach to funding the programs and services that address Indian Country were outlined during the 2014 White House Tribal Nations Conference.

She noted that last year, the president and first lady Michelle Obama visited the Standing Rock Sioux Tribal Nation in North Dakota.

During their visit, they heard from young tribal members who shared stories about dealing with social issues like alcoholism, poverty and suicide.

In response to that visit, a new initiative focusing on Native American young people — Generation Indigenous — was launched, Gillette said.

Investments to start Generation Indigenous were included in the proposed IHS budget, including $25 million to expand the Methamphetamine and Suicide Prevention Initiative.

That funding would go toward increasing the number of child and adolescent behavioral health professionals working to provide direct services to Native youth.

Another $50 million has been requested within the Health and Human Services Department to start the Tribal Behavioral Health Initiative for Native Youth.

Noel Lyn Smith covers the Navajo Nation for The Daily Times. She can be reached at 505-564-4636 and Follow her @nsmithdt on Twitter.


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Native American health insurance enrollment surges in South Dakota, but some remain skeptical

In this July 10, 2014 photo, Denise Mesteth poses outside the powwow grounds in Pine Ridge, S.D. Mesteth is a member of the Oglala Sioux Tribe, born and raised on the Pine Ridge reservation. She has signed up for health insurance through the federal marketplace. (AP Photo/Nora Hertel)
In this July 10, 2014 photo, Denise Mesteth poses outside the powwow grounds in Pine Ridge, S.D. Mesteth is a member of the Oglala Sioux Tribe, born and raised on the Pine Ridge reservation. She has signed up for health insurance through the federal marketplace. (AP Photo/Nora Hertel)

By NORA HERTEL  Associated Press

PINE RIDGE, South Dakota — Denise Mesteth signed up for new health insurance through the federal Affordable Care Act, despite concerns that it may not be worth the money for her and other Native Americans who otherwise rely on free government coverage.

Mesteth, who has a heart murmur and requires medication and regular blood work, said she’s cautiously optimistic that the federal insurance will be superior to what she has now. Many other American Indians have been more reluctant to enroll, choosing instead to continue relying on the Indian Health Service for their coverage and taking advantage of a clause in the federal health reform law that allows them to be exempt from the insurance mandate if they meet certain requirements.

“If it’s better services, then I’m OK,” Masteth said of ACA. “But it better be better.”

Mesteth and other American Indians in South Dakota account for 2.5 percent of the people in the state who have signed up for insurance under the federal health care law, according to the latest signup numbers. The state, with nearly 9 percent of its overall population Native American, ranks third for the percentage of enrollees who are American Indian among U.S. states using the federal marketplace.

The Great Plains Tribal Chairmen’s Health Board, which provides support and health care advocacy to tribes, received $264,000 to help Native Americans in South Dakota navigate the new insurance marketplace.

Tinka Duran, program coordinator for the board, said people are primarily concerned about the costs of enrolling. Insurance is a new concept to most because health care has always been free, she said.

“There’s a learning curve for figuring out co-pays and deductibles,” she said.

During a U.S. Senate Indian Affairs Committee hearing in May, tribal leaders chastised IHS as a bloated bureaucracy unable to fulfill its core duty of providing health care for more than 2 million Native Americans and Alaska Natives. IHS acting director Yvette Roubideaux said changes were underway but that more money will be needed than the $4.4 billion the agency receives each year.

She noted that federal health care spending on Native Americans lags far behind spending on other groups such as federal employees, who receive almost twice as much on a per-capita basis. Meanwhile, American Indians suffer from higher rates of substance abuse, assault, diabetes and a slew of other ailments compared to most of the population.

Native Americans and Alaska Natives are exempt from the health insurance mandate if they meet certain requirements. ACA also permanently reauthorized the Indian Health Care Improvement Act and authorized new programs for IHS, which also is starting to get funds from the Veterans Affairs Department to help native veterans.

When American Indians do obtain insurance, it means fewer people are tapping the IHS budget, said Raho Ortiz, director of the IHS Division of Business Office Enhancement.

“If more of our patients have health insurance or are enrolled in Medicaid, this means that more resources are available locally for all of our patients,” Ortiz said in an emailed statement. “This, in turn, allows scarce resources to be stretched further.”

Those who sign up for federal health care can still use IHS facilities but have the option of seeking health care elsewhere, Ortiz said.

State Democratic Sen. Jim Bradford is among the skeptics. The Oglala Sioux member lives on the Pine Ridge reservation, home to two of the poorest counties in the nation.

The U.S. government provides health care to Native Americans as part of its trust responsibility to tribes that gave up their land when the country was being formed. Bradford and others object to the shift in health care providers on the principle that IHS is obligated by treaty to supply that care.

Harriett Jennesse, a member of the Lower Brule Sioux Tribe who lives in Rapid City, said she already has seen the benefits of the new health insurance and doesn’t mind paying a little out of pocket.

Jennesse said she put off treatment for a painful bone chip in her elbow after IHS denied a doctor’s referral to a specialist on grounds that it wasn’t an urgent enough need. She’s now seeing a specialist for dislocation in her other elbow and will also try to get the bone chip fixed when the other arm heals.

Cherokee veterans gain care options

New agreement links tribal service to VA health system

By Anita Reding, Muskogee Phoenix Staff Writer

Cherokee Nation Secretary of State Chuck Hoskin Jr., left, and Principal Chief Bill John Baker sign the reimbursement agreement Friday. Next to Baker is James Floyd, the director of the Jack C. Montgomery VA Medical Center. Watching from behind are Gayla Stewart, left, the victim witness coordinator for the regional U.S. Attorney’s Office; Dr. Ricky Robinson, the director of the Cherokee Veterans Center; Vickie Hanvey, the Cherokee Nation self-governance administrator; Jacque Secondine Hensley, the Native American liaison for Gov. Mary Fallin; Connie Davis, the executive director of Cherokee Nation Health Services; Tribal Council Speaker Tina Glory-Jordan; Deputy Chief S. Joe Crittenden; and John Alley and Bunner Gray, Indian health liaisons for the VA center.
Cherokee Nation Secretary of State Chuck Hoskin Jr., left, and Principal Chief Bill John Baker sign the reimbursement agreement Friday. Next to Baker is James Floyd, the director of the Jack C. Montgomery VA Medical Center. Watching from behind are Gayla Stewart, left, the victim witness coordinator for the regional U.S. Attorney’s Office; Dr. Ricky Robinson, the director of the Cherokee Veterans Center; Vickie Hanvey, the Cherokee Nation self-governance administrator; Jacque Secondine Hensley, the Native American liaison for Gov. Mary Fallin; Connie Davis, the executive director of Cherokee Nation Health Services; Tribal Council Speaker Tina Glory-Jordan; Deputy Chief S. Joe Crittenden; and John Alley and Bunner Gray, Indian health liaisons for the VA center.

TAHLEQUAH — Veterans who are members of the Cherokee Nation can now choose from several locations to receive health care.

Cherokee Nation Principal Chief Bill John Baker signed a reimbursement agreement with the U.S. Department of Veterans Affairs on Friday.

The Cherokee Nation is one of several tribes that have contracts with the VA, said James Floyd, director of the Jack C. Montgomery VA Medical Center in Muskogee.

The contract allows the tribe to be reimbursed by the VA for services rendered to Native American veterans using Cherokee Nation health centers for primary care. The contract also allows the Cherokee Nation and the VA to share patient information and charts. The VA will provide medication for veterans.

Now that the contract has been signed with the Cherokee Nation, veterans’ care can be tied to the VA system, Floyd said.

The contract will make it possible for veterans with the Cherokee Nation to receive vital services and not have to travel as far as they have been, said Baker.

“I think it’s a win, win, win for the veterans, for the Cherokee Nation and for the VA hospital,” Baker said.

The agreement with the Cherokee Nation provides health care at W.W. Hastings Hospital and eight clinics. The Cherokee Nation also is planning to build a hospital in Bartlesville, Baker said.

The initial users who can benefit from the contract total 4,500, and that number could easily increase by 1,000, Floyd said.

There are 37,000 users at the Muskogee medical center, and Native Americans are the second highest population group, he said.

“This helps us to grow as a system and to grow from within the tribe as well,” Floyd said.

Some veterans who are members of the Cherokee Nation have not used services at the VA, and this offers them an opportunity to be a part of the VA, he said.

“We are excited to partner with the Cherokee Nation in providing health care to our American Indian veterans,” Floyd said. “This agreement will allow for better coordination of care, allows tribes and IHS (Indian Health Service) to expand care for their users, shortens wait times for medical care and increases access at VA facilities for all veterans.”

Debra Wilson of Briggs is a member of an advisory committee with the VA. Many Native American veterans will be more comfortable receiving medical care at Cherokee Nation facilities, she said.

“This is something we have looked forward to for a really long time,” said Wilson, one of several veterans who witnessed the signing of the agreement.

Don Stroud of Tahlequah said he uses the Cherokee Nation Health System, and the funding that will be provided by the contract will benefit the veterans initially, “but it’s also going to impact the care that’s available for all the patients in the health system.”

“The less money spent on us, the more money available to treat that next little kid that comes in and needs the care, or the next one of our elders that comes in and needs some medication,” he said.

The funds will be there to help them because another source of funding will be available, which will equal things out, he said.

Tulalip TV program explores diabetes in first Tulalip Health Watch episode

Tulalip TV’s Tulalip Health Watch will air this summer and will focus on health issues Native Americans face today.
Photo/ Brandi N. Montreuil, Tulalip News

TULALIP, WA – Tulalip TV viewers will soon be able to watch a new informational program called “Tulalip Health Watch,” which focuses on health issues Native Americans face today.

In the program’s first episode, “Diabetes,” the disease is examined through interviews with health professionals at the Tulalip Karen I. Fryberg Health Clinic. Viewers will learn the fundamental characteristics of diabetes, along with resources available for testing, prevention, and treatment.

Diabetes affects 57 million Americans, and only 8.3 percent are diagnosed. But more shocking are the epidemic proportions of diabetes in Indian Country with 16.2 percent Native Americans and Alaska Natives diagnosed.

According to the U.S. Department of Health and Human Services and Indian Health Service, Native Americans are at a 2.2 times higher risk than their non-Indian counterparts. Between 1994 and 2004 there was a 68 percent increase in diabetes diagnosis in American Indian and Alaska Native youth, aged 15-19 years old.

In “Diabetes,” viewers will learn how a poor diet, lack of regular exercise, and a genetic pre-disposition are the leading contributing factors for 95 percent of American Indians and Alaska Native with Type 2 diabetes, and 30 percent with THW---Diabetes-BryanCooper-2pre-diabetes.

Viewers will also learn how clinic staff incorporates Tulalip culture and traditions into programs available at the clinic for diabetes education, prevention, and management.

“The providers that we have here are great. The Tribe is putting money into this clinic and our goal is to be here with an open mind and heart, and to be a partner here for them regarding their health needs. We have a collaborative team here that you don’t see at other clinics,” said Bryan Cooper, Tulalip Karen I. Fryberg Health Clinic Nurse Practitioner in “Diabetes.”

“Tulalip Health Watch,” will air this summer. Future episodes will explore heart disease, obesity, and other health issues Native Americans face.

You can watch “Tulalip Health Watch” on Tulalip TV at or on channel 99 on Tulalip Cable.


Brandi N. Montreuil: 360-913-5402;

IHS Confused Whether Indian Diabetes Funding Faces Another Sequestration


Rob Capriccioso


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.

RELATED: A Miscalculation on the Sequester Has Already Harmed Indian Health

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.

RELATED: 6 New Year Nomination Battles for Obama’s Native-Focused Nominees

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.

Navigators help get Native Americans insurance


Indian Health Care ServiceOctober 20, 2013

 SIOUX FALLS, S.D. (AP) — Insurance enrollment helpers are encouraging Native Americans to sign up for coverage under the nation’s new health care law, saying it will help them better access X-rays, mammograms, prescription drugs and trips to specialists not covered under Indian Health Service.

American Indians are exempt from the Affordable Care Act’s requirement that people carry insurance, but the law opens up resources that for years have been limited through IHS, said Jerilyn Church, executive director of the South Dakota-based Great Plains Tribal Chairmen’s Health Board.

“There’s a huge gap in access to services, so being enrolled in the marketplace is going to make a big difference in terms of accessibility to health care,” Church said.

The Indian Health Service, a branch of the U.S. Department of Health and Human Services, provides free health care to enrolled members of tribes, their descendants and some others as part of the government’s treaty obligations to Indian tribes dating back nearly a century.

Critics long have complained of insufficient financial support that has led to constant turnover among doctors and nurses, understaffed hospitals, sparse specialty care and long waits to see a doctor.

The Great Plains Tribal Chairmen’s Health Board received $264,000 in South Dakota and $186,000 in North Dakota to assist with Native American signups on the states’ reservations and urban areas.

The new law health care law will especially benefit people who seek treatment at urban Indian health clinics, which collectively are funded by just 1 percent of the IHS budget, said Ashley Tuomi, executive director of the American Indian Health and Family Services clinic in Detroit.

“Our resources are extremely limited, even more so than the tribes,” Tuomi said. “What we have within our walls is what we can offer for free.”

The clinic has seen a lot of patient interest in the health care marketplace, but “navigators” helping with signups have had to cancel many appointments because of continued issues with the federal website, Tuomi said.

The Ponca Tribe of Nebraska has received about $38,000 in federal grant funds to encourage signups for tribal members scattered in 12 counties in Nebraska, two in Iowa and one in South Dakota.

The tribe’s IHS-contracted clinic in Omaha, Neb., has a medical doctor and two nurse practitioners, but the X-rays, specialists and prescriptions that are outsourced are not covered, said Jan Henderson, the tribe’s navigator project director. “And if they don’t have insurance, they have to pay for it themselves,” she said.

Tribes across the country get some federal money for referrals, but the small pools run out quickly, Henderson said.

She views the new health care law as a great step for Native Americans, but the greatest challenge is educating tribal members who are weary from decades of promises of improved health care.

“Education is very important in this right now to get people to be open to actually hearing about it,” Henderson said. “We hear a lot of people who say they don’t need this, they don’t want this.”

Native American journalists tackle tough issues during July conference

Stan Bindell
The Observer 7/30/2013

TEMPE, Ariz.-Journalists covering Indian country received training and discussed Native American issues during the 29th annual National Native Media Conference in Tempe July 18-21.

Native American Journalists Associaiton President Rhonda LeValdo speaks with Dr. George Blue Spruce about the state of dentistry in Indian country. Photo/Stan Bindell
Native American Journalists Associaiton President Rhonda LeValdo speaks with Dr. George Blue Spruce about the state of dentistry in Indian country. Photo/Stan Bindell

The Native American Journalists Association (NAJA) and Native Public Media sponsored the conference.

The theme of this year’s conference was “Our voices, Our stories, Our future.” The conference was designed to empower native journalists and media professionals to tell their own stories. Journalism professionals lead sessions to train native journalists to tell their stories in a professional manner.

Arizona was well represented with journalists attending from the Navajo Hopi Observer, Navajo Times, Tutuveni and KUYI radio station among many others.

The issues those in attendance focused on included violence against women, dental care and the availability of radio frequencies for Indian communities.

Deborah Parker, vice chairwoman of the Tulalip Tribe in Washington state, fought successfully to have native women included in the reauthorization of the Violence Against Women Act. The act was signed into law this past year and promises sweeping changes in the way violent offenders on tribal land are held accountable.

Parker spoke about the legislative process and media coverage of the fight to protect women in Indian country.

“This is also an opportunity to teach our young people about laws, the past and what our future looks like,” she said.

When Parker first started to look into the Violence Against Women Act, people told her that it didn’t have the steam to include native women on reservations because “they have no face here.”

“That made me angry,” she said. “I could see all these faces that were from my bloodline.”

With the help of U.S. Sen Pat Murray, D-Wash. Parker put on a news conference and spoke about the lack of prosecutions of non-Indians committing crimes against women on reservations.

“It was amazing to be that voice,” she said. “The Senate was abuzz. How could they not include Native American women?”

Parker continued to work with the National Congress of American Indians to see the bill passed with inclusion of protecting native women. She said many racist comments came out of the House of Representatives. Some congressmen doubted whether Indian governments had the ability to arrest non-Indian men.

At the beginning of the process, she said one congressman was outspoken against the inclusion of Indian women, but Parker was able to get him to change his mind. She said the way to change the minds of elected officials is to personalize the stories.

“So many children, women and men came forward with what happened to them as children, teenagers and adults,” she said.

Tribes have until 2015 to implement the law with help from the U.S. Department of Justice.

One statistic states that 88 percent of crimes against women on reservations are committed by non-Indians. She said some congressmen did not believe that statistic.

Eric Cantor, R- Va., a conservative congressman, was one of those opposed to including native women in the law. When Parker met with Cantor’s aide, she told Parker that neither she nor the congressman had met a Native American.

“There are a lot in congress who don’t understand us politically, spiritually and traditionally,” she said.

Parker said she knows of several hundred women who have been murdered on reservations without any justice.

Parker said the media was a big help in covering the Violence Against Women Act.

Another topic at the conference was the crisis in rural America, including on reservations, where there are no oral health providers. Lack of dental services and dental problems can cause disease and sometimes death.

Indian Health Service’s dental provider vacancies average 20-30 percent.

Alaska natives have offered one solution by creating the Dental Health Aide Therapist program. Tribes could replicate the program in other parts of the country.

The Arizona School of Dentistry and Oral Health at A.T. Still University in Mesa recently graduated six American Indians to help fill the need.

Dr. George Blue Spruce, the first native dentist in Arizona, said the dental problem also includes a lack of Native American dentists.

Spruce, 82, said until Native Americans can go to a native dentist, Indian self-determination remains a myth.

The others leading this session included Dr. Todd Hartsfield, DDS faculty at A.T. Still; Maxine Brings Him Back-Janis, faculty at Northern Arizona University; Connie Murat, dental aide therapist at Yukon-Kuskokwim Health Corporation and Yvette Joseph, project manager at Kaufman and Associates. W.K. Kellogg Foundation sponsored the dental session.

Geoffrey Blackwell, chief of the Federal Communication Commission’s (FCC) Office of Native Affairs and Policy, announced that those seeking non-commercial radio stations on reservations can apply for low frequency FM radio stations between Oct. 15 and Oct. 29.

President Barack Obama recently signed the Local Community Radio Act, which mandates expansion of low power FM radio stations that provide listening areas of three to 10 miles.

Since 2000, the government has licensed more than 800 low power FM stations.

A session also took place on the importance of bringing more broadband services to reservations. Those leading this session included Loris Taylor from Native Public Media; Traci Morris from Homaholta Consulting, Michael Copps, from the FCC and Blackwell.

Taylor, a member of the Hopi Tribe, said in order for native radio stations to be successful they need champions on the inside who are non-Indians. She pointed to Coppes as one such champion.

Coppes said that better broadband means more money creating more jobs, education and health care. He said that broadband services throughout the U.S. are not as good as they should be.

“It’s not just Native Americans. Everybody in the country is being held back, especially in the rural villages. We need a sense of mission,” he said.

Blackwell said broadband is as important as roads and water. He said the FCC and tribes need to work together on bringing more broadband services to Indian country.

Blackwell noted that local radio stations continue to provide life saving services such as announcing when tornadoes will hit.

“Lives can be on the line when you can’t get a signal,” he said.

Blackwell said his office works with 50 Indian tribes at any given time. He hopes that his office will soon announce that there will be consultations and trainings to bring more broadband to Indian country this coming fiscal year.

Tim Giago was one of the founders of NAJA and one of the many elder journalists who received recognition during the conference. He founded the Lakota Times in 1981 when the Pine Ridge Reservation was located in the poorest county in America.

Giago, 80, had his office firebombed, his office windows shot out and his life threatened, but he continued publishing until he sold the paper in 1998.

Giago urged the young journalists not to get discouraged. He also offered them some advice.

“You can do a thousand good things, but if you do one bad thing that is what will be remembered,” he said.