Mainstream entities test the waters of ACA in Indian Country

By S.E. Ruckman, Native Times Special Contributor

Two dancers in regalia work a Native American Professional Parent Resources outreach booth at the 2014 Gathering of Nations powwow in Albuquerque, N.M. | Courtesy Photo
Two dancers in regalia work a Native American Professional Parent Resources outreach booth at the 2014 Gathering of Nations powwow in Albuquerque, N.M. | Courtesy Photo

OKLAHOMA CITY – Despite living in a state where Medicaid was not expanded, Oklahoma’s 38 federally recognized tribes have found a way to state tribal liaison, Sally Carter – and she has found her way to them. In this newly created position, Carter is quick to tell you that she considers Oklahoma to have 39 tribes because even though the Euchee are not federally recognized, they are state recognized. Breathlessly, she says she is learning fast.

“I still count them,” she said.

Carter carries Euchee concerns on health matters back to the state capital as part of a new stance where the health decision makers seek to repair a long and tenuous relationship between historical archetypes. When the Affordable Care Act (ACA) was passed in 2010, a series of listening sessions between Oklahoma and the tribes occurred at six different tribal jurisdictions across the state to talk about the federal health overhaul.  Replete with opening ceremonies and songs, the state was figuratively stretching its hand toward its Native inhabitants.

From these beginnings, Carter takes the message back to the capital that the tribes want to be at the decision-making table with state leaders, including the newly re-elected Republican governor, Mary Fallin.

Carter said the tribes don’t just want to be told about important developments, they want to help shape the direction the state will take on things such as the implementation of the ACA and how to reduce health disparities like high smoking and diabetes rates in their nations.

To date, 1,638 American Indians in Oklahoma have enrolled for federal health insurance through ACA while 13,061 have enrolled nationally, according to a U.S. Department of Health and Human Services (HHS) report. When compared to the 9.1 million estimated Obamacare enrollees, American Indians number roughly 1 percent of all Americans who now have health insurance who had none before.

But that thing that makes Oklahoma’s Indian Country so different—that thing that separates it from other U.S. states with tribes – is that it has no official Indian reservations. A federal land allotment experiment from the 1900s crisscrossed the state’s territory into a veritable smorgasbord of jurisdictions – federal, tribal, municipal, state.

Carter is working on how to stimulate enrollment among Oklahoma tribes.

If the government wants to reach the American Indians here, it’s best to go to each tribe, Carter said. That was a go-to move state health officials embraced as they discussed ACA with the tribes. The things Carter found surprised her although she is an Oklahoma resident and had lived near various tribal jurisdictions for years.

“They are the only (minority) group that has to show their race,” she said, her voice lilting. “I mean, no other group has to do that. They have to prove it with an enrollment card of some kind.”

Official American Indian citizenship is important because the ACA has special provisions that allow Indians to “opt out” of having to enroll in federal health insurance, if they choose. But Indians need to fill out form OMB No. 0938-1190 that officially removes them, officials said. Not doing so will mean an eventual penalty.

“(ACA) is very complex and not one of us would say that we know it all,” Carter said. So the state took the best of what they knew after weeks of training on the health plan to several tribal jurisdictions. When all sides met, Carter said she was schooled. American Indians have strong opinions about the state/ federal government encroaching on their personal privacy and tribal sovereignty with this new federal health insurance.

Because Oklahoma chose not to expand Medicaid, enrolling American Indians in ACA takes a certain degree of cultural finesse and dogged persistence, Carter said. In other tribally populated states, like North Dakota, the move to expand Medicaid fills in where ACA may not be a strong priority, said Sen. Heidi Heitkamp, D-ND. The emphasis is reducing uninsured numbers, she said.

“The State of North Dakota expanded Medicaid, which has helped uninsured, low-income individuals and families, including many Native Americans throughout the state, get access to affordable health care,” Heitkamp said. “ Medicaid expansion is giving families opportunities they didn’t have before to afford to see a doctor regularly and get access to needed medications, while reducing costs for everyone – those with health coverage and those without.”

The Oklahoma tribal liaison added that even while enrollment curiosity abounded, many did not qualify for ACA because they did not file income tax returns. American Indians can enroll in ACA at any time – not just during enrollment periods, but their tax filings allow them also to file the exemption – if they chose to forgo coverage.

American Indians have a higher unemployment rate than other groups–peaking in 2013, according to the Bureau of Labor Statistics Current Population survey. Indian unemployment rates averaged 11.3 percent compared to 9.1 percent of the mainstream during that time. High unemployment rates among Indians tend to keep more Indians ineligible for ACA enrollment, Carter said.

What has also dampened Oklahoma’s outreach has been a distrustful relationship between the state and tribes—this makes it harder for federal initiatives to come through the front door, said Terry Cline, Oklahoma’s commissioner of health. He points to the good faith of the tribal/state meetings.

“I considered the listening sessions a good start,” he said. An official summary on the sessions reported 193 attendees at the six sessions, several of which Cline attended.

“We held those sessions to have open dialogue,” he said. “What you hear from one tribe might be different from another tribe says.”

As for ACA and tribes,  a tribe’s type of relationship with the federal government, either Self-Governance or direct service, dictated outreach approaches because that’s how health dollars are administered by tribes in states, especially in Oklahoma, officials said.

Tribes that operate under provisions of the Indian Self Determination Act might outreach on ACA directly to members in their own tribally run health systems and tribes that are direct service entities may forgo outreach to their local Indian Health Service (IHS) service facility. In both regions, IHS and tribal facilities can accept ACA insurance from patients and lessen the amount of contract (out-of-IHS system) health dollars it spends, officials said.

“Tribes have a lot of interest in ACA,” Carter said. “Tribal leaders and the health department can inspire and direct tribal members to enroll.”

Both of the tribal-to-federal relationships are considered when the state of Oklahoma contacts tribes, and the state tends to follow the federal approach, Carter said. Putting on different hats to deal with different tribes is prudent.

“Tribes need to see people they know and that they can trust who know about American Indian provisions,” she said. “I believe in face-to-face interactions.  States usually contact them (tribes) with emails or letters, but a relationship needs to be worked on and allowed to develop.”

Cline said no special state appropriations exist to outreach to tribes for ACA enrollment in Oklahoma but he’s optimistic that other types of federal grants to reduce health disparities will help. The health commissioner said he knows Oklahoma has room for ACA Native growth through grants.

The HHS report points out that Oklahoma has the highest density of Indians among Federally Facilitated Marketplace (FFM) states with 3.5 percent of the population followed by Wyoming, with 3.1 percent. Wyoming’s total Native ACA enrollment stands at 309, the report shows.

At this point, Oklahoma seems to lead the state in the number of Natives it has enrolled, just exceeding figures for California. But as enrollment rolls on, officials expect more American Indians to register.  Indian Country (the term used to characterize where a federal-tribal relationship exists) extends beyond Oklahoma.

Other states with significant Native populations include Arizona, California, New Mexico, South Dakota and North Dakota. ACA data gathering for Native numbers is in its infancy, organizers said. They say the goal is to pool their information from various regions (via Indian advocacy agencies) to get a more precise picture of Native ACA enrollment. Due to their smaller population numbers, American Indian statistics are often overlooked, officials said.

Other mainstream entities who track the progress are unclear about just how many have actually signed up for ACA. Michelle McEvoy, vice-president of survey, research and evaluation for the Commonwealth Fund, said that no Native specific information has been garnered by her group.

“Latinos currently represent about 17 percent of the U.S. population, so they have a greater probability of being sampled than American Indians who represent about 1.2 percent of the U.S. population,” she said.

Likewise, the non-profit Enroll America, relies on Native ACA enrollment numbers from federal sources, wrote Jessica McCarron, deputy press secretary, by e-mail.

“We do work with partners at the local level to reach different communities, like Native American groups in certain parts of the country,” McCarron stated. “We work with a few partners who have made outreach to tribal communities a high priority.”

Meanwhile, Carter is optimistic about ACA enrollment and reaching American Indians in Oklahoma.

“(ACA) is bigger than all of us,” she said. “We can’t do this alone; it only happens when the state extends its hands across the table and says we need to do this for all the people.”

– This story was funded by the University of Southern California’s (USC) Annenberg School of Journalism as one project undertaken by the 2014 class of California Endowment Health Journalism Fellows. S.E. Ruckman is writing a three-part series on the Affordable Care Act (ACA) in Indian country. In addition to mainstream viewpoints, American Indian health advocates and American Indian enrollees are visited to gauge the national health plan’s implementation in Native populations. Fellows’ projects can be found at


*Wyoming: 309

*New Mexico: 566

*Oklahoma: 1,635

+California: 1,401

*Arizona: 514

*North Dakota: 82

*South Dakota: 271

TOTAL: 13,061

Sources:  (March 2014) *HHS Summary Report;  +California Department of Health Care Services

Rep. Paul Gosar Calls Native Americans ‘Wards Of The Federal Government’

UNITED STATES - NOVEMBER 14: Rep. Paul Gosar, R-Ariz., talks with reporters outside a meeting of House Republican Steering Committee meeting in Cannon Building, November 14, 2014. (Photo By Tom Williams/CQ Roll Call) | Tom Williams via Getty Images
UNITED STATES – NOVEMBER 14: Rep. Paul Gosar, R-Ariz., talks with reporters outside a meeting of House Republican Steering Committee meeting in Cannon Building, November 14, 2014. (Photo By Tom Williams/CQ Roll Call) | Tom Williams via Getty Images


By Felicia Fonseca, AP

FLAGSTAFF, Ariz. (AP) — U.S. Rep. Paul Gosar’s reference to American Indians as “wards of the federal government” has struck a harsh chord with tribal members and legal experts in the days following a discussion about a controversial Arizona land deal that would make way for the country’s largest copper mine.

The Arizona Republican was responding to concerns from Phil Stago of the White Mountain Apache Tribe when he made the comment that stunned people at the round-table talk.

Stago said the phrase is antiquated and ignores advances made in tribes managing their own affairs and seeking equal representation when it comes to projects proposed on land they consider sacred.

“He kind of revealed the truth — the true deep feeling of the federal government: ‘Tribes, you can call yourselves sovereign nations, but when it comes down to the final test, you’re not really sovereign because we still have plenary authority over you,'” Stago told The Associated Press.

Gosar spokesman Steven Smith said that wasn’t the intent of the congressman, whose constituents in the 4th Congressional District include Apache tribes. He didn’t respond to requests to elaborate further.

“If that’s what he got out of that, I think it’s misconstrued,” Smith said. “If you look at the work the congressman has done, that’s far from the truth.”

Smith said Gosar has been an advocate for strengthening the relationship between tribes and the federal government. He pointed to legislation he sponsored this year that would do so.

Gosar held the discussion Friday in Flagstaff with Democratic Rep. Ann Kirkpatrick, who grew up with Stago on Arizona’s Fort Apache Reservation.

Dozens of people attended the meeting to discuss land, mining and forest issues with the representatives.

One topic they addressed was a proposal to swap 2,400 acres of southeastern Arizona’s Tonto National Forest for about 5,300 acres of environmentally sensitive land throughout the state controlled by a subsidiary of global mining giant Rio Tinto. Stago said the proposal was disrespectful to tribal sovereignty.

Gosar said: “You’re still wards of the federal government,” according to the Arizona Daily Sun.

While former U.S. Supreme Court Chief Justice John Marshall described tribes’ relationship with the federal government as that of a ward to its guardian in the 1830s, that characterization has long been irrelevant, experts in federal Indian law said.

Tribal members once seen as incompetent in the Supreme Court’s eyes became U.S. citizens in 1924, and the Indian Reorganization Act of 1934 pushed the concept of tribal sovereignty and self-determination, said Troy Eid, a Republican and former U.S. attorney in Colorado.

Congress maintains control over Indian affairs.

However, the Interior Department is moving away from archaic paternalism when it comes to relationships with tribes, a spokeswoman said. The Bureau of Indian Affairs’ website notes the federal government is a trustee of Indian property — not the guardian of all American Indians and Alaska Natives.

Eid said the language that defines core concepts of Indian law is old and often ethnically offensive. “Wards of the federal government” is no different, he said.

“That’s just not appropriate,” Eid said. “In the heated context of what this represents, it’s especially inappropriate to be resorting to what amounts to race baiting.”

The trend has been for tribes to take more control over their affairs while holding the federal government to promises generally born out of treaties. In exchange for tribal land, the government promised things like health care, education and social services in perpetuity for members of federally recognized tribes.

Some tribes are taking advantage of federal laws that allow them to prosecute felony crimes and assert jurisdiction over non-Natives in limited cases of domestic violence. They also have the authority to approve trust land leases directly, rather than wait for BIA approval.

Sam Deloria, a member of the Standing Rock Sioux Tribe who served for 35 years as director of the American Indian Law Center in Albuquerque, New Mexico, said tribes welcome discussion about policy matters.

But when someone makes a comment like Gosar’s, “it doesn’t contribute much to the debate,” he said.

Obama unveils plan to help young American Indians

In this June 13, 2014 file photo President Barack Obama and Chairman of the Standing Rock Sioux Tribe David Archambault II, left, watch dancers during a visit to the Standing Rock Indian Reservation in Cannon Ball, N.D. Obama on Wednesday, Dec. 3, 2014 announced an initiative to improve conditions and opportunities for American Indian youth, more than one-third of whom live in poverty. (AP Photo/Charles Rex Arbogast, File)
In this June 13, 2014 file photo President Barack Obama and Chairman of the Standing Rock Sioux Tribe David Archambault II, left, watch dancers during a visit to the Standing Rock Indian Reservation in Cannon Ball, N.D. Obama on Wednesday, Dec. 3, 2014 announced an initiative to improve conditions and opportunities for American Indian youth, more than one-third of whom live in poverty. (AP Photo/Charles Rex Arbogast, File)


By Blake Nicholson, AP

BISMARCK, N.D. (AP) — President Barack Obama announced an initiative Wednesday aimed at improving conditions and opportunities for American Indian youth, more than a third of whom live in poverty.

Obama’s Generation Indigenous initiative calls for programs focused on better preparing young American Indians for college and careers, and developing leadership skills through the Department of Education and the Aspen Institute’s Center for Native American Youth. Members of the president’s staff also plan to visit reservations next year.

The White House did not provide a cost estimate for the initiative, but a spokeswoman said the administration plans to fund it with existing money and the help of nonprofit and philanthropic organizations.

The announcement, made as part of the White House Tribal Nations Conference that Obama is hosting on Wednesday, comes five months after the president and his wife visited the impoverished Standing Rock Indian Reservation in the Dakotas.

The 3,600-square-mile reservation is home to about 8,500 people, many of whom live in run-down homes, and where the unemployment rate runs as high as 20 percent. The suicide rate for American Indians aged 15 to 24 is more than twice the national rate.

Cecilia Munoz, director of the White House Domestic Policy Council, said the president and first lady “were deeply moved” after listening to children’s stories about challenges they faced on the reservation, such as depression and alcohol abuse. Vice President Joe Biden said in a morning appearance before the conference that for Obama, helping Indian youth is “something that he came back from his June visit fired up about doing something about.”

Wednesday’s conference involves leaders from 566 federally recognized tribal nations, along with 36 White House Youth Ambassadors chosen from around the country through an essay contest.

“People who grow up in a poverty culture sometimes need guidance, need values, need a little bit of structure,” said Chase Iron Eyes, an attorney and Native American rights activist from Standing Rock who is attending the conference.

“Through some of the things the administration is doing, it looks like they’re trying to do that,” he said. “Youth — they just need the right tools, and maybe they can empower themselves.”

The White House also released a report Wednesday acknowledging failures in federal policy and highlighting the need for more tribal help in the areas of economic development, health and education. Slightly more than two-thirds of Native youth graduate from high school, according to the 2014 Native Youth Report.

One of the report’s recommendations is to strengthen tribal control of the education system on reservations. Officials are working to overhaul the Bureau of Indian Education, which is responsible for educating 48,000 Indian students in 23 states, Interior Secretary Sally Jewell said.

Jewell estimated it would cost more than $1 billion to fix schools with crumbling infrastructures. Officials are pursuing money through Congress, existing government programs and philanthropic organizations.

“We have to get creative,” Jewell said.

Hundreds of American Indians Rally Against Washington NFL Team

Norman “Wounded Knee” O’Deocampo addresses the protesters.
Norman “Wounded Knee” O’Deocampo addresses the protesters.


By Blu Wakpa, Native News Online , November 24, 2014


OCCUPIED TAMIEN OHLONE TERRITORY (Santa Clara, California) – After successful demonstrations in O’odham (Glendale, Arizona) and Dakota (Twin Cities, Minnesota), four-hundred Indigenous Peoples and their allies poured into Tamien in solidarity with a national grassroots campaign to change the name and mascot of the Washington NFL team. Traveling by carpool, Bay Area Rapid Transit (BART), and out-of-state flights, many amplified a growing voice for decolonization in sports.

The demonstration began at 8 a.m. with a prayer at one of many desecrated sacred sites (shell mounds and burial grounds) maintaining its indigenous Ohlone place name, Ulistac. According to Corrina Gould, a Karkin and Chochenyo Ohlone, Uli is the name of an Ohlone warrior who inhabited the area and stac refers to place/land. The prayer to the land and ancestors was followed by a march to Levi’s Stadium held prior to the game between San Francisco and Washington.

The peaceful event included a two-hour series of passionate and informed speeches from local, regional, and national activists, including people Indigenous to the area and upcoming leaders like Jacqueline Keeler of Eradicating Offensive Native Mascotry (EONM) and Dahkota Brown a 16-year-old Wilton Miwok student and founder of Native Education Raising Dedicated Students (NERDS). Elders who’ve inspired future generations also spoke on the topic, including Charlene Teeters and Clyde Bellecourt of the National Coalition on Racism in Sports and the Media (NCRSM).

Asian, African, and European people also educated fans by engaging, chanting, and holding picket signs and banners. Tribal African music blessed the event and recognized the similar histories between the African and Indigenous diaspora. Mexica (Aztec) dancers joined together in prayer, symbolizing the remembrance of the so-called Latino/Hispanic’s Indigeneity and pan-Indigenous interests across the colonial US-MX border.


Santa Clara Rally 1123


Radio and television ads criticizing the nickname were aired throughout Ohlone and Miwok territories leading up to the game. Many broadcasters became allies when they chose not to mention Washington’s mascot. Audiences must understand the scalps of Indigenous Peoples were captured to collect bounties from the United States and expand White Supremacy outside of Europe.

Although Washington’s team owner, Dan Snyder, has vowed to “never change the name” and the NFL commissioner, Roger Goodell said earlier this year the nickname has been “presented in a way that honors Native Americans,” the demonstrations outside Levi’s Stadium and nationwide indicate Indigenous decolonization and self-determination is inevitable.

As fans passed the demonstration, many were quite surprised. “I’ve been a Washington fan for a long time and I’ve seen more resistance the last few years,” says Brian Jones, 35. He continued, “This demonstration helps me understand the mascot impacts actual people. It made me think about the other side of this issue.” John, 29, agreed saying, “When I see actual Native American’s are offended—I have to respect that.”

A die-hard Washington fan, Robert Magnini, 60, said, “I’ve been a fan since I was a kid. I think the name is offense and we need to change the name as soon as possible.”

Not all Indigenous Peoples agree, including Joseph Rey Potter, 14, who passed the demonstration wearing a Washington jersey and a Pomo baseball hat. “My Dad was a fan, so I just stayed with it. I understand it’s racist, but I’m just a fan of the game.” Potter concluded, “If they changed their name, I’d be a bigger fan.”

Kris Longoria and Antonio Gonzales, co-chairs of the Bay Area Coalition Against Racism in Sports and Media, said they will continue to escalate pressure on the NFL football team and build more partnerships with local organizations and government institutions.

Many urgent struggles exist across the Western Hemisphere and we must all do our part to challenge colonialism and honor Indigenous nations, leadership, and goals.


A grandmother and her granddaughter appeared severely wounded, covered in bloody hair and hair buns held together with knives. “Redskin means someone whose been scalped, so me and my grandma put fake blood all over to show what a redskin means,” said Calissa Gali, 11. “None of my friends know what redskin means. They should learn at school, but some of the teachers don’t want to talk about it.”

Sacred Sites Protection & Rights of Indigenous Tribes (SSPRIT) has transferred the pain of another desecrated Ohlone Shell Mound in Karkin by decolonizing Vallejo High School’s Apaches and Solano Middle School’s Chieftains this year. The connections between appropriated sacred sites and stereotypes in sports are undeniable.

SSPRIT are now contractors, collaborating with students and administrators to educate about Indigenous mascots at school assemblies. Teacher training was also included in the negotiations to foster an integrated ethnic studies program across the school district. A duplication of this attainable model is also occurring with the Carquinez Coalition to Change the Mascot (CCCM) for John Swett High School Indians in Karkin (Crocket, CA).

Changing Washington’s name and mascot is not the end of changes to come. Colonization was several lifetimes of trauma and decolonization will take several lifetimes of healing. We envision post-colonialism. We’re not your mascot anymore.

Bay Area Coalition Against Racism in Sports is sponsored by American Indian Movement-West, Bay Area American Indian Two-Spirits, Eradicating Offensive Native Mascotry, Indian People Organizing for Change, Sacred Sites Protection & Rights of Indigenous Tribes, ANSWER Coalition, Idle No More SF Bay, and National Lawyers Guild San Francisco Bay Area Chapter. National ‘Change the Mascot’ supporters can be found at:

#NotYourMascot #ChangeTheName #ChangeTheMascot #NoHonorInRacism

 Native News Online Photos by Arthur Jacobs


Native Firm Wins Prestigious Health Communications Award

By KAI Meida Release

Kauffman & Associates, Inc.Kauffman & Associates, Inc., an American Indian-owned communications and professional services firm, has won the 2014 National Health Information Award for its 2-year national campaign encouraging American Indians and Alaska Natives to sign up for health insurance under the Affordable Care Act. Other 2014 award winners include the American Association of Retired Persons, American Lung Association, Parents Magazine and the Mayo Clinic.  The National Health Information Awards program honors high-quality consumer health information. The awards program is organized by the Health Information Resource Center, a national clearinghouse for consumer health professionals who work in consumer health education fields.

Working with its client, the Centers for Medicare and Medicaid Services’ (CMS) Tribal Affairs Group, KAI tested messages and images with American Indian and Alaska Native stakeholders throughout the United States and created radio spots, videos, billboards, bus signs, brochures, fact sheets and social media spots. KAI also recruited partner organizations from across the country and conducted outreach at large powwows, conferences, summits and sports events. KAI Vice President for Communications, Kim Blessing, reported “the campaign generated more than 100 million media impressions, recruited 113 tribal and organizational partners and distributed 23,000 informational brochures”.

“American Indian and Alaska Native people finally have the opportunity to ensure their health needs are fully covered, but they have to sign up. This is so important. It was a privilege to help CMS with this campaign,” said KAI President Jo Ann Kauffman, a public health professional and member of the Nez Perce Tribe.

The campaign also included a 7-minute video featuring former CBS News reporter Hattie Kauffman. This video, directed by Josephine Keefe, won the 2014 Telly Award earlier this year. The video is available online and is currently being played in Indian health clinic waiting rooms across the nation. Monthly radio public service announcements (PSA) were also produced by KAI, and featured both English and Native language speakers. Radio PSAs were sent to Native radios each month on topics about special benefits and protections for American Indians and Alaska Natives. These PSAs were recorded in English, Navajo, Lakota, Ojibwe and Yupik. Companion “drop-in” articles were placed in Native newspapers to reinforce the radio messages.

KAI has provided research and communications support to federal agencies, tribes, nonprofits and foundations in the area of public health, education, justice and community development since 1990.

Court orders tribal night deer case re-opened

TODD RICHMOND, Associated Press

SUN PRAIRIE, Wis. (AP) – A federal appeals court on Thursday ordered a Madison judge to reconsider a decades-old ruling barring Chippewa tribes from hunting deer at night across much of northern Wisconsin.

A three-judge panel from the 7th U.S. Circuit Court of Appeals found hunting deer at night probably isn’t as dangerous as U.S. District Judge Barbara Crabb concluded in a 1991 ruling barring tribal night hunts, noting that four other states allow such hunts, Chippewa hunters’ safety record is outstanding and hunting during the day is probably more dangerous than at night because more people are out and about.

“All that can be said is that on the present record there is scant reason to think that safety concerns justify forbidding Indians to hunt deer at night in the thinly populated (by human beings) northern part of Wisconsin,” Judge Richard Posner wrote for the panel.

The order doesn’t mean Chippewa hunters can go after deer at night. But it does mean Crabb must reconsider her 1991 decision.

Sue Erickson, a spokeswoman for the Great Lakes Indian Fish and Wildlife Commission, which oversees the Chippewa’s off-reservation treaty rights, said the tribes are reviewing the ruling and are “pleased that the court recognized the regulated type of night hunt they’ve proposed doesn’t present safety issues.”

A state Department of Natural Resources spokesman said the agency was reviewing the decision and consulting with the state Justice Department. A DOJ spokeswoman had no comment late Thursday.

The DNR has long banned hunting deer at night for safety reasons. The Chippewa have pushed for years for a tribal night deer hunt in the ceded territory, a gigantic swath of northern Wisconsin that the bands handed over to the federal government in the 1800s.

The tribes tried to convince Crabb in 1989 to exempt tribal hunters from the state prohibition during a court battle over treaty rights in the ceded territory, but she ruled in 1991 that night deer hunting is dangerous and that the state ban applies to the tribes.

The Chippewa renewed their push for night hunting in 2012 after legislators angered the tribes by allowing hunters to kill wolves at night. The Chippewa consider the wolf a spiritual brother.

The tribes asked Crabb to revisit her 1991 ruling, saying the state believes night hunting is safe it allows the wolf hunts. The DNR also instituted night deer hunting programs to slow chronic wasting disease, protect crops from deer depredation and prevent car-deer collisions. They also said tribal hunters would be required to lay out lines of sight during the day in their hunting area and submit a shooting plan for approval.

In December, Crabb said the tribes had failed to prove that circumstances had changed sufficiently to reopen the 1991 decision. She noted state officials did almost all the night hunting and most of it was designed to slow chronic wasting disease. Legislators also ended night wolf hunting after one season, she said.

But the 7th Circuit’s Posner noted Oregon, Washington, Minnesota and Michigan all allow tribal night hunts and that deer hunting has grown considerably safer in the last 20 years.

The Chippewa’s hunts would be tightly regulated with shooting plans, he said, adding that tribal members already can hunt deer at night on their reservations and are clearly proficient since there’s been only two or three recorded hunting accidents involving American Indians in the ceded territory.

Tribal Programs Reduce ACEs – Building Family Resilience with Federal Healthy Families Programs

Jennifer Olson, SPIPA Data Analyt and Evaluator
Jennifer Olson, SPIPA Data Analyt and Evaluator

(Part three of a four-part  ACEs series)

By Kyle Taylor Lucas, Special to Tulalip News
This is the third in a series of stories on Adverse Childhood Experiences (ACE) and the intersection of disproportionately high substance abuse, behavioral, and health disparities in American Indians as compared to the general population.

A landmark 25-year research project by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente has linked childhood trauma to major chronic illness and social problems such as heart disease, diabetes, depression, heart disease, diabetes, violence, suicide, and early death.

Begun in the 1980s, “The Adverse Childhood Experiences (ACE) Study is one of the largest investigations ever conducted to assess associations between childhood maltreatment and later-life health and well-being,” said the CDC. The study included more than 17,000 patients who provided detailed information about childhood abuse, neglect, and family dysfunction.    Since the breakthrough study, hundreds of scientific articles, workshops, and conferences have helped practitioners better understand the importance of reducing childhood adversity to overcome myriad social and health issues facing American society. Learn more about the ACEs Study here: See the ACEs questionnaire, here:

Federal Program Helps Build Family Resiliency with Home Visiting and Early Childhood Parenting Education
The Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) is a federal and state partnership administered by the Healthy Resources and Services Administration (HRSA) and the Administration for Children and Families (ACF).
The MIECHV program was established by the Congress in 2010 with an initial $1.5 billion investment. In March 2014, Congress extended funding through March 2015. Said, the HRSA, “While decades of scientific research has shown home visiting improves child and family outcomes, the program is the first nationwide expansion of home visiting.”
Consistent with research on ACE reduction, the program is based upon scientific research, which shows that home visits by a nurse, social worker, or early childhood educator during pregnancy and in the first years of life prevent child abuse and neglect, encourage positive parenting, and promote child development and school readiness. An HRSA white paper cites a recent Pew Charitable Trusts study that showed “every dollar invested in home visiting yields up to a $9.50 return to society.”
The program supports pregnant families and parents of children to age five to access resources and develop necessary skills for raising healthy children. All of the HRSA-supported home visiting programs are locally managed and voluntary.
According to the HRSA, “The Home Visiting legislation prioritizes American Indian and Alaska Native populations through the inclusion of a three percent set-aside for discretionary grants to Indian Tribes, consortia of Tribes, Tribal Organizations, and urban Indian organizations. Currently, the program supports 25 Tribal grantees’ home visiting programs.”
Several tribes and tribal organizations in Washington State have applied for MIECHV funding and have established programs that will help to reduce ACEs among their members and simultaneously help establish benchmarks and data long missing.

South Puget Intertribal Planning Agency (SPIPA) – Helping Build Family Resiliency by Increasing Traditional Native Parenting Practices
The South Puget Intertribal Planning Agency (SPIPA) is one of several local tribal organizations and tribes that have undertaken training and applying intervention and have begun measurements similar to the ACE Study indicators to address generational trauma, support prevention programs, and to strengthen families.
SPIPA is a five-tribe consortium that supports each tribe’s vision of success and wellness. Its mission is “to deliver social, human, and health services and provide training and technical assistance, resource development and planning” to its member tribal communities—the Chehalis, Nisqually, Shoalwater Bay, Skokomish and Squaxin Island Tribes.
Founded in 1976, despite a challenging economy, SPIPA strives to carry its past successes forward. In its most recent annual report, SPIPA Chairman Dan Gleason said, “While much has changed for the better at the five Tribes, the underlying issues that made the formation of SPIPA necessary still exist. These issues center on self-sufficiency for our families, youth, and elders as they strive to overcome external forces that are barriers to their personal, educational, and career development.”

Asked how SPIPA incorporates the ACE indicators in its work, Jennifer Olson, SPIPA Data Analyst and Evaluator, said, “We are doing some pretty exciting things about addressing early childhood trauma and the ACE Study, but we don’t use the term. We talk about it more in terms of historical trauma. We use a similar intervention and measurements to the ACEs within our own cultural context.”

Olson, who has been with SPIPA for the path fifteen years, earned MA degrees in both Public Health and Community Planning from the University of Iowa. Her work is focused on grant writing and program evaluation.
Olson said their staff has taken ACEs training, and “We have found the ACE measurements dove-tail nicely with our work. They especially align with our work on intergenerational trauma and diabetes.”
SPIPA is starting the fourth year of a six year project supported by federal MIECHV funding from the Administration for Children and Families. It is a Healthy Families Home Visiting Program geared toward tribes. “The Port Gamble S’Klallam Tribe and United Indians also received funding in that cycle,” said Olson. The program emphasizes culturally appropriate parenting skills to develop happy, healthy, well-adjusted children. “We blend our program to give support in teaching the basics of parenting to pregnant families and those with children up to three years of age,” said Olson.
SPIPA has an approximate budget of $450,000 to $600,000 to fund, in part, six home visitors (five of whom are tribal members) for four tribes and “We also have urban Indian Temporary Assistance for Needy Families (TANF) offices in Tacoma and Bremerton,” added Olson.
A longstanding obstacle in Indian Country is lack of benchmark data making it difficult to measure success which could help communities to secure continued program funding to both reduce ACEs and fill the data gap for other programs. Asked how SPIPA measures success, Olson replied, “We have served over 120 families that are now getting developmental screening who were not previously screened. Four tribes and two urban Indian sites now have early intervention services for birth to three.” Included among their early intervention services are child development screening, parenting education, family wellness assessment, resource/referrals, parent-child interaction activities, ‘Positive Indian Parenting,’ and child development classes.
“In terms of measurement and evaluation tools, SPIPA incorporates some of the federal goals of improving maternal/infant health, reducing child injuries or maltreatment, increasing school readiness, access to healthcare, addressing family violence, family economic self-sufficiency, and referrals for other community resources,” said Olson. She emphasized that it is also important to their member tribes to include a “full program” measurement in which they ask, “Does this program increase traditional Native parenting practices?”
SPIPA does developmental screening with a tool called the “Ages and Stages Questionnaire,” and they utilize an annual survey that incorporates screening for domestic violence, depression, parental stress, family planning and other parenting issues. They have a family assessment called “Life Skills Progression,” which both identifies development and stresses in the family’s health.
Asked about foster care, adolescents, and teen suicide, Olson noted they have a foster care program, but they are not yet applying the ACE Study to adolescents. She added, “We do screen for all ten of the ACE questions at least once per year and routinely with all of our home visits.” SPIPA incorporates the ACE measurements in its work with parents and guardians, and foster home families, for substance abuse and domestic violence screenings among others.
“It is sometimes hard to convince families how critical early childhood education, parenting education, and continuing support are to the family. We meet twice a month with families. This is a new concept for many, so we try to emphasize early screening and intervention,” added Olson.
The SPIPA Healthy Families Home Visiting Program grant has another two to three years and Olson is hopeful the program’s funding will be continued indefinitely, but it is dependant upon congressional approval.

The United Indians of All Tribes Foundation – Reducing ACEs in Urban Indian Population through Culturally Relevant Parenting Program

The United Indians of All Tribes Foundation (UIATF) is a non-profit corporation in Seattle. UIATF was founded in 1970 when a group of Northwest Indians and supporters, led by the late Bernie Whitebear, engaged in an occupation to reclaim Fort Lawton as a land base for urban Indians. Eventually, a twenty-acre site was secured at Discovery Park, and in 1977 the Daybreak Star Indian Cultural Center was completed. The UIATF provides social, education, economic opportunities, and cultural activities for the local urban Indian community.
One of the Foundation’s central services for the urban Indian community is the Ina Maka Family Program with its goal to improve family bonds by visiting in the home, making referrals and coordinating with community resources and support. Their work aims to reduce crime and/or domestic violence by making improvements in family self-sufficiency. They focus on “prevention of injuries, child abuse, neglect or maltreatment, and reducing emergency room visits, improving school readiness and achievement.”
In 2012, the Ina Maka Family Program began a five-year home visiting program funded by the HRSA and ACF. As noted, ACE research has established the link between infant, early childhood home visiting and family health. In 2012, the Ina Maka Family Program conducted a community needs assessment among members and service providers, the results of which they have used to develop a home visiting program.
Katie Hess, who is Program Manager for the Ina Maka Family Program, has been with the foundation for almost three years. Hess is part Native Hawaiian and earned her MA in Public Health from the University of Washington. She was born and raised in Seattle and went to Berkley where she earned a B.A. in Creative Literature.
Speaking to the UIATF’s work to reduce ACEs, Hess discussed the results of their qualitative and quantitative data collection, which she said, “provides contextual support for the need for home visiting in the King County American Indian/Alaska Native (AIAN) community and guidance for our choice of the appropriate curriculum that will best fit the needs of our community.”
Hess noted, “We are participating on the tribal side of this, but there is also state expansion. At the same time we received our five-year project, the state is using a public-private program through “Thrive by Five” for home visiting programs. The state side is where most of the home visiting money is coming from. They’re doing work with tribes, too, and have recently funded a two-year home visiting (promising practice) program for a tribe.”
In terms of measurements, Hess said, “What’s really special about this program is that we work closely with an evaluator, and we have real vigorous measurements. We established our own measurements. We looked at what’s a realistic measure and how to measure change. For example, breast feeding. We’re only seven months in and data takes awhile to collect, but we also will be doing more qualitative measurement.”
Asked about what she considers the foundation’s next milestone, Hess said, “Oh good question! We only have another year and a half of home visiting in our five-year project. For us, our goal is to ensure our program and data is strong enough to ensure continued funding.” Hess emphasized that in their data and evaluation process, they affirm theirs as a full-service urban Indian organization providing critical services that are “culturally designed.”
The Ina Maka Family Program used a survey tool and results to identify all of the components of its home visiting program. “We have an advisory board that helps guide our work, so we’ve also included pieces that were not in the assessment. It’s going very well. We have about 29 families and we’re still recruiting,” said Hess.
Noting that their home visitors are on a learning curve, Hess nonetheless expressed confidence in their training and program. “Three of our four home visitors are tribal. All have training in curriculum. We also have two elders, two grandmothers working in our program who advise and guide our home visitors. They have a lot of experience in early childhood education. They go on some of the home visits. The other piece that we do is we work with an evaluator. We’re constantly making changes and enhancements to ensure it’s a good fit for our Indian community.”

Asked whether they had utilized the ACE measurements, Hess said, “ACE was not part of our original assessment because people were only starting to talk about it two years ago.” However, she stressed how valuable the ACE measurements are. She explained why. “From a programmatic perspective we want to ensure that we have the tools in place to help our clients so that they are not re-traumatized. Our home visitors are familiar with the ACEs and have an understanding of generational trauma, but we want to ensure that the trainers are prepared. We just haven’t gotten there yet. It can be a really slow process,” but she said they wanted to get it right before including the ACE questions.
In terms of its other efforts to address childhood adversity, Hess replied that at United Indians, “We’re doing our best; we have a workforce program where individuals can receive support to find employment or educational opportunities. We have a Department of Corrections program that provides religious and cultural services with a chaplain, other activities, and helps to coordinate powwows.”
Asked whether their programs include training on Fetal Alcohol Spectrum Disorders (FASD), Hess noted that while theirs is still a new program, all home visitors have prior training on FASD, and it is on the list for further specialized incorporation into their programs.
Speaking to teen suicide education and prevention, Hess noted, “There is nothing in the schools, but there are several other programs in the Seattle area that we partner with—Clear Sky, and Red Eagle Soaring—a youth theater group, and we partner with Seattle Public Schools education program. We will be opening up an ECAP [Early Childhood Assistance Program] in January at Daybreak Star and geared toward school readiness and long-term school success.”
Although the program is not presently applying the ACE Study questions in their surveys and home visits, as does SPIPA, they do intend to incorporate the research after further training. It is evident that their Maternal, Infant, and Early Childhood Home Visiting Program addresses the findings of the ACE Study and subsequent research—that reducing childhood adversity is essential to overcome myriad social and health issues facing society and disproportionately—the American Indian and Alaska Native communities.
Hess said, “I love doing this work because home visiting has great potential for families and to make some big changes in the long run for the urban Indian families we serve.”

Next in the Series

Both the SPIPA and UIATF tribal programs and overall MIECHV program data thus far demonstrates tribal communities are creating resiliency among their members by reducing adverse childhood experiences. The final story in this series will look at subsequent ACEs research, including neurobiology, epigenetics, and the developing brain. Because ACEs extend beyond the nuclear family to educational and child welfare policies, and to institutional racism in police, courts, and other institutions controlling the lives of Indians, those intersections are reviewed. Finally, the series will explore the potential of ACEs measurement in prevention and for building resiliency for American Indian people and tribes.

Kyle Taylor Lucas is a freelance journalist and speaker. She is a member of The Tulalip Tribes and can be reached at / Linkedin: / 360.259.0535 cell

Reducing ACEs in Indian Country by Addressing Historic Trauma and Building Capacity

(Part Two of a Four-Part ACEs Series)


Pam James.Photo/Shannon Kissinger
Pam James, co-founder of Native Strategies
Photo/Shannon Kissinger


By Kyle Taylor Lucas, Tulalip News

This is the second story in a series on the intersection of chronic health and addiction issues and Adverse Childhood Experiences (ACEs among American Indians. The series focuses upon contributing factors of high ACE numbers and substance abuse and behavioral and health disparities in American Indians.

The ACEs Study became a reality due to a breakthrough from an unexpected source—an obesity clinic led in 1985 by Dr. Vincent Felitti, chief of Kaiser Permanente’s Department of Preventive Medicine, San Diego. Dr. Felitti was shocked when more than fifty percent of his patients dropped out of the study despite their desperate desire to lose weight. His refusal to give up on them led to individual interviews where he learned that a majority had experienced childhood sexual trauma. That led to a 25-year research project by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente. The landmark study linked childhood adversity to major chronic illness, social problems, and early death.

According to the CDC, “the Adverse Childhood Experiences (ACE) Study is one of the largest investigations ever conducted to assess associations between childhood maltreatment and later-life health and well-being.” The study included more than 17,000 Health Maintenance Organization members who in routine physicals provided detailed information about childhood experiences of abuse, neglect, and family dysfunction. The ACEs Study links childhood trauma to social and emotional problems as well as chronic adult diseases such as disease, diabetes, depression, violence, being a victim of violence, and suicide.

Since the ACEs Study, hundreds of published scientific articles, workshops, and conferences have helped practitioners better understand the importance of reducing childhood adversity to overcome myriad social and health issues facing American society. See the ACEs questionnaire, here: Learn more about the ACEs Study here:

The ACEs research is of significant relevance to American Indian/Alaska Native (AIAN) communities beset with behavioral and physical health issues—disproportionately high as compared to the general population.

Unquestionably, any discussion of social and health disparities in Indian Country must include historic trauma, and the political and economic realities affecting American Indians and tribes. Research into epigenetics subsequent to the original ACEs Study indicates that historic trauma is likely one of the primary contributors to disparate behavioral and physical health issues affecting AIANs. Subsequent stories will more fully explore the physiological brain changes that result from childhood adversity.


Native Strategies – Addressing Historic Trauma in Native Communities

Tribal experts in the area of historic trauma emphasize that while the ACEs Study is important, it is also important to ensure concurrent address of historical trauma on AIANs and tribal communities.

One of those experts is Pam James who is co-founder of Native Strategies, a non-profit organization established with her husband and partner, Gordon James, in 2009. Pam is a member of the Colville Confederated Tribes and Gordon is a Skokomish Tribal member. The two have been consulting on historic trauma and Native wellness in tribal communities for the past thirty years. Pam earned a B.A. Degree in Psychology and Native American Studies from The Evergreen State College and a BHA in community health from the University of Washington.

“Until we established our non-profit, we did freelance consulting. We worked with the Native Wellness organization, sought grant funding, and wrote a wellness book. Then we used our book to write a curriculum that we’ve applied in our work,” said James.

The non-profit allows better access to funding and resources to further their work empowering tribal people and communities. “We are able to provide training and technical assistance absent tribal politics,” said James who noted they are also free to be creative in designing a broad array of programs, training, services, and technical assistance. “We’ve helped several organizations start their own non-profits. We do a lot of grant writing. We do workshops around historical trauma, parenting, healthy relationships, and government-to-government training. We also do planning and program evaluations and help organizations get into compliance.”

James said one of the most sensitive and impactful of their workshops is healthy workplace training. “We look at it holistically, at interpersonal relationships, family relationships, and relationships to all things–earth and to all creation.” She asks, “How do you create a healthy workplace? You can’t do that until you begin to address the historic trauma.” In their work, James said they help to rewire the brain for positive impact, noting, “Behavior is just a habit. We have to change the habit. I do it from a cultural perspective and I blend in humor.”

However, James is mindful of her approach. She said, “every workshop, every training I do, people get triggered,” so she is careful with her audience. They try to unlearn negative behaviors. In the communities, she finds, “Though it doesn’t work, people do the same thing over and over again expecting a different result.” She said their training “takes people back to that value system that our people always had, treating people with honor and respect. We have a roadmap that asks, “What do you want in your life, spiritually, emotionally, and how do you start creating the life you want?”” She said repetitiveness in practice and training is critical and noted the impossibility of creating change in a workshop or two.

Asked whether training the trainer is part of their work, James replied that it was and that it is essential. “We help train the trainer for tribes so that they can teach it themselves. First, we do community training, then a three-day “train the trainer” workshop, and then we come back in 3-6 months to assist them with their first training. It’s very sensitive. What do you do when someone gets triggered? We help to prepare them.”

About their generational trauma and wellness work, James added, “In our training, we’re opening awareness. The second step is intervention. How do we implement and make change? The third step is continuing education and putting it into practice. It is developing new ways of coping, replacing behaviors, and doing it on a consistent basis. It’s a theory and it’s ongoing.”

However, she said, “Most of our tribal communities are in crisis mode by the time they call. I urge them to call us before that.” She noted three stages—prevention, emergent, and intervention. “I urge them to look at those areas and ask, “How do we get to the place where we’re doing prevention rather than intervention?” Tribes have to start looking at this type of training as ongoing. Just like computer classes. This is not a one-time shot.”

In their training, James said they often support eight-week parenting classes. However, she recommends to clients, “Before we do that, let’s do a healthy relationship class!” Again, she says it is a matter of steps, mentally, emotionally, and educationally. “First of all, we start with the parents to help them learn how to interact with each other. We are in a society that wants a quick fix, but there is no quick fix. It’s about awareness, learning new skills and behaviors, and then we have to practice, practice, practice. It’s not about the end result it’s the journey.”

James said she attended one of Laura Porter’s workshops on ACEs and thought, “Wow, this would have been great to know years ago! Oh my gosh, I wish we had been involved.” To date, only a few tribes have engaged with the state’s research work around the CDC ACEs Study and measurements. James believes “ACEs is one piece of the puzzle, one piece of the process for Native people.” She said her non-profit is looking at funding opportunities to develop a curricula based on their 30 years of work. They plan to work with an advisory team of Native people and the curricula will be designed for implementation by tribal communities, and culturally appropriate to their needs.

Specific to generational historic trauma, James believes “The ACEs information doesn’t go far enough. The State is a very good example of a sense of guilt. They don’t really want to acknowledge it. It’s painful to acknowledge what was done to Native people. There is a lot of effort being made to change it, but it’s still there.”


ACEs and Physiological Rewiring of the Developing Brain

Asked about her knowledge of current scientific research on the relationship of childhood adversity and epigenetics—the study of physiological brain changes and potential application to the study of historic trauma in Native communities, James becomes animated. She noted a weeklong workshop she attended with Dr. Bruce Perry, the author of “The Boy Who was Raised as a Dog” and “Born for Love.” She said, “What an amazing man. His focus has been trauma.” She said he validated the tribal community’s long assertions of unresolved multigenerational trauma, and that the brain is actually hard-wired for empathy, but things happen to the brain when babies and children experience adversity and trauma.

James discussed the work of Dr. Patricia K. Kuhl who of the University of Washington, whose trainings she has attended. She co-authored the book, “The Scientist in the Crib.”

At one workshop, Dr. Kuhl presented studies of two children’s brains from newborn to age three–one child from a happy home and the other from a neglected home. They conducted CAT scans at ages 3, 6, and 9 months. At the beginning, their brains were identical, but by the time they were nine months old, the brain of the neglected child was visibly shrinking. Considered in the context of social and health disparities and life chances for AIANs, this is quite remarkable. The above study demonstrated that disparities begin in the crib, but as the ACEs Study and ensuing research has shown, it is intergenerational, and even in the womb. If the mother and father have high ACE scores based upon their own childhood adversity, the children are also likely to have high ACE scores unless there is intervention.

James is optimistic. She said that although the research shows adversity is generational, “It also validates that we can reverse it. It doesn’t have to be permanent. Some of it might be, but we can reverse much of it. Our ancestors adapted. We learned how to adapt for our environment; it is human nature to survive. Those are the pieces that are not happening in our community.”


Family and Community Roles and Traditions

Lamenting the negative impacts of technology, James said, “Televisions, iPads, Xboxes are the babysitters of today. They are impacting how our children develop, how their brains develop. Technology has disconnected us as people.” She grew up in Inchelium where they did not have a telephone until 1978. “All the grandmothers and everyone would come together, bring old clothes, and make quilts. They lined them with old army blankets. There was a spiritual part of that. Every newborn received a quilt. We’re not doing those kinds of activities that inspire and help our children to learn about community.” James is concerned that technology today limits human contact important to a sense of being part of something greater and of the responsibility accompanying it.

Another significant hurdle is overcoming the lateral violence that is a symptom of ACEs. James said that in her counseling work, she discovered, “We get addicted to pity, to negativity, and we become chaos junkies.” She believes people have forgotten about how just to be. “The Vision Quest taught us how to be alone, to be one with nature, to be alone physically and mentally. It taught us how to control our mind, our spirit, and our bodies.” She thinks some of those teachings can be built into the curricula to teach people how to, again, “sit quietly with themselves, to sit and listen.”


Applying the ACEs Study and Measurements to Native Wellness

James’ family of origin was not unlike many Native homes. She and her eight brothers and sisters grew up with domestic violence, alcoholism, and physical and sexual abuse. She began doing this work in 1986 when the Seattle Indian Health Board received a federal grant to put together a curriculum. She was among 40 chosen from different tribes to participate in a two-week intensive training that was life changing for her. “They stripped us spiritually and emotionally. We had to address our own trauma. We could not help others until we worked on ourselves and healed ourselves. There was no college that could give me what that training did!”

In the training, Jane Middelton-Moz, an internationally known speaker and author with decades of experience in childhood trauma and community intervention took part in the training. She addressed the pain of adult children of alcoholics (ACoA), a topic about which she has written extensively. “It was basically an ACE’s study done with Native people and it was all about the trauma.” James recounted Middleton-Moz’s journey to Germany where she worked with holocaust survivors and her later study of American Indian tribes. She discovered that they had developed the same trauma characteristics. “She was a psychotherapist and I felt blessed to have the opportunity to be mentored by her.” James noted that their work has essentially taken Middleton-Moz’s study of ACoA and applied it to multi-generational trauma among tribal communities.

Asked how the new research on childhood adversity can help Native communities, James said, “The ACEs Study is good in that it gives us the validation and affirms what we’ve known. This is what has been happening in our communities for hundreds of years.” She noted the mental and physical health issues evidenced by high juvenile suicide rates, 638 percent higher incidence of alcoholism than the general population, addiction, and disparate social, and health issues in Indian Country are all traceable to generational trauma and adverse childhood experiences.

However, James believes the survey mechanisms must be appropriate. She said, “The reality is that a lot of times when so-called experts go in and do the surveys, the tribal members don’t tell the whole truth.” Tribal communities are tight-knit and everyone knows everyone and their business. It may be that a special survey mechanism is necessary for tribal communities. James said, “It will be difficult to get reliable data if the members don’t trust enough to give accurate information, to tell the whole truth.”

Those involved in tribal wellness have said for years, and James echoes this, that it is important to put the disparate social and health issues in Indian Country into context. “We have people who have suffered such trauma in their lifetimes, in their parents, and grandparent’s lives!” said James.

People forget that generations of American Indians experienced breaks in the family unit caused by the government’s forcible removal of children placed into Indian boarding schools. Indian children were deprived of parental nurturing; many were physically and sexually abused. They did not learn how to parent and nurture their children, but at adulthood, they were returned to the reservation to start their own families and the same cycle was repeated.

In their workshops, James stresses traditions. “We’ve adopted behaviors that were not ours traditionally. Instead, we go back to the medicine wheel, it teaches you everything—body and mind. When you look at what is happening with our communities, we’ve lost touch with all of the ceremonies, languages, and the practices that kept us resilient. There is a veneer of positivity, but underneath there’s all this pain.”

Clearly passionate about her work, James makes the call, “Someone has to be the voice of our children, someone has to stand up and take the arrows, stand up and say this is not what our ancestors wanted. I really believe this is the core work if we can get it into our communities, we’re going to change, and it has to take place for our survival.”


Integration of ACEs Research in Tribal Family Services and Other Programs

As Sherry Guzman, Mental Health Manager in the Tulalip Family Services Department said, about the ACEs Study, “Most tribes were very leery at first, but I went forward with it because I saw the value of it. It enabled me to see the difference in average of Washington State versus Tulalip Tribes. I like the ACEs model because it gives a base to compare something to.” She, too, felt the ACEs measurements validated what she and others in Indian Country have advocated—that unresolved generational trauma is a significant contributor to social and health disparities among tribes.

Guzman’s department has scheduled an all-staff meeting focused upon the ACEs Study and Tulalip’s work with the statewide network a few years ago. They hope to re-establish a dialogue and consider the future direction the Tribe may take in applying the ACEs Study and measurements in its programs.

In communities utilizing the ACEs measurement across the nation, the subsequent application of community resilience building has consistently demonstrated success in lowering of ACE scores in community members, which in turn helps build stronger and more resilient communities. Imagine the possibilities if communities invested in families on the front end, supporting pre-natal work, pre-school and all day kindergarten, rather than building juvenile detention centers and adult prisons.

At least twenty-one states have communities actively engaged in ACEs work.

Future stories in this series look at that work and new developments in ACEs research, including neurobiology, epigenetics, and the developing brain. Also featured will be tribal organizations applying similar intervention and measurements to address generational trauma. Because ACEs extend beyond the nuclear family to educational and child welfare policies, and to racism in social, police, courts, and other institutions controlling the lives of Indians, those intersections are reviewed along with the economics. Finally, the series will explore the potential of ACEs measurement in prevention and for building resiliency for American Indian people and tribes.

Kyle Taylor Lucas is a freelance journalist and speaker. She is a member of The Tulalip Tribes and can be reached at / Linkedin: / 360.259.0535 cell



Alaska Natives Wait… And Wait, For Health Law Exemption

Most Americans are supposed to have health insurance under the Affordable Care Act. But up to 50,000 Alaska Natives and American Indians in Alaska are excused from the requirement. They have to apply for that lifetime exemption though. And the federal government is mishandling many of those applications.

By Annie Feidt, Alaska Public Media Network

The form Alaska Natives and American Indians need to fill out to get an exemption from the individual mandate.
The form Alaska Natives and American Indians need to fill out to get an exemption from the individual mandate.

Evelyn Burdick thought it would be easy to apply for her American Indian exemption. As a member of the Cherokee Nation, the Anchorage resident sees a doctor at the Alaska Native Medical Center. Burdick likes the care she gets there and has no plans to sign up for private insurance under Obamacare. So she sent an exemption application to the federal government almost as soon as it was available, on January 9th:

“I have yet to receive any correspondence from them back whatsoever. Not even to let me know they’ve received my application.”

Burdick is not alone. The Alaska Native Tribal Health Consortium has helped hundreds of Alaska Natives and American Indians in the state who have had problems with their exemption applications. The exemption is a simple six digit number applicants need for their tax forms to avoid paying a penalty ($95 dollars or 1% of income, whichever is greater) for not having health insurance. Monique Martin, with ANTHC, has been working with the federal government to resolve the problems:

“Every time we call it’s a bear with us sort of request but we’ve been bearing with them since February when we first started reporting issues and we are anxious for a resolution to this issue.”

The Federal government has fumbled the applications in several different ways. Martin works closely with three other people at ANTHC who all applied for the exemption for themselves. Martin’s exemption number came back with no problems. But her three colleagues were not so lucky:

“One of our coworkers received her letter twice, with two different exemption numbers for her and her kids. One received the wrong exemption… and another one is still waiting to hear on her application. So we’ve seen all the errors come to us, so we have real world examples that we can show the federal government.”

No one from the Centers for Medicare and Medicaid Services was willing to do an interview for this story. In an e-mail, a spokesperson with the agency wrote that they are working to improve the process daily and committed to providing consumers with their exemption numbers in time for tax filing season. Martin says she’s cautiously optimistic that can happen:

“We are the squeaky wheel in Alaska and we’re really pushing the federal government to resolve this issue and to get this addressed for people so they aren’t negatively impacted.”

Martin worries about how the federal government will handle the rush of exemption applications as tax time approaches. She expects many Alaska Natives and American Indians haven’t even thought about sending in the application yet. Evelyn Burdick, who was proactive and applied early in the process, says the nine month long wait for a response has been frustrating:

“I don’t want to be penalized for not having the insurance. I’m trying to follow the rules and regulations that set up and they’re not making it any easier.”

Late last month, Monique Martin was able to get Burdick’s exemption number for her from a contact at the federal government. Burdick is happy to have the number, but she still wants to see it in writing. She says she has no idea when it will arrive in her mailbox, but at this rate she’s not expecting it any time soon.

This story is part of a reporting partnership between APRN, NPR and Kaiser Health News.

Native American politics heat up in Wyoming

BEN NEARY, Associated Press

CHEYENNE, Wyo. (AP) — American Indians in Wyoming increasingly are asserting themselves, fighting for more say on environmental issues and fielding more candidates in state and local elections.

The Northern Arapaho and Eastern Shoshone tribes share the Wind River Indian Reservation, a block of land in central Wyoming that’s roughly the size of Yellowstone National Park.

Rep. Patrick Goggles, D-Ethete, announced early this year he’s not seeking re-election to the Legislature after 10 years of representing a district centered on the reservation. Yet Goggles, a Northern Arapaho and the only Indian in the Legislature, said it’s critical that the tribes continue to have a political presence in the state.

“There are issues that are unique to this reservation, and to the other Native Americans that reside here,” Goggles said. “That perspective should not get lost.”

Democrat Andi Clifford, a Northern Arapaho, is running for Wyoming House of Representatives seeking the District 33 seat held by Goggles, her uncle. Clifford, 42, works as a manager at the Wind River Hotel and Casino.

“We have 2.2 million acres with a lot of resources in our land and water,” Clifford said. “We want to be sitting at the table. We want to start discussing things that impact us and start having those conversations, and people to respect those conversations and respect where we’re coming from, because we live here.”

Gary Collins, tribal liaison between the Northern Arapaho Tribe and the state of Wyoming, said he counts seven Native American candidates in area legislative and local elections this year, up from three in 2012.

Collins, a Northern Arapaho, said a victory he and other tribal members won in a Voting Rights Act lawsuit against Fremont County a few years ago has inspired greater political involvement among Wyoming Indians.

U.S. District Judge Alan B. Johnson in 2010 ruled Fremont County’s system of at-large voting for county commissioner elections left Indians disenfranchised. Despite bitter opposition from county officials, Johnson ordered the county to establish voting districts to ensure Indian representation.

“The long history of discrimination against Indians in the United States, Wyoming and Fremont County is undeniable,” Johnson wrote in his 2010 decision. “The evidence presented to this court reveals that discrimination is ongoing and the effects of historical discrimination remain palpable.”

The U.S. Environmental Protection Agency added to local tensions late last year when it ruled that lands around Riverton, a town on the reservation’s eastern boundary, legally remain Indian Country.

The EPA addressed the boundary issue when it granted a request from both the Northern Arapaho and Eastern Shoshone tribes to treat their reservation as a separate state under the federal Clean Air Act.

Wyoming, together with Riverton, Fremont County and other groups, has appealed the EPA decision in federal court in Denver. The tribes have entered the lawsuit, too, arguing to uphold the federal agency’s position.

The tribal boundary dispute also drew the attention of a national group that’s dedicated to ending tribal sovereignty. The Citizens Equal Rights Alliance held a workshop in Riverton in June, saying they wanted to instruct local officials how to fight over federal government overreach.

Sen. Cale Case, R-Lander, is a veteran state lawmaker and a non-Indian. He faces Democratic challenger Sergio Maldonado Sr., a Northern Arapaho, in November’s general election.

Case said he was invited to the CERA workshop but didn’t attend. Although he said he believes the state ultimately will win on the boundary issue in court, he said he regarded CERA’s presence as unhelpful and divisive.

Case served as chairman of the legislative committee that redrew legislative districts after the 2010 census. He said the committee was careful not to dilute Native American voting strength and credits that as a factor in their increasing involvement.

Case said all voters in his district will have to assess which candidate they believe can do the best job. “I’m not native, but I really try very hard to do a good job of representing them,” Case said.

Kimberly Varilek, attorney general for the Eastern Shoshone Tribe, said she believes both the Voting Rights Act ruling and the uproar over the EPA boundary decision both have given tribal members hope that they have a chance to play a greater role in politics beyond the reservation boundaries.

“I’ve noticed that there’s more interest in regards to tribal members,” Varilek said. “Potentially, maybe they feel like there’s more access.”

Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.