NIHB's 38th Annual National Tribal Health Conference
Comes to a Close
WASHINGTON, DC—October 8, 2021— The National Indian Health Board(NIHB) 38th Annual National Tribal Health Conference (NTHC), held virtually, came to its close yesterday, finishing a week of health policy workshops, seminars, and institutes. NTHC attendees learned about the innovative and collaborative health solutions that are driving the growth of Indian health policy. The conference also allowed participants to explore historical and structural issues that are currently impacting Indian health care. Participants heard from speakers who discussed Indian boarding schools, their historical roots, and their continued impacts of American Indian and Alaska Native health. Speakers also explored the importance of third party reimbursors, particularly Medicare and Medicaid, to the financial health of the Indian Health Care system, a condition caused by the chronic underfunding of the Indian Health Service. The conference provided an opportunity to examine structural issues while looking at the road ahead.
The pre-conference day hosted three federal agency Tribal listening sessions; Indian Health Service (IHS), Department of Veterans Affairs(VA), Centers for Disease Control and Prevention(CDC), and the Health Equity Listening Session. Fowler, Acting Director, IHS senior staff discussed health policy and program management issues related to the provision of health services to Indian Country. Denis McDonough, Secretary, VA led the VA Listening Session and assured Tribal leaders his team is dedicated to working with Tribes and Tribal organizations to improve healthcare services to veterans at all stages of their life. CDC’s Dr. Jose Montero, Director of the Center for State Tribe, Local, and Territorial Support, addressed funding streams that flow directly to Tribes, strategy around vaccine hesitancy, and meaningful Tribal engagement. Ending the pre-conference day was the Health Equity Listening Session, which included presentations by experts in Indigenous health equity and a breakout session that allowed participants to explore this issue in their home communities.
The first full day of the NTHC kicked off with the Opening Plenary Session: Achieving Health Equity through Partnership and Self Determination. The theme, Achieving Health Equity through Partnership and Self Determination was found throughout the weeklong virtual conference.
The virtual conference workshop tracks consisted of five tracks: Health Equity and the Trust Responsibility: Be Heard, Make Change, Disruption, Governance, and Politics in the Tribal Health Space, Transformational Approaches to Financing Our Health System, Resilience During Periods of Sustained Crisis, The Rise of Technology to Revolutionize AI/AN Health, and Transformational Approaches to Financing Our Health System.
Wednesday had a packed agenda beginning with the Centers for Medicare and Medicaid Services (CMS) Listening Session, which served as a forum for CMS to hear directly from Tribal nations on the current CMS Tribal Consultation Policy. The second Plenary Session: Fulfilling the Trust Responsibility: A Discussion of the Federal Government's Role as a Funder of Indian Health Care explored the importance of the CMS as a third party reimburser of the Indian healthcare system. Participants heard from Chiquita Brooks-LaSure, CMS Administrator, who discussed the agency’s commitment to working with Indian Country. This was followed by a panel which consisted of members of the CMS Tribal Technical Advisory Group (TTAG) about ways that CMS programs impact their community, offering participants an unparalleled opportunity to hear about this issue from subject matter experts who are serving on the ground. U.S. Senator Lisa Murkowski of Alaska concluded the plenary by stating, “The pandemic and related social and economic adversity certainly tested your communities over the last year and a half, but you all rose to the challenge. It is an honor to work in partnership with you to address Indian health issues as Vice Chairman of the Senate Committee on Indian Affairs and also as Ranking Member on the Interior Appropriations Subcommittee…Whether our work is building up infrastructure in Tribal communities, supporting the IHS budget, acknowledging and helping to heal the wounds of the policies of assimilation, or improving the delivery of services to Native children, I appreciate your partnership—working together to get it done.”
NIHB CEO, Stacy Bohlen was joined by NTHC 2021 warrior sponsor Cerner’s Vice President of Interoperability, Sam Lambson on Facebook Live for a conversation on interoperability for electronic health records.
Two sets of concurrent workshops were offered on Wednesday, October 7 during the NTHC. Institutes: University of Oklahoma, Institute for American Indian Arts, John Hopkins, UC San Diego, University of California, and UC Davis School of Medicine; Native nations: Chickasaw Nation and Choctaw Nation of Oklahoma, organizations: National Native Children’s Trauma Center, Southcentral Foundation, and Community Catalyst; Health boards: Southern Plains Tribal Health Board and Northwest Portland Area Indian Health Board, were some of NIHB’s partners who explored and presented hot topics in Indian health.
That evening, NIHB recognized and honored a group of Tribal health leaders, providers and advocates during its virtual Outstanding Service Awards. Honorees were presented 43 awards in the categories of Local Impact, Area/Regional Impact, National Impact, Youth Leadership and the prestigious Lifetime Achievement Jake Whitecrow Award. Chester Antone, former Tohono O'Odham Tribal Council won this year’s Jake Whitecrow Award. The Youth Leadership Award Award went to Ki-shan Daniels from the Yurok Tribe.
On Thursday, October 7, the last full day of the NTHC, attendees were part of the Substance Abuse and Mental Health Services Administration (SAMHSA) Listening Session, where Tribal leaders met with Dr. Miriam E. Delphin-Rittmon the SAMHSAAssistant Secretary for Mental Health and Substance Use who was joined by Kimberly Beniquez, Public Health Advisor at SAMSHA. Mental health and substance abuse service needs in Tribal Nations along with available funding were the main focus. With the alarming rates of substance abuse in Tribal communities, leadership requested SAMSHA examine the connection between COVID and suicide of American Indian Alaska Native populations. Aaron Payment, Chairman Sault Ste. Marie Tribe of Chippewa Indians and other Tribal leaders provided recommendations on data collection and reporting requirements, substance abuse and the opioid epidemic, and increasing funding and grant programs.
NIHB Policy Center Director Christopher Chavis was joined by NTHC 2021 warrior sponsor Leidos’ Donald Kosiak, Chief Medical Officer on Facebook Live for a conversation on health information technology to meet the healthcare needs of Tribal communities.
The afternoon’s agenda included COVID Roundtables, workshops, and the closing plenary session. The roundtables focused on federal trust responsibility, emergency preparedness, and data usage. During Thursday’s workshops attendees heard from the American Indian Cancer Foundation about Indigenizing public health and storytelling campaigns. Another workshop highlighted the importance of paying traditional healers through IHS and the Tribal health system. The Crisis in the AI/AN Physician Pipeline: Tribal Response to Address Urgent Need workshop featured speakers who are working to mitigate rural and urban Indian health workforce shortages. Tribal Advisory Committees (TAC) and the Trust Responsibility educated attendees on how TACs can be a revolutionary tool for advocacy.
A powerful plenary session closed out the final day of NTHC. Healing our Trauma: A Discussion to Address the Legacy of Federal Indian Boarding Schools and Looking to the Future.
Esteemed speakers from the United Nations Permanent Forum on Indigenous Issues, National Native American Boarding School Healing Coalition, Michigan State University College of Law, Women Empowering Women for Indian Nations (WEWIN), Department of the Interior, Indigenous Services Canada, Mohegan Tribe, United States Senator for Massachusetts, Fond du Lac Band of Lake Superior Chippewa, and UC San Diego School of Medicine gave updates and/or served as guest panelists while joining NIHB board members in the discussion.
U.S. Senator Elizabeth Warren welcomed the NTHC 2021 attendees and shared the work she has been doing around healing, including the Truth and Healing Commission on Indian Boarding School Policy (THCIBSP) Act, introduced with Deb Haaland on September 30, 2021. Senator Warren also touched on the Suicide Prevention Act, which was signed into law last year and is being configured to be implemented fairly and requires Tribes have a seat at the table in statewide suicide prevention strategies. Also introduced was the American Indian Alaska Native Child Abuse Prevention and Treatment Act that will increase Tribal funding and make sure Tribes receive resources and data. Provisions were included in June 2021 legislative package. Professor Matthew Fletcher from Michigan State University College of Law followed Senator Warren’s remarks by discussing the legal history of the Doctrine of Discovery and how it led to boarding schools, noting that early American policy was rooted in the idea that non-westernized people are “less than human.”
Plenary session conversation continued with recognizing the need for mental health resources to help promote healing. For NIHB, efforts are focused on advocating for the resources needed to help healing and trauma recovery throughout Tribal nations. Congress and the Department of Interior (DOI) are working with IHS to ensure resources are in place to support families and survivors.
Truth, Justice, Healing: How American Indian and Alaska Native Peoples Move Forward from the Boarding Schools Trauma, Injustice and Brutality – this question dominated discussion for the remainder of the session. NTHC attendees heard survival stories from some of the panelists are learned of the staggering statistics of youth suicide, substance use, and mental health issues linked to boarding schools and the trauma of survivors. All these traumas travel through time, all Native people carry these pieces. It is the work of the people, like NIHB that provide the framework for truth, justice, and healing and that is why our advocates are so important.
NIHB Chairman William “Bill” Smith introduced Tim Davis, Chairman of Blackfeet Nation, as the newest Billings NIHB member. Chairman Davis thanked NIHB and the board of directors and devoted his commitment for healing and good work for Tribal communities.
On Friday, October 8 the Department of Health and Human Services (HHS) in collaboration with the Health Resources and Services Administration (HRSA) held its consultation, which was a follow up on the Dear Tribal Leader Letter (DTLL) and highlighted Health Center Program’s Uniform Data System and the scoring of Health Professional Shortage Areas.
NIHB thanks its sponsors for their generosity, guest speakers for their knowledge, and attendees for their willingness to learn and advocacy.