Shutdown Impacts Native Americans' Ability To Get Health Services

21 hours ago
Originally published on January 8, 2019 8:13 am
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RACHEL MARTIN, HOST:

Throughout the course of the partial government shutdown, we've been taking a look at the impact on different communities and different industries. This morning, we focus in on Native Americans in this country and their ability to get medical care. I'm joined now by Kerry Hawk Lessard. She is the executive director of Native American Lifelines. It's a nonprofit contracted by the Indian Health Service, and it's based in Baltimore and Boston.

Thanks so much for being with us this morning.

KERRY HAWK LESSARD: (Speaking Lakota) Hihanni waste.

MARTIN: Can you start off by explaining how this shutdown is taking a toll, frankly, on Native Americans and their health care?

LESSARD: Sure. So as a contract site with the Indian Health Service, we operate on a cost-reimbursement basis, which means that we spend the money and send a voucher into the IHS, and then we get paid back. Before the shutdown, IHS owed us two months worth of vouchers. So when the shutdown occurred, any payments to us stopped, which means that we had to make some quick decisions about what we were going to do. And unfortunately after a meeting, our board of directors, in concert with our fiscal people, decided that we would have money to operate just to the end of this week. So at the end of this week, we are looking at laying off our employees and suspending medical services and mental health services to our clients in both Baltimore and Boston.

MARTIN: Can you give us a sense of how that affects the people who you serve? What's the scope of your work, and what's - how's this going to take effect in people's lives?

LESSARD: Sure. So we're considered an outreach and referral program, which means we don't provide direct medical services. But we do connect Native people to those services in our areas. But we do provide direct dental care, direct behavioral health care. And we pay for folks to get care at other places. Now keep in mind. In the Baltimore area, we are home to - in the state of Maryland, the Indian Health Service Headquarters. And we're also near Washington, D.C. So we're serving a lot of tribal citizens who've come from their homelands to serve in the federal government. So just a snapshot of what will happen in Baltimore - over the last two weeks, we've experienced four opioid overdoses, two of which have been fatalities. So for me, the thought that we won't be there to support grieving families or to connect people who have survived overdoses or who currently have substance abuse problems with treatment is really scary.

You know, in addition to the fact that 90 percent of my staff members are Native - and for us, you know, these are our relatives. So to, you know, think of telling your grandma, well, I'm sorry; I can't pay for your insulin this month because there's the federal government shutdown, and I don't know when I can pay for it again, it's really scary. Our people are already really burdened by high health care problems, behavioral health problems. So to know that there is no safety net for them is really scary. I can't tell any of my clients or vendors or even the people - you know, my car payment in real life. Well, I'm going to pay you in border wall. That's not an accepted currency right now.

MARTIN: So I imagine it is frustrating to have to think about layoffs, think about the repercussions of not giving these people access to healthcare as a casualty of this particular political debate about immigration.

LESSARD: It's really difficult for a lot of reasons. But I think primarily because all the services to Indian people are predicated on treaty rights and trust responsibilities. We paid well in advance in our lands and with our bodies. One of my ancestors is a survivor of boarding schools. So the fact that these things aren't available to us now because the government can't get along is just mind-boggling to me.

MARTIN: Kerry Hawk-Lessard is executive director of Native American Lifelines. Thanks so much for your time this morning.

LESSARD: Thank you. Transcript provided by NPR, Copyright NPR.