Some native leaders say they have difficulty grasping the dissonance between Kennedy’s words and his actions. With little information, they question whether Healthy Tribes is part of the Trump administration’s push to end diversity, equity and inclusion efforts. There is also confusion about what and who is left in the 11-year-old programme, which was part of the US Centres for Disease Control and Prevention, under Kennedy’s agency, and distributed $32.5 million annually.
Tribal leaders and health officials told the Associated Press that the cuts to the Healthy Tribes programme are another breach of the federal government’s legal obligation, or fiduciary responsibility, to tribal nations under treaties, laws and other acts. This includes funding health care through the Indian Health Service, as well as education and public safety for citizens of the 574 federally recognised tribes.
But federal funding has long been unable to meet these needs, leaving tribal governments to rely on additional grants and programmes such as Healthy Tribes.
Several tribal facilities received an email from a CDC employee on 1 April informing them that the positions of many people working on the Healthy Tribes programme had been eliminated ‘as part of the reduction in force efforts at the CDC’.
The American Federation of Government Employees union, which represents thousands of workers at the CDC in Atlanta, stated that more than 30 positions have been or are being eliminated. This includes 11 positions in the Healthy Tribes programme and others in the broader Division of Population Health.
An email sent to the account of Healthy Tribes director Dr Julianna Reece, an enrolled member of the Navajo Nation, received an automated response: ‘Due to the recent reduction in the HHS workforce, I have been placed on administrative leave and will be separated from the agency on 2 June. Reece did not respond to requests for comment sent to her federal and personal email accounts.
Native leaders call the change “a breach of trust”
Part of the government’s upheaval in recent weeks includes offering transfers to senior National Institutes of Health officials in Indian Health Service offices far from Washington, DC. The National Indian Health Board also said the government has eliminated key staff and programmes in the Office of the Assistant Secretary for the Centre for Innovation and Indigenous Health.
The government is required to consult with tribes on decisions that affect them, such as the mass layoffs in February at the Indian Health Service that were rescinded hours later, and tribal leaders have warned the Trump administration that such consultations are not happening. In some cases, tribes can take legal action against the US for not fulfilling their fiduciary responsibilities.
“It’s a breach of trust, no question,” said W. Ron Allen, chairman of the Jamestown S’Klallam tribe in Washington state.
The US Department of Health and Human Services did not respond to questions about the Healthy Tribes cuts, but told the AP in an email that the Indian Health Service was not affected by this month’s workforce reductions and there are no plans to consolidate any of its offices.
Kennedy’s swing through the Southwest included a visit to a community health centre in metro Phoenix that provides physical and mental health care to Native people and an outing with the president of the Navajo Nation. He also moderated a panel at the Tribal Self-Governance Conference, held on the Gila River Indian Reservation in Arizona, but did not answer questions from the audience, tribal leaders on stage or reporters.
Allen said he had a constructive conversation with Kennedy, reminding him that IHS is already underfunded and understaffed and that tribes rely on additional grants and federal programmes.
“Your problem is to reduce the central office, and so we agree, but to move the functions that serve the tribes to the tribes,” Allen told Kennedy. “Because if we don’t have those resources, how are we going to make our communities healthy? He agrees.”
Grants fund traditional medicine practices
Research shows that Native Americans have a shorter life expectancy than other ethnic groups, and the Indian Health Service says they face higher mortality rates for chronic conditions such as diabetes and liver disease.
In Seattle, Healthy Tribes money pays for a programme called GATHER, which focuses on integrating traditional tribal medicine practices into health care. Providers from the Seattle Indian Health Board can use medicines made from plants grown in a community garden. A traditional native medicine apprentice or healer is part of a patient’s care team.
Seattle Indian Health Board President Esther Lucero, a descendant of the Navajo Nation, said her staff meets with people from the CDC and other Healthy Tribes beneficiaries twice a month to discuss project updates and ensure grant compliance. But after last week’s layoffs, they are having trouble contacting anyone.
“If you can’t actually administer the dollars, how are you going to actually get them to the programmes?” he said. “With the current administration, it’s almost like every day we get an unexpected notice, and then we’ll get a follow-up notice saying. You have to go on as usual.”
Lycia Ortega, interim CEO of Los Angeles-based United American Indian Volvement, echoed concerns about the ambiguous and somewhat confusing messages. Her organisation uses Healthy Tribes money to promote connections between youth and elders in Native American and Alaska Native communities.
Natives “have distinct political power,” said Ortega, a citizen of the Fort Yuma Quechan Indian Tribe, but “there are politicians who see tribes as a threat rather than a partner.”
Stephen Roe Lewis, governor of the Gila River Indian Community, said he told Kennedy privately that consulting and engaging in respectful partnerships with tribes is key to fulfilling the federal government’s trust responsibilities.
Since the Trump administration began making massive cuts to the federal workforce, many tribal leaders have had to clarify with newly appointed federal officials that services to tribes are not based on race, but rather on the political status of tribal nations.
“I made it very clear, we are not GODS, as tribal nations, as a political entity,” he said.
