Importance Score: 75 / 100 🔴
Health Secretary’s Visit to Tribal Communities Overshadowed by Program Cuts
CHANDLER, Ariz. – U.S. Health Secretary Robert F. Kennedy Jr. recently concluded a visit to tribal communities in Arizona and New Mexico, where he emphasized initiatives aimed at combating chronic diseases among Native Americans and Alaska Natives. This issue, Kennedy stated, is a leading priority for his department. However, his tour coincided with concerns over significant reductions to a key Native health program.
Healthy Tribes Program Facing Setbacks Amidst Federal Layoffs
Notably absent from Kennedy’s public agenda was any direct acknowledgment of the “Healthy Tribes” program. This initiative, focused on utilizing traditional medicine and foods to address the disproportionately high rates of conditions such as diabetes and liver disease within Native populations, has reportedly been severely impacted by recent federal health agency layoffs.
Confusion and Concern Among Tribal Leaders
Several Native leaders have voiced difficulty in reconciling Kennedy’s stated commitments with the apparent actions impacting Healthy Tribes. With limited official information forthcoming, questions are arising about the program’s future and whether its restructuring is linked to broader administration efforts to curb diversity, equity, and inclusion (DEI) initiatives. Uncertainty prevails regarding the remaining capacity and staff of the 11-year-old program, formerly under the Centers for Disease Control and Prevention (CDC) and responsible for distributing $32.5 million annually.
Cuts Seen as Breach of Federal Trust Responsibility
Tribal leaders and health officials have conveyed to The Associated Press that the reductions to the Healthy Tribes program represent another infringement of the federal government’s legally mandated trust responsibility to tribal nations. This obligation, rooted in treaties and legislation, encompasses essential services like healthcare funding through the Indian Health Service (IHS), as well as education and public safety for the 574 federally recognized tribes.
Historically, federal funding has been insufficient to fully meet these obligations, compelling tribal governments to depend on supplementary grants and programs like Healthy Tribes to bridge the gap.
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Impact on Collaborative Efforts
Onawa Miller, a citizen of the Quechan Indian Nation and director of tribal public health for United South and Eastern Tribes, an organization serving 33 tribes, highlighted the disruptive impact of these cuts. “So many layers of communications of collaboration and partnerships have just been disrupted,” Miller stated. She confirmed her organization had already received its annual $2 million in Healthy Tribes funding prior to the layoffs.
CDC Layoffs and Program Staff Reductions
Reports indicate that numerous tribal facilities received a notification email from a CDC employee on April 1st. This email detailed the termination of positions for many Healthy Tribes program personnel as “part of the reduction in force efforts at CDC.”
The American Federation of Government Employees union, representing CDC workers in Atlanta, has confirmed over 30 civil service positions have been or are being eliminated. This includes 11 positions specifically within the Healthy Tribes program and additional roles within the broader Division of Population Health.
Program Director Affected by Restructuring
An email inquiry sent to Dr. Julianna Reece, the Healthy Tribes program director and an enrolled member of the Navajo Nation, received an automated reply confirming her administrative leave due to the “recent HHS reduction in force,” with separation from the agency scheduled for June 2nd. Dr. Reece did not respond to requests for comment.
Wider Government Restructuring and Tribal Health
Recent governmental reorganization has extended beyond the CDC, with reports of senior officials at the National Institutes of Health being offered transfers to IHS offices distant from Washington, D.C. The National Indian Health Board has also reported the elimination of crucial staff and programs at the Office of the Assistant Secretary for Health’s Center for Indigenous Innovation and Health.
Tribal Consultation and Trust Obligations
The federal government is legally bound to consult with tribes on decisions affecting them, exemplified by mass layoffs at the Indian Health Service in February that were later reversed. Tribal leaders have cautioned the administration against insufficient consultation. In cases of unmet trust responsibilities, tribes possess the option to pursue legal action against the U.S. government.
W. Ron Allen, chairman of the Jamestown S’Klallam Tribe in Washington state, asserted, “It is a breach of trust obligation, without a doubt.”
HHS Response and Kennedy’s Southwest Visit
The U.S. Department of Health and Human Services (HHS) did not directly address inquiries regarding the Healthy Tribes cuts. However, in an email to the AP, HHS stated that the Indian Health Service was not impacted by this month’s workforce reductions and that there are no plans for office consolidations.
Secretary Kennedy’s Southwest tour included a visit to a Phoenix-area community health center serving Native populations and a meeting with the Navajo Nation president. He also participated in a panel at the Tribal Self-Governance Conference in Arizona without taking questions from the audience or journalists.
Tribal Leaders Advocate for Resources and Consultation
Allen recounted a “productive discussion” with Kennedy, underscoring the chronic underfunding and understaffing of the IHS, and the critical reliance of tribes on supplementary federal programs. Allen conveyed to Kennedy, “Your issue is to reduce the central office, and so we’re OK with that, but move the functions that serve the tribes out to the tribes. Because if we don’t have those resources, how are we gonna make our communities healthy? He agrees.”
Health Disparities and the Role of Traditional Medicine
Research indicates that Native Americans experience shorter life expectancies and higher mortality rates from chronic diseases like diabetes and liver disease compared to other ethnic groups, as reported by the Indian Health Service.
In Seattle, Healthy Tribes funding supports the GATHER program, which integrates traditional tribal medicine practices into healthcare. The Seattle Indian Health Board utilizes plant-based medicines from a community garden and incorporates traditional healers into patient care teams.
Program Administration Challenges Post-Layoffs
Esther Lucero, president of the Seattle Indian Health Board and a descendant of the Navajo Nation, mentioned regular meetings with CDC and Healthy Tribes personnel to discuss project updates and grant compliance. Following the recent layoffs, however, contacting program staff has become problematic.
“If you can’t actually administer the dollars, how are you going to actually get them out to the programs?” Lucero questioned, expressing concern about the operational impact of the staff reductions. She added, “With this current administration, it’s almost like every day we receive an unexpected notice, and then we will get a follow-up notice that says … you need to move forward as usual.”
Ambiguity and Conflicting Messages
Lycia Ortega, interim CEO of Los Angeles-based United American Indian Involvement, echoed concerns regarding the “unclear and perplexing” messaging. Her organization utilizes Healthy Tribes funding to strengthen connections between young people and elders in Native American and Alaska Native communities.
Tribal Nations as Political Entities, Not DEI Initiatives
Ortega highlighted ongoing efforts by Native communities to “resist” administration attempts to cut programs perceived as DEI-related, supported by legal and policy experts who emphasize the government’s trust responsibility.
“Native people ‘have a distinct political power,’” Ortega stated, ”but ‘there are policymakers who see tribes as a threat rather than a partner.’”
Stephen Roe Lewis, governor of the Gila River Indian Community, recounted a private conversation with Kennedy where he stressed the importance of consultation and respectful partnerships with tribes to uphold federal trust obligations.
Since the administration workforce cuts, many tribal leaders have had to “reiterate” to newly appointed federal officials that services to tribes are rooted in the political status of tribal nations, not DEI principles.
“I made it very clear, we are not DEI — as tribal nations, as a political entity,” Lewis stated.