Tribal health leaders from around the country meet at Pechanga

Tribal leaders, Indian health providers, health experts and advocates gather at the National Tribal Health Conference at Pechanga Resort Casino hosted by the National Indian Health Board, Sept. 18. Shane Gibson photo

Over the course of five days at Pechanga Resort Casino last week, the National Indian Health Board held its annual National Tribal Health Conference.

More than 600 tribal leaders, advocates, health experts and health care providers converged on Temecula to inform, educate and decide upon the next steps toward defending Native Americans’ health care rights.

“There are 573 tribes in this country,” Stacy A. Bohlen, CEO of National Indian Health Board based in Washington, said. “In the early 1970s, tribes were very clear that if they did not do something to get a hold of their health disparities, there would be no more tribes, there’d be no more Indians. We would all die of the incredible disease burdens that we were carrying. The tribes came together and formed this organization, the National Indian Health Board, so that they would be heard in Washington. NIHB would be dedicated to improving the health care and health systems of native people across this continent.

“We serve them, they own this organization,” Bohlen said.

This year’s conference theme, “Health = Sovereignty,” focused on strengthening health policy through advocacy and federal relations and highlights that health is a key component of the federal trust responsibility and a pathway to sovereignty.

“The significance of this conference is to serve that end and this brings together native people from all over the country to learn to elevate their knowledge but to also share their knowledge,” Bolen said. “There’s so much excellent work that the tribes across the country do in health care. We do incredible, groundbreaking work, lifesaving work with the fewest resources of any group in this country. When you come here, you can share that knowledge. You can be bolstered to make your business operations of your tribe better, to do your third party billing better, to learn about policy and advocacy.”

Bolen said NIHB learned during the conference that the U.S. Department of Health and Human Services zeroed out appropriations dedicated specifically for Native Americans.

“No reason given, just zeroed it out,” Bolen said. “We have people monitoring that we can come right here and say, ‘This is what’s going on. This affects every person in this room. You need to make calls.’”

According to organizers, there has been a lot of discussion about what sovereignty means in relation to the relationship that tribes have with the federal government. Tribes have been looking at new ways to capture sovereignty, to leverage sovereignty in order to ensure that that trust responsibility is upheld.

One of the major topics of discussion was the recent policy decision of Medicaid work requirements. Medicaid plays a huge role in the provision of services for federally recognized American and Alaska Native people and adding that requirement would also apply to those enrolled tribal members.

NIHB said that flies in the face of sovereignty and the trust responsibility.

“The administration wanted to put workforce requirements on Medicaid as a condition of being able to have Medicaid,” Bolen said. “And they tried to put them on us. But health care for American Indians, it’s wrong for two reasons. One is that in our treaties, we fought for that already. That’s already negotiated. That’s a done deal from hundreds of years ago. Trying to find a way to make us pay for health care, well, that’s what all this land that everybody’s owning is about. We already paid for it with the land, our cultures, our ways of life, our freedom.

“Second, we’re not a race; we’re a political status. It’s not violating the Civil Rights Act if you’re not a race. And we’re not. The difficulty with that particular battle is that it’s fundamental to our identity.”

The conference featured myriad workshops, talk panels and meetings. Additional major topics included the opioid epidemic and how it is affecting tribes nationwide.

“We have tribal caucuses every morning, and we engage with all of the different delegations of tribes that are here,” Bolen said. “Our board members represent all 12 geographic areas of how health care is delivered. All the peoples who come from their areas meet together, and we ask them to talk about what is going to be our priority next year? What are the priorities going to be for the National Indian Health Board? What do we all agree that we will all put our efforts into together and sort of bless up, move forward? That’s a really an important thing that comes out of this conference.

“I think that one of the greatest things that NIHB brings forth is, because of the relationships that we’ve been able to form in Washington, we’re able to bring the dominant culture, sovereign nation decision-makers to our sovereign nations and have discussions here,” Bohlen said.

Jeff Pack can be reached by email at