an introduction to urban indian health · the target population of the missoula urban indian health...
TRANSCRIPT
An Introduction to Urban Indian
Health Prepared for the
National Conference of State LegislaturesMay 30, 2019
Established 1970• Over its 49-year history, MUIHC has had several names
and historically focused on the substance abuse and chemical dependency struggles experienced by American Indians living in and around Missoula.
• Beginning in September 2018, MUIHC hired its first ever full-time medical provider and began offering primary care services.
Federal Indian Policies • Removal (1825 – 1850)
• American Indians are forced to move west of the Mississippi River• Open hostility and violence toward American Indians
• Reservation (1850 – 1887)• Treaties with tribes to establish land-bases and rights• Regulations prohibit Indian culture and religion; and allow both military and religious
control of reservations• Allotment and Assimilation (1887 – 1934)
• American values of ownership and farming are forced on Indians• Increased emphasis on outlawing Indian culture and “civilizing” tribal citizens
• Indian Reorganization (1934 – 1940’s)• Tribal governments are established in the image of American structure• Allotment is discontinued in an effort to salvage tribal land-bases
• Termination (1940’s – 1961)• Assimilation through forced absorption• 109 tribes see their federal recognition terminated; 1.3 million acres of tribal land is lost
• Self Determination (1961 – present)• Began under Kennedy (D-MA) administration, defined under Nixon (R-CA)• Tribal governments regain major roles, can contract with federal gov’t
*This slide is a summary of: Miller, Robert J., The History of Federal Indian Policies (March 17, 2010). Available at SSRN: http://ssrn.com/abstract=1573670
• Comprehensive health service delivery system to approximately 2.56 million American Indians and Alaska Natives
• Network of over 600 clinics, hospitals and health stations
• System comprised of IHS (Direct Service), Tribal (638 Compact) and Urban (Title V) clinics
• FY 2018 Enacted Budget of $5.5 billion
• FY 2018 Enacted Urban Indian Health Budget of $45 million (0.8%)
Public Law 94-437Indian Health Care Improvement
Act of 1976
IHCIA Authorized:
• Health Promotion Services
• IHS Loan Repayment Program
• Urban Indian Health Programs
Urban Indian Health Programs
Meeting the needs of more than 150,000 American Indians each year…
41 UIHPs are located throughout 8 regions
MUIHC Profile
The MUIHC provides limited ambulatory care in addition to behavioral health (mental health and substance abuse), community health, and other health promotion and disease prevention services. The MUIHC also provides patient transportation assistance for referral and dialysis appointments as well as transportation to Confederated Salish and Kootenai Tribal Health and Human Services on theFlathead Reservation. MUIHC further enhances its services through collaborative efforts with local health organizations and non-profit organizations.
Target Population:The target population of the Missoula Urban Indian Health Center is the approximately 5,000 Native Americans residing in the Missoula,
MT service area. According to 2017 Census estimates, approximately 4,894 American Indians reside within Missoula County. TheMUIHC Ambulatory Patient Care (APC) workload for FY2015 was 1,681 visits.
Scope of Services:Services provided are medication management, limited optical support, mental health services, dental referrals, diabetes screening and
education. MUIHC Chemical Dependency Program is State Certified and provides adult chemical dependency services consisting ofevaluations, prevention education assessments, cultural activities, counseling, outpatient treatment, inpatient (referred) and outreach/referral.
Sources of Funding:IHS Contract Funding: $561,234IHS 4-in-1 Grant Funding: $178,135Special Diabetes Grant Funding: $169,428
