Well being Secretary Robert F. Kennedy Jr. made a present on Fb of his assembly with American Indian and Alaska Native leaders final month, declaring himself “very impressed” and dedicated to enhancing the Indian Well being Service, which he says has “all the time been handled because the redheaded stepchild” by his company.
Now Native leaders have some questions for him.
Why, they wish to know, did he lay off staff in applications aimed toward supporting Native folks, just like the Facilities for Illness Management and Prevention’s Wholesome Tribes initiative? Why has he shuttered 5 regional places of work of the Division of Well being and Human Companies that, by the estimate of 1 advocate for tribes, cowl 80 % of the nation’s Indian inhabitants?
Why had been 5 senior advisers for tribal points throughout the division’s Administration for Youngsters and Households, all of them Indian or Native folks, let go? Why are all of those adjustments being made with out consulting tribal leaders, regardless of centuries-old treaty obligations, in addition to presidential govt orders, requiring it?
However the ultimate indignity, Native leaders say, got here final week, when Mr. Kennedy reassigned high-ranking well being officers — together with a bioethicist married to Dr. Anthony S. Fauci, a tobacco regulator, a human assets supervisor and others — to Indian Well being Service areas within the American West, when what the chronically understaffed service actually wants are medical doctors and nurses who’re acquainted with the distinctive wants of Native folks.
“They’re breaching their belief obligation to Indian tribes by the entire scams that they’re doing,” mentioned Deb Haaland, the previous inside secretary and congresswoman, who’s a member of the Laguna Pueblo tribe and a Democratic candidate for governor of New Mexico. “It’s horrible, it’s shameful and it isn’t proper.”
This week, Mr. Kennedy will go to Native well being suppliers and meet with tribal leaders in Arizona and New Mexico to highlight his dedication to Indian well being. The secretary, who has additionally been invited to look earlier than the Senate well being committee on Thursday to testify concerning the job cuts and the huge reorganization of his division, has spoken typically of his and his household’s longstanding dedication to Native Individuals. The Coalition of Giant Tribes, an advocacy group, gave his nomination its highest endorsement.
“I spent 20% of my profession engaged on Native points,” Mr. Kennedy informed Senator Lisa Murkowski, Republican of Alaska, throughout his affirmation hearings in January, including that his father and his uncle, former Senator Edward M. Kennedy, “had been deeply, deeply essential of the functioning of the Indian Well being Service again in 1968 and 1980, and nothing’s modified.”
He vowed that if confirmed, he would usher in a Native particular person as an assistant secretary “to be sure that the entire choices that we make in our company are acutely aware of their impacts on First Nations.” The division has a Secretary’s Tribal Advisory Committee, which met with Mr. Kennedy final month.
The Indian Well being Service, a community of hospitals, clinics and well being facilities, some operated by tribes themselves, flows from a collection of treaties and courtroom rulings that obligate the federal authorities to offer well being care to American Indian and Native folks — an obligation that may be traced again to 1787, when the Structure acknowledged “Indian tribes” as sovereign nations. The folks it serves have profound well being challenges.
Native Individuals have lengthy had shorter life expectancy and better charges of illness than different ethnic teams. In keeping with an evaluation revealed final yr by the Nationwide Council of City Indian Well being, white folks born in 2021 are anticipated to dwell a mean of 11 years longer than their American Indian and Alaska Native friends. Native Individuals die disproportionately from power liver illness, diabetes, murder, and suicide, in line with the Indian Well being Service.
A spokesman for Mr. Kennedy famous that the service itself had not been affected by the current layoffs, and mentioned there have been no plans to consolidate any of its places of work. (One tribal chief, Aaron Fee of the Sault Ste. Marie Tribe of Chippewa Indians, mentioned that was not true; Indian Well being Service employees in his space had been informed to cancel their lease on a neighborhood workplace, he mentioned, and didn’t know the place they might go.)
The spokesman mentioned the proposed transfers had been voluntary, though authorized specialists mentioned those that refused can be topic to termination with out severance pay. The spokesman wouldn’t say what number of staff had been affected.
However in interviews, greater than half a dozen leaders of Native American teams used phrases like “merciless,” “disingenuous” and “offensive” to explain the proposed transfers. Merciless as a result of the administration gave employees someday to resolve whether or not to uproot their households as a way to maintain their jobs; disingenuous as a result of the strikes appeared aimed toward eliminating high-performing staff who may in any other case be tough to put off; and offensive as a result of they play into the racist trope that the areas served by this system represent a backwater.
Some selected their phrases rigorously, fearing that in the event that they angered Mr. Kennedy or President Trump, it might make issues worse for the folks they signify. A.C. Locklear, who runs the Nationwide Indian Well being Board, a nonprofit representing the nation’s 574 tribes, was requested whether or not he seen the current job transfers as a severe effort to enhance the well being of Native Individuals.
Mr. Locklear, an legal professional and citizen of the Lumbee Tribe of North Carolina, was silent for a protracted whereas. “I’m not precisely certain how you can reply that,” he lastly mentioned.
Authorized specialists say the transfers are permissible below the regulation. These affected maintain positions throughout the senior govt service, a corps of high-ranking authorities staff created by Congress in 1979 to provide company heads extra flexibility in transferring folks with govt expertise.
Two staff who bought switch notices mentioned that they had been positioned on administrative go away and lower off from their work electronic mail accounts. One mentioned she would think about a reassignment, regardless of the hardship for her household. One other mentioned she had turned the supply down. Each spoke on situation of anonymity for concern of retribution. Dr. Fauci’s spouse, Christine Grady, declined to be interviewed.
David Simmons, the federal government affairs and advocacy director for the Nationwide Indian Baby Welfare Affiliation, a nonprofit in Portland, Ore., mentioned it appeared to him as if the administration was waging stress campaigns to push senior leaders who are usually not acquainted with Indian tribes into jobs for which they aren’t suited.
“That’s an enormous waste of time, and it’s an ineffective and inefficient solution to get enterprise finished,” he mentioned.
He additionally mentioned his group had labored for years with the well being division to place collectively a staff of 5 advisers for Native points throughout the Administration for Youngsters and Households, a sub-agency of the well being division. He discovered that each one 5 had been laid off as a part of final week’s “discount in power” that eradicated 10,000 staff.
“It’s an unimaginable loss,” Mr. Simmons mentioned.
Tribal leaders have lengthy labored to be handled as equals by American politicians. However, they are saying, by no means have they struggled as a lot as below Mr. Trump.
Even earlier than Mr. Kennedy was confirmed by the Senate, Mr. Trump’s assault on range, fairness and inclusion initiatives infuriated Native Individuals, who felt pressured to elucidate that applications that serve them shouldn’t be eradicated. “We’re not racial minorities; we’re political minorities,” Mr. Simmons mentioned.
Mr. Trump’s hiring freeze and mass firing of probationary staff prompted a string of letters from the Nationwide Indian Well being Board, demanding that the Indian Well being Service be exempt from the cuts. In keeping with Abigail Echo-Hawk, an epidemiologist and citizen of the Pawnee Nation who’s a frontrunner of the Seattle Indian Well being Board, tribal leaders “had been capable of educate Secretary Kennedy,” and 950 staff had been reinstated.
However whereas Native leaders anticipated such strikes from Mr. Trump, many say they really feel betrayed by Mr. Kennedy. As an unbiased presidential candidate, he visited with the Coalition of Giant Tribes and spoke of his household journeys to the Rosebud Sioux Indian Reservation, the Pine Ridge Indian Reservation and Hopi and Navajo reservations whereas he was a toddler, in line with Final Actual Indians, a information group that lined the occasion.
“This was very a lot part of my youth,” he was quoted as saying, including that his father, who was killed in 1968 whereas operating for president, “believed the therapy of Indigenous folks on this nation — the Native Individuals, those who above all others can name themselves American — that that was the unique sin of our nation.”
Mr. Fee, who served on the Secretary’s Tribal Advisory Committee below three presidents, together with throughout the first Trump administration, mentioned in an interview that he believes Mr. Kennedy is real. He blamed Elon Musk, who’s main an effort to overtake the federal government,. He wrote on LinkedIn that whereas Mr. Kennedy “cleans up good for his new position and had a collegial interplay” with the committee, “main cuts are occurring proper below our noses along with his consent.”
Ms. Echo-Hawk, who made headlines in 2020 when she criticized the C.D.C. for not sharing information about Covid-19’s unfold amongst Native communities, mentioned she was particularly involved concerning the C.D.C.’s Wholesome Tribes Program, which seeks to “respect and promote Indigenous data, traditions, and cultural practices for well being and therapeutic.”
This system supplies grant funding that helps Ms. Echo-Hawk’s work. She mentioned she discovered by way of company contacts that the pinnacle of Wholesome Tribes and lots of of its staff had been let go, and that the C.D.C. Workplace of Tribal Affairs would most definitely be damaged up, its parts transferred to different divisions.
As “a buddy of Indian Nation,” she mentioned, Mr. Kennedy “has eloquently said that considered one of his first focuses goes to be on power illness prevention for American Indians and Alaska Natives — which is why this transfer is so puzzling.”
Ms. Haaland, who mentioned she used the Indian Well being Service for her well being care as a youthful lady, used one other phrase to explain the reorganization, layoffs and transfers: disrespectful.
“It’s disrespectful of the I.H.S., it’s disrespectful of the individuals who have devoted their careers to H.H.S. and to our nation, combating illness and regulating the issues that should be regulated,” Ms. Haaland mentioned. “I simply don’t perceive what they suppose they’re doing.”
