Like Begay, Denny says family and community are central to the healing process.
“Those who did that to us with all the religious intolerance, human rights violations, historical trauma, and all the diseases that happened to our people could not make medicine for us. ,” he said.
“They didn’t know how to cure it, how to cure us.”
barriers to care
Native Americans have access to traditional services free of charge at facilities operated by the Bureau of Indian Health, but supply cannot always keep up with demand at the chronically underfunded federal agency.
A 2011 federal report found that of the 514 IHS and tribal facilities providing mental health services, only 33% offered traditional healing. And even though his 70% of Native Americans live in urban areas, many of those clinics are on or near reservations.
“Nearly all of these services are aimed at people who live on reservations, and for decades the majority of Native Americans have not lived on tribal territory,” said Weaver of the University at Buffalo. “There is a mismatch between where services are and where people are. Some Native people have private insurance and are able to pay for mental health care. Many others That is not the case.”
In some states, health officials are trying to address all of this.
For years, Arizona, California and other states have asked the federal government for permission to reimburse traditional healing services under Medicaid.
IHS provides free health care services to Native Americans, but services are only available to members of federally recognized tribes and within certain geographic service areas.
More than 50% of Native Americans do not have private health insurance, making Medicaid another important source of health care. As of 2019, about 42% of American Indians and Alaska Natives rely on Medicaid or public health insurance, according to federal data.
In 2015, Arizona established a workgroup to help develop parameters and potential payment methods related to traditional treatments for consideration by federal and state Medicaid officials.
In a memo a year later, Arizona leaders wrote that traditional treatments “are beneficial to tribal members,” but “despite being promoted by the Indian Health Care Improvement Act and IHS.” It noted that they are not considered eligible for Medicaid services.
However, to date, the federal government has refused to approve reimbursement.
In a letter from the federal Centers for Medicare and Medicaid Services to the Arizona Health Care Cost Containment System last month, the federal agency “recognizes the state’s goal of addressing disparities in American Indian and Alaska Native communities; We will continue to cooperate.” Regarding this request, the state. ”
CMS declined additional comment on why the change took so long. So far, no reimbursement for traditional treatments has been approved for any state. A spokeswoman said the request was “still under consideration.”
Arizona Medicaid Agency spokeswoman Heidi Capriotti said federal officials “recognize our interest in traditional healing services and how important they are to tribal communities and are willing to negotiate this topic.” We agreed to continue.”
“I don’t know the specific issues that are preventing that, just that they want multiple states to work together,” Capriotti said. “So it could be a conversation that involves more than just Arizona.”
