- Details
- By Elyse Wild
A federally recognized tribe in California is suing the Indian Health Service (IHS) for unlawfully rejecting a proposal for an opioid treatment facility for its citizens amid the ongoing overdose crisis.
The suit was filed on Dec. 31, 2025, in the Central District of California. In July 2025, the Pechenga Band of Indians was notified that the IHS had rejected its compact for the opioid addiction treatment program, after nearly two years of good faith negotiations.
The Tribe alleges that the agency’s rejection of the much-needed program violates the Indian Self-Determination and Education Assistance Act (ISDA).
The ISDA was implemented in 1975 to end the federal government's dominion over public services in Native communities, allowing Tribes to plan and administer services for their own people. Under the act, Tribes are eligible to receive federal funds to serve IHS beneficiaries.
The compact was rejected on three grounds: insufficient benefit to Native patients; excessive federal funding; and the programs fall under inherent federal function. The tribe alleges that the rejection criteria are not factual. The lawsuit contends that Native Americans have limited access to opioid addiction treatment in the area, and its proposed opioid services would be open to every Pechenga citizen and Native people in the region.
The programs were to be funded by a $5.5 million investment from the tribe and a 2.5% withdrawal from the tribe’s existing funding allocation to a regional intertribal health organization. Additional monies were not requested in the compact, nullifying the rejection on the grounds of excessive federal funds.
The suit claims that the IHS never raised concerns during the lengthy compact negotiations.
The IHS has approved similar opioid treatment facilities for other federally recognized tribes, including those in California, using the same management service provider that Pechenga planned to use — OneTogether Solutions, a majority Native-owned entity.
The tribe is asking the court to order IHS to immediately approve the compact.
Native American communities continue to be on the front lines of the ongoing opioid crisis, experiencing the highest number of overdose-related deaths of any other population in the U.S. A culmination of generational trauma, federal apathy, and barriers to healthcare leaves Native people with disproportionate comorbidities for opioid use disorder.
Riverside County, California, where the Pechenga Band reservation is located, saw more than 2,900 opioid overdoses in 2023 alone.
According to the lawsuit, one Pechenga tribal citizen died of an opioid overdose during the compact negotiations.
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