- Details
- By Levi Rickert
U.S. Senators Brian Schatz (D-Hawaiʻi), vice chairman of the Senate Committee on Indian Affairs, and Lisa Murkowski (R-Alaska), Chairman of the Committee, issued a warning to U.S. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. regarding his proposed departmental reorganization. The senators expressed deep concern that planned job and budget cuts would harm vital programs serving Native communities. They also urged Secretary Kennedy to immediately initiate formal consultations with American Indians, Alaska Natives, and Native Hawaiians, as required by HHS’ Tribal Consultation Policy and the Native Hawaiian Health Care Improvement Act.
“The responsibilities of HHS in upholding the federal trust obligation to American Indians and Alaska Natives extend beyond just the Indian Health Service (IHS),” the senators wrote in a letter to Secretary Kennedy. “Similarly, its duty to the Native Hawaiian community is not limited to the Native Hawaiian Health Care Systems Program within the Health Resources and Services Administration (HRSA). For decades, HHS has overseen programs that are essential to the health and well-being of Native communities. These programs fulfill federal commitments established through treaties, statutes, executive orders, and other legal frameworks. Eliminating the staff responsible for these services puts Native health systems at risk.”
The senators pointed to the closure of HHS regional offices in five areas, which has disrupted support for approximately 461 Tribes—representing nearly 80% of all federally recognized Tribes. This disruption has left many without technical assistance for critical programs, including Head Start, Child Care Development Funds, and the Low Income Home Energy Assistance Program. Additionally, the termination of the CDC’s Healthy Tribes initiative has stalled culturally appropriate public health efforts. Cuts at the Substance Abuse and Mental Health Services Administration (SAMHSA) are impacting critical mental health and substance use programs, such as Circles of Care and Native Connections.
“We ask that the same consideration that held the IHS harmless from previous staffing reductions be given to non-IHS programs at HHS that support the well-being of Tribes and the Native Hawaiian Community. HHS must take every precaution to ensure that any administrative changes, including the termination of federal agency employees, do not compromise the ability of Tribes and the Native Hawaiian Community to access health care programs and services,” the senators wrote. “We accordingly urge you to honor the federal trust responsibility by engaging in meaningful consultation and ensuring that the Department’s RIFs and Reorganization efforts do not undermine the critical services and support Native communities' health care needs.”
The full text of the letter can be found below and is available here.
Dear Secretary Kennedy:
We write to express concern regarding your March 27 announcement outlining reductions in force (RIFs) and Reorganization plans for the U.S. Department of Health and Human Services (HHS). The restructuring of HHS, including job cuts and consolidating agencies, will result in significant changes and further harm programs serving Tribes and Native communities. We urge you to convene consultations and seek meaningful input from American Indians, Alaska Natives, and the Native Hawaiian Community on impacts from HHS RIFs and Reorganization efforts across HHS, including all Tribal and Native Hawaiian-serving programs.
The work that HHS provides in fulfilling the trust responsibility to American Indians and Alaska Natives goes well beyond the programs at the Indian Health Service (IHS). HHS’ trust responsibility to the Native Hawaiian Community likewise goes beyond the Native Hawaiian Health Care Systems Program at the Health Resources & Services Administration (HRSA). For decades, HHS has administered programs that provide essential support to Native communities, including programs within the Administration for Children and Families (ACF), Centers for Disease Control and Prevention (CDC), Substance Abuse and Mental Health Services Administration (SAMHSA), and other agencies. As you know, the programs administered by these federal agencies support the federal government’s commitment to provide health care services to Native people grounded in treaties, statutes, executive orders, other federal laws, and agreements. The termination of staff responsible for managing these programs threatens the health, safety, and well-being of Native communities across the country.
Specific concerns regarding impacts of HHS RIFs and Reorganization that have been brought to our attention include:
- Closure of Regional Offices at the Administration for Children and Families: The closure of ACF regional offices in Regions 1, 2, 5, 9, and 10 has directly affected an estimated 458 Tribes in 13 states – approximately 80 percent of all federally recognized Tribes. Many Tribes rely heavily on regional staff for technical assistance with complex federal grant programs, including Head Start, Child Care Development Funds, Low Income Home Energy Assistance Grants (LIHEAP), and Family Violence Prevention and Services Grants (FVPSA). The elimination of these offices without transition planning has left Tribal programs without points of contact, guidance and access technical assistance, or a means to build internal capacity.
- Termination of CDC’s Healthy Tribes Program: The termination of CDC’s Healthy Tribes program has eliminated crucial public health initiatives in Indian Country, including Good Health and Wellness in Indian Country, Tribal Practices for Wellness in Indian Country, and support for Tribal Epidemiology Centers. These chronic disease prevention programs address health disparities in Tribal populations through culturally appropriate interventions to improve health care delivery and access.
- Staff Reductions at the Substance Abuse and Mental Health Services Administration: SAMHSA staff reductions have impacted critical mental health and substance abuse programs in Tribal communities, including the Circles of Care program and potentially the Native Connections program, at a time when these services are desperately needed.
- Termination of Key Agencies Serving Native Communities: SAMHSA, ACF, HRSA, the Administration for Community Living (ACL), the National Institute of Health (NIH), and other HHS agencies improve health care for Native communities, yet these agencies are being considered for termination (or have already faced devastating staff reductions).
- Staff Support for Tribal Advisory Councils (TACs): While the impact of RIFs and Reorganization Plans on key TACs at ACF, CDC, SAMHSA, HRSA, and other agencies is unclear, there are growing concerns that TACs will be weakened as they require staff in Tribal HHS offices in D.C. in order to fulfill their missions.
Staffing reductions were implemented without proper consultation in accordance with the Department’s own Tribal consultation policy and the Native Hawaiian Health Care Improvement Act, and we are unaware of any plans to convene consultation sessions regarding upcoming RIFs and Reorganization efforts to date. Meaningful consultation with Tribes and the Native Hawaiian Community on any changes to HHS that may impact Native health care – from IHS to HRSA to CDC – is crucial to ensure that health disparities are not further exacerbated
We ask that the same consideration that held the IHS harmless from previous staffing reductions be given to non-IHS programs at HHS that support the well-being of Tribes and the Native Hawaiian Community. HHS must take every precaution to ensure that any administrative changes, including the termination of federal agency employees, do not compromise the ability of Tribes and the Native Hawaiian Community to access health care programs and services. We accordingly urge you to honor the federal trust responsibility by engaging in meaningful consultation and ensuring that the Department’s RIFs and Reorganization efforts do not undermine the critical services and support Native communities' health care needs.
Thank you for your attention to this important matter. We look forward to your response.
Sincerely,
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