Achieving Health Equity: Through a Tribal Lens Lisa Sockabasin, Director Maine Office of Minority Health Maine Department of Health and Human Services

Tribes Nationally Greater than 550 federally recognized tribes in the United States 34 States have federally recognized tribes 21 States have state recognized tribes 42 States have state and/or federally recognized tribes.

Tribal Sovereignty Government to government relationship Ensures that any decisions about the tribes with regard to their property and citizens are made with their participation and consent.

Tribal and Maine State History 1000 Norseman visit Passamaquoddy Bay and kill 8 Wabanaki 1498 Explore Cabot visits Passamaquoddy Bay and kills 3 tribal people. 1600 Wabanaki Population total 32,000 1602 France formerly plans to colonize Passamaquoddy lands 1694 Massachusetts Governor issues scalping proclamation 1700 Wabanaki Population total 10,000 1794 land set aside for Passamaquoddy 1820 Maine becomes a State 1832 Maine authorizes Passamaquoddy land to be seized for right away. 1852 Tribal governmental structure changed to match State system 1892 Maine Court declares the Passamaquoddy Tribe no longer exists 1892 Maine court rules against the Passamaquoddy regarding their right to sustenance hunt & fish. 1921 Federal policy issued requiring full assimilation and eradication of tribal culture 1924 Indian Citizen Act grants Indians the rights of citizenship, including the right to vote in federal elections. 1932 Indian Reorganization Act issued but excludes the Passamaquoddy 1967 Maine Indians receive right to vote in state elections. 1990’s Maine Indian Tribal-State Commission, established by the Indian Land Claims Settlement Act, struggles with sovereignty and other contentious issues, such as fisheries, land-use regulations and gambling casinos.

Savagism and Civilization: A Study of the Indian and the American Mind The White Man’s Indian: Images of the American Indian from Columbus to Present The Great Father: The United States Government and the American Indian A Final Promise: The Campaign to Assimilate the Indian

Life Expectancy US All Races 77.9 yrs Maine 75.6 yrs Eastern Tribes 62.4 yrs Maine Tribes range from 49-55 years

Indian Health Service Indian Health Service is funded with discretionary funds each year Funded at 60% level of need Appropriations have not kept up with costs of inflation or population growth. It has become increasingly difficult to provide a continuous level of health care to the Native American Population. Although HIS has been fortunate enough not to have experience the level of funding cuts as some other federal agencies, because of the fact that the cost of inflation has not been accounted for and the population growth, our purchasing power has decreased. This has made it increasing difficult for HIS and the Tribes to offer a constant level of services. Funds often run out before the next funding cycle.

Tribal Consultation in Maine Executive Order to Promote Effective Communication between the State of Maine and the Native American Tribes Located within Maine. Promotes effective two-way communication between state agencies and the tribes Promotes positive government to government relations between the state and tribes Enables tribes to provide meaningful and timely input into the development of legislation, rules and policies proposed by an agency on matters that significantly/ uniquely affect the tribes Encourages similar communication efforts by the tribes

Moving Forward.. Tribes and/or tribal members within your home state Tribal history (state/tribal relations) Developing consultation policies Relationship/trust building