Oversight hearings to examine delivering essential public health and social services to Native Americans, focusing on Federal programs serving Native Americans across the operating divisions at the Department of Health and Human Services.

2025-05-14

Summary

This meeting convened to discuss critical programs within the U.S. Department of Health and Human Services (HHS) that are vital for upholding the federal government's trust responsibility to Native communities, extending beyond the Indian Health Service (IHS)[ 00:23:43-00:23:56 ] . Participants voiced significant concerns about the impact of the ongoing HHS reorganization, workforce optimization, and proposed budget cuts on these essential services, emphasizing the urgent need for meaningful tribal consultation[ 00:25:58-00:26:01 ]

Themes

Impact of HHS Reorganization and Budget Cuts

Numerous speakers expressed deep concerns over the HHS reorganization, staff layoffs, office closures, and funding freezes, which are occurring without meaningful tribal consultation and in violation of federal trust responsibilities. Specific examples of negative impacts include significant staff reductions at the CDC affecting syphilis response and chronic disease programs, losses at OASH impacting HIV initiatives, and staffing cuts at SAMHSA that jeopardize mental health grants. The closure of five HHS regional offices, particularly Region 10, means that over 250 tribes in Alaska, Washington, Idaho, and Oregon must now report to a distant Denver office, leading to a critical loss of local cultural and political knowledge[ 00:40:41-00:41:01 ]

. These disruptions have already resulted in canceled grants, loss of institutional knowledge, communication breakdowns, and widespread uncertainty for vital community programs[ 01:41:13 ] .

Importance of Non-IHS HHS Programs

Many HHS programs outside of IHS are deemed crucial for Native communities, often serving as the primary source of basic support services[ 00:24:16 ] . These include Tribal Head Start, LIHEAP (Low Income Home Energy Assistance Program), FIPSA (Family Violence Prevention and Services Act), child welfare services, and tribal TANF[ 00:24:38-00:24:41 ]

[ 00:25:18-00:25:42 ] . Such initiatives are fundamental for fostering family stability, promoting child development, ensuring basic dignity, and addressing intergenerational trauma[ 00:25:08-00:25:45 ] . Tribal Head Start programs are particularly effective, integrating cultural identity and language, providing essential early intervention, and offering comprehensive support to entire families[ 00:44:28-00:44:54 ] . FIPSA acts as the primary federal funding source for crisis services and shelters for victims of family violence, which is critical given the disproportionately high rates of violence experienced by Native women[ 01:40:28-01:40:39 ] . Furthermore, SAMHSA programs are indispensable for youth mental health and culturally responsive healing practices, offering non-competitive funding and the flexibility to incorporate traditional approaches[ 01:47:08-01:47:41 ] . Programs under the Older Americans Act (Title VI) provide vital services such as meals, case management, and opportunities for elders to engage with their communities, strengthening intergenerational bonds.

Federal Trust and Treaty Responsibility

Speakers underscored that the federal government's provision of healthcare and social services constitutes a fundamental trust and treaty responsibility toward American Indians, Native Hawaiians, and Alaska Natives. This obligation extends broadly across all relevant HHS agencies and programs, not solely to IHS. The current administration's actions are perceived as directly violating these responsibilities, especially when changes are enacted without tribal consultation. The exclusion of Native Hawaiians from carve-outs in proposed Medicaid cuts is particularly concerning, as it reinforces a harmful perception that they are not recognized within federal frameworks. Tribal nations and native organizations are emphasized as being uniquely qualified to deliver these services due to their deep understanding of their communities' histories, strengths, and specific needs.

Ineffective Consultation and Loss of Expertise

A consistent criticism leveled against the administration's reorganization efforts is the pronounced lack of meaningful tribal consultation[ 00:59:47-00:59:56 ]

. The loss of experienced staff with nuanced tribal understanding and institutional knowledge within ACF and other agencies has created significant operational gaps, making it challenging for tribes to navigate federal programs and access funding effectively. The proposal to transfer laid-off staff, such as research scientists, to clinical roles within IHS is viewed as an ineffective solution that neither addresses IHS staff shortages nor provides the specialized tribal knowledge needed across HHS. Furthermore, communication breakdowns and delays in grant solicitations are causing considerable uncertainty, forcing programs to potentially halt vital services or lay off staff[ 01:41:19-01:41:36 ] .

Tone of the Meeting

The overall tone of the meeting was serious, concerned, and urgent, reflecting the critical nature of the programs discussed and the potential adverse impacts of current administrative actions[ 00:25:58-00:26:01 ]

. A palpable sense of frustration was evident regarding the consistent lack of tribal consultation and the perceived disregard for federal trust responsibilities[ 01:00:14 ] [ 01:27:47 ] . Despite these profound concerns, there was also a recurring call for collaboration and a shared belief that working together could lead to more efficient and effective programs. Speakers emphasized the life-saving impact of these programs and the devastating consequences of their disruption, resulting in emotional and heartfelt appeals throughout the discussions[ 01:00:26 ] [ 01:10:18 ] .