Native health officials testify that HHS cuts have caused ‘significant harm’ to programs serving tribal communities

In the hearing, led by U.S. Senators Lisa Murkowski (R-Alaska) and Brian Schatz (D-Hawaii), five tribal officials spoke to the Senate Committee on Indian Affairs on how Secretary Kennedy’s management has disrupted staffing and services and therefore affected the availability of programs to their respective communities.

Among the first to speak was Janet Alkire, chairwoman for the Standing Rock Sioux Tribe at Ft. Yates, North Dakota. Alkire testified about how HHS programs and funding benefit tribal communities in her region.

In fiscal year 2024, she said, “HHS provided Great Plains Area Tribes and tribal organizations approximately $124 million in funding, less than 0.002% of the HHS budget, which supports life-saving programs that address some of the most extreme health disparities in the nation.”

Alkire also spoke to the effects of President Trump’s Feb. 11 executive order cutting staffing across many federal agencies as part of the Department of Government Efficiency’s “workforce optimization.” Tens of thousands of federal workers were fired in the latter half of February, including those who worked with Native communities.

“The reduction in staff has impacted grant funding access and distribution to Tribes, the operation of Tribal Technical Advisory Committees, and is causing remaining Tribal program staff to seek opportunities outside federal employment,” Alkire’s testimony states. “Without Tribal Consultation, Tribal Nations have already incurred significant harm, including the abrupt cancellation of no less than $6 million in grants from various HHS agencies — jeopardizing the sustainability of health and public health systems in Indian Country.”

Alkire added that there’s still a syphilis epidemic happening with Great Plains tribes that needs monitoring, and services addressing youth suicide and reproductive health are also facing uncertainty.

Bipartisan letter addresses repercussions of HHS cuts

In a joint letter sent this week, senators Murkowski and Schatz wrote to Secretary Kennedy about the effects the layoffs, freezes and reorganization have already had on Native people.

“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 letter also urges Kennedy to honor the federal trust responsibility between the U.S. government and tribal governments “by engaging in meaningful consultation and ensuring that the Department’s (Reduction in Force) and Reorganization efforts do not undermine the critical services and support Native communities’ health care needs.”

A place at the table

One refrain during the nearly two-hour hearing was how the Trump administration failed to seek tribal input before implementing actions that affected tribes.

Echoing Murkowski and Alkire, Lori Greninger, vice chair of the Jamestown S’Klallam Tribal Council in Washington state, lamented the lack of engagement. She said staffing cuts have affected her work as chair of the Administration for Children and Families’ Tribal Advisory Committee, leaving less-experienced people to deal with more work.

“In almost every situation, tribal nations found out about these changes after the fact, usually in the media, well after the decisions had been made,” Greninger testified. “While I and many other tribal leaders can appreciate your desire to improve the effectiveness and efficiency of the federal government, something that is important to tribal leadership too, respecting the nation-to-nation relationship requires adherence to formal government-to-government protocols, which begin with consultation before decisions are made that impact our communities.”

Melissa Charlie, executive director of the non-profit Fairbanks Native Association in Alaska (FNA), told the committee that the HHS supports her organization through the program areas of community services, behavioral health services and early childhood development.

“Our Head Start and Early Head Start programs are a strong example of how Alaska Native culture is thoughtfully woven into early childhood education,” Charlie testified. “Our children are introduced to our Native languages throughout these programs through songs, simple phrases and greetings. Elders and cultural bearers are regularly invited to share traditional stories, legends and oral histories, passing down intergenerational knowledge.”

Charlie also said how Title VI funding through the Older Americans Act provides “critical nutrition” for 362 elders and caregivers in the FNA program. The program serves 800 hot lunches a month in a designated critical need area in Fairbanks. A 2022 FNA survey showed that 57% of elders often could not afford a balanced meal.

A matter of life and death

Sheri-Ann Daniels, CEO for the non-profit community health organization Papa Ola Lōkahi in Honolulu, gave an extensive summary of how the Trump administration’s executive orders have already disrupted operations and services. Besides putting $12 million of current and pending funding at risk, a two-decades-old National Institute of Health grant for $208,000 per year that supports a longitudinal study on diabetes has been eliminated, as well as a $270,000 annual grant for minority health training.

Daniels also talked about the Missing and Murdered Native Hawaiian Women and Girls issue, saying over a quarter of missing girls in Hawaii are Native Hawaiian and that the state has the eighth highest rate of missing persons per capita in the nation, with 7.5 missing people per 100,000 residents. In 2021, the Missing Child Center-Hawaii assisted authorities with 376 recoveries of missing children, though the cases comprise only 19% of the estimated 2,000 cases of missing children in Hawaii each year.

“Continued collective, systemic and community-based efforts are needed to address MMINHWG issues,” stated Daniels.

Lucy Simpson, executive director of the National Indigenous Women’s Resource Center based in Lame Deer, Montana, shared similar concerns. She said many protection services for Native people who’ve suffered sexual violence and intimate partner abuse are funded just enough to have one full-time victims’ advocate.

Family Violence Prevention and Services Act funding is often the only lifeline preventing Native survivors from falling through the cracks, she said, adding, “Since 2011, we have responded to nearly 15,000 requests for technical assistance, hosted more than 700 trainings and community engagement sessions, trained close to 100,000 individuals and distributed more than 800,000 resources to support survivors, advocates and programs nationwide.”

Simpson said that her organization’s digital resources have been accessed more than six million times, “a clear indication of both the reach and ongoing need for culturally specific, Native-led solutions.”

Most who spoke at the hearing said they perceived Secretary Kennedy as a receptive person, who had previously expressed a strong interest in bettering the livelihood of Native Americans. Murkowski said Kennedy was absent at the hearing because he was scheduled for two other hearings before Congress. She said that the concerns expressed would be shared with him later.

All of those testifying from Indian Country reminded those present that the United States has a federal trust responsibility with tribes, a legal obligation that serves to support and uphold conditions outlined in treaties and other agreements.