Kaiser Health News: Little Shell Tribe prepares for healthcare milestone

The small Shell Tribe of Chippewa Indians became the 574th federally recognized Indian nation in December 2020. Photo: Senator Jon Tester (D-Montana)

‘Heart’ of Little Shell: New Federally Recognized Tribe Opens First Clinic

The Little Shell Tribal Health Clinic is set to open in Great Falls on Jan. 31, about two years after the tribal nation won its long-sought federal recognition.

Friday, January 21, 2022

By Katheryn Houghton

Kaiser Health News

GREAT FALLS, Montana — Louella Fredrickson has long created workarounds to fill gaps in the unequal medical care she had as a member of the small Shell Tribe of Chippewa Indians in Montana. The 86-year-old uses reading glasses from a dollar store to improve her blurry vision because she worries about the cost of an eye appointment. And when she needed hearing aids, she was told it would cost her over $1,300. So Fredrickson asked a doctor to modify her husband’s old pair to fit his small ears. “My husband had only used them a few months before he died, so they work well,” Fredrickson said. But one thing she hasn’t figured out is the 200-mile round trip from her home in Great Falls to the nearest Indian Health Service clinic that offers such services to tribal members free of charge. Soon, however, getting care will be easier for Fredrickson and the other Little Shell members living in and around Great Falls. The Little Shell Tribal Health Clinic is set to open in the town of about 60,000 on Jan. 31, about two years after the tribal nation won its long-sought federal recognition. For the first time, Little Shell members will have guaranteed access to healthcare services and see their culture reflected in the offerings. The brick-and-mortar center is a powerful symbol for a tribe that has no reservations, especially given the clinic’s focus on providing care to people who have faced health barriers. long standing that the pandemic has underlined. The building is a concrete example of what Little Shell can become, said tribal member Darrel Rummel, 81. “The clinic is going to be the heart of everything.” Little Shell became the 574th federally recognized Native tribe in the United States in December 2019, approximately 150 years after Little Shell leaders began advocating for the tribe to be recognized as a sovereign nation. This recognition came just months before the covid-19 pandemic took hold and disproportionately killed Indigenous peoples due to entrenched structural inequalities in health. Of the nearly 2,800 Montanans who died Dec. 3 from covid complications, 12% identified as Native American. Indigenous people make up about 7% of the state’s total population. Amid the health crisis, the Little Shell Tribe used federal pandemic relief funds to expedite the opening of its clinic. It will provide primary and behavioral health care, as well as dental, vision, pharmaceutical, laboratory and radiology services. The tribe has had free access to Indian Health Services clinics throughout the state since Montana recognized it as a tribal nation in 2000. But those clinics can be scattered far and wide, and even then, medical services vary. Little Shell members said their access has waned as health facility budgets have tightened and clinics have to prioritize care for tribal members affiliated with local reservations.

Molly Wendland, director of tribal health at Little Shell, said the new clinic, initially run by the Indian Health Service, will be open to any member of a tribal nation and the tribe hopes to eventually expand services to n’ anyone else after taking over daily. operations. IHS will oversee it for at least three years. “Having our community and our members healthy means we have a healthy tribe,” she said. “I wanted this clinic to be comfortable and something new and enjoyable. Our members deserve it. Recently, Wendland smiled as he pointed to the word boozhoo at the entrance to the clinic, greeting people with the Ojibwe word, which means “greetings.” Inside above the front desk is a massive image of Ayabe-Way-We-Tung, also known as Chief Little Shell III, who began lobbying the US government for a reservation in 1872. Historic photos of the people of Little Shell are displayed nearby. Lines of gray and burnt orange take the form of abstract teepees along the walls and floors of the clinic. Plaques, designed with the help of language students from the tribe, name clinic rooms after animals in Ojibway, like waagosh next to its English translation, “fox.” For the rooms Wendland calls “chat rooms,” two chairs face each other instead of an exam table and doctor’s stool, which she says lends itself more to conversation between the patient and provider. “It really narrows that power differential,” she said. Upstairs is a small apartment, which Wendland hopes will serve as a place to stay for visiting doctors when they come to provide additional services, such as fitting hearing aids. Another room on the ground floor is the Purification Room, where patients can burn plants such as sage in a ceremony to purify a person or place. “It’s a place to pray and just for families to catch their breath,” Wendland said. “If people have to travel, I want everything they need to be here.” Little Shell’s headquarters are in Great Falls, although many members are scattered throughout Montana, Washington and beyond. The tribe always tries to set up hiking programs for its members who live in rural Montana. But for tribal members in central Montana, the opening of the clinic will be an immediate benefit. Sherlie Bolich, 76, of Great Falls, said she had sometimes waited for services amid patient backlogs at facilities in other tribes. When Bolich’s children were in high school, she changed jobs for more flexible hours to take her children on the four-hour round trip to a clinic in Browning. Years later, she made those same trips when her aging mother needed more frequent medical attention. Even then, Bolich said, Indian Health Service clinics felt like safe spaces because Indigenous peoples are the minority elsewhere, and health service costs outside of the federal health service can exceed paychecks. pays – even with insurance. Yet now she is thrilled to have something closer, something for her tribe. “With the clinic here, you feel like you have someone here watching over your people and all of us,” Bolich said. “My grandchildren will be able to come in and see someone right away.”

Rummel, a member of Little Shell, has also long traveled beyond Great Falls to places such as Browning for treatment. Since last fall she has had dizziness which can make it difficult to stand up and said she was told she would have to wait until spring to see a doctor. At the recent Little Shell Clinic Open Day, Rummel said she wore a pair of pearl earrings and a traditional ribbon skirt, with pink, blue, purple, yellow and white ribbons wrapped horizontally just above his moccasins. She is proud to see her tribal nation reflected on the walls of the new clinic. Like many members of Little Shell, Rummel said, she grew up in a predominantly non-Indigenous culture and is still working to learn the traditions of her people. She immediately noticed the Ojibwa words printed on the doors and walls of the clinic – the first time she had seen her tribe’s language in a permanent place. “I was so impressed with it that I thought, ‘This is going to help us learn our language,'” Rummel said.

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Katheryn Houghton is Kaiser Health News’ correspondent in Montana. She owes her start in health reporting to years in daily newsrooms, including those of the Bozeman Daily Chronicle and the Daily Inter Lake. She was a Fellow of the Association of Health Care Journalists and a Fellow of the Solutions Journalism Network. She graduated from the University of Montana. She can be contacted at [email protected] Find it on Twitter @K_Hought.

Note: The story originally appeared on Kaiser Health News (KHN), a national health policy news service. KHN is an independent editorial program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

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