Report to Congress on the Social and Economic Conditions of Native Americans U.S. Department of Health and Human Services Fiscal Years 2007 and 2008 This U.S. Department of Health and Human Services Report to Congress is in accordance with 42 U.S.C. 2992-1, to report on the social and economic conditions of American Indians, Alaska Natives, Native Hawaiians, American Samoan Natives and other Native American Pacific Islanders. Executive Summary ........................................................................................................................ 1 Health and Human Services ............................................................................................................ 3 Intradepartmental Council on Native American Affairs ................................................................. 5 Administration on Aging ................................................................................................................ 7 Administration for Children and Families .................................................................................... 36 Administration on Children, Youth and Families ..................................................................... 37 Children’s Bureau ................................................................................................................. 37 Family and Youth Services Bureau (FYSB) ......................................................................... 49 Administration for Native Americans (ANA) .......................................................................... 58 Office of Child Support Enforcement ....................................................................................... 69 Office of Community Services ................................................................................................. 71 Office of Family Assistance...................................................................................................... 88 Child Care Bureau................................................................................................................. 88 TANF Bureau...................................................................................................................... 104 Office of Head Start ................................................................................................................ 111 Agency for Healthcare Research and Quality ............................................................................. 120 Assistant Secretary for Planning and Evaluation ........................................................................ 123 Assistant Secretary for Preparedness and Response ................................................................... 125 Centers for Disease Control and Prevention ............................................................................... 127 Food and Drug Administration ................................................................................................... 163 Health Resources and Services Administration .......................................................................... 166 Indian Health Service .................................................................................................................. 174 National Institutes of Health ....................................................................................................... 239 Office for Civil Rights ................................................................................................................ 258 Office of Public Health and Science (OPHS) ............................................................................. 260 Substance Abuse And Mental Health Services Administration ................................................. 272 i Page left intentionally blank. ii EXECUTIVE SUMMARY This report contains the descriptions of Staff Divisions and Operating Divisions under the Office of the Secretary who have made a significant impact on Native Americans (Indian tribes, both federally recognized and state recognized, Alaska Natives, Native Hawaiians and Pacific Islanders located in Guam, American Samoa and the Northern Mariana Islands). The report provides data specific to awards made to Native Americans and Agency highlights of Native American projects that were impacted by HHS funding. Some of the highlights included in this report are: The Administration on Aging recognized eight exemplary Title VI programs at the FY 2008 National Forum: Alu Like, Inc., Hawaii; Karuk Tribe of California; Miami Tribe of Oklahoma; Oneida Nation of Wisconsin; Salt River Pima-Maricopa Indian Community, Arizona; Santee Sioux Nation of Nebraska; Spirit Lake Sioux Tribe, North Dakota; and Toiyabe Indian Health Project, Inc., California. Technical assistance provided by the Children’s Bureau to the Native American Community has ranged from designing and implementing Indian Child Welfare Act training modules for state and tribal welfare workers to tribal child welfare information systems. In FY 2008, the Family and Youth Services Bureau, National Runaway Switchboard reached out to tribal communities in an effort to share its “Runaway Prevention Curriculum”, presenting at native conferences and providing resources to encourage use of this tool in school and community settings. In FY 2007 and 2008, the Administration for Native Americans provided 819 instances of training and technical assistance to tribes and Native non-profit organizations. In FY 2007, under the Office of Child Support Enforcement program, the Shoalwater Bay tribe entered into an agreement with the Washington State Outreach, Education and Support Enforcement Program. This allowed the tribe to have Full Faith and Credit for child support orders issued through the tribal court. Conversely, the state assisted the tribe with cases outside the reach of the tribal court. Additionally, the tribe enforced state-ordered obligations from those who were employed by tribal enterprises through wage withholding. In July 2008, the territories participated in the annual State and Territory Child Care Administrators Meeting (STAM) that included a pre-session “State and Territory Administrators Day’ and post meeting” Territory Administrators Day.” The Office of Head Start funded tribal colleges and universities to increase the number of classroom staff with AA and BA degrees in Early Childhood Education. In FY 2007 and 2008, the Agency for Healthcare Research and Quality supported a research network of 54 primary care providers, including 21 American Indians all of whom served a largely American Indian population in Robeson County, North Carolina. The network studied disease- and tribal-specific data on such issues as diabetes prevalence and processes of care. The Assistant Secretary for Planning and Evaluation conducted a study entitled Obesity and American Indians/Alaska Natives (AI/ANs). The report of the study summarizes research findings about the prevalence, determinants, and consequences of obesity 1 among AI/ANs as well as the nature and outcomes of clinical and community-based interventions. The Assistant Secretary for Preparedness and Response reported that Dr. Elizabeth Boyd, an enrolled member of the Seneca Nation of Indians, was selected to serve on the National Biodefense Science Board (NBSB) Disaster Mental Health Subcommittee as mandated by Homeland Security Presidential Directive 21. The Centers for Disease Control and Prevention collaborated with the Tribal Leaders Diabetes Committee, as well as an indigenous author and indigenous artists, to develop “The Eagle Books,” a series of four books that teach children about diabetes prevention and healthy living. In FY 2007, the Food and Drug Administration, Office of Regulatory Affairs, Central Region (Chicago) provided food safety information (ALERT and Fight Bac) to the Oglala Sioux Tribe. FDA worked through a U.S. Public Health Service Officer to provide training to Head Start Educators at the Pine Ridge Hospital in Pine Ridge SD. In April of 2007, the Health Resources and Services Administration provided technical assistance (TA) to Cascade City-County Health Department in Great Falls, Montana. The purpose of the TA was to provide cultural sensitivity training in a region with a large AI/AN customer base seeking to increasing the ability of clinicians to provide culturally appropriate quality care. The Indian Health Service Chronic Care piloted 14 sites that led change by focusing on strategies that improved the health status of patients and populations affected by chronic conditions by adapting and implementing the IHS Chronic Care Model. Healthy Hearts, Healthy Families: The National Institutes of Health, National Heart, Lung and Blood Institute, implemented efforts to promote heart health among Filipino Americans by partnering with communities to develop culturally appropriate educational materials. In FYs 2007 and 2008, the Office of Civil Rights conducted several technical assistance and outreach activities to Native Americans on major civil rights laws such as Title VI of the Civil Rights Act of 1964 and the Americans with Disabilities Act of 1990, and the Health Insurance Portability and Accountability Act of 1996 (HIPAA). In FY 2008, Healthfinder®, a user-friendly website, ensured access toresources that target AI/AN communities. Through its collaboration with the Office of Public Health and Science’s Office of Disease Prevention and Health Promotion the Healthfinder® website http://odphp.osophs.dhhs.gov/projects