Finding and retaining qualified doctors, nurses, teachers and cops to serve in Native American communities is hard enough.
A federal hiring freeze will make the situation worse and is breaking the federal government’s trust responsibility to tribes, a group of Democratic senators said in a letter this week to President Donald J. Trump.
Sen. Tom Udall, ranking Democrat on the Senate Committee on Indian Affairs, and six other senators asked the president to exempt health, education and law enforcement jobs in Indian Country from the federal hiring freeze.
“Even before the hiring freeze was announced, Federal agencies that provide these services were struggling to recruit and retain a qualified workforce, with personnel vacancies consistently cited by the Government Accountability Office and agency inspectors general as a major factor in the lack of essential and basic services for Native peoples,” the letter said.
The other senators who signed the letter were Maria Cantwell, D-Wash.; Jon Tester, D-Mont.; Al Franken, D-Minn.; Brian Schatz, D-Hawaii; Heidi Heitkamp, D-N.D.; and Catherine Cortez Masto, D-Nev.
Trump issued a broad hiring freeze for federal government just three days after his inauguration. Under the president’s directive, positions vacant after 12 p.m. Jan. 22 are to remain unfilled until further notice and no new positions can be created except for military personnel, the U.S. Postal Service, some seasonal employees and those positions needed for national security and public safety.
Agencies providing services specific to tribes were not exempted, but health care professionals with the Commissioned Corps of the U.S. Public Health Service can fill some positions. It was unclear how many Indian Health Service positions could be filled through the Public Health Service.
The Indian Health Service serves 2.2 million American Indians and Alaska Natives in 36 states through clinics and hospitals. The vacancy rate at those facilities hovers around 20 percent for doctors, nurses and other clinical providers, according to the senators’ letter.
The Albuquerque service area of the Indian Health Service, or IHS, provides health care to 86,000 Native American patients from 27 pueblos and tribes across four states. The IHS Albuquerque area has four hospitals, 12 health centers, six health stations, two urban Indian programs, one dental center and one regional residential treatment center.
As of Thursday, the IHS Albuquerque service area had openings for 78 nurses and 49 doctors, according to the USA Jobs federal website. The Albuquerque area IHS office listed 41 openings for pharmacists and 20 for dentists as of October.
The Navajo IHS service area had 1,100 unfilled positions for doctors, nurses, nurse practioners and pharmacists as of October, according to an agency briefing report.
“The federal hiring process is already very complicated, and often takes longer than your local hospital or clinic,” said Emily A. Haozous, an associate professor at the University of New Mexico School of Nursing and head of the school’s doctoral program. “The federal hiring freeze will result in a loss of qualified, dedicated people who would have otherwise taken those jobs because they wanted to specifically work at IHS.”
IHS referred questions to the White House. The White House did not reply to emails sent Friday morning requesting comment. Officials with the Eight Northern Pueblos Council declined to comment on the potential impacts of the federal hiring freeze.
Haozous, who is Chiricahua Warm Springs Fort Sill Apache, was part of a team that issued a report in 2016 on the long underfunded IHS hospital in Santa Fe and the health impacts on Native Americans in Santa Fe County.
Haozous said it is tough to attract health care professionals to any rural areas, including facilities serving tribes. On top of that, “working for IHS isn’t always a glamorous job. Clinicians and staff must tolerate outdated equipment and facilities, many are already understaffed,” she said. “This means these sites are already working at a deficit, and this ultimately impacts patient care, morale and retention. A hiring freeze could have dire consequences for these facilities.”
The senators also asked the president to exempt open job positions at the Bureau of Indian Education, which is responsible for educating 48,000 Native American children through 183 schools. The bureau had 100 vacancies nationwide in January. There were 21 bureau job openings in New Mexico alone, eight of those were teaching positions.
When it comes to health, Native Americans often prefer IHS clinics even if they have private insurance and can go elsewhere, Haozous said, at least partly for political reasons. Native people see health care as “a treaty-obligated right for which we gave up our land,” she said. The IHS was initially set up under Article 1 of the U.S. Constitution.
And while the Affordable Care Act helped insure more Native Americans, about 24 percent still lack health insurance, Haozous said. They are part of what she calls the “doughnut” group, people who don’t qualify for Medicaid but can’t afford health insurance. If they can’t get services at IHS clinics, they may not be able to afford health care elsewhere.
Kathryn Harris Tijerina, an attorney and former president of the Institute of American Indian Arts in Santa Fe, said the effects of the federal hiring freeze are just another example of actions by a new president with negative impacts on tribes. “I’m not sure if there’s ever been an administration, regardless of party, who truly understands the trust responsibility,” said Tijerina, who is Comanche. “Very few people in the United States are educated about treaty rights and tribal government. You don’t get it in public schools and you don’t get it in most law schools. You certainly don’t get it in popular culture.”
Tijerina said Native people already live under more regulations and codes than any other group of Americans. “So Indians, as individuals as well as tribes, have to manage an unmanageable situation. When there are hiring freezes or any other federal action that doesn’t take into account those federal laws and codes then we get into a triple bind.”
The United States’ trust responsibilities to tribes — such as federally funded health care — aren’t about privilege, Tijerina said. “Really it is just about property rights,” she said. “If you buy a refrigerator, you expect to pay for it. The U.S. obtained a huge amount of land from Indian people. In exchange they agreed to provide certain services. If you don’t believe in paying for the property, then please return it.”
Contact Staci Matlock at 505-986-3055 or email@example.com. Follow her on Twitter @StaciMatlock.