Gov. Paul LePage’s administration says it will restore state funds that the four federally recognized Native American tribes in Maine were using to plan an expansion of addiction treatment and mental health care.
The decision from the Maine Center for Disease Control and Prevention came nearly three months after the state agency cut off the last remaining direct investment of state funds in the tribes’ local efforts to improve public health. It followed a Sept. 11 BDN Maine Focus article that detailed the funding situation and the collapse of a range of collaborative, tribal-state public health efforts in recent years.
“I’m pleased that they’ve decided to do this. I think that’s a good decision,” said Clarissa Sabattis, chief of the Houlton Band of Maliseet Indians. “I hope that, in the future, we can have conversations if there are issues that come up.”
State law designates nine public health districts covering different regions of the state. One of those districts encompasses the five tribal communities in Aroostook, Washington and Penobscot counties, and the tribes’ approximately 10,000 members.
The law also provides for tribal government employees to serve as full-time liaisons between the state and the tribal public health district. Historically the Maine CDC has funded those positions through a contract.
The CDC funded two tribal liaison positions until the summer of 2016, when the state reduced the amount of public health funding for the tribes by more than half. The funding for the one remaining liaison ended June 30 of this year when the state didn’t renew the contract, leaving the tribal public health district as the only district in the state without a liaison.
It had been the last remaining, direct state investment in the tribes’ public health improvement efforts.
The liaisons were responsible for educating tribal communities about chronic disease prevention and management, representing the tribes on a range of state health boards and committees, and coordinating community efforts to improve tribal members’ health.
Compared with Maine’s population, tribal members face higher rates of diabetes, obesity and high blood pressure; they have markedly higher smoking and heavy drinking rates; and they have lower life expectancy.
Before funding ended on June 30 for the tribal liaison, the council that oversees the tribal public health district had begun working on plans to expand culturally sensitive addiction treatment services. Council members from the four tribes signed a resolution agreeing to pursue the development of a treatment center, and they met with treatment experts and with federal officials to discuss funding.
Kristi Ricker, the tribal public health liaison, coordinated those efforts, but Ricker lost her job when the funding for her position ended.
Ricker welcomed the reinstatement of funding, but she said public health efforts have been set back because of the three months during which the tribes had no state public health funding.
“I think it’s going to take a while for that momentum to build back up again, but I think there’s definitely still a need for that, and they recognize that,” she said.
In a Sept. 20 letter, Maine CDC Chief Operating Officer Sheryl Peavey informed Sabattis, the Houlton Band of Maliseets chief, that the CDC intended to reinstate funding for the liaison position on Oct. 1. The funding would last for a year, until Sept. 30, 2018, the letter stated.
“Thank you for contacting me and sharing your concerns,” Peavey’s letter read.
In June, Sabattis met with LePage to discuss the CDC’s plans at that point to end funding for the tribal public health liaison and instead hire a state employee to fulfill the liaison’s duties — even though a 2011 state law specifies that liaisons to the tribal public health district “are tribal employees.”
After her meeting with LePage, Sabattis said, she heard no information from state officials in response to her follow-up communications. Even when the state’s funding for Ricker’s position ended, the CDC sent no notification to tribal officials, though a CDC employee requested in mid-August that Ricker return her state-issued computer.
Sabattis said Monday she was still waiting to see contract documents from the state to confirm that the amount of funding and contract terms would remain the same.
Ricker, a nurse who has begun working at Acadia Hospital in Bangor since her liaison work ended, said she would consider applying for the liaison position depending on how the Penobscot Indian Nation, the tribe that officially holds the contract, goes about filling the position.
Penobscot Nation Chief Kirk Francis wasn’t available for comment Tuesday. A CDC spokeswoman didn’t respond to several questions from the BDN about the contract terms, the funding source and how the agency had found money in its budget to fund the liaison position.
Earlier this month, the CDC cited public health funding cuts included in the two-year state budget that took effect July 1 as one reason for ending the tribal public health contract.
Maine Focus is a journalism and community engagement initiative at the Bangor Daily News. Questions? Write to firstname.lastname@example.org.