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Native health contractors choose to work without pay to care for community during shutdown

"We can’t abandon them."

WASHINGTON, DC - JANUARY 10: Hundreds of federal workers and contractors rally against the partial federal government shutdown outside the headquarters of the AFL-CIO January 10, 2019 in Washington, DC. As the second-longest government shut down continues, Democrats and Republicans have not found a compromise for border security funding and President Donald Trump's proposed wall on the U.S.-Mexico border. (Photo by Chip Somodevilla/Getty Images)
WASHINGTON, DC - JANUARY 10: Hundreds of federal workers and contractors rally against the partial federal government shutdown outside the headquarters of the AFL-CIO January 10, 2019 in Washington, DC. As the second-longest government shut down continues, Democrats and Republicans have not found a compromise for border security funding and President Donald Trump's proposed wall on the U.S.-Mexico border. (Photo by Chip Somodevilla/Getty Images)

The partial government shutdown forced employees with Native American Lifelines (NAL), a nonprofit contracted by the Indian Health Service (IHS), to make an impossible decision: work without pay or be laid off. The majority of staff chose the former.

NAL employees, who provide a host of health services to Native Americans, are likely to miss a paycheck next Friday because the president won’t sign a budget deal that doesn’t include money for a border wall he said Mexico would fund. Already, an estimated 800,000 federal workers are missing today’s paycheck for the first time since the shutdown began on December 22. Many providers with IHS, an agency that offers care to nearly 2 million American Indians and Alaska Natives throughout the country, are among those who will miss paychecks on Friday, but many will continue working regardless.

The Trump administration is failing Native Americans, who negotiated treaties generations ago with the United States government, which agreed to provide health care, among other services, in exchange for large swaths of land. Yet, the partial shutdown has meant treaties have been violated and Native Americans are stepping up to help their own.

“Ninety percent of staff members are, themselves, native,” said Kerry Hawk Lessard, the executive director of NAL. “Because we are working with our people, working in our community, and come to work with long-term relationships with people…we can’t abandon them.”

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At least 75 Native Americans have come to depend on health care services offered by NAL’s Boston and Baltimore locations. An 82 year-old woman living in Boston, for instance, has come to rely on one staff worker named Janelle, who visits several times a week to help her manage her type 2 diabetes. Janelle has also been trying to help the elderly woman secure accessible housing, as she has a fractured hip and lives in a fourth floor walk-up in public housing.

It’s difficult to quantify the effects of the partial shutdown. There are many single-service folks who reach out to NAL because they need help paying for health costs, be it a doctor’s visit or drug co-pay.

The federal government already owed NAL money. The non-profit operates on a cost-reimbursement basis — meaning, for example, that it pays for a patient’s prescription drug, and then sends a voucher to IHS to get reimbursed. Before the shutdown, the government was two months behind on vouchers.

Screenshot of NAL's services
Screenshot of NAL's services

This left NAL in a precarious situation. Indeed, the board of directors decided it only had enough money to operate until Friday, Lessard first told NPR on Tuesday. The directors passed a resolution Thursday night, giving employees the option to work without pay as opposed to laying off employees.

“What is likely going to happen is we will continue to work, but services will have to be scaled back,” Lessard told ThinkProgress. She’s confident the organization will have to cut dental services until the government reopens, and be extra selective about what kind of care the non-profit pays for.

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The partial government shutdown, currently tied as the longest in U.S. history, stems from the Trump administration’s insistence to fund a border wall along the U.S.-Mexico border, which President Trump claims is essential for national security. When the president was asked about furloughed workers last week, he said, “The safety net is going to be having a strong border because we’re going to be safe.”

Lessard found Trump’s words to be insulting and insensitive.

“How out of touch are he and his family with average people? The border wall is not a safety net for any of my clients,” said Lessard — the services she provides, she says, are.

Credit: Native American LifeLines of Baltimore Facebook
Credit: Native American LifeLines of Baltimore Facebook

What’s even more offensive, Lessard added, is the notion, repeatedly perpetuated by the Trump administration, that the border wall will keep drugs out and mitigate the opioid crisis. As research shows, a border wall won’t stop the flow of drugs, since most drugs come at legal ports of entry, but the shutdown is getting in the way of treatment. NAL, for one, provides addiction treatment to Baltimore, a city that saw 761 overdose deaths in 2017 alone.

This isn’t the only blow the Trump administration has dealt Native Americans. The administration also broke with precedent last year in forcing Native Americans to meet Medicaid work requirements. The president has also repeatedly insulted Native people.