On January 22, Tribal Council announced plans to operate the Little Shell Health Clinic through a process called Self-Governance.
The Tribe began working toward Self-Governance in 2020 with the purchase of the building at 425 Smelter Ave NE in Great Falls. After completing necessary renovations, the Tribe signed an agreement with IHS to provide primary care, dental, behavioral health, pharmacy, laboratory, and other outpatient clinical services at the clinic. Then the Little Shell Health Clinic (Clinic) officially opened in April 2022.
The Tribe is thankful for the services and support IHS has provided to our community over the past two years. However, the Tribe always had a desire to directly operate programs and services that are customized to the needs of its members and the community. For this reason, and after nearly a year of working closely with IHS to plan and prepare for a change, Tribal Council has requested to enter into a Self-Governance Agreement.
Below, please find a list of frequently asked questions about Self-Governance, what it might mean for the Little Shell, and how it might impact the health care services provided at the Clinic.
Your thoughts and questions are important as the Tribe prepares for this transition. Please complete the survey linked below to share your excitement, concern, and hopes about the Tribe operating the Clinic.
Self-Governance is part of the Indian Self-Determination and Education Assistance Act, which first passed in 1975. The Act recognizes that tribal leaders and members are in the best position to understand the healthcare needs and priorities of their own communities. By participating in Self-Governance, the Little Shell Tribe will become responsible for determining how we use the federal money intended to provide health care services to our tribe rather than IHS determining what’s best for us.
Right now IHS determines how the federal funding that is intended to support health care for our Tribe is used at the Clinic. Instead, under Self-Governance, the Tribe will receive that funding to manage the programs and services at the Little Shell Health Clinic. Self-Governance will give our Tribe the ability to prioritize the use of funds based on the needs of the community. This means we can design new programs, create new partnerships, recruit specialty providers, and increase access to the healthcare programs and services our community wants. Rest assured funds transferred to the Tribe will stay in the Clinic, as required under federal law.
No. The amount of funding a tribe receives is based on what Congress provides to IHS. The intent of Self-Governance is not to decrease a tribe’s federal funding but to empower them to manage those funds more effectively to best meet their needs. Did you know approximately 50% of IHS’s annual budget goes to self-governance programs?
There are more than 360 tribes that operate under Self-Governance. In Montana, two tribes operate under Self-Governance Agreements and administer their own health care programs: Confederated Salish and Kootenai Tribes and Chippewa Cree Tribe of Rocky Boy Reservation.
Yes! Self-Governance also provides the Tribe flexibility to offer services in other community settings – increasing access where it is most needed. The Tribe is already planning how to best leverage resources and provide better access to health prevention and education services.
Tribal Council has passed a resolution guaranteeing all qualified and eligible IHS employees an opportunity to continue working at the Clinic. Our hope is to retain providers and staff so that Clinic operations remain steadfast during and after the transition. The Tribe also plans to hire some new employees for key positions that are not currently filled.