Minority and Multicultural Health - Tribal Government Grants
LPH Block Grants
The Local Public Health Block Grant for Tribal Governments was designated for tribal governments and must be used to continue programs or activities currently funded. This money cannot be used to take the place of other funding for other organization and community activities. Three categorical grants were combined to create the Local Public Health Block Grant for Tribal Governments. These three categorical grants were, Temporary Assistance for Needy Families (TANF), Maternal Child Health (MCH) and Eliminating Health Disparities Initiative (EHDI). Each of these categorical funding sources will retain some specific requirements even though they have been consolidated into a block grant. For this reason, tribal governments will receive their block grant funding with specific portions earmarked for use on health priority topics approved for each categorical funding source. Categorical funding sources are described in greater detail below.
TANF (Temporary Assistance for Needy Families) Home Visiting Program for Tribal Governments
In the 2002-03 legislative session TANF funds were included in the Local Public Health Block Grant dollars and distributed to the tribes along with EHDI and MCH programs. During the 2007 session, additional funds were allocated to the tribes to address TANF home visiting. These funds became available to the tribes in July of 2007 and were distributed based on a formula which included Indian Health Services statistics reported by the tribes and were developed with input from ten tribal health directors.
All agencies including schools, social services, corrections, chemical health, and environmental health on the reservations have been included as potential partners in this initiative. With these partnerships, creative strategies can be used when looking at home visiting and how to best serve the American Indian population. On reservations, many of the various agencies serve as multi purpose resources so this new program validates their current collaborations. In addition, the opportunity is there to address many of the obstacles that confront the tribes. For example, communities within each reservation are located in remote areas, therefore lack of access to resources are common on most reservations due to transportation issues. Unique home environments can also be challenging for home visiting services so these services may not be consistent as needed.
In recent years, tribal members moving back and forth from reservations did not have continuity of services and therefore lacked good health care. With this TANF home visiting initiative, uninterrupted resources can and will be provided as people move from one service area to another. Each reservation has issues that are specific to their region. Statistics have shown that certain health issues can be more prevalent in one region over another so it is important to allow for each reservation to identify their individual needs. Culturally appropriate activities will be most effective in their community and will be determined by the tribe. American Indian communities hire staff members from the community they serve, whenever possible, as they best understand the needs in that community.
This initiative offers the opportunity to use paraprofessionals to provide services under the guidance of public health nursing. Most tribes employ health care representatives to serve the community members, however they can now partner with the Community Health Worker project and receive appropriate training to become certified. This is a project that will provide additional resources to all tribes. Each agency serves a different population of people and now, all potential clients are given information that otherwise might not have known about before the collaborative.
The Office of Minority and Multicultural Health will be developing a training component for the tribes to ensure they receive the latest information on home visiting activities and other areas necessary for the success of this new initiative. Trainings will include all areas of concern on home visiting as identified by tribal staff and grant administrator. Currently, the trainings identified by tribal staff include infant and children mental health, obesity, special needs and developmental health, safety and assessment, nutrition, and prevention. Other trainings will be provided as needs are identified. An outside consultant will be hired to coordinate the training and the evaluation component of the TANF Home Visiting grant.
Maternal & Child Health
Maternal Child Health was included in the block grant and specifically addresses the highest risk population by providing services, including pre-pregnancy family planning services that are calculated to produce measurable decreases in infant mortality rates,
instances of children with low birth weight and medical complications associated with pregnancy and child birth, including infant mortality, low birth weight, and medical complications arising from chemical abuse by a mother during pregnancy.
The target population is pregnant women whose age, medical condition, maternal history or chemical abuse substantially increases the likelihood of complications associated with pregnancy and childbirth or the birth of a child with an illness, disability, or special medical needs. In addition, this program addresses the health needs of young children who have or are likely to have a chronic disease or disability or special medical needs, including physical, neurological, emotional, and developmental problems that arise from chemical abuse by a mother during pregnancy.
Family planning and preventative medical care for specifically identified target populations, such as minority and low-income teenagers will be one of the focuses in a manner calculated to decrease the occurrence of inappropriate pregnancy and minimize the risk of complications associated with pregnancy and childbirth. The program will also address the frequency and severity of childhood and adolescent health issues, including injuries in high risk target populations by providing services calculated to produce measurable decreases in mortality and morbidity.
Several other potential areas to address include:
- preventing child abuse and neglect,
- reducing juvenile delinquency,
- promoting positive parenting and resiliency in children,
- promoting family health and economic sufficiency through public health nurse home visits, and addressing nutritional issues of women, infants and young children through WIC clinic services.
Elimination Health Disparities Initiative (EHDI)
The Eliminating Health Disparities Initiative awarded grants to the tribal governments for the purpose of eliminating the health disparities that exist on Minnesota reservations. Eight areas were identified as necessary to address:
- Breast and cervical cancer
- Cardiovascular disease
- HIV/AIDS and STIs
- Infant mortality
- Healthy youth development
- Violence and unintentional injury
The programs were designed by each tribe and were culturally specific to that tribe.
More information can be found on the EHDI page.
Bois Forte Reservation Tribal Council
Fond du Lac Band of Lake Superior Chippewa
Grand Portage Reservation Tribal Council
Leech Lake Band of Ojibwe
Lower Sioux Community
Mille Lacs Band of Ojibwe
Prairie Island Foundation
Red Lake Comprehensive Health Services
Upper Sioux Community
White Earth Reservation Tribal Council
For a complete list of grantees serving American Indians, see the EHDI grantees page.