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Eastern Shoshone Tribe Considers Taking Over IHS Clinic Management

Indian Health Service (IHS)

The Eastern Shoshone Tribe is looking at taking over management of a federally-operated health clinic in Fort Washakie.

The tribe has a treaty right to government-provided healthcare. But tribal leaders say that high staff turnover at the Fort Washakie Health Center, combined with a lack of local oversight, is preventing the facility from meeting tribal members' medical needs.

"I believe the last check at the Fort Washakie clinic, there were 26 vacancies," Eastern Shoshone Business Councilwoman Karen Snyder said. "That's an astounding number when you look at empty seats and people not performing their duties."

Under Section 638 of the Indian Self Determination Act of 1975, government agencies like the Indian Health Service can enter into contracts with federally recognized tribes and allow them to manage funding for their own programs.

During a meeting with federal Indian Health Service (IHS) officials last month, Snyder said she and former Business Council Co-Chairman Leslie Shakespeare discussed applying for a self-determination contract to assume management of the Fort Washakie clinic.

Snyder said that arrangement would allow tribal leaders to respond directly to staffing issues at the Fort Washakie clinic and other community healthcare needs. For example, it might give them the flexibility to hire a full time, dedicated pediatrician to serve the 60 percent of tribal members who are under the age of 18.

"I think if we can start doing prevention as opposed to being reactionary - because that's, to me, typically how the Indian Health Service has operated - we'd be going in the right direction," Snyder said.

In a statement provided to Wyoming Public Radio, IHS's Director of Tribal Self-Governance Jennifer Cooper said the Eastern Shoshone Tribe will be subject to a vetting process if it chooses to pursue a self-determination contract.

"Once a tribe notifies IHS of its desire to participate in the Tribal Self-Governance Program, there is an eligibility criteria that they must satisfy including submitting a formal request for participation in the program, successfully completing a planning phase and demonstrating financial stability and financial management capability," Cooper said.

The tribe currently operates several programs, including part of the Eastern Shoshone Tribal Health Program, through self-determination contracts. Snyder said that those programs have been successful and that the Business Council will take that into account while it considers applying to manage the clinic.

"You hear a lot of pros and cons in Indian County, with tribes that have been very successful and other tribes that have had failures," Snyder said. "So what this period of time does is give us an opportunity to really look at the details and evaluate whether the tribe is ready to take that on."

Have a question about this story? Contact the reporter, Savannah Maher, at smaher4@uwyo.edu.

Savannah comes to Wyoming Public Media from NPR’s midday show Here & Now, where her work explored everything from Native peoples’ fraught relationship with American elections to the erosion of press freedoms for tribal media outlets. A proud citizen of the Mashpee Wampanoag tribe, she’s excited to get to know the people of the Wind River reservation and dig into the stories that matter to them.
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