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$17.1 million grant to Calif. Indian health board

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SACRAMENTO, Calif. - The federal Department of Health and Human Services
(HHS) has given a $17.1 million grant over the next three years to the
California Rural Indian Health Board (CRIHB) for drug abuse evaluations and
treatments.

The grant was announced at a ceremony at CRIHB headquarters on Aug. 30 and
was given through the Substance Abuse and Mental Health Services
Administration (SAMHSA) as one of 14 grants to various programs across the
United States.

Specifically, the grant is intended to not supplant any state or federal
cuts and is supposed to fund the new program.

Essentially the way the grant will work is that CRIHB, which administers
rural Indian health throughout California, will be able to dispense funds
for substance abuse through federal vouchers. HHS and CRIHB officials said
that ideally the requests will be made primarily through a family doctor to
those requesting help for substance abuse problems.

"This program is unique because it is a client-driven program," said SAMSHA
Administrator Charles G. Curie, who traveled from Washington, D.C. to
participate in the announcement.

Once help is requested a voucher will be issued so that a certified state
counselor can issue an evaluation and decide what course of treatment is
necessary to best suit that patient's need.

"What's nice about this program is that it provides the client the
opportunity to seek the right kind of care," said Deborah Carter, a
psychologist and CRIHB behavior health consultant.

HHS estimates that some 88,000 California Indians are grappling with
substance abuse problems and that Indians in general suffer addiction rates
about four times the national average.

Curie said that the providers of the care will be asked, in return for
receiving vouchers, to track the progress of individual patients through
the recovery process.

Curie added that statistics will be kept to track the level of success for
those who go through the treatment program and that a series of specific
areas will be tracked including whether the patients get access to needed
services; lack of involvement in criminal activity and their success with
employment and housing.

In keeping with the general goals of the Bush administration, Curie also
reported the main tenets of this program are to give consumers a choice and
expand the list of providers including so-called faith-based providers,
which is potentially one of the most controversial elements of this plan.

Faith-based providers, which are part of the larger Bush agenda of
faith-based initiatives, which expanded on a government aid program to
religious charitable organizations that was started under President Clinton
in 1996, have come under fire from critics.

Though the White House claims to not keep statistics on which particular
denominations and religions receive money, the PBS television show
Frontline claimed in a report earlier this year that at least a
disproportionate amount has gone to Christian organizations.

However, such criticism is disregarded by CHRIB Director of Family and
Community Health Michael D. Weakhee who said that the CRIHB program is
consistent with American Indian tradition of including faith as part of a
recovery program.

"Every one of our initiatives is faith-based as well," said Weakhee.

HHS literature on the grant said that the program will "allow patients to
select among Indian and non-Indian providers of services; traditional
Native spiritual and mainstream faith-based services ..."

CRIHB chairman Joseph Saulque said that at least some of the funding is a
reshuffle of money that would go to the Indian Health Service. CRIHB was
formed as an alternative to IHS after the latter organization's presence in
the state was severely diminished by the federal termination of California
Indian tribes in the 1950s.

For years rural California Indians had to see physicians through overtaxed
local and county programs. CRIHB was ultimately founded by several
California tribes in response to the void left by the IHS and the
inadequacies of the local programs. CRIHB now administers Indian health
programs statewide including a myriad of substance abuse programs.

"The tribes were empowered by taking ownership [of health clinics]," said
Saulque.

Though in recent years IHS has returned to California Saulque contends that
CRIHB has improved IHS by providing competition, and he believes that
grants such as these are proof that CRIHB can handle most of the current
health needs of California Indians and that IHS can go back to being a
program office.

Though CRIHB does offer assistance to out-of-state Indians and non-Indians,
they are typically married into member tribes of CRIHB, which as its full
name suggests addresses rural California tribes. However, the majority of
California Indians by a fairly large margin are from out-of-state tribes,
though Saulque points out that there are several urban clinics in the
state's larger cities many of whose patients are from out-of-state tribes.