A new program from the Montana Legal Services Association is boosting legal assistance to people living on the state's tribal land.

The Tribal Advocate Incubator Project gives lay people the skills they need to help Montana's underserved Indigenous population. Right now, many of Montana's Indigenous people lack legal services or the money they need to pay for them. The incubator project recruits and trains lay people from each of Montana's Indigenous communities to help tribal members who need legal assistance.

Valerie Falls Down, tribal advocacy coordinator for Montana Legal Services, who coordinates the 14-week training program, said while the lay advocates are not lawyers, they are equipped to help address some of the unique legal challenges Montana's tribal members face.

"The remote nature of Montana's seven reservations and the lack of locally available educational programs for lay advocates contribute to the shortage of qualified lay advocates in Montana's tribal communities," Falls Down explained. "It has a huge impact with all of the community members who now have access to legal services."

Seven students from each of Montana's tribal reservations recently took part in a mock trial in Billings to practice the skills they will use when they represent tribal members in their communities.

Most legal issues on the reservation wind up in tribal court.

Kathryn Seaton, supervising attorney of the tribal law practice group for Montana Legal Services, said lawyers have to be licensed to practice there. Since most are not, the program provides opportunities for local lay advocates.

"By providing education and mentorship opportunities and case referrals to people from tribal communities who want to open up their own businesses and provide legal services to low- and moderate-income people who have legal issues in tribal courts," Seaton outlined.

Falls Down spoke to the American Bar Association about the incubator project, and noted other legal aid organizations are considering replicating it elsewhere in the country.

Arizona State University has developed a new tool that they hope will help researchers analyze connections between illnesses and health determinants within Indigenous populations. The Indigenous Health Research Dashboard is an online repository of peer-reviewed, published studies that focus on medical conditions and diseases impacting Indigenous health since 2020.

Angela Gonzales, a member of the Hopi Tribe in Northern Arizona, and an ASU professor and director of the American Indian Studies Program, said it is important for her to be a part of an initiative that aims to move the needle for Indigenous health equity. She explains that she has seen firsthand the "devastating impacts" of limited access to health care in Native communities.

"By having it public available and accessible, when tribes are interested in trying to find out the latest research, for instance let's say on COVID-19 vaccinations, they have a one stop source to be able to access a lot of that information. You can search by keywords, can search by key topics, it breaks it down into regions," she said.

Gonzales added that the dashboard is what she calls 'bio-directional,' meaning it's an effort that is driven by what tribal partners have identified as major health concerns, and said the project has also allowed students to develop their research skills and learn to synthesize information. They are currently recruiting students to be a part of the team that will continue working on the initiative next year. She hopes they're able to capture a more 'holistic' and historical view of health trends and findings.

Gonzales says they're ramping up outreach efforts to ensure public health professionals and medical providers in Indigenous communities know about the useful resource. But she adds that Native communities have already expressed the need for such information.

"If you're a tribal health professional, the opportunity to do research, it takes away from your other responsibilities that are oftentimes more pressing. By having this dashboard available, they can go right to it," she continued.

Gonzales said that Indigenous health equity has been improving in recent years, but she says as an academic she hopes researchers do better to create a stronger 'knowledge bridge,' and develop resources that are use-inspired. She feels the dashboard is a step in that direction.


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The state of Washington is helping Native Americans access health care after decades of barriers.

Health insurers have made it difficult for tribal members to get care covered, despite state and federal laws that bar this.

Vicki Lowe is the executive director of the American Indian Health Commission, which has led efforts to remove hurdles for Native Americans.

She said health insurers would try to make tribal clinics charge out-of-network rates, and wouldn't honor their referrals.

However, the Washington State Office of the Insurance Commissioner has come out with guidance to prevent this.

"Not only will tribes have more money to help pay for services for their tribal members, tribal members will get care in a more timely manner," said Lowe. "So those two things just are really important, and insurance companies have been a barrier for that for decades."

Washington is among the first states to move forward with guidance for insurers and also enforcement of the law so that insurers will stop putting up roadblocks for tribal members to get care in the state.

Todd Dixon is the deputy commissioner for consumer protection and the tribal liaison for the Office of the Insurance Commissioner.

He said one reason for releasing the guidance was that the agency has seen an uptick in complaints - the number one compliant typically coming from billing managers at clinics.

"It says, 'Hey, we have an enrolled member. He or she was seen at our clinic. We billed the insurance company. They said we're out of network and so "we're only paying 60%." And then they send a bill to the enrolled member,'" said Dixon. "It's not how it works."

The Insurance Commissioner's office has been sending notices to insurers who violate protections for Native Americans.

Lowe said before they got involved, tribes fighting with insurers on their own were getting them nowhere. But it's different with the state backing them.

"Knowing that if somebody violates these laws that they're going to get that outreach from the insurance commissioner and that they have 15 days to respond," said Dixon. "Where if a tribe asked them, they would maybe not respond or respond in some convoluted way - it's a power shift to really have the state agency behind this."

A new survey of Native American teens and young adults highlights a growing preference for the term "Indigenous" rather than being referred to as "American Indian."

Researchers from the Aspen Institute's Center for Native American Youth surveyed close to 1,000 Native Americans under age 24, including a large contingent from California.

Cheyenne Runsabove, associate director of youth programs at the center, said the term "Native American" is still dominant.

"Fifty-three percent of Native youth prefer the word 'Native American,' and only 7% prefer the word 'American Indian,'" Runsabove reported. "We continue to see that 7% going down, and what we continue to see uptick is the word 'Indigenous.'"

The report, called "Center Us," also found many Native youths are apathetic toward U.S. elections and disappointed in the rate of change. It also found Native youth who feel culturally educated are four times more likely to see themselves as capable of making a difference than those who do not.

Runsabove pointed out culture is identity for Native youth and noted more than 60% of California Native youth said they feel either moderately, a lot, or a great deal culturally educated.

"Language, history, stories, connection to land, all of those things are at the core of identity for Native youth," Runsabove explained. "And so, we have to be mindful of their true cultural identities."

The survey noted big differences between young people in urban areas versus small towns and reservations, when it comes to the availability of culturally-informed health care, after-school programs and money for college.


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