Implementing the Executive Order: HHS takes lead in developing comprehensive plan

Sep 15th, 1999 | By | Category: 11-1: 10th Anniversary Issue, Features
By Marjane Ambler

Dep. Sec. Kevin Thurm pledged to look into legislative impediments.

After spending days writing a grant proposal for serving American Indian reservations in Washington, Northwest Indian College found out that the Department of Health and Human Services (HHS) had rejected the application for rural health funds. Why? Because the HHS computers indicated that Bellingham, Wash., was in an “urban” and not a “rural” county. The college runs one of the leading tribal health programs in the nation, and its application clearly said that the college planned to serve some of the most isolated and needy people in America. However, the HHS review process rejected the application without it ever being read.

Tribal colleges are accustomed to having meaningless obstacles stand in the way of funding quality programs. That was part of the rationale behind the Executive Order that President Bill Clinton issued on Oct. 21, 1996. It directed agencies of the United States government to create new partnerships with tribal colleges and strengthen old relationships. Although the first tribal college was created more than 31 years ago, most federal departments and agencies weren’t aware that tribal colleges even existed. Executive Order 13021 was expected to result in recognition and benefits, as previous executive orders had benefited the Historically Black Colleges and Universities and the Hispanic-Serving Institutions (see TCJ, Vol. VIII, N.3, p.18 and Vol. X, N.2, p.16).

Changing bureaucracies in meaningful ways takes time, however. The White House Initiative on Tribal Colleges and Universities Initiative acts as the liaison between these 32 agencies and the 31 tribal colleges in the United States, but the bureaucratic process took 16 months before Executive Director Carrie Billy had an advisory board or any permanent staff. The Executive Order encompasses a total of 32 different agencies, each of which must develop a five-year plan for integrating tribal colleges into their programs. It’s easiest for agencies to provide internships and scholarships, but tribal colleges are looking for systemic change that puts them on equal footing with other colleges and universities

The Department of Health and Human Services stands out from the others in its efforts to develop a comprehensive five-year plan that will change the way that all HHS agencies deal with tribal colleges. Carrie Billy credits the leadership of Kevin Thurm, the U.S. deputy secretary of health and human services. The department established a work group on tribal colleges and universities in June 1997, met with tribal college presidents in February 1998, and agreed upon a conference to develop its plan. Veronica Gonzales, executive director of the American Indian Higher Education Consortium (AIHEC), said, “If each federal department took this kind of approach, the colleges’ capacity for serving their communities would be significantly enhanced.”

The conference in Phoenix last January brought tribal college presidents and top officials of the department together to find common ground for the department’s five-year plan. The conference was planned by staff of HHS and AIHEC. In theory, the missions of HHS agencies seem a natural match with tribal colleges’ work. HHS agencies address Indian health and well being through diverse programs such as Indian Health Service hospitals and clinics, National Institutes of Health minority research, Head Start, Temporary Assistance to Needy Families (welfare), Indian child welfare, substance abuse, and services for the elderly. The administration has committed itself to eliminating health disparities in the United States (see the HHS website,

Tribal colleges and universities serve communities with some of most serious health problems in the United States. They promote community health, train new health professionals and drug counselors, provide child care services, train Head Start employees, and research community health (see TCJ issue on medicine, Vol. 5, N.3).

However, institutional barriers and misunderstandings, such as the “rural” county problem alluded to above, stood in the way of cooperation between HHS agencies and tribal colleges for years. The conference in Phoenix provided a platform to help overcome those barriers and fill in the information gaps. For example, college presidents expressed their feelings that HHS grant guidelines seemed designed to exclude tribal colleges. “You may want innovation, but we need core support,” said Little Big Horn College president Dr. Janine Pease-Pretty on Top. Salish Kootenai College (SKC) President Dr. Joe McDonald compared the tribal colleges to desert flowers. “We bloom on very little moisture and hang in there.” The colleges cannot survive forever without moisture, however. SKC Vice President Gerald Slater said the nationally recognized nursing program at their college could fold if it didn’t get core support. “We can’t sustain it at a cost of $3,000 per student.”

“When we apply for discretionary grants, comments (by reviewers) are so off the wall that they discourage us,” Pease-Pretty on Top said. She recommended that the agency find grant application readers and program officers who are more sensitive to American Indian reservation conditions.

The isolation and poverty that create health and human services problems inadvertently became obstacles to resolving them. The Third World conditions on the reservations were difficult to fathom from the Washington beltway. “You can’t just look at the number of people served by a program,” Dull Knife Memorial College Vice President Judith Davis explained at the conference. “There are more people working in a federal building in Washington, D.C., than live in any community in southeast Montana,” she said. Dull Knife Memorial College turns down faculty from all over the world because the college has no housing to offer them.

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