'We’ve got to take ownership of what’s going on'Meeting with Indian Health Service focuses on treatment options
By Kevin Abourezk
@Kevin_Abourezk SIOUX CITY, Iowa – Krystal is 29, has three children and is homeless. Last year, Krystal was drinking a lot and living on the streets when she was sexually assaulted. Her tribal beliefs prevented her from aborting the baby that resulted from the assault. In November, she gave birth to a girl. “I didn’t report the rape,” she said. “I didn’t kill the baby. She’s alive right now. She’s in the next room.” She now lives at Jackson Recovery Centers' Women and Children’s Center in Sioux City, with her baby. They aren't alone. With more than 30 rooms, the center is typically full, said Mandy Oetken, the manager of the women's recovery program at Jackson. Last week, more than a dozen federal, state and local leaders toured Jackson to learn more about the services it provides to Native people. They want to understand what gaps exist for Native people who are homeless and addicted to drugs and alcohol in Sioux City, a crossroads for tribal people from around South Dakota, Nebraska and Iowa. And they are considering ways to help the city’s homeless Native people.
Frank LaMere, director of the Four Directions Community Center, said he would like to see a treatment center built for Native people in Sioux City. “If we want to change things, we’ve got to take ownership of what’s going on here,” he said. The Siouxland Street Project hosted a conference last week for several Indian Health Service officials, Sioux City leaders and Rep. Steve King (R-Iowa) to discuss the need for a detoxification center in Sioux City. Among those IHS officials who attended the meeting were Emily Williams, behavioral health director for the Great Plains Area, and Dr. Joel Beckstead, acting director of the IHS Division of Behavioral Health. In 2017, more than 1,200 people were admitted to Sioux City hospitals needing medical detox services. In that same year, 52 percent of those arrested for public intoxication were Native American. Chris McGowan, president of the Siouxland Chamber of Commerce, said the business community understands the need for additional services for Native people. “The business community will support this financially,” he said of the detox center idea. Gerardo Hernandez, community benefit outreach coordinator for Mercy Medical Center in Sioux City, said his hospital encountered 3,400 homeless people, mostly Natives, in fiscal year 2017. He said a detox center would save the city’s health care industry money by helping homeless people get sober before they get sick and have to go to the hospital. “It’s costing a ton of money,” he said. “We’re being terrible stewards of our money.”
Beckstead said in order to help Natives get sober it would be important to address issues of emotional trauma, including historical trauma suffered by indigenous people. King said while a detox center would help address the problem of homelessness among Native people, more services are needed to help Native people lift themselves out of poverty and substance abuse. “I don’t think that we should be thinking that a detox center solves this,” he said. “The substance abuse is the symptom.” LaMere questioned the IHS officials who attended last week’s meeting about why a treatment center for Native people was closed down in Sioux City in 2007. Williams said the program wasn’t compliant with state and federal health and safety standards. The program lost its state certification, and then IHS cut funding for it, she said. The funds for the program were later diverted to two other programs – the Nebraska and South Dakota urban Indian health coalitions. Eventually, the funding was diverted to Jackson Recovery Centers in Sioux City and was meant to be used for assessments for Native people and treatment at an urban Indian program in Omaha, Williams said.
LaMere said IHS’s decision to end funding for the Sioux City treatment program meant Native people struggling with addiction have had nowhere to turn for more than a decade. “You made a whole lot of decisions for us, and I don’t think they were the right decisions,” he said. Asked whether IHS could fund a treatment program for Natives in Sioux City, Beckstead said Congress decides how to appropriate IHS funds. Williams said it was unlikely Sioux City would be able to get back the funding it lost when the Native treatment program closed there in 2007. Dave Drew, Woodbury County sheriff, said the city likely would have to depend on private donations to build the detox center. Krystal, the homeless young Native mother, said it’s difficult to stay sober when you’re homeless and often programs in Sioux City won’t provide housing to homeless people. She said her son has had to undergo therapy in order to deal with his own stress. “I fail him as a parent by relapsing,” she said.