Linda Watson draped a sweater with the words 鈥淟ittle Shell Chippewa Tribe鈥� over her as she received the newly recognized tribal nation鈥檚 first dose of covid-19 vaccine.
鈥淚 wanted to show my pride in being a Little Shell member,鈥� Watson, 72, said. 鈥淭he Little Shell are doing very good things for the people.鈥�
Watson has diabetes and a heart condition. The shot brought some peace of mind during a time when that isn鈥檛 fully possible. One of her sons is among those who have died of covid.
The Little Shell Tribe of Chippewa Indians of Montana is building its health services largely from scratch roughly a year after becoming the United States鈥� 574th federally recognized Indigenous tribe. Because of the pandemic, it鈥檚 doing it on hyperdrive.
The long-sought recognition came just months before the pandemic took hold, arriving in time to guarantee the right to crucial health care and a tribal supply of protective covid vaccines. Federal pandemic relief dollars are speeding up the Little Shell Tribe鈥檚 ability to build its own clinic.
Without the CARES Act funds, Indian Health Service and Little Shell officials said it would have likely taken years using only IHS resources to establish a clinic. The IHS already has a list of new and replacement health care facility projects nationwide estimated to cost more than $14.5 billion, yet it reported in 2019 it receives roughly $240 million each year to get that work done. At that pace, it would take 60 years to get through its current needs.
Now, in Great Falls, roughly 2 miles from where Watson got her shot, a brick building under renovation bears a banner announcing the Little Shell Tribal Health Clinic: 鈥淐oming 2021.鈥� The former animal hospital site that the tribe purchased will provide medical, dental, vision and behavioral care, alongside traditional medicine, a pharmacy and a lab. The goal is to open the clinic by late summer.
When Watson drives by the future clinic鈥檚 site on her way to work as the tribal nation鈥檚 enrollment officer, she said, she feels proud.
鈥淭o have a Little Shell name on it, to see the results of what our ancestors had worked so hard for,鈥� Watson said. 鈥淚t鈥檚 their descendants that are now experiencing it.鈥�
The Little Shell have advocated for their place as a sovereign nation for more than 150 years. Although Montana formally recognized the tribe in 2000, not having federal recognition until December 2019 kept it from accessing many vital services and programs.
And without a recognized homeland, the tribe鈥檚 more than 5,700 members had scattered across Northern Plains states and Canada. The vast majority live in Montana.
Because of the federal recognition, Little Shell tribal enrollment has surged and its Ojibwe language course has a lengthening waitlist.
But this newfound strength is tempered by the deep challenges of the pandemic. The coronavirus has stalled in-person celebrations and planning in the tribe鈥檚 first year of federal recognition.
Worst yet, covid has disproportionately infected and killed Indigenous people nationwide, exposing long-standing caused by a history of colonization and underinvestment in Indian Country. In Montana, Native Americans make up roughly 7% of the population yet account for .
The Little Shell tribal health care system is so new, it doesn鈥檛 have electronic health records set up and hasn鈥檛 tracked the statistics.
In October, the tribal nation hired its first health director, who had to create a covid vaccination plan while juggling other immediate needs, such as helping establish a transportation service for members to get to doctor appointments. Setting up infrastructure for a sovereign nation without a reservation presents challenges. The tribe鈥檚 service area encompasses four counties 鈥� Blaine, Cascade, Glacier and Hill 鈥� that together would span an area larger than Maryland. Only two of those counties share a border, so the distances are even greater.
Little Shell members now have access to any IHS facility nationwide, but, until their clinic is ready, some services such as dental and vision care are far-flung even for those close to the nation鈥檚 Great Falls headquarters.
鈥淲ithout our clinic, members would have to drive 118 miles one way to get some basic services 鈥� and try doing that in January and February in Montana,鈥� Tribal Chairman Gerald Gray said.
In the meantime, the tribe is partnering with the Cascade City-County Health Department to administer about 100 vaccine doses each week, according to the tribal health department. The effort has attracted tribal members from out of state.
Many questions remain as to how the new clinic will operate. Gray said the tribe has been told IHS will operate the clinic for at least three years before the tribal nation has the chance to completely run its services. Bryce Redgrave, the Billings-area IHS director, said in a statement the agency is discussing the possibilities but 鈥渘o plan has been finalized at this time.鈥�
Little Shell leaders plan to model the clinic after an nonprofit called Southcentral Foundation that has been emulated by other tribes, including the Eastern Cherokee in North Carolina.
鈥淭he model is about treating the whole person and prioritizing Indigenous interventions,鈥� said Little Shell tribal council member Kim McKeehan.
What that looks like for the Little Shell is still being decided, said Molly Wendland, the Little Shell tribal health director. She said one idea is to grow plants for traditional medicines behind the clinic. The tribe also plans to have a smudge room, she said, in which members can burn sage and ask for healing.
Linda Wilmore, 51,聽a Little Shell member who lives in Great Falls, said the new clinic would mean she wouldn鈥檛 put off care such as going to the dentist anymore. Without an option close to home, she said, she has often waited until she鈥檚 in enough pain to warrant the three-hour round trip to an IHS health care facility that offers dental care, where her insurance won鈥檛 leave her with unwieldy out-of-pocket costs.
She is also excited about having a clinic designed for, and by, the Little Shell Tribe. Growing up, Wilmore remembers her family having to ask permission to use IHS facilities in Montana before state recognition in 2000 guaranteed it.
鈥淵ou felt like the redheaded stepchild asking, 鈥榃e鈥檙e Little Shell, can we use your clinic?鈥欌�� Wilmore said.
The Great Falls clinic will also fill gaps in care for other Indigenous people in nearby rural communities and the city itself.
Little Shell members who live far from Great Falls are sorting through how to tap into newly granted services or how to access specialty treatment they can鈥檛 get at an IHS clinic.
Little Shell member Jonni Kroll, 55, lives in Deer Park, Washington, some 380 miles from the tribe鈥檚 future clinic. Her closest IHS alternative is a roughly 50-minute drive. Her first call was to book an eye appointment, only to find the clinic doesn鈥檛 have an optometrist.
鈥淪o then I go to the next clinic on my list,鈥� Kroll said. 鈥淭hat鈥檚 a problem across the board with IHS nationwide, and I think that will affect Little Shell people trying to figure out: How do we utilize this when we are scattered?鈥�
Little Shell people are spread out largely because they weren鈥檛 recognized, she noted, and now they鈥檙e having to play catch-up to understand how to access the services that recognition ensures. She said members, some of whom have never met, are connecting by phone or online to work through those questions together.
鈥淭he Little Shell are so resilient,鈥� Kroll said. 鈥淲e鈥檝e gotten to the point of federal recognition and so now we find a way to come past that. There are lots of doors that opened, but we have a lot to learn.鈥�