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Pictured from left: NJP Native American Unit staff members Janel Riley (Laguna Pueblo),
Camille McDorman, Cina Littlebird (Laguna Pueblo), and Jennifer Yogi
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Social determinants of health, such as access to health care services, contribute significantly to disparities, especially in Indian Country.
Efforts to expand access to care are more likely to be successful when we address common administrative hurdles. For example, sometimes people are denied health care benefits because language or literacy issues prevent them from telling their story in a way that adequately substantiates their eligibility.
In other cases, access to care is directly influenced by one or more legal issues. For instance, American Indians and Alaska Natives (AI/ANs) are significantly more likely than White people to have administrative disqualifications from employment (ADEs), which can hurt people's ability to support their families or meet medical needs. The problem is compounded when someone with ADEs survives a crime, such as sexual assault, and is unable to obtain medical or behavioral health services in a timely fashion.
"Health care access is so closely correlated with resource access," says Cina Littlebird (Laguna Pueblo), a staff attorney in Northwest Justice Project's (NJP's) Native American Unit. "And often people have a whole host of legal problems that impede access to medical care."
Organizations like NJP play a significant role in efforts to address social determinants of health. A nonprofit with 18 offices throughout Washington state, NJP provides free legal services to low-income people.
"We look at what will help folks gain more stability when experiencing poverty, and access to care is a main piece of that." — Cina Littlebird, Staff Attorney, NJP's Native American Unit
NJP's staff handles a variety of civil (non-criminal) cases, including those involving denial, termination, and reduction of benefits or health care services. The Native American Unit focuses on areas of critical and unique importance to AI/AN clients. Examples include Indian Child Welfare Act cases, discrimination in schools, and issues arising from a client's survival of domestic violence, sexual assault, wage theft, or other crimes.
Counseling and other health services can go a long way toward helping crime survivors recover, but people often require financial assistance to access such services. To that end, the Native American Unit helps clients access resources available through the nonprofit Victim Support Services, the Washington State Labor and Industries' Crime Victims Compensation Fund, and restitution in collaboration with prosecutors. This work is in addition to other general civil legal support the unit offers crime survivors.