Service Delivery for Native American Children in Los Angeles County, 1996

By

Duane Champagne, Ph.D., Carole Goldberg-Ambrose, J.D., Amber Machamer, Bethany Phillips, and Tessa Evans, MSW

Thanks for financial and other assistance to the Drew Foundation for Children, the Interethnic Children’s Council and to Southern California Indian Center, Inc. Special thanks to the research assistance and help from the UCLA American Indian Studies Center.

The 1992 Los Angeles riots developed a deep concern for the future and welfare of children of color within the Los Angeles community. The riots underscored the absence of sustained interest and attention by county agencies and mainstream institutions for children of color. Most existing governmental and quasi-governmental planning and development agencies had little direct contact or sustained attention within minority neighborhoods and communities. Consequently, much effort and resources were directed away from the needs and interests of minority children. Many in the minority community believed that mainstream agencies needed to direct greater attention and deliver better resources and services to minority children. Seldom do major county agencies make significant investments in community building and training, provide technical assistance and access to minority communities for active participation and development of initiatives that will protect and develop the life chances, choices, and aspirations of children of color.

The present project is part of an initiative to study the institutional and community relations of African American, Latino and American Indian children to the service agencies, organizations, and resources available in Los Angeles County. Our task was to explore the service delivery system for American Indian children in Los Angeles County. The study of urban Indian children’s conditions consists of collection of secondary data, review of published material and a survey of children services among county agencies, Indian organizations, and with community people. We wanted to know how county and community organizations served Indian children and what services were provided. We inquired about what kinds of programs succeeded, and what improvements could be made over the present form of service delivery. The survey was open-ended and directed to major agencies and the Indian organizations and community members who were actively engaged in service delivery for American Indian children or engaged in Indian childrens’ issues. The group of agencies, organizations and people involved in American Indian children’s service delivery proved relatively small, with few agencies and advocates. Our search through the literature found very few works on the conditions and service situation of urban Indian children.

The results of the research bear out that American Indian children are not well served by county agencies. Indian children tend to be invisible in the county children’s service delivery system, and the county system does not serve the special cultural, community and economic needs of Indian children. There is little direct interaction with county agencies and Indian service delivery organizations and the Indian community. Our findings suggest that urban Indian children are difficult to identify, and there are few programs or services available to fill current needs. County agencies often refer questions of Indian services onto Indian organizations and commissions which often are already overburdened and underfunded. County agencies, while well meaning, have little knowledge or understanding of the diversity or character of the Indian population.

Indian service organizations are underfunded, understaffed and have too many clients. Community advocates for Indian children believe that major reorganization of county agencies and Indian service organizations is necessary in order to effectively serve the needs and aspirations of Indian children. Many Indian community members favor more grassroots approaches that emphasize holistic or multidimensional solutions to education and economic problems, substance abuse, cultural alienation, community, spiritual and other issues that are confronting Native American families, youth and children. The present-day bureaucratic emphasis of county agencies does not provide a favorable forum for effective or long-term solutions to the issues confronting the Indian families and children of Los Angeles County. Service delivery for the American Indian community requires sensitivity and respect for the community, culture and needs of American Indian children. Most Indian advocates prefer that their children are serviced within an Indian community context and with spiritual and community guidance.

Most Indian families prefer to seek services with Indian organizations, since the Indian client servers are more culturally sensitive to their needs and aware of their life situations. Indian families also prefer Indian organizations because they are places for community gatherings, staging of powwows, places where more accurate knowledge about Indians and the Indian community can be obtained. Indian organizations, however, are underfunded, understaffed, have too many clients to serve, have few or only fragmentary relations with other Indian organizations and county agencies. While service providers are often very committed and intelligent people, the organization and culture of LA County services tends to inhibit effective delivery to needy Indian children. Most service programs and agencies focus on the delivery of crisis services. Indian community members saw education programs as the path out of poverty and dependency. Our findings suggest that greater cultural sensitivity training, special attention to the education of Indian children, more centralization of service delivery, more funding, more personnel, and greater holistic emphasis on long-term culturally and community-based solutions are needed. Thus the Indian advocates suggest that more Indian people must be trained and strategically stationed in county agencies to improve the delivery of services to Indian children within the county delivery system. As many services as practical, however, should be delivered through Indian organizations where community and cultural relations can support service efforts with knowledge, understanding, and participation in Indian community and culture. Some centralized organization or coalition of Indian-managed service, cultural and community organization is seen as necessary for effective delivery services to Indian children. We recommend the formation of a centralized multi-service and community-cultural center with appropriate satellite offices as a major step in the direction of providing adequate services to the needy urban Indian children of LA County. An alternative or enhanced education program for Indian children is suggested to curb high rates of dropout and noncompletion of high school and college.

The Urban Indian Experience

There appears to be relatively little research and information about the conditions of American Indians in urban environments. There are a few reports dating from the 1970s, based on hearings, which outline concerns about Indian urban life. It is generally understood that most Indians migrated to urban areas by means of the Relocation Program started in the 1950s as part of the government program to terminate Indian reservations and move Indian labor from rural areas to where the jobs were in urban areas.[1] There was a wave of urban Indian migrants during the 1920s and again in the post-World War II period. In 1920 there were already 27,000 urban Indians or about 8.1% of the Indian population.[2] Between 1952 and 1970 about 100,000 Indians were relocated to urban areas by the Bureau of Indian Affairs (BIA). By the middle 1970s, as many as 160,000 Indian relocatees and dependents may have participated in BIA assistance for migration to urban areas.[3] In 1970, however, there were over 300,000 Indians in urban areas, and BIA relocatees had a 50% return rate in the 1952 to 1968 period.[4] The BIA Relocation Program contributed to urban migration but was not the only important factor.[5] The push of poverty on the reservation and the pull of opportunity in the urban areas attracted a considerable number of Native Americans.

Urban Indians appear to have higher incomes and lower poverty rates than reservation or rural Indians. In 1969, the urban Indian poverty rate for families was 20%, while the reservation family poverty rate was twice as high at 40%. In the 1970 census, 38% of urban Indian individuals were living below the poverty line, while 54% of reservation Indians were classified in poverty.[6] Nevertheless, the urban experience does involve tradeoffs and costs to migrants. Land, housing and the cost of living are often cheap on reservations, and access to federal, BIA, and Indian Health Service (IHS) programs provides further support. Furthermore, family networks and exchanges provide a safety net for many reservation residents. While jobs and economic opportunity are often in short supply on many reservations, the transition to the urban environment is usually fraught with new problems and issues. The cost of living, the loss of friends and family networks, and the loss of access to BIA and IHS services often reduce new Indian migrants to less secure circumstances. Services are harder to get in urban areas and Indians are reluctant to use them. Many Indians work in the city, but return to the reservation for services such as serious medical problems.[7] Indian migrants with fewer job skills will have greater difficulty compensating or equaling the quality of life on the reservation. Most Indian migrants are unskilled and often return to the reservation. Research indicates that migrants who were supported by BIA relocation funds did only slightly better economically than rural reservation Indians who stayed home. Those Indians who migrated to an urban area without financial assistance from the BIA often did worse economically than those who remained on their reservation.[8] Increasingly, however, there is a larger Indian middle class in urban areas who have become economically stable, but are relatively invisible. In 1968, about 10% of the Chicago Indian community was in the middle class, but about 70% were day laborers.[9]

By 1980, 719,000 Indians lived in urban areas, about 52.7% of the total Indian population.[10] In 1979 the median income for Native American living on the reservation was $9,920 and about 45% of the reservation population lived below the poverty line.[11] The 1980s saw the dismemberment of many anti-poverty programs and throughout the nation, many urban Indians community and multi-service centers were dismantled. Three urban centers were closed in Los Angeles alone.[12] Many urban centers depended on Administration for Native American (ANA) or job programs. When funding declined for these major programs, many urban Indian centers across the country closed or had to down size. This trend toward less direct funding available to urban Indians continues in the middle 1990s. Socio-economic conditions for many urban Indians continued to decline or remain poor. Health conditions of urban Indians are worse than for reservation Indians in several categories. In 1985, when compared to reservation Indians, urban Indians rates of alcoholism, tuberculosis, diabetes mellitus, unintentional injuries, and homicide were significantly higher, when controlling for age-adjusted mortality rates.[13] Over 40% of urban Indians suffer from moderate to high cholesterol and 39% of urban Indian men had blood pressure in the moderate to high range.[14]

Urban American Indian children graduated at lower rates from high school, in part because Indian children had different values from those found in most American schools. More training and sensitization of school staff were encouraged.[15] Overall nearly 75 % of Indian college students did not graduate from college, although about 30% succeeded very well in primary and high school.[16]

During the 1980s, suicide rates among Indian children of school age were three times higher than suicide rates among non-Indian youth.[17] In 1985, 50% of urban Indian youth and 80% of reservation Indian youth were at least moderately involved with alcohol, while in comparison only 23% of urban non-Indian youth moderately used alcohol. Indian populations suffered from use of marijuana, inhalants and other illicit drugs.[18] Substance abuse contributed to educational setbacks for Indian youth, were associated with criminal acts for adults and contributed to economic marginalization.[19] Indians were arrested while under the influence of drugs or alcohol at rates four times higher than blacks and ten times higher than whites.[20] Between 1975 and 1987, the prevalence of substance abuse among American Indian school age children increased. A 1986-87 sample of Native American high school seniors reported that over the previous month 58.5% used alcohol, 35.5% used marijuana, 1.8% used inhalants, 3.7% used cocaine, 9.1% used stimulants, 38.3% used cigarettes, and 31.4% used smokeless tobacco.[21] Indian children are exposed to various substances early in their lives. In one sample, by the 7th grade 28% of the sampled Indian children had been drunk at least once, 44% had smoked marijuana, 22% tried inhalants, 12 % tried stimulants, and 72% had smoked cigarettes.[22] In one sample, Indian children as early as the 4th and 5th grades with an average age of 10 indicated over their lifetimes that 33.5% experienced cigarettes, 36.6% tried smokeless tobacco, 43.6% tried alcohol, 6.6 % tried inhalants, 10.2 tried marijuana and 2.6% tried cocaine or crack. Researchers report that in the same sample of young people with average age of 10 in the week before the research survey that 11.6% used cigarettes, 25.5 % chewed smokeless tobacco, 6.8 % drank alcohol, 3.5 % sniffed inhalants, 3.8% smoked marijuana, and 1.6 % used cocaine or crack.[23] American Indian children use drugs and alcohol at earlier ages, engage in heavier use, and suffer dramatic economic, health and educational effects more than other major ethnic groups.[24]

Health data on the urban Indian population is scanty. Research on various samples of Indian urban populations suggests that urban Indian health clientele have annual incomes far below the national average and below the average for all urban Indians. Many Urban Indian health clinic clientele did not carry health insurance and had low levels of education. They used primary care facilities less often than the non-Indian population, but about as much as Indians in rural Oklahoma and Kansas. Many urban Indians have difficulty obtaining primary health care because they can not afford to pay, and do not have health insurance, and because Indian Health Service facilities are often not available in many urban areas. Urban Indians suffered from high levels of diabetes mellitus and hypertension among middle-aged groups, while young women were in need of prenatal care and contraception.[25] Other reports also suggest that many urban Indians have low incomes and about half did not have health insurance. Indian women were less likely to obtain prenatal care than black or white women, and suffered more unwanted pregnancies than white women, but fewer than black women. Economic, social and behavioral risk factors combine to put urban American Indian women at high risk for complications while pregnant and during the delivery of children.[26] Despite considerable improvement over the past three decades, infant mortality among American Indians remains higher than the non-Indian population.[27]

Indian children may be underserved in the mental health area. Although in the early 1980s, 45% of the Indian population was under 15, less than 15% of the mental health contacts with the IHS were with children.[28]

About two-thirds (66%) of self-identified Indians in the 1990 census were living in urban areas. California is the second largest state in Indian population, with 242,000, a 19% increase over the 1980 census. Nevertheless, leaders in the urban Indian community argue that the 1990 census represents a serious undercount of at least 10-15%, which impairs the urban Indian community from competing with other ethnic groups for community block grants or other funding. The majority of Indians in California have their tribal origins in some other state of the union. More than 100 tribes are represented in Los Angeles alone.[29]

Many urban Indian communities are unable to participate in federal, state, county or local programs because the Indian population is such a small percentage. In the top 50 major metropolitan areas, American Indians represent about .5% of the population. Thus Indians are not usually well known or predominant in any urban contexts. For example, since Indians are such a small urban population, large urban school districts refuse to allow Indian magnet schools.[30]

Although most Indians currently reside in urban areas, only about 5% of Indian Health Service funds support the urban Indian population.[31] The proportion of support of BIA funds for urban Indians is probably smaller than the IHS budget. Over the 1983-1993 period, federal support for urban Indian programs declined 50% despite the increase in urban Indian population. In 1990, about 1.3 million Indians lived in urban areas and many do not benefit from government programs that serve Indians living on or near a reservation.[32]

The IHS, an agency of the U.S. Public Health Service, has responsibility for supplying health care to members of federally recognized tribes. In 1990 the IHS had 127 service centers on or near reservations. Unfortunately, IHS service assignments were made in 1955 when more Indians were living on reservations. There are only 28 urban clinics run by the IHS providing medical services to urban Indians. The services offered are not comprehensive and vary widely. If the services do not exist at a close-by urban clinic the only option is an IHS reservation health unit which may be hundreds of miles away.”[33] Most urban Indians are not provided convenient medical services from the IHS. In some cities, the IHS provides primary care through contracting (P. L. 93-638) with local health care agencies. While some of the contracting health care agencies are Indian owned and operated, historically, urban Indians have been reluctant to attend non-Indian health facilities, in part because of previous bad experiences and discrimination.[34]

Health concerns remain high among urban Indians. Ten percent of urban Indians report having diabetes and 40% have high cholesterol and blood pressure. Urban Indians have age-adjusted mortality rates for alcoholism, diabetes mellitus, unintentional injuries, and homicide that are considerably higher than those for reservation Indians. The number of urban Indian mental patients increased 200% from 1988-1990.[35] HIV related care is very limited, as well as other special medical treatments which are not easily provided by the IHS.[36]

The Urban Indian Community in LA County

According to the 1990 census, Los Angeles had the largest urban Indian population in the nation with 43,899 people, a 7.1% decrease of 3,335 from the 1980 census count for LA Indians. Some members of the Indian community dispute the census figures and recommend that a more accurate number may be 10 to 19% higher than the official census count. There were over 100 tribes represented in Los Angeles according to the 1990 census, including Navajo, Hopi, Cherokee, Chippewa, Apache, various California Indians, many Oklahoma Indians from many tribes, as well as others. Consequently, the contemporary American Indian community is very culturally diverse. Most of the Indian residents of Los Angeles County were from non-California tribes. Nevertheless, the original Indians of the Los Angeles basin continue to live in Los Angeles. The Gabrielino/Tongva and the Fernandeño live in scattered small communities within Los Angeles County. Most Indian immigrants to Los Angeles appear to have come over the past 50 years. During World War II, many Indians served in the armed forces and many others migrated to Los Angeles to work in national defense plants. At least 30,000 American Indians were resettled in Los Angeles during the BIA’s Relocation Program.[37] During the 1960s and 1970s, the Los Angeles Indian population grew steadily.

On many socio-economic indicators, such as homeownership, education, income, poverty rates, employment and others, the Los Angeles American Indian population lags behind county averages. A survey of 380 Indian community members by Eagle Lodge found that poverty issues were of greatest concern, while drug and alcohol abuse were relatively secondary considerations. Money (282 respondents), jobs (231), housing (142), physical health (123), transportation (121), food (108) and adult drinking (106) were the 7 most frequently mentioned concerns and were mentioned by at least 100 respondents.[38] A complex of poverty-related issues seemed to concern Eagle Lodge clients most.

According to the 1990 census figures, 31% of American Indian preschoolers lived in poverty, while in general 22% of county preschool children lived in poverty. For children between ages 5 and 17, American Indian poverty rates of 21-23% compared only slightly worse than LA County poverty rates of 21-23% for children in the same age group. Very young Indian children from the ages of 0-4 are suffering high rates of poverty in Los Angeles County.[39] The average poverty threshold for a family of four in 1989 was $12,674. Nationally American Indian children lived in poverty at the high rate of 37.6%. For urban Indian children living in metropolitan areas greater than 500,000 people, the poverty rate was 31.6%.[40] LA Indian children were better off than Indian children in general, although urban Indian families are confronted with higher costs of living and fewer federal services than are available to reservation Indians.

The very young Indian children in poverty may be due to a higher than average rate of children in single parent households. 48.6% of American Indian children are not living with both parents, while the county-wide figure is 35%. Indian families with female heads of households accounted for 19% of Indian families, while female head of household families accounted for 12% of the county families.[41] American Indians have fewer families with married parents, at 41%, while the county average was 49%. In a sample of census data comparing LA Indians to Indians in the top 50 metropolitan areas, 36.6% of LA Indian children lived in single parent households while 45.5% of other urban Indian children lived in families without two parents.[42] The relative frequency of female and single family households, combined with generally less income, may be contributing to the prevalence of poverty among young American Indian children. More LA Indian children are living in single parent families than the average in LA County, but fewer LA Indian children live in single parent households than other urban Indian children from major metropolitan areas.

Overall the Indian poverty rate for individuals was 17.1% while the county poverty rate was 15.1%. By 1992, because of the recent economic recession, the county poverty rate grew to 17.2%.[43] Although there are no comparable 1992 poverty figures of the LA American Indian community, it is likely that the poverty rate for Indians in LA County also grew to a figure higher than 17.2%. The poverty rate for rural California Indians was 34.1% and the national American Indian poverty rate was 30.9 %, and so LA Indians are doing better, when not counting urban cost of living and access to federal services.

The average household income in the LA Indian community in 1989 was $37,071, while the county average household income was $47,252. Among American Indian households, 41% earn less than $25,000, while 35% of county households earn less than $25,000.[44] In comparison with Indians in other major metropolitan areas, LA Indians have a significantly higher mean household income ($41,800) than other urban Indians ($34,599).[45] In general LA Indians were doing worse than the county income averages, and worse than whites, blacks, and Asians, but somewhat better than Hispanics.[46] LA Indians, however, are doing better in household income than other urban Indians, although the cost of living in LA may be higher than in many of the other cities.

Thirty-seven percent (37%) of American Indians in LA County owned their homes, while the rate of homeownership within the county was 48%. Consequently, 63% of the American Indian population were renting, while 52% of county residents rented their living quarters. About three quarters of American Indians rented apartments at $500 or above. American Indians rent more often and own their own homes less often than the general population in LA County.[47] In household characteristics, LA Indians had more phones, 92.8 % to 81.8%, more complete kitchens, 97.1% to 94.3%, and more complete plumbing, 98.2% to 86.0% than Indians from other major metropolitan areas. Nevertheless, more LA Indian households did not have a car, 14% to 9.6 %, than other urban Indians.[48] LA Indians have better housing conditions than other major metropolitan Indians, but have fewer cars. The lack of a car in Los Angeles is a major obstacle to any household and reflects the often-repeated need for transportation within the LA Indian community.

The unemployment rate for Indians 16 or over was 10.2% in the 1990 census, while the county-wide unemployment rate was 7.4, and the unemployment rate for whites was 4.8% Since the recession starting in 1989-90, the unemployment rate in Los Angeles County has risen dramatically. It was 9.7% in 1993, and is closer to 7.5% in recent months. There are no comparable unemployment rates of LA Indians over the past 6 years, but most likely the LA Indian unemployment rate rose significantly higher than the 10.2% gathered by the census in 1989.

The mean non-farm self-employment income for LA Indians was $16,847, which is below all other ethnic groups in Los Angeles County. Whites had $31,727 in average non-farm self employment income, while blacks had $20,331, Asians $28,860 and Hispanics $18,013.[49] Although there are many small “mom and pop” type businesses owned and operated by American Indians in Los Angeles, Indians are far behind other ethnic groups and the county average in generating business income. In recent years, more interest has been generated by Indian business people, as evidenced by the organization of a Los Angeles American Indian Chamber of Commerce, and long-time efforts of The National Center for American Indian Enterprise Development. Nevertheless, American Indians are less engaged in capitalist enterprise than other groups, and more information should be given to young people about how business ownership and a career can be made compatible with Indian values and lifestyle.

The LA American Indian community reports relatively lower educational achievement than any other major ethnic groups in Los Angeles County, except Hispanics. For persons 16-19, 21.2 % of American Indian youth were not enrolled in school and were not high school graduates. Only 5.2% of Asians, 7.5% of whites, and 12.9% of blacks were not enrolled in school and had not completed high school. Only Hispanics had a higher rate, at 26.7%, of not completing high school.[50] American Indian high school retention rates may be worsening.[51] In a comparison of urban Indian communities, LA Indian youths ages 16-19 who were not enrolled in school and not high school graduates averaged 25.6%, while non-LA urban Indian youth averaged 11.5%.[52] LA Indian children are dropping out of school at over twice the rate of Indian children in other urban areas. American Indians in LA County also drop out of college (26%) at higher rates than the county average (20%). LA Indians, however, complete college at higher rates than other urban Indians. For ages 18-24, 5.6% of LA Indians have a bachelor’s degree, while 2.7% of other urban Indians finished college. In the 25 years and older group, 9.3% of LA Indians have a college degree, while 7.9% of other urban Indians had a degree.[53] Education is one of the primary concerns of the Indian community, and many American Indian children are not doing well in public schools. More attention needs to be directed to high school and college retention of Indian youth. LA Indian youth are not doing well in school when compared to county averages. They compare well in completing college with other urban Indians, but are worse in finishing high school.

Information on the health of the Native American population in Los Angeles County is very incomplete. The LA County Department of Mental Health reported that for the fiscal year 1992-93, the county facility served 417 Indian clients. Most Indian youth were treated for adjustment and personality issues (77%). Major depression was a far lower second concern with 17% (1992) and 15.5% (1993). Among adults major depression was the most frequent treatment for both older adults, 41.2% in 1992 and 54.5% in 1993, and adults, 36.3% in 1992 and 37.3% in 1993. Adults were often treated for schizophrenia, 21.6% in 1992 and 21.5 % in 1993, and bipolar and other psychoses with 20.9% in 1992 and 23.8% in 1993. Major depression seems to be a significant problem among the adult mentally impaired members of the Indian LA community, while youth are most often treated for adjustment and personality problems, with depression a secondary issue. The frequency of depression among the Indian community members seeking help far exceeds the depression frequencies of other ethnic groups. In 1993, among the other ethnic groups who sought county help depression was diagnosed for adult Hispanics at 24.8 %, whites 20.8%, African-Americans 20.7%, Asians, 28.2. Among Indian youth, the personality adjustment diagnosis was given at a lower rate than Hispanic, white, African-American, and Asian youth, but Indian youth were diagnosed for major depression at higher rates than other ethnic youth who sought help at county facilities.[54] Major depression should be a significant concern within the American Indian community. Depression may lead to or be associated with other types of dysfunctional actions such as drinking, drug abuse, loss of work, violence and perhaps other issues.

The Eagle Lodge survey indicates that in their sample the leading psychological concerns were Feeling Good About Oneself (91 respondents), Use of Alcohol in the Family (77), Worries About Money (68), Angry and Bitter (67), Anxious (58), Fear of Neighborhood Violence (57), and Use of Drugs in the Family (57). Self perception topped the list while substance abuse was a significant concern.[55]

Los Angles appears similar to other urban Indian communities in that most Indian people who seek services are poor and relatively recent migrants to the city. The survey conducted by Eagle Lodge found that 42.4% of their sample of 380 did not have any type of insurance. Only 19% of the Eagle Lodge respondents had private medical insurance, while 38% had no medical insurance, 8% had IHS coverage and 17% had Medicare, Medicaid or VA coverage.[56] The primary reasons for not having medical insurance were that the individuals were unemployed or they could not afford health insurance. Some agencies and Indian organization providers believe that 60-80% of their caseloads are recent arrivals who are battling with drug and alcohol abuse problems. Nevertheless, substance abuse facilities and Indian organization providers are severely underfunded and compete with non-Indian agencies for funding and grants. Many Indian clients are confronted with dual diagnosis situations: They are suffering from both mental illness, usually major depression, and substance abuse. Present programs, however, are not equipped to manage more than one issue at a time. County mental health funding requires that substance abuse issues must be addressed before beginning mental health treatment. The requirement of detoxification or primary treatment before beginning mental health treatment greatly limits the possibilities of comprehensive treatment for those who are suffering multiple pathologies. HIV/AID is an increasing health danger to urban men and women, especially among the homeless, but no services are set aside to address the social and health problems at any Indian agency or organization.[57]

Like urban Indians in many large cities, many LA Indians cannot find good health care. Many do not have insurance, do not have the means to pay for health care, and cannot manage county health care facilities. Local Indian health care facilities are not comprehensive. Those urban Indians form recognized tribes can return to their reservations for serious care. Nevertheless, even returning to their home reservations for health care requires money, time off from work, and transportation. Consequently many LA Indians wait until they are severely ill before returning to their home reservations or IHS health care units.[58]

The Department of Children and Family Services reported placement of 332 Indian children during 1995. Indian children were placed within Indian homes in 61% of the cases, while 39% were placed in non-Indian situations, which included non-Indian legal guardians, state non-Indian foster homes, non-Indian foster father adoptions, non-Indian fathers, group homes, adoption, or non-Indian relatives. A relatively high rate of non-Indian placements suggests that Indian Child Welfare Act (ICWA) protections are not entirely able to ensure that Indian children are placed in Indian homes. Urban Indian children are less likely to be placed in Indian homes than reservation children. There appears to be an insufficient number of Indian foster homes in Los Angeles. In 1990, Los Angeles had 250 Indian foster children and only 12 Indian foster homes.[59] ICWA services need to be considerably expanded to ensure proper disposition of Indian child adoption cases.

Experienced care givers in the LA Indian community emphasize that services should be delivered from a culturally informed perspective and be combined with experience and knowledge about community needs.[60] Most Indian clients continue to maintain lifestyles that emphasize Indian values and community. Indian community members strongly emphasize the importance of children, family and community as well as respect for oneself, for others, and the earth; honesty; trust; generosity; sharing; modesty; discipline; sincerity; and polite, kind, courteous behavior. These values characterize the value orientations of many members within the LA Indian community. The ability to practice Indian community values is mediated by the urban environment, substance abuse, acculturation, relations with the home reservation, and opportunity to engage in social and cultural activities with other Indians. Children and children’s health are highly valued. Chronic illness for children occurs when conditions emerge that erode a child’s relations with parents, family and tribe, impair a healthy sense of identity and well-being, or interfere with balanced development as a result of poverty or substance abuse. Children’s health is interrelated with family health and can not be separated. Service providers for the Indian community suggest that poverty, geographic distances to services and other Indians, erosion of native rights, the absence of a culturally sensitive service delivery network and the relative invisibility of the Indian community are the main reasons that cultural integrity and health are threatened among urban Indian children and families.[61]

Urban Indian Needs Assessment:

With Application to the Indian Children of LA County

Over the past 20 years numerous hearings and assessments have been made about the conditions and needs of urban American Indians. During the 1990s, several assessments were made about the urban Indian community in LA County. Many of the reports are very good and outline the issues confronting urban Indians, although most of the reports have gone relatively unheeded during the 1980s and 1990s, a period of government contraction and deemphasis on social programs. Many of the studies and needs assessments address issues that still confront urban Indian communities. This section summarizes the literature on urban Indian conditions, with special attention to the needs of Indian children and youth in LA County, and draws upon the recommendations suggested in the various reports and studies.

Eligibility for Services of Urban Indians in L.A. County[62]

In 1976, the Task Force on Urban and Rural Non–reservation Indians of the American Indian Policy Review Commission [AIPRC Task Force] wrote in its final report to Congress:

In reviewing the history of the general problem of services to off–reservations Indians, it has been evident at least since the urban hearings of 1928 that the prevailing policy has been to deny services;...[T]he limited assistance, essentially designed to encourage Indians to leave their homelands, [has] done little, if anything, to alleviate Indian needs....The migration has not brought even moderate economic well–being to the majority of migrated Indians....

...[U]rban Indians do not avail themselves of non–Indian programs and ... have tended to remain an invisible minority, holding less power and receiving less in the way of assistance than their numbers would warrant. In spite of the mistaken belief that urban Indians are an assimilated, undistinguishable group, many of them have retained their tribal identity and the need for programs that are specifically designed for Indians.[63]

The past twenty years have witnessed modest changes in federal policies and legislation regarding urban Indians, resulting in a small number of additional services to such individuals. Nonetheless, the statements quoted above remain essentially accurate. Whether the federal government's trust responsibility to Indian tribes encompasses urban Indians was debated in the AIPRC Task Force Report, and continues to arouse controversy today. Over the past five years, this debate has been augmented by concern among federal officials that benefits for urban Indians violate federal constitutional norms of equality on the basis of race and ethnicity.[64] The upshot is that increased services for urban Indians are unlikely in the future.

Denial of services to urban Indians is more often a function of agency policies than congressional mandate. By far the largest source of funds for services to Indians is the Bureau of Indian Affairs within the Department of Interior.[65] The broadest source of authority to dispense such services is the Snyder Act, enacted in 1921.[66] General assistance, child welfare services, employment assistance, and higher education scholarships, among other benefits, are funded by appropriations to Interior made under the authorization of this statute. Although the Snyder Act defines the class of eligible beneficiaries as "Indians throughout the United States," the Bureau has generally limited the class to Indians living "on or near reservations."[67] In some instances, as with higher education scholarships, the Bureau has established priorities, such that urban Indians may be awarded benefits only after Indians living on or near reservations have been served.[68]

The Supreme Court has never interpreted the Act to require such a narrower class of beneficiaries that excludes or limits eligibility for urban Indians; it has, however, affirmed the Bureau's power to designate a group that is less inclusive than the statute to receive benefits if the designation is made in accordance with proper procedures.[69] At the same time, some limits on the Bureau's power are suggested by a recent opinion of the U.S. Court of Appeals for the Ninth Circuit in a case involving higher education grants. There, the court stated that in formulating eligibility standards for programs funded under the Snyder Act, the BIA "must adopt criteria consistent with the broad language of the [statute]."[70] This court also encouraged the Bureau to "look to eligibility criteria used in other Snyder Act programs...for guidance when promulgating the standard for grant programs."

If the Bureau follows the Ninth Circuit's advice and turns to other Snyder Act programs for guidance, it will find only limited authority to include urban Indians in California. The particular program cited by the court was the Indian Health Service [IHS] health benefits for Indians, eligibility for which is defined by the 1988 and 1992 the Indian Health Care Improvement Act [IHCIA]. The Snyder Act serves as the basis for appropriations for this program, which is administered by the Department of Health and Human Services rather than the Department of Interior. As a general matter, eligibility for IHS services is limited to members of federally recognized tribes who live in designated "Health Service Delivery Areas" [HSDA's].[71] According to federal regulations, HSDA's normally consist of reservations and surrounding areas.[72]

Both the requirement of membership in a federally recognized tribe and the geographic limits of HSDA's can operate to bar urban Indians in California from health care services. The former requirement is relaxed, however, for some members of non–recognized California tribes. According to the 1988 amendments to the IHCIA, the class of "California Indians" eligible for IHS services includes holders of trust allotments and distributees under the California Indian land settlement process and their descendants, regardless of their membership in a federally recognized tribe.[73]