CODI: Cornucopia of Disability Information

Native American Rehabilitation - Mississippi


Mississippi Band of Choctaw Indians
Tribal Office Building
P.O. Box 6010 - Choctaw Branch
Philadelphia, Mississippi 39350

Note: Mississippi Band of Choctaw Indians is a newly funded project and is reprinted as submitted.

Section One - Descriptive Information

1. Describe the reservation in terms of geography, people, language and government.

Tribal background and community setting: The Mississippi Band of Choctaw Indians, federally- recognized tribe since 1945, has almost 6,000 enrolled members residing on or near 22,000 acres of trust land scattered over seven counties in east- central Mississippi, one of the most impoverished sections of the state. Members of the tribe live in eight separate reservation communities with most living a substantial distance from the Pearl River community which is the site of tribal headquarters, the high school, the industrial park, the hospital, and other public service agencies. All of the communities are distant from Jackson and Meridian, the two major urban centers in the state, and the location of most medical and rehabilitation providers for the disabled.

Distances between Pearl River and each
community center are shown, following:
Community      | Distance from Pearl River 
               | Round Trip in Mlles 
Bogue Chitto * |          50
Bogue Homa     |         200
Conehatta*     |          70
Crystal Ridge  |          96
Red Water*     |          50
Standing Pine* |          50
Tucker*        |          30

* The asterisk indicates a school in the comunity

The Mississippi Choctaws are descendants of the Choctaw people who escaped removal to Oklahoma in the 1830's. Those who remained in Mississippi did so by hiding in unsettled lands, a separation which created an exaggerated isolation over time. With the establishment of the tenant farming system after the Civil War, the Choctaws became sharecroppers, farming under barely subsistence living conditions on what had previously been their own lands. For almost a century, the tribe struggled with poverty and segregation, yet preserved the traditional culture and language. During this time, the population was dangerously diminished from repeated removal efforts and a death rate exceeding the birth rate. Following the death of over one-third of the Mississippi Choctaws in the 1917 influenza epidemic, a Congressional investigation examined the plight of the tribe and limited health and education services began to be provided in the early 1920's.

This late federal government recognition of the rights of the Choctaws in Mississippi led to the creation of a reservation in 1944 and the re- establishment of tribal government in 1945. The tribe remained poor and dependant with virtually all tribal business and services managed by Bureau of Indian Affairs and Indian Health Service officials.

Community and economic development: In 1963, the tribe hired its first employee, a beginning step in the development of an executive branch of government. From this modest starting point, the Mississippi Choctaws have moved with persistence to achieve self-determination in all matters of tribal life. Since there were no mineral resources or productive land, the tribal economic development strategy became that of creating jobs through industrial attraction so that the tribe could draw from its only resource-its people. Through persistence, the tribe has made marked progress in tribal government, adequate housing, health and human services, a tribal education system for training an uneducated and unskilled adult labor force, and an infrastructure which attracts and supports public employment. The gains are summarized here:

Demographic profile: The population on the reservation is a young and growing one with 36.9% under age fourteen and 20% under age six, figures which have striking implications for planning tribal service delivery systems in the future. Fortunately, the Mississippi Choctaws are achieving economic and social development without paying the customary price of assimilation. Over 90% of tribal members are full-blooded Choctaw and 95% of Choctaw families speak Choctaw in the home with 53% speaking no English at home. Among adults, only 49% (according to the 1990 Choctaw Demographic Survey) indicate that they speak English well and 30% indicate that they can hardly read English. This continued dominance of Choctaw language use is indicative of the strength and extent of Choctaw cultural practices among tribal members.

Despite what the tribe believes to be its great progress, the original extent of need here was so widespread that the effects of generations of discrimination and neglect in health care, social services, and education have not nearly been eradicated. For example, low income remains a problem, but significant progress has been made with per capita income at $2,952. In consequence, 76.2% of households remain at poverty level according to the most recent federal poverty guidelines. Major contributing factors to such low family incomes are those of large numbers of young children in households, a fairly small number of employable adults, and moderate wage jobs. Education for the Mississippi Choctaws has proceeded with difficulty and discontinuity, with effect reflected in a broad lack of education among adults. Unlike other tribes who received educational services early in their dealings with the United States, Mississippi Choctaws were systematically denied access to education at all. Although Bureau of Indian Affairs (BIA) elementary schools were gradually built in the Choctaw communities by 1930, Choctaw children were often prevented from attending these schools by white land-owners who insisted that the children be available for fieldwork.

The absence of a high school and the practice of segregation further barred Choctaw students from high school completion. Choctaw students were prohibited from attending local public schools and were able to secure a high school education only by leaving home for federal Indian boarding schools or other boarding high schools away from the reservation. Finally, upon strong insistence by the tribe and with the support of the Mississippi congressional delegation, a boarding high school for the reservation was built in 1963 in the Pearl River Community. Within this system, there were no special services for handicapped students prior to 1976, with special education programs beginning at that time. At present, the 1354- member school population in K12 consists of the following disabilities: mental retardation (1%); hearing impairments (.1%); speech/language impairments (3%); visual impairments (.1%); emotional disabled (.1%); orthopedic impairments (.1%) other health impairments (.2%) (this includes ADD and ADHD); severe learning disability (14%). As a result of these and other circumstances, there is today a striking absence of formally educated and trained adult tribal members. There are only 90 college graduates in the tribe's history and, despite the operation of a tribal GED program which has had 477 graduates since 1972,52.9% of the adult population still lacks a high school diploma or GED certification. Many of these adults are potential or actual vocational rehabilitation clients now.

Although a public school education is now available to Choctaw students, few choose off-reservation schools which are unprepared to respond to the cultural and language differences of Choctaw students. Most Choctaw students attend the six reservation schools which came under tribal administration on July 1, 1989, after action taken by the tribe in response to the dismaying deficiencies in the academic performance of Choctaw high school graduates. The 1,354 students attend elementary school in their home communities and, for secondary school, are either bused daily to Choctaw Central High School in the Pearl River community near Philadelphia or reside in the dormitory there, returning home for the weekend.

This school system is extended by the tribe's large and diverse education department whose programs range from preschool, English as a second language (ESL), adult, vocational and rehabilitative, and post-secondary education

services. This administrative structure enables tribal enterprises and tribal programs, such as vocational rehabilitation and special education, to coordinate very closely and efficiently.

2. Describe the major health issues addressed by the rehabilitation and medical services on the reservation.

Health and social concerns: Other conditions, beyond those of educational shortfalls, unemploy- ment, and low income, also serve as useful indicators of the essential function performed here by this proposed project. The prevailing health problems are those leading to disabilities which frequently alter employment-potential, ie. diabetes and injuries. Alcoholism accounts for injuries and a body of alcohol-related illnesses which generate disability and contribute to family disruption. The most persistent, debilitating health concern here is chronic diabetes, the leading cause of adult inpatient admissions to Choctaw Health Center. vOver 40% of Choctaw adults (791) are diabetics, giving the tribe one of the country's highest adult rates for adult onset diabetes and the highest rate for diabetic-related amputations. The incidence of diabetic-related chronic kidney disease is so high (twenty-three times the U.S. all races rate) as to justify the location of a hemodialysis treatment unit on the reservation. Treatment costs for diabetes and its complications absorb a major portion of the Choctaw health care budget. In one year (1990), according to calculations by the Indian Health Service (IHS), Department of Health and Human Services (DHHS) and United States Public Health Systems (USPHS), the wage loss among Choctaw diabetic patients was $136,302. The cost for medical care for Choctaw diabetics in that same time was $1,954,344 or approximately one-third of the tribets health care budget for that year. Health status and health care resources for the tribe are also diminished by injuries, often of such severity as to require lengthy hospitalization and extensive rehabilitation, especially among young males. Choctaw leads the Indian Health Service area in injuries with a rate 4.5 times higher than that of all tribes served by Indian Health Services. Over the period from October 1990 January 1992, over half the tribal population was involved in an injury or accident, with 433 so severely injured as to require transfer to a trauma care facility. A serious complicating agent and a source of both health and social concern is that of alcohol abuse. According to the 1990 demographic census, 51% of families reported problems with alcohol abuse. Sixty-three % of all arrests by Choctaw Law Enforcement Services are alcohol-related. A survey of the blood alcohol content (BAC) for those arrested in 1991 identified 246 arrests with a BAC over .20. A BAC of .10 is required for a lawful arrest of driving while intoxicated. Ninety-nine of those arrested had BAC of .25 and over, with some arrestees at .30 and above. These numbers document the extent to which severe intoxication affects a portion of the tribal population, primarily young males. The tribal work force is diminished by alcoholism as a disabling condition itself as well as by alcohol- related accidents, by liver and kidney failure, and by other medical symptoms exacerbated by alcohol abuse.

3. Describe the employment/economyw education system and the culture, consumers, hmily and social structure?

Rehabilitative Services: Rehabilitative services were not existent on the Mississippi Choctaw reservation until late 1987. Before that time, tribal members only had access to the state rehabilitative services which were often not accessible at all due to language, cultural, transportation, and economic barriers. Since 1987 when the rehabilitation program was established, services have increased in scope and quality on a continual basis. The community, and disabled individuals in particular, see the service program as an assisting structure to improve their employment status. The Choctaw Rehabilitation Services Program is unique in its structure which mandates complete cooperation between all reservation service programs. This interdisciplinary service delivery is able to address all barriers to employment in every aspect of an individual's life. Services include the following:

The rehabilitation client: The Choctaw rehabilitation client has the same needs and wants of any Choctaw individual, that is, to be self- determining of his or her future and to be self- sufficient, able to support him or herself and the family. Concerns of the disabled client may differ from the non-disabled person in that, first, the disabled individual is concerned about progressive disabilities which threaten a family breadwinner's employment future; and, secondly, the disabled individual is concerned about who will care for their family if a premature death occurs. In terms of characteristics, our clients vary in their disabling conditions. An example of the distribution can be seen in the following report.

           July 1, 1990 January 13, 1994
               Disability Information
           Total Number of Referrals: 119
Visual Impairment	2    |		 0
Mental Retardation	2    |	 	15	
Alcohol/Substance            |		
  Dependence	        2    |		15
Cardiac Condition	1    |		 0
Diabetes Mellitus	9    |  	 9
Orthopedic Condition    3    |		 1
Learning Disabilities  10    |		21
Degenerative joint DS   2    |		 1
Hearing Impairment      1    | 		 0
Obesity                 1    |		 0
Seizure Disorder        2    |		 0
Hypertensive Disorder   1    |  	 4
Head Injury             1    |		 0
No Disabling Condition  8    |		49
Unknown	                4    |		 4

Future of rehabilitation: On the Choctaw reservation, the future of rehabilitation is bright as long as federal funding is continued. State and tribal relationships are being defined and the two rehabilitation programs are coordinating benefits for tribal members to receive the utmost services possible. Rehabilitation staff work as a team with a mission and can't be stoppedl Tribal administration supports program efforts, and other tribal entities see the benefit of hiring the disabled worker and are making commitments to do so.

In terms of Native American Rehabilitation as a whole, the future needs to become more stable. Funding should be provided on a continual basis and not on a competitive basis. Policy manuals need to be directed to American Indian vocational rehabilitation programs which deal with issues directly related to Indian vocational rehabilitation programs.

Technology: Technology is a new area being discovered in the lives of individuals with disabilities on the Choctaw reservation. For the most part, professionals and consumers need more training in identifying, evaluating, and using technolow with disabled clients.

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