1. Describe the reservation in terms of geography, people, language and government.
The Lower Brule Sioux Indian Reservation at one time was fairly large but various treaties and executive orders reduced its size until finally, in 1891, the exterior boundaries encompassed only some 240,000 acres. Much of the remaining land was removed from trust and opened for homesteading. In recent years, a substantial increase in the Indian population has produced the current need for increasing the tribal land base. During the past 15 years, the tribal administration has initiated a plan to acquire more reservation land
The tribal government was established in 1934 with the initiation of the Indian Reorganization Act. Lower Brule is located in central South Dakota along the Missouri River that was dammed in 1963 by the Big Bend Dam, resulting in the formation of a reservoir that was named Lake Sharpe. The reservation is located along the lake. The Lower Brule Reservation boundaries are located in Lyman, Brule and Sully counties. Most of the reservation consists of grazing and farm land.
Like the Northern Plains, in which it lies, the area represented by the Lower Brule Indian Reservation is relatively isolated, Iying in the center of South Dakota, cut off from the urban complexes by vast distances, and limited by the nature of its non- intensive agriculture. Travel distance to major cities is shown by the following approximate mileage: Pierre (75), Huron and Mitchell (100), Sioux Falls and Aberdeen (165), and Rapid City (210).
The Lower Brule Sioux Reservation was established in 1865 by a treaty that was signed by the chiefs of the Lower Brule Band. The Lower Brule people are descended from the Teton Brule Sioux and Two Kettle Sioux Band of Lakota. They were formerly located on what is now the Rosebud Reservation. The Lakota dialect of the Sioux language is spoken by the Lower Brule.
The Tribal Council serves the governing body for the Tribe. The Council is comprised of six members including the Tribal Chairman, Vice-chairman, and four other Tribal representatives, each elected to a two Year term.
2. Describe the major health issues addressed by the rehabilitation and medical services on the reservation.
The major health issues on the Lower Brule Reservation are diabetes mellitus, alcoholism, heart disease, and respiratory problems. There are no independent living or physical therapy services for those who need these services. The leading causes of in-patient visits, according to Indian Health Service Information, are due to injuries and accidents. The greatest need for health care services appears to be in the area of prevention, e.g., diabetes monitoring, alcohol prevention, accident prevention, and pre-natal care.
In regard to the rehabilitation services on the reservation, there are no rehabilitation services located on the reservation besides the Maza Oyate Vocational Rehabilitation Program. The Maza Oyate Vocational Rehabilitation Program provides services to the disabled only if there is a vocational objective as the outcome. Independent living services, assistive technology, and services to the blind and visually impaired are provided by other agencies in the state on a limited basis. Access to these services are hindered by lack of transportation, lack of funding, and lack of information to the people who may be eligible and in need of these services.
The major health care provider is the Indian Health Service which has an out-patient clinic located on the reservation. They provide services from 8:00 AM to 4:30 PM, Monday through Friday. Patients who require emergency outpatient care or hospitalization must go to the nearest hospital located in Chamberlain (45 miles east). Prenatal care and obstetrical care are provided at a hospital in Mitchell (100 miles) or Pierre (75 miles) through a contract with the Indian Health Service. Specialized care is contracted at other cities, e.g., Sioux Falls, SD; Rapid City, SD; Minneapolis, MN; and Denver, CO.
3. Describe the employment/economy, education system and cultural kinship systems in place.
The current rate of unemployment is 48%. The largest employer on the reservation is the Lower Brule Sioux Tribe. Seasonal employment in housing and road construction provides employment on a temporary basis. The Lower Brule Sioux Tribe operates a casino, motel and restaurant that provides employment to tribal members. Due to the fluctuation of the tourist season and hunting season, employee layoffs have been necessary.
There is an elementary, high school, and community college located on the Lower Brule Reservation. An alternative school opened in January, 1994 for those students interested in receiving their high school diploma or GED certification. Literacy skills tutoring is also provided through the alternative school.
A strong extended family kinship system, which is traditional for the Lakota people, is the basis for most families on the Lower Brule Reservation. Family involvement is integral in the case development and implementation of the Individual Written Rehabilitation Plan (IWRP) of the client, providing significant family members with information about the vocational rehabilitation process, assessment procedures, etc., improving the chances for successful closure.
4. How is rehabilitation viewed by the community, culture, consumers, family and social structure.
Rehabilitation in the Lower Brule Community, historically, has been viewed as something one is forced to do or a process which one is coerced into in order to receive some type of service in return. Persons with disabilities were expected to accept their situation in life. Culturally, Native American persons with disabilities were seen as being messengers from the Great Spirit having a role in our Native American society. They had a purpose in life as being able to experience things which others could not see or hear, providing a link to the spiritual world.
5. How is rehabilitation different today from the practices five years ago? Twenty years ago?
Tribal Vocational Rehabilitation did not exist on the reservation five years ago. Vocational Rehabilitation services were provided by the South Dakota Rehabilitation Services but these were provided on a limited basis. A South Dakota Vocational Rehabilitation counselor visited the Lower Brule Reservation every two weeks and continues to do so but due to the time limitations, budget, and time constraints, very few of the Native American disabled on the Lower Brule Reservation completed their IWRPts and became rehabilitated. Of a total of 126 persons with disabilities (1989), three have been successfully rehabilitated by the South Dakota Rehabilitation Services. Twenty years ago, vocational rehabilitation services were unheard of on the reservation. Various factors may have contributed to the lack of services to the Native Americans on the reservation including lack of transportation, cultural bias, lack of information about eligibility, and vocational rehabilitation services.
6. what makes rehabilitation unique or exemplary on your reservation?
The Maza Oyate (Iron Nation) Vocational Rehabilitation Program began providing services to the Native American disabled on the Lower Brule Reservation on October 1, 1992. The Program is staffed by members of the Lower Brule Sioux Tribe and consists of a Program Director, Vocational Rehabilitation Counselor, Rehabilitation Technician and Secretary. AS members of the Lower Brule Sioux Tribe, they have knowledge of the area, people, tribe, and community resources (Indian Health Service, Bureau of Indian Affairs, Tribal Services, etc.). The Maza Oyate Vocational Rehabilitation Program is the only program in the central South Dakota area geared specifically for the employment needs of Native American disabled persons.
Networking with other service providers, reservation and state wide, is one of the major components of the Maza Oyate Vocational Rehabilitation Program. Locating comparable resources within the community and coordinating services for the consumer are integral parts of the Tribal Vocational Rehabilitation Program. Another valuable aspect of the Maza Oyate Vocational Rehabilitation Program is the incorporation of Native American values and healing into the rehabilitation plan for the client. The rehabilitation process for the Native American consumer involves an assessment of the family, social concerns, where they see themselves in relation to their Native American belief system, as well as their health and psychological assessment.
Our program has adapted to the needs of the consumers for this particular area (Lower Brule Reservation). As the program has progressed over the past two years, we have had to reassess the services provided, program components, and counseling techniques in order to adjust to the specific needs and disabilities of the consumers of the Maza OYate Vocational Rehabilitation Program.
7. What are the characteristics of persons with disabilities on your reservation?
The disabilities of highest prevalence on the Lower Brule Reservation, according to Indian Health Service statistics (1988), are diabetes and alcoholism. The average age of persons with disabilities is 37 years.
There are no reliable statistics with regard to disabilities on the Lower Brule Reservation. No assessments are being recorded for those disabilities which are not recognized through the health service system. Those with learning disabilities are not assessed unless they are in school. Adults who have dropped out of school or have completed high school before such testing was done did not get assessed for any type of learning disabilities. Persons who exhibit Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Effects (FAE) do not get assessed unless they are of school age. Often this does not guarantee that they will be screened in school unless the fetal alcohol characteristics are severe or behavioral problems warrant testing.
We are finding since beginning the Tribal Vocational Rehabilitation program that approximately one-third of our clients exhibit some type of learning disability which may or may not be attributable to FAS or FAE. We do believe that the future clients we may encounter will have some type of disability related to the abuse of alcohol, whether in-utero or self-abuse. Approximately 750/o of persons with disabilities on the Lower Brule Reservation can attribute their disabilities directly or indirectly to alcoholism; i.e. automobile accidents, cirrhosis, heart disease, and other chronic health problems which may be attributable to the neglect of minor health conditions due to chronic and long-term drinking.
8. What do you see as the needs and wants of individuals with disabilities on the reservations? What are the immediate concerns of persons with disabilities on your reservation?
Individuals with disabilities on the Lower Brule Reservation want and need accessible housing and workplaces. One concern that has been expressed is the lack of accessible community services and programs. Accessible transportation is not available in the community; most persons with disabilities must rely on their family members for transportation. There are no recreational facilities for this segment of our population. Also, physical therapy is nonexistent for persons who are need of this service.
People with disabilities on the Lower Brule Reservation need access to employment and need to be given the chance to prove themselves as valuable employees and contributing members of the community. Independent living services are also nonexistent in the central part of the state (Lower Brule Area). Services available are not culturally relevant and are not located near any reservation areas. There is a greater chance for success and continuity of care for the Native American with a disability if the treatment plan and follow-up care are provided by someone from his own culture near the extended family who provides support for the person with the disability.
Suitable stable employment is a great concern for all people living on the reservation. There are no industries or other businesses that can provide stable employment for people in the work force. We have been having difficulty locating training work sites and employment for some of our clients who have a physical disability which prevents them from any type of manual labor and a learning disability which further prevents them from acquiring any other type of position. What is needed for this segment of the disabled population is some type of assembly line work which will accommodate their ability to do repetitive tasks without involving heavy physical labor.
9. What is the future of rehabilitation on your reservation and, from your perspective, for the Native American Nationc?
The future of rehabilitation on our reservation will have to answer to the needs of the persons with disabilities to accommodate the various strengths and weaknesses associated with life on the reservation
I believe that cultural relevancy is imperative to the success of the rehabilitation of the consumer and that aspect must be reflected in all areas of the rehabilitation services on the reservation (staff, IWRP, service provision, follow-up and community education)
There are nine tribes located in South Dakota; only two have Section 130 Projects located on their reservations. Lower Brule and Standing Rock, which are located in North and South Dakota, serve the Native Americans with disabilities on their reservations. Seven other tribes do not have access to rehabilitation services through their respective tribes.
Vocational rehabilitation services are provided through the State Rehabilitation Services program but not on a consistent, culturally relevant basis. Due to the lack of transportation, location to district offices, and time restraints, the State vocational rehabilitation counselors have difficulty in successful rehabilitation of the Native American clients located on these reservations. My concern is that those clients or applicants who are deemed not feasible, for whatever reason, are not given the opportunity to achieve their potential or do not receive rehabilitation services. Many options which can be applied to Native American clients living on the reservations are often overlooked because of the lack of knowledge on the part of the vocational rehabilitation counselor and supervisor. The traditional work setting is not always a workable solution for the client; other aspects of employment must be considered such as home based employment and small business ventures.
Independent living services geared to the unique needs of the Native American consumer must be considered by the Indian tribes. There is a definite lack of funding resources in this area for independent living centers and services nationwide. Indian Tribes will have to compete for those resources that are available. Currently, there is a Native American organization in South Dakota (Tateya Topa Ho; Voice of the Four Winds) which is made up of representatives from each tribe and other interested people from various tribal organizations across the state as well as Native Americans with disabilities. We have joined together as one cohesive entity to find a solution to the lack of culturally appropriate and relevant independent living services for Native American people in South Dakota. We have joined together with the South Dakota Advocacy Services and the State Rehabilitation Services to develop a plan of action for this need.
10. What role does technology play in the lives of individuals with disabilities on your reservation?
Native American people with disabilities on the Lower Brule Reservation have limited access to any type of assistive technology. In order to receive assistive technology, the person with the disability must be assertive in attempts to find such services. There are limited resources on the reservation such as Indian Health Services, Tribal Vocational Rehabilitation Services, and the Tribal Housing Authority. The South Dakota Assistive Technology Project, located in Rapid City, has provided one individual with an assistive device for his visual impairment. Ramps have been provided for those in need through the cooperative efforts of the Maza Oyate Vocational Rehabilitation Project and Tribal Work Training Program. Technology is a new area which is being recognized by the Tribal Council, Bureau of Indian Affairs, and Indian Health Services Programs. Often such devices were associated with only the elderly. Very often, the other segments of the population were excluded from access to such funding sources and services. I believe as community awareness grows and those with disabilities become more aware of their rights to services, there will be resources made available to those in need.
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