CODI: Cornucopia of Disability Information

Native American Rehabilitation - Washington

Washington

Colville Confederated Tribes
Vocational Rehabilitation Program
P.O. Box 150
Nespelem, Washington 99155

Section One - Descriptive Information

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

The Colville Indian Reservation is located in north central Washington state and is comprised of 1.4 million acres or 2,100 square miles (equivalent to the state of Connecticut) which covers parts of Ferry and Okanogan counties. It is bounded on the east and south by the Columbia River, on the west by the Okanogan River, and on the north by the line between township 34 and 35 north of the Willamette Meridian baseline.

The Reservation is comprised of forested mountains, steep canyons, rolling hills, lakes, streams and rivers. Land and water are among the most important resources of the Colville Indian Tribes. Current land use on the Reservation includes residential, irrigated and dryland farming, livestock, ranges, commercial forests, recreational areas, and mining sites. The Reservation is divided into four districts: Omak, Nespelem, Keller, and Inchelium.

The Confederated Tribes of the Colville Indian Reservation include the following: Okanogan, Lakes, Colville, San Poil, Nespelem, Methow, Entiat, Chelan, Wenatchee, Moses Columbia, Palouse, and the Nez Perce Joseph's Band). These tribes' traditional lands stretched from the Cascades east to the Rockies, north to the top of the Okanogan Valley and Arrow Lakes in British Columbia, and south to the Columbia Basin in the area which now is much of the states of Washington, Idaho, and Oregon. There are approximately 7,800 members of the Confederated Tribes of the Colville Indian Reservation with about 50ø/0 of them living on the reservation.

The twelve Plateau tribes can be classified by language family which is either Salish or Sahaptian, the majority of whose language are dialects of the Salish. The Nez Perce and parts of the Wenatchee bands speak Sahaptian. Use of the Native language is limited to an estimated 300 persons; however, the tribes have funded projects and received grants to rekindle the languages which are a critical component of the culture.

The Tribal Government is composed of a 14-member Business Council. Each of the four prominent districts is represented on the legislative body. Elections are held annually with seven of the Business Council facing re-election. Representation is four from the Omak, Inchelium, and Nespelem Districts, and two from the Keller District. The Business Council is the primary legislative body of the Confederated Tribes of the Colville Indian Reservation.

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

The major health issues addressed by rehabilitation are alcoholism, substance abuse, and specific learning disorders. There are high incidents of rheumatoid arthritis, traumatic brain injury, and diabetes.

Medical services available to the residents of the Reservation are provided, for outpatient services only, by the Indian Health Service. The main facility is located in Nespelem and outreach offices are located in Omak and Inchelium.

3. Describe the employment/economy, education system and the cultural kinship systems in place.

Unemployment on the Reservation stands at about 50%, although the Tribal Government and its enterprises hire at least 600 persons. The Bureau of Indian Affairs and Indian Health Service employ approximately another 400 persons. Much of the employment on the reservation is seasonal and is largely centered in the lumber industry. The tribes' enterprise corporation includes businesses such as three Trading Post Grocery outlets, a houseboat enterprise, a pine lumber mill, and bingo. The Tribes are on the threshold of opening a casino and are also looking at a power generating plant.

There are several school districts on or near the Colville Indian Reservation which serve students in each of the specific areas: Paschal Sherman Indian School (tribal owned and operated) serving 1st through 6th grades, Nespelem School serving 1st through 8th grade, the Grand Coulee and Omak Schools which serve pre-school through 12th grade, Keller serving 1st through 6th, Wilbur serving junior and high school students, and Inchelium which serves pre-school through 12th grade.

In addition, there are three colleges which provide higher educational opportunities: Wenatchee Valley College North (WVCN), a two-year program, and Heritage College, a four-year program, in the Omak community. WVCN also provides outreach classes in the Nespelem area on a regular basis. Big Bend Community College, at Moses Lake, also provides outreach classes to the Coulee Dam/Grand Coulee area. It should be noted that Heritage College is a private college and the costs associated with attendance are high.

Access to vocational-type training is limited and is an area which our Tribe will likely pursue in the near future.

In terms of cultural kinships, from my understanding of this phrase, you're asking for information regarding familial support systems. Here on the Colville Indian Reservation, extended family is still alive and well. Our close family ties can be drawn on for support and, unfortunately at times, can also be a sabotaging mechanism. When we can entice positive family networking, it is used in the rehabilitation process. Families provide a stabilizing and influential component of any plan. Because we are somewhat of a closed community, the foundation given through familial linkages can make the difference between a successful or non- successful plan.

Section Two - Program and Services

4. How is rehabilitation viewed by the community, culture, consumers, family and social structures?

Rehabilitation is viewed by the community as an additional resource for assisting persons with disabilities. There are times and occasions when vocational rehabilitation is seen as a market in which you enter with a shopping list. We attempt to bring a reality perspective to the community by stressing in our pamphlets and our interaction with the public that there are components which must be met and satisfied prior to provision of services. At times, I'm sure our clientele see these regulations as the "barrier" to their Plans.

Consumers, family, and social structures are generally quite receptive to the vocational rehabilitation program. This is, in part, due to the fact that the staff in vocational rehabilitation are part and parcel of the community. We are not coming into the community trying to "fix things.Xw We are a vested interest whose work is viewed as helping and positive.

5. HOw is rehabilitation different today from the practices five years ago? Twenty years ago?

Rehabilitation is different today from five years ago in that we're becoming more astute in the provision of services. We are able to serve many persons, in at least a limited way, through the vocational rehabilitation process. We are also becoming more sophisticated at accessing other resources to assist our clientele. Our ability to provide a "circle of caring" for our clients has greatly been enhanced. Whereas five years ago we likely attempted to be all things to all people, we now are able to network with other programs like jOBS, Joint Training Partnership ACt, Adult Vocational Training, Higher Education, Child Care Block Grant, etc., to utilize first dollar resources before using vocational rehabilitation funds to provide service. We can stretch our resources further and we are annually imDroving the numbers of clientele served.

Twenty years ago, vocational rehabilitation services were provided by the state to our reservation residents and these services were limited. Few, if any, tribal members were served by vocational rehabilitation under the state.

6. What makes rehabilitation unique or exemplary on your reservation?

Rehabilitation is unique in our setting because we are challenged by a rural and isolated environment. Jobs are hard to come by and available work is many times seasonal. We serve a population that, if it weren't for the Tribal program, would likely not pursue vocational rehabilitation. The gift of our traditional healing practices aids us in our planning and our rehabilitations. The extended family support systems can be a benefit to our client's successes. We use many of the contemporary tools and processes, but interwoven throughout our vocational rehabilitation process is the strong thread of history, culture, and traditions.

7. What are the characteristics of persons with disabilities on your reservation?

Characteristics of our clientele:

  • Most are between the ages of 33 and 45 (middle aged).
  • The majority of clientele are men.
  • The prominent disability is alcoholism or substance abuse.

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?

The needs and wants of individuals with disabilities here are to become employed in a setting that is comfortable for persons with disabilities. Our clientele desire to work in an environment that is accessible to them and allows them to grow within their own boundaries. Accessibility and how to fund accessible buildings and offices are an immediate concern of Dersons with disabilities here.

9. What is the future of rehabilitation on your reservation and, from your perspective, hr the Native American Nations?

The future looks good for rehabilitation on our reservation. As time goes on, we would anticipate that we will only improve in both our services to and for clients.

However, with Section 130 funding as it is now legislated, we in Native American country are placed in a position of competing with one another for the same pot of money. This federal strategy might encourage an environment of adversity among Section 130 projects. We can combat this plan only by working with one another, supporting every program, and keeping our lines of com- munication open. We additionally may want to expend our energy toward concentrating our efforts upon obtaining the full funding levels allowable under the Section 130 legislation.

10. what role does technology play in the lives of individuals with disabilities on your reservation?

Technology is an area which very much needs to be explored and amplified in use within the Colville Indian Reservation setting. We look to an expansion of our technological expertise in our plan development and performance. Access to technology resources is limited due to the rurality of our communities. We have incorporated technology in some areas of vocational rehabilitation assistance but certainly realize that more information, use, etc., is needed for our program to be more effective.


Confederated Tribes and Bands
Of the Yakama Indian Nation
P.O. Box 151
Fort Road Toppenish, Washington 98948

NOTE: Confederated Tribes and Bands of the Yakama Indian Nation is reprinted as submitted.

Section One - Descriptive Information

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

The 14 Confederated Tribes and Bands of the Yakama Nation are a federally recognized tribe with a reservation of 1.3 million acres and enrollment of 8,007 members. There are an estimated 7,000 non-Yakamas Indians of other tribes also living on the Yakama Indian Reservation which is located within south central Washington state.

The rural area has limited access to services necessary for native people with disability. The transportation issues include the lack of rural bus service and the actual commute distance between each community. This is further compounded due to actual health services which are centered around the Indian Health Services clinic facilities and tribal government offices located in Toppenish, Washington.

In the area of native language, our Yakama language is used within all our Longhouses which are the center of religious and cultural activities. Our language is currently being taught at the Tribal High School and Heritage College and is offered in the various community centers on the reservation. Perhaps, in this way and in similar efforts1 our language will be carried on for those that follow us. The strongest use of our language is in the sweatlodge services which are held throughout the reservation.

The Yakama Nation governmental offices are located in the Yakama Valley which has one of the highest unemployment rates in the State of Washington. As of January 1990, the State of Washington's unemployment rate was 6.9%; the unemployment rate for Yakima county was 14%; and the Yakama Nation's unemployment rate was 63%

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

In the area of disability and the possible combination of primary or secondary disabilities, we have included the following: visual impairments, hearing impairments, orthopedic deformity or functional amputation of major and minor members, mental disorders, alcoholism, drug addiction, mental retardation1 neoplasms, closed brain injuries, allergic, endocrine system, metabolic and nutritional diseases, diseases of the blood and blood forming organs, specific learning disabilities (including ADD, DD, FAS, FAE), cardiac and circulatory conditions, respiratory diseases, diseases of digestive system conditions of genitourinary system, speech impairments, and diseases and conditinns nf the skin and celililar tissue.

Section Two - Program and Services

The community supports rehabilitation for Indian people with disabilities. The unique thing is that our staff is all Native American. Five years ago, it would have been an "all white" staff with a very low case load of Native Americans. Twenty years ago, it would have been an "all white" staff with a concern for the Native American community and the issue of how to get its involvement.

It's the involvement of our Tribal community and specifically those Native people with disabilities in finding the solutions for services and need. These services, sensitive to Native culture, are aimed at promoting employment and/or acquiring skills for employment.

Many consumers want our program to "fix it!" The second question usually involves "what does your program pay?", such as maintenance payments, SSI, tribal support, or welfare. The third common aspect is multiple disability and/or dual diagnosis. Other concerns would be the lack of service within the reservation area, all medical or restoration services are contacted out to the urban areas, and the requirement of constant travel.

Rehabilitation can only get better for the Native American community because of the education process and actual experience of doing it for ourselves.


South Puget International Planning Agency
SE 2750 Old Olympic Highway
Shelton, Washington 98584

NOTE: SPIPA is a newly funded project and is reprinted as submitted.

Section One - Descriptive Information

The South Puget Intertribal Planing Agency (SPIPA) is proposing to implement a three year Vocational Rehabilitation Initiative on behalf of the Chehalis, Nisqually, Shoalwater Bay, Skokomish, and Squaxin Island Tribes. The initiative is designed to increase access to rehabilitation services for the more than 400 differently abled Native Americans within the five reservation communities who are impacted by a handicapping condition and place these individuals in gainful employment following training. The definition of lsdifferently abled individual" utilized under the program is an individual who has a physical or mental disability resulting in a substantial barrier to employment. The project will concentrate on outreach, training, and networking activities during the first year with service delivery beginning in the latter part of the first year. The project will serve 25 handicapped individuals within the five tribal communities during the first year with three of these individuals being transitioned to employment, 75 individuals the second year with ten transitioned to employment, and 100 individuals the third year with 20 transitioned to employment.

The project will focus on providing vocational rehabilitation and job placement services to individuals impacted by the three most prevalent handicapping conditions within the five communities: disabilities resulting from substance abuse, disabilities resulting from accidenVinjuries, and specific learning disabilities. Individuals impacted by more severe handicapping conditions will be given first priority for services and served on a case by case basis.

The overall goal of the Vocational Rehabilitation is to provide a culturally sensitive, community based program of vocational rehabilitation services accessible to the disabled population within the five tribes, tied to tribal economic development and off reservation employment opportunities, focusing initially on the most prevalent types of disabilities while addressing more severe disabilities as a number one priority on a case by case basis.

The specific objectives for the project include Project Startup, Outreach/Education Intake/Assessment/Vocational Rehabilitation Plan Development, Plan lmplementation/placementl and linkages with Tribal Substance Abuse Programs. The objectives have been developed to provide for an emphasis on outreach/education, networking, and staff/community training in year one with the preponderance of direct program services taking place in years two and three. This conservative community consultation intensive approach is based on the previous experience of the SPIPA agency in introducing new services into the five tribal communities over the past 15 years.

The project model for the Vocational Rehabilitation Initiative has been developed in cognizance of the Geographic isolation of the tribes; the financial, cultural, and transportation barriers that have prevented community members with handicaps from accessing rehabilitation services; and the need for program outreach and case management services to be provided by trained individuals who are accepted within their respective communities.

To address the above issues, the project model includes a vocational rehabilitation counselor position to be stationed at the tribal center for each of the tribes with supervisory, administrative, financial, management, training, and reporting functions to be provided through the project

director stationed at the centrally located SPIPA office. This same project model has been used with success on a number of other intertribal services delivery projects administered through SPIPA including adult education, child, and family services. Youth substance abuse prevention has proven to be a cost effective means of delivering services.

The project budget is $283,369 for year one, $371,307 for year two, and $434,750 for year three with a 10% applicant contribution for each of the three years.

Evidence of Need for Project: Overview of Project Background/SPIPA Disabilities Planning Project:

The five consortium tribes have over the past two years carried out a disabilities planning project aimed at assessing the prevalence and extent of handicapping conditions within the five tribes and formulating long range goals for increasing services to differently abled individuals and their families. This project has been carried out through funding support from the state of Washington Develop- mental Disabilities Planning Council and has served as a planning and philosophical springboard to the proposed vocational rehabilitation project. Major findings of the disabilities planning project have been as follows:

  • The extended family system has served as the major support system for individuals with disabilities within the five communities.
  • Financial and transportation barriers have been major impediments to differently abled individuals and their families receiving services available through off reservation sources
  • Cultural barriers have played a significant role in the lack of services being received by differently abled individuals and their off reservation services due to previous negative experience with the state child protective and foster care systems.
  • Vocational Rehabilitation services were identified as a high priority by differently abled individuals and their families with most differently abled individuals interested in meaningful employment.
  • The most prevalent handicapping conditions within the five communities are closely related to the low levels of health and poor economic conditions impacting these communities. These conditions have contributed to a high rate of substance abuse, a high rate of disabling accident/injuries (especially among the young adult male population), and a high rate of learning disabilities due in part to lack of access to prenatal and early childhood health care.

Overview of consortium Tribes: All five of the SPIPA member tribes are participating in this Vocational Rehabilitation proposal: Skokomish, Squaxin Island, Chehalis, Nisqually, and Shoalwater Bay. Their service areas include Thurston, Mason and Pacific Counties, and portions of Lewis, Grays Harbor, and Pierce Counties. Over 750/o of the combined tribal service population of over 5,000 Native Americans live on or near the respective reservations including more than 2,500 Native American adults over the age of 16. The service populations of the SPIPA member tribes have seen tremendous growth over the past 15 years as tribal housing programs, employment opportunities, and health and social services have continued to grow with many Indian families returning to the four reservations from out of the area. Most of these returning families have been young with large family sizes, low incomes, low educational levels, and serious health and personal problems. It is these extreme need families that SPIPA is proposing to target for services under the Vocational Rehabilitation Initiative.

All five of the participating tribes, as well as the SPIPA organization itself, have more than doubled the size of their respective organizations over the past five years. The combined overall budgets of the tribes and SPIPA currently exceed $14 million with a combined staff of over 300. This budget and organizational growth is projected to continue for the next five years and provide unprecedented opportunities for the tribes and SPIPA to address longstanding educational, social, health, and governmental issues.

Educational vision: The SPIPA Tribes have established as a major community development objective over the next several years the improvement of educational opportunities for Indian adults. This vision includes the continuation and expansion of the SPIPA three year adult education initiative, the development of an ongoing vocational education program to meet the training needs of Indian adults, a continuation and expansion of the present efforts to form a tribally controlled community college for the South Sound Tribes through a phased development effort in conjunction with Northwest Indian college, and development of a vocational rehabilitation program to serve differently abled individuals within the five communities.

Emergence of Education As Tribal Priority: The SPIPA Tribes believe that increased adult educational services are one of the keys to the achievement of social and economic parity between tribal service population members and the off- reservation sector. The tribes have out of necessity concentrated on survival issues such as fishing rights, treaty rights, land acquisition, health status, and jurisdictional issues over the past 15 years. They are just now able to turn to the area of vocational and adult education and start addressing the serious needs in that area.

The SPIPA Tribes are in the midst of a prolonged period of growth, both in terms of service population and tribal organization expansion. This growth has in turn generated a high demand for trained tribal members to fill positions within the tribal organization, tribal enterprises, and tribal member businesses. Many tribal members have not completed high school or have become so disillusioned with the educational system that they have not gone on to receive post-secondary education. Other individuals have the desire and the capability to fill emerging job openings but are held back by a handicapping condition which prevents them from completing the necessary vocational training. These individuals, to whom the tribes are turning to fill new positions within tribal enterprises and the tribal government, desperately need a solid base of vocational educational skills in order to contribute to the tribes' long range development efforts.

The tribes recognize that all community members have a vital role to play in the rebuilding of the respective reservations and that the contribution to be made by the community members with disabilities to this effort is enormous

overview of Economic Conditions: Although economic conditions within the four tribes have improved significantly over the past 10 years, there is still a critical need for business development, job creation, training, and educational skills improvement within each community. Unemployment among the four tribes averages in excess of 30ø/0 and the annual average family income is still under the $10,000 level. Much of the employment within the tribal communities is seasonal and centers around treaty fishing and timber industry related employment. With downturns in both the timber and fishing industries over the past several years, the tribes have attempted to diversify their economic bases through increased tribal enterprise employment and training of the labor force for off-reservation work. Tribal government employment has also played an increasing role in the reservation economic base within the past several years with over 200 individuals within the five tribes presently working for tribal governments or inter-tribal organizations. Overall, approximately 20% of the labor force works for tribal government or enterprises, 20% are employed as treaty fishermen, 300/o are employed in the off-reservation sector, and 300/o are unemployed. Providing vocational rehabilitation services to community adults with handicapping conditions is an important part of this effort as the economy of the region continues to shift away from a timber and fishing dependent economy and towards a more diversified economy with increased service and governmental employment.

Overview of Vocational Rehabilitation Needs: The community consultation and needs assessment processes carried under the disabilities planning project provided the tribes with a clear picture of the extent and impact of disabilities on educational and economic conditions within the five communities.

Disabilities within the five tribal communities are related to the external and environmental factors that have impacted Indian communities and families over the past several generations and include a high rate of substance abuse, a high rate of accident/injuriest and a high rate of learning disabilities related to lack of access to adequate prenatal care and health care.

The number of persons within the five tribes with handicapping conditions is estimated at almost 10% of the population or over 400 persons. The types and prevalence of these handicapping conditions are as follows:

                               |
Disability                     |  Number
_______________________________|__________
                               |
Substance Abuse	               |  250
Accidents/lnjuries	       |   70
Specific Learning Disabilities |   50
Severe Handicaps	       |   30
_______________________________|__________
                               |
Total Number	               |  400
_______________________________|__________

        

The proposed project will serve 25 persons the first year, 75 persons the second year, and 100 persons the third year through a combination of outreach and community education; intake, assessment, and plan development; case management and purchase of vocational rehabilitation services; and linkages with other tribal and SPIPA programs for support services, career guidance and job placement.

An overview of the above prevalent handicapping conditions within the communities to be addressed under the project include:

  • Alcohol and Drug Abuse: A major cause of handicapping conditions within the five tribes has been the multigenerational substance abuse problem that has plagued these communities. The introduction of alcohol into the five tribal communities began with the first white/lndian contact over 150 years ago and, in a sense, the tribes have never recovered from that initial devastating blow. The introduction of alcohol tore asunder a stable and highly successful culture that had survived and flourished in co-existence with its environment for thousands of years and plunged the community into a self perpetuating cycle of alcohol abuse, family disintegration, and self destruction that has continued unabated until the present time. The breakup of Indian families and the placement of Indian children in foster homes, the erosion of tribal traditions and cultural values, the early death of a large proportion of com- munity members due to the degenerative effects of long term alcohol abuse, the injury or death of a large number of tribal youth and young adults due to alcohol related accidents, the low educational levels and high rates of unemployment within the communities, and the depletion of tribal resources and erosion of tribal sovereignty might well have been avoided or significantly lessened had the strength of the community not been sapped by alcohol abuse.

    The devastation caused by alcohol abuse to the family unit over the past several generations is incalculable. The strength and cohesion of the family unit has been severely eroded by alcohol abuse; children do not receive the support, love and attention they require to grow and are more vulnerable to abuse and neglect. These children bring with them into the school system a range of emotional, developmental, and self-esteem problems that cause them to fall behind in school and drop out at an early age, thus perpetuating the problems of low educational levels, poverty, and alcohol abuse into the next generation.

    The member tribes have also witnessed an alarming increase in the extent and severity of drug abuse among community young adults and youth that has seriously undercut noteworthy accomplishments in other areas of tribal community development efforts such as social services and economic development. Presently, more than 50% of young adults ages 18-24 are impacted by drug abuse dependency. It is these same young adults which the tribes will need to turn to in a few short years to provide the leadership to take the com- munities successfully into the 2rst century.

  • Accidents/Injuries: A major and increasingly serious cause of handicapping conditions within the five communities has been accidents and injuries, particularly among the young male adult population. These can include disabled limbs, chronic back problems, and head and/or neck injuries.

    Many community members by necessity engage in high risk occupations, such as logging, construction, laborer jobs, farming, fishing, and hunting, and are at high risk for job-related accidents. Many times Indian community members who have been injured on the job do not receive the necessary rehabilitation and restorative services they need to remain employed. These individuals generally return to the reservation, support themselves through odd jobs and subsistence activities, and fall into a cycle of low self esteem and depression exacerbated by substance abuse. These individuals also are confronted with emotional problems in dealing with their disabling condition and the reality that they are no longer able to serve as the breadwinner for their family.

    The community-wide substance abuse problem has also been a major contributor to disabling accidents and injuries within the reservation population, especially among the young adult population. The toll that alcohol and drug abuse is taking on these young adults is frightening. Young adults are succumbing to substance abuse related accidents/injuries on virtually a weekly basis. Substance abuse related violence, vandalism, suicides/attempted suicides, assaults, and auto accidents among these age groups have become commonplace.

    Monday mornings, a numb community literally assesses the damage and counts the survivors. It is for this reason that the tribes will include in the vocational rehabilitation program model outreach services aimed specifically at these young adults, many of whom had reached a dead end in terms of educational and employment prospects.

  • Specific Learning Disabilities: The disabilities planning project revealed a significantly higher rate of learning disabilities among the tribal population than for the population in general. These conditions include Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE), dyslexia, attention deficit disorders, hyperactivity, and a high rate of hearing disorders associated with otitis media. A high percentage of reported learning disabilities are related to the severe health and environmental conditions within the community including lack of adequate prenatal health care, high rates of birth complications, and a high incidence of serious early childhood disease. Additionally, the high rates of substance abuse within the communities have resulted in some cases of FAS and a significant incidence of FAE.

Overview of Other services

SPIPA has consulted extensively with the state of Washington Division of Vocational Rehabilitation and Developmental Disabilities Planning Council in developing the proposed project model. The state has been candid in its recognition that it has not been successful in reaching the Native American population within the five reservations nor in the off-reservation tribal service areas. Thus, the proposed project would fill a critical gap in services that the state has not been able to overcome and the tribes have not to date had the resources to adequately address.

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