Indian Health Board of Minneapolis a 50 Year Vision for the Future

Fresh out of Family Practice residency at the Hennepin County Medical Center in 1997, Dr. Patrick Rock (Leech Lake Band of Ojibwe Tribal member) was hired by the Indian Health Board of Minneapolis (IHB). Dr. Rock became IHB’s first Native American staff physician. Over the years, IHB came to rely on Dr. Rock’s gift of seeing the big picture and he eventually accepted the role of medical director, then later became CEO. Now, after 25 years of service, a different leader might be tempted to take a breather or rest on the tremendous accomplishments of IHB, but not Dr. Rock. This small Federally Qualified Health Center (FQHC) has grown to include medical, dental, and counseling clinics, a psychology training program, chemical dependency and medication-assisted therapy programs as well as numerous culturally-integrated health and wellness grant programs, and an innovative COVID team. No time to rest, Dr. Rock finds himself looking to the future and drawing on his inner resolve to carry forth a community vision for the next 50 years. Despite these uncertain times, IHB is in steady hands. The FQHC has expanded services and is poised to open a new campus on east Franklin Avenue, in the heart of Minneapolis’ American Indian cultural corridor. Getting IHB to this point necessitated staying power of key leadership, and skills one does not learn in medical school such as smart land investment decisions, political representation at the state level, and a keen understanding of Urban Indian Programs nationally. Dr. Rock might argue that IHB came this far by remaining true to the history and mission of IHB’s founding and the centered approach of a nine member community board of directors. In 2021, IHB celebrated its 50-year anniversary as the first urban American Indian clinic funded by Congress. As IHB grew, so did the community of Native organizations and initiatives in the Twin Cities, but such growth was not always the case. In fact the clinic began as a direct community response to the death of a young Native American woman, Gloria. She had come to Minneapolis from a reservation in Minnesota seeking a better life. Instead, in the city, Gloria faced discrimination, poverty, and premature death due to hepatitis when she was unable to access hospitalization in Minneapolis. Native people organized in grassroots fashion and founded IHB in response to her tragic story, which was detailed by Bill Moyers Journal in an episode entitled: “Why Did Gloria Die?” The Indian Health Board of Minneapolis is a place of tremendous history. Just as a Native person might introduce themselves with tribal affiliation and where their family comes from, IHB’s origin makes better sense in context of the Phillips neighborhood and Federal Indian Policy. Phillips in Minneapolis is one of the most diverse neighborhoods in the US. While immigrant communities have historically found Phillips a launching pad to success, Native people claim Phillips as an own urban homeland. This is due in large part to Little Earth of United Tribes public housing, the only tribally-owned public housing in the country, and other nearby Native-focused housing, community meeting places, galleries, cultural centers, and businesses. Phillips retains its Native American identity despite bouts of gentrification nearby and demographic fluctuations. In the nineteenth century, Native people were forcefully removed from Minneapolis and returned cautiously over the span of nearly a hundred years prior to the founding of IHB in the late twentieth century. The Indian Removal Act of 1863 forcibly drove Dakota people out of their homeland including the resource-rich Minneapolis area. Dakota people were exiled to reservations on leftover land in the west. At this time, Phillips was being developed due to its proximity to rail yards. While western

Phillips became a mansion district for some of the city’s wealthiest families, the eastern area was built for workers and industry. The latter left Phillips with a legacy of arsenic contaminated soil and other environmental challenges that still plague the community. After the Great Depression, housing in the area deteriorated and in the 1950s, parts of East Phillips were characterized as slum and rooming houses were the only housing option for many families. While some Natives came to the cities as part of the World War II work effort, many more began to move back to urban centers like Minneapolis due to the Federal Indian policy of Termination, which sought to remove tribes, and the companion assimilationist effort to move Indians off reservations, a policy known as Relocation. At the time of IHB’s founding in 1971, Native people were living in Phillips due to Relocation, but neither thriving nor assimilating. Relocation is widely considered a failed policy that did not live up to the promise of jobs and prosperity. The tragic story of Gloria embodies the struggle of many Native Americans of the era. Gloria relocated to the cities only to face poverty and lack of opportunity. IHB’s formation came at a time when the government had ushered in a new era, ending Termination and Relocation and embracing Federal Indian policy that remains in effect today. In 1970, President Nixon proclaimed the beginning of the policy of Indian self-determination and in 1972 the Office of Economic Opportunity provided funds for urban Indian clinics in Minneapolis, Rapid City, and Seattle. The original vision of IHB has not changed. Humbled by his predecessors, Dr. Rock states “It didn’t start with me. My job is to carry forward the shared mission of serving the community.” What has changed is that the community is more vocal about priorities and we follow our own lead on issues such as environmental justice, lack of affordable housing, homelessness, crime, addiction and overdoses, as well as human trafficking. With these serious issues in mind,

IHB recently unveiled plans for a new culturally-centered campus located in the heart of the Native community. IHB Administrative & Specialty Services Center 27,000 SF, Future Sacred Garden Plaza, IHB Counseling Center 7,700 SF and a newly constructed IHB Medical & Dental Center 42,600 SF new building on East Franklin which will mark the eastern gateway to American Indian Cultural Corridor.

the leaders of IHB work to create financial sustainability through bonding and revenue for the next 50 years. Healthcare services payment parity remains a perennial lobbying item and recurring topic of conversation for Dr. Rock who has pursued equitable reimbursement with relentless determination. The Indian Health Service (IHS) partially funds urban sites, in IHB’s case, mainly in the form of grant initiatives. Although IHB operates under the umbrella of the IHS, IHB does not receive the higher IHS reimbursement rate from Medicaid/ Medicare. Clinic leadership continues to lobby the State of Minnesota to increase the reimbursement rate to match the IHS reimbursement rate for Medicaid. Today, IHB’s new campus pre-development phase and building plans are coming into focus. In the new buildings, IHB will do what it does best: continue to address health inequities and remove barriers to care. Like the IHB of the last 50 years, the new IHB will be a place that builds community pride and serves as a trusted medical home for historically traumatized and marginalized people. An orientation to Native American health initiatives in the Twin Cities should include clinics like IHB and its friendly competition, the Native American Community Clinic. Native American health is a holistic organic movement that is starting to permeate the entire Metro as we collectively acknowledge the Native origins of the land and as we take a hard look at the imbalance of prosperity and wealth that shaped the cities. IHB acknowledges that closing health disparities is a great challenge within our own community. We witness our relatives suffering displacement and illness while also celebrating the international success and genius of local Native innovators. As such, IHB serves as both a safety net and a vehicle of creative renaissance as we promote holistic health and collaborate with the local organizations and businesses who carry on Native traditions of food sovereignty, education, ceremony, dance, art, literature, and wellness. IHB finds itself envisioning the future from solid ground. And we are far from alone in our vision and action, because we are only one of the many local native-led organizations honored to share responsibility for the holistic health of future generations in this great Native American metro.

Angela Erdrich, MD (Turtle Mountain Ojibwe Tribal member) is a pediatrician at Indian Health Board and can be reached at 612-721-9800.