Washington Lawyer - March/April 2025 - 15

FEATURE
that meant something monetarily, " says Pavel, founding president of the
Native American Bar Association of Washington, D.C. She has also served
as staff director and chief counsel for the United States Senate Committee
on Indian Affairs.
Pavel's mother was a leader in the tribe at the time. " She had to build
houses, have health care and educational programs that responded to
the needs of children. She had to have water, infrastructure. And by embracing
the Indian Self-Determination and Education Assistance Act ...
she could begin to have control, " Pavel says.
TRANSFORMATIVE IMPACTS
Signed into law by President Gerald Ford in 1975, the ISDEAA illustrates
both the federal government's unique trust relationship with Native Americans
and the legislation's underpinning substantive self-determination.
" Federal domination of Indian service programs ... has denied to the
Indian people an effective voice in the planning
and implementation of programs for the benefit
of Indians which are responsive to the true
needs of Indian communities, " the law states.
The ISDEAA further states that " Congress declares
its commitment to the maintenance of
the Federal Government's unique and continuing
relationship with, and responsibility to,
the Indian people as a whole through the establishment
of a meaningful Indian self-determination
policy which will permit an orderly
transition from Federal domination of programs
for, and services to, Indians to effective
and meaningful participation by the Indian
people in the planning, conduct, and administration
of those programs and services. " The
ISDEAA was substantively amended in 1988,
1994, and 2000, and has been the focus of four
U.S. Supreme Court cases and many disputes
in lower courts.
Mary Smith, a member of the Cherokee Nation
and the first Native American woman to serve
as president of the American Bar Association,
says the ISDEAA was a major turning
point for Native Americans. " The act reversed a
30-year effort by the federal government under
its preceding termination policy to sever treaty relationships with and
obligations to Indian tribes, " says Smith. " The act was the result of 15 years
of change, influenced by American Indian activism, the civil rights movement,
and grassroots political participation. "
By enacting the ISDEAA, Congress recognized " that tribal leaders and
members are in the best position to understand the critical needs and
priorities of their communities " and " the importance of the nation-tonation
relationship between the United States and tribes, " Smith adds.
The ISDEAA directly supports the transfer of governmental responsibilities
- most prominently, but not solely, for health care and self-governance
- to tribes and tribal organizations. Pursuant to negotiations,
contracts, and compacts, the federal government transfers funds to
these Indian-run programs.
Smith formerly served as CEO of the national Indian Health Service (IHS)
within the U.S. Department of Health and Human Services (HHS), which
supports tribe-run health care systems under the auspices of the ISDEAA.
She is currently vice chair and principal of the government relations firm
The VENG Group and is a board member with PTC Therapeutics.
" My grandmother, Ora Mae Pallone, was born in 1905 in Westville, Oklahoma,
to a family of 16 children, only 10 of whom lived above the age of
three because of a lack of adequate health care. It was in honor of my
grandmother that I decided to assume the role of CEO of the Indian
Health Service, " Smith says. " I wanted to improve health care for Native
Americans, ensuring that they were a partner with the federal government
and able to exercise their right of self-determination to provide the
best health care in their communities. "
The independent tribal health care systems fostered by the ISDEAA are a
standout success all over the country, with more than 60 percent of IHS
We are still trying
to animate Justice
Marshall's vision
of what that federal-
tribal relationship
was meant to be.
MARY PAVEL, Sonosky,
Chambers, Sachse, Endreson
& Perry, LLP
appropriations administered by tribes through self-determination agreements.
Smith cites the opening of the first tribe-affiliated medical school
in the United States, located in Tahlequah, Oklahoma. The Oklahoma
State University College of Osteopathic Medicine at the Cherokee Nation
produced its first graduating class in 2024.
Smith also points to Alaska as an emblematic success. " I saw the reach
of self-governance all over Alaska, from the Alaska Native Medical Center
in Anchorage to the [Yukon-Kuskokwim] hospital in Bethel. I also traveled
to Alaska villages like Chevak where the ISDEAA and the Indian Health
Care Improvement Act bring health care to the most remote areas of the
state, " Smith says.
" The implementation of the ISDEAA has been transformative to tribes, "
adds Smith. " The number of tribal self-governance program success stories
grows each year. "
MARCH/APRIL 2025 * WASHINGTON LAWYER 15
Jeremy Conrad
Washington Lawyer - March/April 2025

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