Native Federation Video 2526606721442955

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Okay, AFN delegates, it's 1:25. I'm going to go ahead and call our meeting back to order.

I'm gonna introduce our Vice President, Nicole Stoops, to deliver our preliminary credentials report. Nicole is Vice President of everything at AFN. She does it all for us. So a round of applause for Nicole.

Thank you, Joe. Good afternoon. On behalf of the Credentials Committee, I am pleased to report that 11 out of 12 regional corporations, 11 out of 12 regional nonprofits are registered and are able to vote. 183 Out of 247 village corporations have paid their dues and are registered to vote. 161 Out of 247 tribes are registered and are prepared to vote.

Registration is located on the first floor by the escalators and will remain open until 5 o'clock today and until 5 o'clock tomorrow. Please keep in mind that registration will not be available on Saturday, and the final credentials report will be given on Saturday morning. Thank you and welcome to the convention.

So, we're going to hear from our IHS Director, Marc Cruz. I'm going to invite to the stage a team here to help with the introduction. We got Tom Ingalls, Administrator of the Health Resources and Services Administration. We also have Chair Strong and CEO Natasha Singh, I think, are going to be part of this segment here, and I want to go ahead and invite Tom to go ahead and make the introductions for our IHS Director.

Well, good afternoon everyone. This is ultimately the toughest act to follow. So you talk about your theme, your theme of rooted in land and tradition and rising in our voices. That is a great representation. And so I think you've got to give them another round of applause.

I truly— this is my first time visiting Alaska. And I am so impressed by these views. I don't know how every day you can't look around this and not take this for granted. Absolutely beautiful. And it's a privilege to be here with all of you today.

I do respect, and I'm the administrator of the Health Resources and Services Administration, which is part of the United States Department of Health and Human Services. We represent federal government here today, but we also understand the government-to-government relationship that we have with each and every one of you and your tribes. So it's a privilege to be here today. And I just want to have a chance— I've had a chance to go out and meet with some of the entities already. And I'm looking forward to more meetings.

But we understand the challenges that you have here, and that's why HRSA is looking forward to working with— in partnership with your governments as we work to try to bring about change for healthcare and knowing the challenges that you have in that healthcare system, whether it's bringing about the workforce that you need. One of the things that I've really learned about today is the challenges that you have in distance and trying to get access to healthcare. I take it for granted when I'm in Madison, Wisconsin, and know that I've got to drive 28 miles to get to the hospital. You may have to get 28 miles just to get to the airport and then ride in another plane for another 500 miles before you get to healthcare. We need to help work partnership.

That's why we're helping our Federally Qualified Health Centers here in Alaska and our Indian Health Services to help bring about real change, to help bring about opportunities for all of you. You have the same challenges that we have in the lower 48, but your challenges are exponentially bigger. And we understand that. And that's why we're going to work together on this. Going forward, going forward, we want to help you in infrastructure changes.

We want to help you in recruiting of providers. Because we know you are taking care of your elders. We know you are trying to take care of your families. And we know all of that is just as important to you as it is to anybody else. And by driving these solutions together, we're going to bring about that change.

One of the changes that we're actually implementing and we're carrying over for another year is this year HRSA is dedicating $16.9 million for tribal set-aside through the National Health Service Corps Loan Repayment Program to support eligible clinicians serving in Indian Health Service facilities tribal-operated programs, and urban Indian health facilities. We know you need these opportunities. We know that the struggles you have of trying to bring healthcare providers into some of your areas is exponentially bigger than some of the areas that we see, and we also know that paying those providers in those areas is a huge problem. We're going to work together on this. We want these providers to come out here because one of the things that I've noticed when we're out here, when you have views like this, why wouldn't you want to come to Alaska?

Why wouldn't you want to serve people here in Alaska? Because this area is massively bigger than the lower 48. But you know what, ladies and gentlemen, you have providers that are already here and providing these services that are dedicated to to helping the health and well-being of Alaska Natives. And we're here to support that. And one of the people that's here to support along with me is a truly great friend of mine.

And I have to take this opportunity to introduce Margaret Bush, who's the Deputy Administrator of the Health Resources and Services Administration. She and I are having an opportunity to tour a number of facilities today. But one of the things that we're doing is that we recognize Alaska is unique. And Alaska needs to have a different system put together than what we see in the lower 48. And we're gonna work to— when we have those opportunities, we're gonna certainly keep that in mind.

But one of the best partners that you have, and probably the strongest advocate that you have working in the Department of Health and Human Services, separate from the Secretary but works closely with the Secretary, Secretary Kennedy has tapped Mark Crews. Mark Crews is a true advocate. For tribal representation. Mark Cruz really understands the importance of that government-to-government relationship. But Mark Cruz knows what the tribal representation needs and what that actually means.

It's a privilege for me to have an opportunity to work with Mark, because Mark is a good friend, but Mark is also a good friend for tribal representatives and speaks your language. I want to have this opportunity to introduce the true, and what would it be, the 12th leader now, Mark, of the Indian Health Services, and he was recently confirmed by the United States Senate. It's an honor to work with this man, and it's an honor to say I get to introduce him today as my friend. Ladies and gentlemen, please welcome Mark Cruz.

Hello, good afternoon. I think I'm going to get this right.

Chamai? Chamai. Well, first off, thank you, Tom. I really wanted to have HRSA here with us because they have such an important role here in the state of Alaska. And I really appreciate Administrator Engel's partnership.

With me at the U.S. Department of Health and Human Services. I also want to thank Senators Murkowski and Sullivan for their support of my nomination and confirmation in the United States Senate. President Trump nominated me to be the 12th Indian Health Services Director on June 1st, and Senator Murkowski's Senate Committee on Indian Affairs team worked very quickly to give me a hearing and work me out of committee and a floor on the United States Senate floor vote. I had two wonderful meetings with the two senators, and, you know, your issues were at the forefront of both of those conversations. And so I humbly want to thank them for their support.

The other thing I've learned over the years is Alaska Native issues are very different. And as a member of the Klamath Tribe and someone who grew up in a tribal community in southern Oregon, You know, I fully appreciate that and respect that. But I couldn't have had a better mentor and friend to teach me the nuances of Alaska Native issues and policy. And that's when I worked with Assistant Secretary Tara Sweeney at the U.S. Department of the Interior. You know, I know she was unable to be here today, but I consider her family.

And that you guys have no better advocate on Alaska Native issues than Tara Sweeney. I also want to acknowledge a federal partner at the U.S. Department of the Interior, Assistant Secretary Kirkland. He and I work very closely together, as well as Cara Moriarty, the Secretary's advisor. I really appreciate all that she does. You know, I can't do the work that I do without strong partnership across the state of Alaska, and another person I'd like to acknowledge and thank for their support and their knowledge is Gloria O'Neill here at Cook Inlet.

I also have the benefit of working closely with the Secretary's Tribal Advisory Committee. Last summer Secretary Kennedy and I had a wonderful visit here in Alaska. We attended the MEGA meeting. We went up to the Chief Andrew Isaac Health Center in Fairbanks. Really had a wonderful meeting with the Tanana Chiefs Conference.

So, I want to thank Sharon Hildebrand for her leadership there at TCC. We also had an awesome day out at Kenaitze. I want to thank that community, especially Diana, who also serves on our Secretary's Tribal Advisory Committee. And I also want to acknowledge Victor Joseph for welcoming us out to the Native Village of Tanana there on the Yukon. Those were very insightful visits and helped the Secretary and I, you know, prioritize what we heard here on the ground in Alaska.

A couple programs of note here in Alaska that as the 12th Director I want to kind of reiterate my support for is first, tribal self-governance and tribal self-determination. As the new Director, you know, those things aren't going to change and I'm going to continue to support the work that happens. Both on the contract support cost front as well as the 105L lease programs. I also want to, like, thank you for the hard work and years of experience on the CHAP program, the Community Health Aid Program. It's become such a successful model here in Alaska that the lower 48 tribes are asking for it.

That's why last month I signed off on the first grant awards for 4 sites in the lower 48 to develop and build out their CHAP program capacity. And that's all modeled off the fantastic work that we saw here in Alaska. So thank you for those of you that have done that work.

You know, I get this amazing opportunity to serve as Senior Advisor to Secretary Kennedy, and I just want to highlight a couple of things that are of note to Alaska. Earlier today, the new CDC Director, Erica Schwartz, who will be visiting Alaska next week, she signed her order to move the Office of Tribal Affairs to the immediate office of the director. That's something we heard from tribal leaders and something that we're very happy that we were able to execute upon. I'm also very familiar with the significant work that CMS is doing up here in Alaska. You know, we hear about it all the time as we visit these beautiful facilities up here, the importance of third-party revenue from billing.

You know, those are all things that we'll continue to support. We also hear about the opportunities with the Rural Health Transformation Fund. So we're very excited to see the state make those awards and see what folks across this great state do with that, with those awards. You know, one of the things that I heard over and over again last summer, and I continue to hear from your leadership, is the need for more mental health and wellness to fight addiction. You know, I'm happy to report that the Secretary of the Interior, as well as the SAMHSA, are leading our Great American Recovery Initiatives and taking the input that we hear from both American Indian and Alaska Native communities.

And so we take that work very seriously. As director, one of the things that I'm very clear with the team on is I'm happy to support robust resources in this network. I'm happy to support self-determination and moving that authority to where it needs to go. But at the end of the day, you know, as the director for the Indian Health Service, my job is patient care and looking out for the most vulnerable amongst us. And I never want us to forget that.

You know, it's our aunties, it's our uncles, it's our family that come to these clinics in their greatest moments of need. And we get to be a part of that solution and use that as an opportunity to help heal them at no matter what moment they may need that health and care.

So with that, you may have also read recently, and I wanted to save this piece for last is I was commissioned by President Trump on August 20th, which was the end of that third week in August, and I went to Rockville IHS headquarters on Monday the 24th, and my first action as director was signing the deed to transfer the Alaska Native Medical Center over to ANTHC.

So I want to make sure we— I do, uh, do, uh, do this right here, but that act alone was based on years of hard work, of effort, multiple people, people who are no longer with us in this world. You know, I fully acknowledge that and appreciate all of that. And we heard— Secretary Kennedy and I heard very loud and clear in the summer of 2025 that this was a priority of the Alaska Native community, is to get that transfer done. When we went back, Indian Health Service told us, "Oh, these normally take 3 to 5 years." And I was sitting across town in a cold room with the Secretary, and he looked me in the eye and he told me, Mark, get this done in 3 months. So I went back to the team and I said, let's get it done in 3 months.

And we ultimately negotiated and we came back at 1 year. I'm happy to report we were able to get that transfer done not only in under a year, but in about 9 months. And that included a lot of hard work from many staff members. So I'm going to go through a list here of thank-yous, but From ATHC, from the bottom of my heart, I want to thank everybody on that side, including Natasha Singh, Jim Roberts, Monique Martin, Peter Rechmeyer, Josh York, Rob Lynch, Brandon Biddle, John Laundez, and Kristin Kiniak Friday. From the state of Alaska, I want to thank the governor for acting quickly when we needed his signature.

And from the Indian Health Service team, they're over here on my side. As I call your name, please raise your hand. Lyle Claw, our acting area office director. Thank you, Lyle, for your leadership there. Please give him a hand.

We cannot have gotten this transfer done without Lyle leaning in on this and, you know, being tough on the team to get it done and meet those deadlines. So I really appreciate his hard work and leadership. Thank you, Lyle. I also want to thank Hugh Denny and Jason Severing. And Luke Vanderwagen from the IHS team.

It got to the point where we were doing weekly reports. They were sending me weekly emails so I knew where things were and knew where we needed to break things loose. And again, the Secretary really cared about this getting done quickly and done right. And so we could not have done it without their hard work. And as the new director, I want to give you guys all the appropriate acknowledgment and kudos for that hard work.

So, If you guys can all join me in giving the IHS team a round of applause.

So with that, I look forward to our continued partnership together. I'm on— just finished 2 months on the job and I'll be back. I've had a number of invitations. Look forward to getting out to your communities and truly finding out who has the best salmon. As a member of the Klamath Tribes, you know, we are a salmon people.

And so it is a very, very competitive thing. I've gotten a jar from Bristol Bay earlier today. That jar is going to go directly to Secretary Kennedy. As I do travels across Indian Country, I get these gifts and I'm always sure to share the bounty with the Secretary who greatly appreciates that. And, you know, salmon is actually on our updated dietary guidelines for Americans.

You know, he and I fought to include that. And you may notice that this polo I'm wearing has a puffin on it. As we were talking about traditional Native foods that we could put on the food pyramid, I heard that some Alaska Native communities like eating puffins and eating their eggs. And, you know, I had to fight to keep them off of that food pyramid because being from Oregon, I'm actually invested in puffin recovery. At Haystack Rock.

So, you know, come to find out, I'm like, these Native communities are eating their eggs. So, you know, we may disagree on that matter, but there's plenty of us for, plenty of us, plenty for us to agree on and work on together. So with that, I really appreciate it from the bottom of my heart. Kweyana. Thank you.

Thank you. Stay with us here on stage, Director Cruz.

I will trade you a jar of Yukon River salmon for a new electronic health record.

The Alaska Tribal Health System is a testament to the power of the Alaska Native unity, sustained advocacy, and tribal leadership. For decades, Alaska Native leaders have advanced self-governance, shaping programs, services, and future of healthcare for our people. The legacy of unity and self-determination brings the AFN convention theme to life. It reminds us that our strength comes from who we are, and our collective voice determines where we go next. Just this morning, Alaska Native Health Board hosted Director Cruz in tribal consultation, where your tribal leaders gave him the what-for.

But that's not what this is about.

I don't know how we can give the what-for to somebody that was able to move mountains so quickly. I want to give my deepest appreciation on behalf of the board of directors of ANTHC for his speediness on his first day of work signing the deed of transfer of the Alaska Native Medical Center to ANTHC.

He is really catapulting Alaska Native healthcare in our tertiary care in a new way where we really— he is— he talked about self-determination, and that's what it's about. When we have control of the facilities, it's just not a building. It is— it is— We have the greatest amount of appreciation again for this work that he does, has done.

The Alaska Native Medical Center is where patients across the Alaska Tribal Health System come together for specialty inpatient and tertiary care. Recognizing the hospital's role in the statewide system, before ownership, the ANA board invested $462 million to fund the largest expansion in ANMC's history. Ownership will give Alaska tribes greater ability to shape the hospital's future. It will give the board greater ability to steward this essential statewide resource, and it will empower tribal leaders to make investments that enhance care and strengthen the health of patients and families.

The ANTHC board remains committed to addressing generations worth of deferred maintenance and needed expansion at our hospital. We are working on plans to invest more than $1 billion in clinical facilities over the next decade. Director Cruz, on behalf of the NTHC Board of Directors and the tribes and tribal organizations within our system, say, "Gunaalchiish." Thank you.

Thank you for recognizing that tribal ownership is more than the ownership of a building. It's about the ability of Alaska Native leaders to determine the future of our healthcare system. Your partnership has turned generations of advocacy and vision into action. On behalf of ANTHC, we are proud to present you with a gift that reflects our gratitude and our meaningful role you played in this historic milestone. Thank you.

Thank you.

How about one more round of applause?

Thank Chair Kimberly Strong and President Toshio Tseng and Director Cruz and all those working in the healthcare industry. I was born in that little hospital in Manajkam, pre-ANCSA. And my sister's been delivering babies down there, helping deliver as a nurse for many, many years. So just to all those in the healthcare industry, thank you. And what a novel idea, you know, for us to get deed to some of our land.

Somebody I'm going to introduce now has a lot of— a good long history here and is an expert in the field. Such the expert that he makes decisions for us on the supreme law of the land of Alaska. In Alaska we have 5 Supreme Court justices, and today we have Justice Jude Pate to present to us some perspective from the Supreme Court. And somebody who's a fellow lawyer but also from Southeast, I can attest this guy is, he's one of us. He cares about us.

He understands our communities. And he's just a true champion for us and our way of life. And a lot of gratitude from me to Justice Jude Pate for serving at our Alaska Supreme Court.

Thank you delegates, AFN board.

I come today bearing a fairly simple but important message from the Alaska court system. Your voices are heard. We hear you.

Kinda Shakwe'ish, yuhat duasakw. My name is Kinda Shakwe'ish. I am so proud to have an honor to have been adopted by the Sikhah Pluknakhari Clan 30 years ago. By Phil Nielsen, my brother.

Son of Dasté Ya Ethel MacKinnon. And I want to thank my sister Lillian Young, who, to the extent my Tlingit is passable, she gets the credit.

30 Years ago, I started, I came to Alaska.

I didn't work for a law firm. I didn't clerk in the Supreme Court or state court. Guess where I started out? Tribal court clerk. I was a tribal court clerk for years.

And there I saw the essence, the root of justice.

I saw due process living and breathing by Chief Judge Bill Brady in the tribal court. Judge Brady did not wear a robe. Judge Brady did not sit on a podium higher than other people when he was holding court. When you came into Judge Brady's courtroom, it was like going to your grandfather's kitchen table and having a serious conversation. And Judge Brady, every hearing he had, he made sure that whoever was impacted by that decision had an opportunity to be there.

And he treated every person who came into his courtroom, basically around his table, with respect and dignity.

It's that grandfather wisdom, that grandmother wisdom, the root of all justice, due process, that I learned in tribal court and that I carry with me, and my brothers and sisters on the Supreme Court carry with them to this day. That is what we share together, tribal and state, at the root.

I want to tell you a short story. I'd been at Sika Tribe as an attorney for 5 or 6 years, and there was an election dispute. Oof. All the tribal council members who were up for election lost, and they were unhappy, and they wanted to do something about it. What did they do?

Did they go to federal court like some tribes do when they have election disputes? No, no. Did they go to state court? No. Did they call the police?

No. They went to their own court. They had such faith in their own court that they took their most important decisions there, just like the people who were looking to have their families healed went to Judge Brady. And to be a part of that, to be a part, to help just even a little way in maintaining a court system that the people themselves had such faith in, that is the proudest moment of my career.

It's not— we have troubled times. We have so many disagreements, every place. Our disagreements do not define us. We are defined by how we resolve our disagreements. And how do we do that?

By listening, by due process, by hearing one another. I'm gonna briefly tell you the ways the court system is listening to you. One way, therapeutic courts, joint jurisdiction therapeutic courts. Where a tribal judge and a state judge sit together. Think about that.

That wouldn't have happened 35 years ago. And today, you have state judges and tribal judges sitting together deciding incredibly important cases. The HINU Court in Kenai, I had the honor of sitting with Judge Pam Steffes of the tribal court in a joint jurisdiction court. Another very simple way that we're making sure that we hear you is text reminders for your hearings. If you have a court hearing, if a loved one has a court hearing, if you're just interested in a case, all you need to do is take your iPhone and wave it over the magic QR code, and you will be let right in.

You'll enter your case number, and you will receive updates about your case, or the case you're interested in.

Another way that we make sure we're listening, and this is important but simple, is having dinners together. Together with my friend and comrade Chief Justice Aurora Laird from the Tlingit and Haida Tribal Court, about 3 years ago, we started Dinners in Southeast, where every 6 months, we sit down, tribal and state judges, and court staff, and we alternate the locations in Southeast. We go around and we talk about issues. We don't talk about specific cases. We get to know each other as human beings.

So when the hard decisions come, when the disagreements come, there'll be a basis there for trust and respect. Breaking bread with someone, sharing a meal with them, builds that trust. In fact, next week we are going to Prince of Wales Island, and the tribe is hosting. And then 6 months from there, the state will be hosting at some other place in southeast. It sounds simple.

If you— there are these dinners and gatherings are happening between state and tribal judges and court staff in other parts of the state. If they're not happening, or you don't know about them, go to your state judge. Go to your tribal judge. Tell them that you want to see this happen. There's probably tribal judges in this— I know there's at least one tribal judge in this audience.

There's probably others. Go to your state judge. Go have coffee. Get to know them.

There's a couple other ways that we're helping the Alaska court system is hearing your voices. One is community justice workers. We live in a legal desert. We do not have enough lawyers to begin to service the needs, especially in rural Alaska, in the villages. And together with Alaska Legal Services, we're helping make sure that community justice workers, those are non-attorneys, but they're trained, and they can go in and provide services, basic services for you.

I also ask you to think about if there's a criminal case you're interested in, and it's affected the community drastically, and you want the community to be involved, there's a process called 11. It's a criminal rule, 11. Excuse me, 11, and it tells our state judges that under certain circumstances that yes, we want the tribe involved, and in fact, maybe doing circle sentencing in very serious cases. But there's one area where we're not doing a very good job. There's one area where we don't hear your voice.

We don't hear your voice speaking on the bench in District Superior Court. We don't hear your voice speaking on the Supreme Court. What am I saying? I'm saying that since Roy Madsen was a Superior Court judge from Kodiak some 50 years ago, and Nora Gwynn before him as a district court judge, there hasn't been, that I'm aware of, an Alaska Native judge. So what do we— we can't have that, can we?

Is that right? No, it can't be. It can't be right. So what do we do? We don't have a law school.

That's where you get most people to come and think, you know, get more lawyers. We need more Alaska Native lawyers. How do we make that happen? If we have enough Alaska Native lawyers, then hopefully there'll be enough to populate the benches in state court.

One way is very simple. We plant seeds. It takes a long time. It takes patience. It takes trust.

Plant the seeds. 20 Years from now, maybe a decade from now, they will bear fruit. Ha daach haan eeyaan jees. For our grandchildren. One way we do that is through the Color of Justice program.

The Color of Justice program is an educational program for high school students, and we spend 2 days, 2 and a half days with those students, lawyers, tribal judges, state judges, paralegals, trying to spark the minds to get those students to see themselves as being lawyers, as being judges. And I can tell you, I help operate the one in Sitka at Mount Edgecumbe.

And the last two times we've done it, it's been a program for about two decades now, the last time we've done this, we have begun to have former Mount Edgecumbe students who attended Color of Justice who went to undergrad, who went to law school, and now are coming back as lawyers in Alaska serving their communities and presenting at Color of Justice. When those students see people who have walked in their shoes, when they— when those people— when those students see that it can be done, it shows them how to be done, their faces light up. They— I am sure that we've planted some seeds that way. Another way is externships and internships. Our court system has a variety of ways for you, your youth, to participate and see if they're interested in a legal career.

I, my chambers personally in Juneau, has an externship program. It's 10 weeks. It's remote. And I, it's basically a law school course. You get a— for 10 weeks, you get a law school course.

It's meant for undergrads to get their— see if they're interested, if they like the law, and to give them a taste of what law school might be like.

We give them credit. We've set up credit through the Alaska University System. And I want to speak out to 2 people specifically now. One is Sarah Byoff. Sarah Bayoff is from Nome.

She attended our, my externship program 2 years ago, and guess where she's at now? The Seattle University of Law. And she is coming back, and she's gonna work in her community.

Another is Martin Carmen from Anchorage. He attended the program last year, and where is he now? He's at American University. He's an undergrad, but he wants to go to law school. In fact, he's interning with Senator Lisa Murkowski now.

So, Martin and Sarah, those are the people that I see, I want them standing in my shoes in the next few years. I want them speaking to you as a Supreme Court Justice.

Don't be silent. Let your voices be heard. Get to know the judges in your community, tribal or state, get to know them. They need to hear your voices. That's the only way that it will work.

And in a few weeks, with many of the state judges on the ballot, your voices will certainly be heard and rising. Thank you.

How about one, just one more round of applause for Justice Pate.

We're going to do a little shuffle on stage and get ready for a panel. This panel is on the independent travel market. As we're getting ready, I'm just going to, I guess, make the comment about Justice Bate and the system because one of my hats, I mentioned before, is Alaska Legal Services.