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Explore the Crow Nation's program for promoting Indigenous health care practices, research, and regulation within a legal framework. Learn about Tribal Banded Healthcare and the Turtle Healing Band.
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TRADITIONAL MEDICINE “The sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness.” (General Guidelines for Methodologies on Research and Evaluation of Traditional Medicine, World Health Organization, 2000).
U.S. TRADITIONAL HEALTH CARE • “Although the Secretary may promote traditional health care practices, consistent with the Service standards for the provision of health care, health promotion, and disease prevention under this chapter, the United States is not liable for any provision of traditional health care practices pursuant to this chapter that results in damage, injury, or death to a patient. Nothing in this subsection shall be construed to alter any liability or other obligation that the United States may otherwise have under the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.).” (U.S.C. Title 25, Section 1680u)(2010).
TRIBAL BANDED HEALTHCARE TRIBAL BANDED HEALTHCARE CHEROKEE MOTHERS OF ROBESON COUNTY NOTTOWAY TRIBAL COMMUNITY U.S. DEPT. OF THE TREASURY AND IRS HOOPA VALLEY TRIBE U.S. FEDERAL GOVERNMENT
IRC 7871 • Internal Revenue Code (“IRC”) 7871 allows for expanded fundraising opportunities without the need for a 501(c)(3) non-profit corporation: • Indian Tribal Governmental Tax Status Act of 1982 passed to give Nations/Tribes the same advantages as states; • 7871 provides Indigenous nations/tribes with the same tax advantages enjoyed by states governments when they receive grants from foundations, charities or individual donors; and • Any Nation/Tribally established fund, program, or subdivision that is an integral part of a Nation/Tribal government and is designed to perform charitable activities for exclusively public purposes is covered under section 7871.
INDIGENOUS HEALTHCARE FNMBIMIRBIHCPOTHB LLC
CROW NATION • OBJECTIVES • (Economic Development) • FNMB—Issues licenses for the practice of indigenous medicine; • IMIRB—Reviews clinical research for products and modalities used in the practice of indigenous medicine; • IHCPO—Issues business licenses to providers of indigenous medicine; • THB—Issues memberships to indigenous medicine patients.
FNMB FLOW CHART CROW NATION TRIBAL DONATION FNMB IMIRB IHCPO THB
FIRST NATION MEDICAL BOARD • OBJECTIVES: The First Nation Medical Board (“FNMB”) will qualify and certify providers for the practice of Indigenous Medicine (‘IM). The following objectives will be pursued: • Patient complaints handled by FNMB; • Records will be the property of the FNMB providers and are under the jurisdiction of the Crow Nation; • Tax deductions are available to IM providers for payments to non-profit entities (e.g., FNMB, Crow Nation, etc.); • Indigenous Medicine Institutional Review Board (“IMIRB”) will only accept study applications from licensed FNMB providers; • Business licenses will be issued only to FNMB providers; and • Tribal donations of five percent (5%) gross receipts is paid to FNMB and held in escrow for Crow Nation.
INDIGENOUS MEDICINE IRB • OBJECTIVES: The Indigenous Medicine Institutional Review Board (“IMIRB”) will assist the First Nation Medical Board (“FNMB”) and Crow Nation in defining, clarifying, and understanding the scope of practice for Indigenous Medicine (“IM”). The following objectives will be pursued: • Guidelines for research submissions will be established; • Applications will be accepted only from FNMB licensees; • Safety and efficacy of IM diagnostic devices, substances, and modalities will be assessed; • Availability of IM therapies will be published; • Clinical outcomes of IM research studies will be reviewed; • Social impact of IM research studies will be evaluated; • Economic impact of IM research studies will be studied; and • Means for developing an integrative relationship between IM and other healthcare concepts will be explored.
TURTLE HEALING BAND • OBJECTIVES:THB members agree to abide by the rules and regulations of the Indian Nation. The following objectives will be pursued: • Members will be protected by the 1st and 14th Amendments to the U.S. Constitution as well as the United Nations General Assembly (Universal Declaration of Human Rights adopted at the Palais de Chailot in Paris on December 10, 1948); • Members will be outside the jurisdiction and authority of federal, state, county, and city agencies and authorities; • THB member complaints will be handled by FNMB/Tribal Court; • Records are the confidential property of FNMB licensees; • Tax deductions will be available for payments to non-profits; and • Special offers from THB and its affiliates will be made only to THB members.
PURPOSE The Crow Nation is seeking to be the center of government for regulation of the practice of indigenous medicine by establishing a tribal: • Licensing entity known as “First Nation Medical Board (FNMB)” for issuing certifications for providers of indigenous medicine; • Research entity known as “Indigenous Medicine Institutional Review Board (IMIRB)” to monitor clinical research for natural products and treatments used in the practice of indigenous medicine; and • Business entity known as “Indigenous Health Care Practitioners Organization (IHCPO)” for issuing business licenses to providers of indigenous medicine. • Membership entity known as “Turtle Healing Band” for patients of providers of indigenous medicine.
TRIBAL GOVERNMENTS [As of July 2018, there are 573 federally-recognized Indian tribes in U.S.] • Tribal Government/Tribal Court Systems • Sovereign Immunity Government cannot be sued in its official capacity (Indian Civil Rights Act, 25 U.S.C. Sections 1301-1303)—applies to a tribe’s commercial as well as governmental activity within and without Indian Country (e.g., a valid exercise of tribal self-governance promotes economic development for tribal benefit). (Finn)(Kiowa) • U.S. Congress Congress has the power to pass laws that have the effect of waiving a tribes’ sovereign immunity, but the intent of Congress to waive a tribes’ sovereign immunity may not be implied, but must be clear and “unequivocally expressed.” (Testan)
INDIAN COUNTRY • The term “Indian Country” encompasses reservations, land set aside for “dependent Indian communities,” and “allotments.” (Pelican) • In 1832, Chief Justice Marshall held that “Indian tribes had always been considered independent political communities” and should be viewed as “a distinct community, occupying its own territory” over which state laws “can have no force.” (Worcester) • States have no jurisdiction over tribal affairs “absent a clear waiver by the tribe or congressional abrogation.” (Santa Clara)
INHERENT RIGHTS • The U. S. Supreme Court has held that the “policy of leaving Indians free from state jurisdiction and control is deeply rooted in this nation’s history.” (McClanahan) • Indians’ independence is supported by federal pre-emption doctrine as well as Tribes’ internal sovereign rights. (Bracker) • According to the Indian Reorganization Act (“IRA”), tribes are permitted to form corporations and other quasi-corporate entities in order to compete in the world of commerce without waiving their immunity. (25 U.S.C. Sections 461-494).
EXCEPTION • An exception exists where a “sue or be sued” clause is applicable (IRA of 1934, Section 17 (Corporations)), but this normally only applies to public corporations (e.g., housing authorities). (Marceau) • A tribal entity, “as an arm of the Tribe, enjoys the full extent of the Tribe’s sovereign immunity.” (Ninigret) (Shelley) • Officers of a Tribal entity are also personally protected—So long as “the actions of an officer do not conflict with the terms of his valid statutory authority then they are actions of the sovereign whether or not they are tortious under general law.” (Boisclair)
LOCATION • Location of a Tribe’s activity is not determinative with regard to the application of sovereign immunity. (Greene) • Tribal sovereignty exists “without drawing a distinction based on where the tribal activities occurred...[or]...between governmental and commercial activities of a tribe.” (Kiowa) • The doctrine of sovereign immunity extends beyond the geographical borders of a tribe’s reservation and covers commercial activities with persons who are not members of the tribe. (Bay Mills)
ENTERPRISE • Tribal enterprise operations cannot be understood as mere profit-making ventures that are wholly separate from the Tribes’ core governmental functions. Tribal enterprises “may be the only means by which a tribe can raise revenues.” (Cayuga)(Kiowa) • Goals of federal government are to render tribes: • more self-sufficient; • better positioned to fund their own sovereign functions; and • less reliant on federal funding. (McGowan)
STATE PROBLEMS • No real interest in indigenous medicine as it is a system based on health optimization, as opposed to disease management; • Demonstrated no clear intent to regulate the practice of indigenous medicine; • No statutes or regulations in place for indigenous medicine other than the states of NV and AZ for homeopathic medicine; • A Weak and non-compelling argument to do so ex post facto; • No advantage of their administrative courts (a.k.a. “Kangaroo Courts”) and will be forced to challenge in: • Tribal Court; and/or • Federal Court; • State medical boards were created to regulate the practice of conventional medicine and the use of controlled substances (a.k.a. “dangerous drugs”) and not the practice of medical alternatives.
SUMMARY OPINION Crow Nation has the right to pursue economic development for tribal benefit by: • exercising tribal jurisdiction over indigenous medicine; • under the protection of its sovereign immunity; • where such jurisdiction has not already been exercised by another nation or state.