When I came back to Alaska, I wanted to bring our leaders together to see if other people here thought it made sense as well. So I asked people from the National Center for Medical-Legal Partnerships and people from the Navajo Nation Project to come and show our community what`s going on there. We brought together health care leaders from across the state, as well as state judges from our Supreme Court and our judicial system. The next thing we learned is that there is no law school here. In the 50 years we`ve operated, we`ve relied on importing people from outside Alaska, mostly white, to serve communities that are predominantly non-white. There are not as many American Indian or Alaska Native advocates as we would like. The health system faced the same dilemma; It relies heavily on importing professionals from outside Alaska for a short period of time. More than 20 years ago, they began developing systems – a community health assistance program that has expanded over time to include dental health therapists and behavioral health assistants – in which they recruit people from local communities and provide training, including through distance learning. to develop a more culturally appropriate, community-based workforce.
Caregivers are then able to serve their communities and are supported by senior physicians or practitioners when needed. And we thought we should do the same with legal aid. Alaska has the highest proportion of Native Americans of any U.S. state. Its 229 tribes make up 18 percent of the total population, and many of them live in remote communities that are difficult to access by public services. Nikole: Our partners in the health sector have made us think about how we can rethink our entire civil legal aid system. They were so far ahead of us in so many things. For example, in the stratification of practitioners. It is not really possible to have a doctor in every village or a specialist of all kinds in a central community, but there may be a nurse or a health worker. There are quite a few health care providers who are qualified to provide a range of services – you don`t need a doctor to give a vaccination. It got us thinking about how we could do the same kind of stratification in the legal system. Do we really need a lawyer to help someone fill out a power of attorney form? Are there things we could train people who did not have to go to law school to do competently and effectively? Alisa: Can you tell me about the goals of Alaska Legal Services and the Native Health Partnership in particular? Nikole: Alaska has a tribal-run health care system run by Alaska Natives themselves.
Although largely funded by the U.S. federal government as part of its treaty obligations, the health care system itself is run by Alaska Native and offers more flexibility than when health care systems are managed by the Bureau of Indian Affairs, a U.S. government program that manages health systems for Native peoples in many other states. Alaska`s tribal health care system takes a more holistic approach to health than I`ve seen in health systems in general. Tribal health system leaders immediately embraced the MLP idea, and they wanted to see if we could move forward to achieve it. Nikole: One of my favorite forensic partnership cases was that of an elder in Juneau. He had to be flown to Anchorage for treatment at the Tribal Hospital. When he arrived, he was unconscious, but staff saw that he had a deportation notice under his papers. When they found this, they took action and turned to the MLP person in the hospital. She found that the elder had already missed his deportation date, meaning he had breached his obligations.
While working with the elder to put the eviction aside, she finally spoke to the landlord and told him what had happened and that this poor man would be released into homelessness. Not only did she persuade the landlord to cancel the eviction, but he felt so bad that he agreed to pick up the eldest child from the airport, take him home and transfer him to another apartment. The new apartment was located in the same complex and was even better suited to the obstructive conditions it had! This is what success looks like for me, many people work together to achieve a result where everyone can feel good. Nikole: Alaska Legal Services is a not-for-profit legal consulting firm. We have been operating in Alaska for over 50 years. Our primary mission is to ensure meaningful access to civil justice for all Alaskans, we have long recognized that for Alaska Natives seeking access to justice, the rights of sovereignty and self-determination are often intrinsically associated with the rights of sovereignty and self-determination, and have therefore worked with Alaska Native American partners to achieve this goal since we opened our Doors. And we`ve learned from our health care partners that a patient`s health doesn`t just depend on the care they receive.