CIHA staff provide information during Town Hall

The Cherokee Indian Hospital Authority was honored to have the opportunity to answer questions from citizens Monday night during the Town Hall hosted by Tribal Leadership. We are constantly working to improve our services and better serve you, so opportunities such as the Town Hall present a great opportunity to hear directly from the public. We are grateful to Tribal Leadership for opening this avenue of communication and for being committed to transparency for the Tribe.


For members of the community who were unable to attend, CIHA wanted to provide our responses to the specific topics we addressed, as well as provide more in depth answers and information.


Human Trafficking on the Qualla Boundary


Where on the Boundary is this happening?


As CIPD Police Chief Carla Neadeau said Monday night, it is difficult to go into specifics surrounding human trafficking at the risk of jeopardizing ongoing investigations, so the broad answer to the question is that Human Trafficking could happen anywhere, and the even better answer is that human trafficking IS happening within the Boundary, with members of the Cherokee Community being identified as victims. There are Hot Spots, the casino being one that was identified, but the more important focus should be education and awareness, not specific locations. There are no limitations of where human trafficking occurs here and around the country. This unfortunately could be happening right in front everyone and without knowing the signs to look for or what to do when resources are needed. Generational trauma, historic oppression, discrimination and other societal factors and inequities create community-wide vulnerabilities. Traffickers recognize and take advantage of people who are vulnerable in certain ways.


CIHA Director of Behavior Health Dr. Freida Saylor spoke during the town hall to emphasize that because human trafficking is an area that operates and thrives in secrecy, it is important to educate the community on human trafficking. The hospital has launched an initiative to educate healthcare workers on these signs and to provide resources to our employees to address human trafficking in the healthcare setting as a strategy. Human Trafficking occurring on the boundary may not be what you original picture or what you see on television shows. It isn’t necessarily a white van that pulls up on a sidewalk and snatches a victim. Rather, Human Trafficking involves the use of force, fraud, or coercion to obtain some type of labor or commercial sex act. Dr. Saylor explained on Monday night, that trafficking victims who have been treated at the hospital sometimes don’t even realize they are victims of trafficking. A victim of trafficking may be someone who believes they are in an intimate relationship, however their partner withholds food or other basic needs unless the victim performs sex acts or some other type of labor.


The first line of defense against Human Trafficking for the community is education. CIHA is committed to working with Tribal Leadership and partners like the CIPD to educate the public on human trafficking and what it looks like in real life, not on a movie screen.

What is being done to help Human Trafficking Victims?


Dr. Saylor addressed programs and resources available at CIHA and within Analenisgi on Monday night. CIHA has three (3) certified Sexual Assault Forensic Examiner (SAFE) nurses on staff who provide specialized support to victims of sexual abuse and violence. These nurse work in collaboration with local law enforcement, CIHA and EBCI Family Safety. CIHA’s S.A.F.E Nurse program is the most robust program of its kind west of Asheville. CIHA secured a $1.2 million multi-year grant from Indian Health Service to increase staff with professional certifications to be able to provide these services 24 hours a day, seven days a week.


In order to offer comprehensive care, the role of the S.A.F.E. includes evaluating and treating the patient in a holistic way, being mindful of both the acute and long-term consequences of sexual violence victimization. The S.A.F.E. can gather a culturally and developmentally appropriate medical history and a history of the assault, with an essential understanding of the medical and legal implications of both. Gathering this history lays a foundation to offer the patient suitable options in care, which may include forensic evidence collection, testing and treatment or prevention of sexually transmitted diseases and the human immunodeficiency virus (HIV), pregnancy prevention, and immediate and follow up services with community-based sexual assault advocacy, and medical and law enforcement partners. The S.A.F.E. ultimately provides culturally sensitive, developmentally appropriate, trauma-informed, and patient-specific evaluation and treatment. S.A.F.E.s are also prepared to testify in a criminal or civil trial as a fact or expert witness when necessary, and understands the ethical obligations of their testimony and the limitations as well.


Mental Health Issues


As a nationwide issue, what is the Tribe doing to deal with mental health issues in our community?


The Cherokee Indian Hospital continues to expand and offer vital mental health services to the community as a resource in the healthcare system. CIHA is integrated in the community to provide mental health services by integrating within Cherokee Central Schools, Dora Reed, EBCI Juvenile Services, EBCI Family Safety, EBCI Justice Center, EBCI Courts, EBCI Cherokee Choices, as well as other community partners.


While CIHA is committed to providing the services, staffing remains an issue. As Dr. Saylor noted Monday night, what the community needs cannot always be addressed by hiring another clinical doctor. Often times, community members struggling with mental health issues are best served through peer support specialists and the opportunity to be heard by someone they know and trust. Someone they can relate to and see as a friend. CIHA has several open positions for such staff members, all of whom play such a crucial role on the overall continuum of mental health care.


Will they provide a facility for these patients and are they hiring more doctors to deal with this matter?


The Cherokee Indian Hospital constantly monitors the mental health needs of the community and adapts to ensure the services being offered are those that are most needed. One of the things we have realized during that process is the immediate and desperate need for enhanced services surrounding youth pediatric mental health services. We are currently exploring the Child Crisis needs alongside tribal partners (ie. Family Safety) and state partners. Staffing the services needed or identified for the services the hospital provides, active recruitment for qualified professionals is a current and ongoing strategy for the hospital.  Dr. Rick Bunio, CIHA’s Medical Director, answered questions on Monday night regarding mental health services and touted Dr. Saylor’s willingness to take on additional students to address the workforce shortage. We are in current partnerships with WCU and MAHEC to ensure we have qualified professional recruitment for needed staff to meet the mental health issues of the community.


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