Where Heritage Meets Healthcare July 15, 2026 Partnering With Oregon Tribes to Improve Access While Honoring Culture & Tradition For Laurel Schwinabart, serving as the Tribal Liaison for InterCommunity Health Network (IHN-CCO) is more than a job title. It’s deeply personal. Schwinabart is a member of the Turtle Mountain Band of Chippewa Indians, based in North Dakota. Though she wasn’t raised on the reservation, her mother and grandmother were, and they each experienced trauma from federal assimilation policies aimed at stripping American Indians of their language and culture. While researching her family history, Schwinabart learned her grandmother had been enrolled in a boarding school where she was listed as an “inmate” at age 9. “I really wanted to learn more about my background and what happened with my Tribe,” Schwinabart said. “It’s really made me love this job more, wanting to help our tribal members and understanding the historical trauma they’ve gone through.” Building Partnerships The Oregon Health Authority maintains government-to-government relationships with the Tribes as their own sovereign nations. Schwinabart meets monthly with the agency’s Tribal Advisory Council (TAC) to support best practices for culturally appropriate care and resolve any issues that arise between CCOs and tribal healthcare providers. Lauren is wearing a ribbon skirt, a sacred garment worn by Indigenous women and girls in North America. The role of Tribal Liaison was created in 2020 to work with the nine federally recognized Tribes across Oregon. Locally, there are three Tribes within IHN-CCO’s service area: the Confederated Tribes of Warm Springs, the Confederated Tribes of Siletz Indians and the Confederated Tribes of Coos, Lower Umpqua, and Siuslaw Indians. For example, Schwinabart said she recently heard about a member in Portland who was having trouble getting dentures. That was on a Sunday, and by Tuesday they had referred him to CareOregon where he was able to schedule an appointment. It’s just one case where Schwinabart said her role can help remove barriers that might otherwise leave people without care. “Just knowing who to turn to and how to get those issues resolved is a huge part of what I do,” Schwinabart said. “It may not seem like much overall, but I feel like these small gestures do make an impact.” Growing Trust Working with tribal communities comes with its own challenges, Schwinabart said, from the remoteness of some reservations to systemic inequities and historical underfunding of services. Amid those factors, perhaps the biggest challenge, she said, is building trust. “When I first started in this position, I thought the relationship-building part was going to be easy, considering I am Native American and they’re Native American. I learned very quickly that is not the case,” Schwinabart said. “There is a lot of distrust not only in the healthcare system, but many tribes just do not trust outsiders. There is a lot of relationship-building that goes into this work, and that’s based on trust, respect and understanding.” Though it has taken time, Schwinabart said she’s built strong relationships with the local tribes by getting out in the communities, attending cultural events, touring healthcare facilities and providing education for other community partners. “You need to walk behind the Tribes. You’re not leading them; they’re the ones leading,” Schwinabart said. “You have to be able to understand that and respect the role you have.” Traditional Medicine If there’s one thing Schwinabart says she has learned as a Tribal Liaison, it’s that Western medicine is not the only medicine. “I have learned that cultural medicines are valued in the tribal communities, and we need to respect that and understand that our metrics for certain types of Western medicine are not always going to be the best approach.” In late 2024, Oregon became one of the first four states in the country to receive approval for covering traditional Tribal practices from the Centers for Medicare & Medicaid Services. These may include but are not limited to: Sweat lodges Talking circles Traditional dancing and music therapy Healing ceremonies “OHA was working very closely with the Tribes to make this a realization,” Schwinabart said. “OHA Tribal Affairs and Tribal leaders worked very closely to develop the handbook that describes the practices Tribes wanted to have reimbursed. It was a heavy lift getting all that submitted to CMS, and thankfully it came to fruition.” Schwinabart said more than 80% of tribal members do not live on their reservation land. She has been getting calls from tribal members living off their reservations who are interested in participating in these practices and reconnecting with their culture. Tribal liaisons for CCOs across Oregon pictured at a recent gathering. Seeing traditional healing practices recognized by the healthcare system represents more than just a policy milestone, Schwinabart said. It’s another step toward honoring the cultures that previous generations were once discouraged from practicing openly. “I am thrilled that we were able to get recognition that these tribal practices are evidence-based and can be reimbursed,” she said. “That’s amazing. It’s a really exciting time for the Tribes.”
