Vol. 15, No. 2, Winter 2001/02

Preparing for a Healthier Future Inside the Granite Rim

Jacquelyn Ross

The Owens Valley is a long, gorgeous sweep of land. Spanning Inyo and Mono Counties on the eastern slope of the Sierra Nevada, this area is known by some as the "Granite Rim." There are abundant attractions: dramatic granite peaks of the sheltering mountains; glowing, quaking aspen trees; majestic bighorn sheep; and the ghostly allure of Mono Lake. Here is a quieter kind of life with sweet air and no rush hour. Yet, along with the beauty comes isolation. Hours away from the closest major cities, such as Reno and Los Angeles, the Paiute and Shoshone communities in the valley have developed creative strategies to keep pace with the outside world. As in other parts of the state, communities here are experiencing a dire shortage of health professionals. In response to this need, a local tribal organization is providing two comprehensive health programs: the Certified Nursing Assistant (CNA) program and the Substance Abuse Counselor (SAC) certificate program. These programs promise not only to fill job openings in local clinics, but also to prepare health professionals for the specific needs of Native American clients.

Responding to Local Needs
Job training and career education are ever present needs in Bishop, Big Pine, Lone Pine, and other local communities. The Indian residents of these communities have provided singular leadership in answering these needs. The Owens Valley Board of Trustees, a consortium of three tribal governments, oversees the innovative Owens Valley Career Development Center (OVCDC). Established in September 1977, the center’s purpose is to provide counseling on career opportunities and job alternatives to the Indian population. The Indian communities of Inyo and Mono Counties have joined with higher education institutions and vocational training schools in this effort. The work of the OVCDC now includes many services: vocational training, counseling, funding and placement assistance, and cooperation with state agencies and other career-related programs. Current objectives also include making services available to outlying county regions and working to provide new and updated programs to Native people. The OVCDC serves seven tribes along a 189-mile corridor. One of the tribes is in Death Valley, on the other side of the mountains.

The OVCDC has an active Vocational Education program, which provides specific training for health careers and other job opportunities in the area. The training is responsive to the needs of local employers and allows students to prepare for their careers without having to relocate. Interested students can pursue training for health such fields as computer science, construction, and--soon--the administration of justice.

Vocational Education Director Dee Odell described how a variety of partners came together to provide contemporary job training in Owens Valley. "All of our programs are accredited through colleges in the Western Association of Schools and Colleges. Our credits [in the Vocational Education program] are transferable from college to college." For the SAC services and the CNA program, the partner school is D-Q University. Partner schools for other programs have included Lassen College and the Community College of Southern Nevada. The program has received three major fundings, all from the U.S. Department of Education, since its inception in 1996. The latest funding on October 1 expanded all of the programs and supported innovations to existing programs.

Certified Nursing Assistants (CNAs)
Certified Nursing Assistants fill a critical role in the care of patients, especially in convalescent or retirement home settings. They perform many of the day-to-day tasks that are essential to the well-being of their patients, such as giving baths, helping patients eat, and making sure that patients can sit or rest comfortably. Students who have completed CNA training can receive additional training to become Home Health Aides.

Training for the CNA program is multifaceted and includes both theoretical learning and closely supervised clinical training. A basic course introduces students to such community health care facilities as convalescent and retirement homes, and discusses ethical and legal issues. Anatomy, physiology, medical terminology, and disease classification are also covered, as are basic first aid and CPR (cardio-pulmonary resuscitation). After this introductory course, classes become focused on specific areas. For instance, students study body mechanics so that they will know how to move patients safely. They learn the basics of day-to-day monitoring of a patient’s condition with regard to vital signs and nutritional needs. CNA candidates also learn about becoming part of a health care team: how to work with nurses and other medical professionals in the workplace, and how to work with patients’ families.

"Not very long ago, people could go into homes [as health care workers]--and they still can--and have no training," says Odell. "Most care-sponsoring organizations do not want to go that route anymore...When we had just opened the CNA program--and we hadn’t been open more than two weeks--I had four phone calls from [local] employers asking when the students were going to be finished."

Originally, there were plans to build a convalescent home on the reservation in Bishop. That did not happen, but a new 99-bed facility, the Bishop Care Center, was built by a private corporation. This center provides employment and is a teaching facility for the CNA program. In fact, the Vocational Education program has adjusted CNA’s training program to fill the needs of the center.

Substance Abuse Counselor Certificate Program
Substance Abuse Counselors (SACs) help people who have problems with alcohol and other kinds of drugs. The Princeton Review describes this occupation as "a demanding form of community outreach that requires patience, compassion, and a keen desire to help others who are in crisis." SACs may work in therapeutic communities, drug treatment centers, mental health agencies, hospitals, or correctional facilities. They can also be called into schools to give educational presentations.

Coursework for this occupation includes the exploration of alcohol and other drug abuse in society, as well as the history, theories, models, and approaches to the prevention of use and abuse of substances. Students study the ways that humans develop and how behavior develops throughout life. Counseling skills and ways to work with families are also taught in the SAC classes. There is a specific class focused on Native cultural perspectives and the ways non-Native counseling approaches might differ. This training is especially important because of the heavy impact that drugs have had on Native communities. Among the other classes in the program is a class on ethics, which helps students recognize the need for professional boundaries. SAC students train to work with other mental health professionals, doctors, nurses, and social workers.

Odell, who is an instructor in this program, noted that the program uses curriculum material from an organization called White Bison to help integrate Native cultural aspects into the training. White Bison, Inc., is a Native non-profit organization that fosters healing and recovery in Native communities. Of the White Bison and the Wellbriety movement Odell says, "It’s all over the country and very effective. I think it’s having an impact. Tribal leaders really want to diminish the effects of drugs and alcohol, and I think they’re being successful. We’re probably going to incorporate a White Bison Recovery Group into our program because substance abuse is a major issue that is now being supported by the political hierarchy across the country in Native nations. I think there’s a push to this because it [substance abuse] is standing in the way of accomplishment, like it does for everybody." Local placements for field instruction or postcertification employment may include Toiyabe Family Services or other Native care centers. Professional certification for state testing requires clinical placement. Certificates may be earned without clinical placement, however.

Service for the Whole Community
Native participation in the Vocational Educational programs is, on average, about fifty percent, with even greater participation in the computer science and construction areas, where a program may have as high as ninety percent Indian enrollment. All the programs are open to anyone in the region--Native or not--who desires this specialized training. As Odell explained, "By law, we are required to be an equal-access organization. Certainly the goal is to raise the level of employment, skills, and self-sufficiency [among tribal people]. It’s related to sovereignty. However, inasmuch as we not only train any and all of the people of the Owens Valley, we look to them for employment. And sometimes, we’re the only source of higher education in a particular field. And we have excellent programs." Is it unusual for a tribal entity to provide training for the whole community? OVCDC Director Paul Chavez says that it is a unique situation, but one that seems to work well for everyone. The participation of non-Natives helps support the program financially as well, and classmates get to see each other as professional colleagues.

Supporting the Students
Odell notes that "the whole field of vocational education addresses current skills in the field across the nation, not just here. Many universities are addressing this problem, such as the University of California. It’s upgrading skills; it’s not the same old thing anymore. We can’t help it--the computer has conditioned us, our world has conditioned us to a kind of 'now' orientation." Continuing education, especially in those fields that have state certification, is part of the package for many people. In this sense, formal training can continue through a person’s professional life, especially in health-related careers. Local training can also help people who make changes from one career to another. The Owens Valley Career Development Center has two excellent career counselors, Nancy Madina and Charlotte David, both Native women with years of experience in serving the local community. These two counselors screen potential students. Of the people that come in for counseling, Odell said,

I believe that, with the exception of someone who’s just extremely mature, every one of our students is more settled. A little life experience always helps.

This is serious business we’re talking about. The CNA and substance abuse programs are both dealing with life-threatening conditions. It’s very important that people have that concept that when they are there, whatever they do, they’re dealing with people who could easily die on their watch. So a great deal of care must be taken and that underpins all of our programs. We do a lot of personal guidance with students. It’s not just "Here’s our program, now come do it." It’s "what kinds of things do we need to have to help make them successful?" We’re always available.

The substance abuse program is offered on alternate weekends, making it accessible for working people. Tutors are available. The Vocational Education program has even transported students out of the area to other facilities for special training opportunities and is prepared to do so again should the need arise. Said Odell, "We have many people who do not have adequate transportation, adequate opportunity, so we have to build in those opportunities. And I think that’s true of a lot of people, not just the Native population. It’s hard for people to be aware of the geographical conditions that we operate under."

To reach all of their clientele, Vocational Education produces a newsletter six times a year, distributing more than 800 copies each time. Advertising, publicity, and outreach booths at county events are also important components of getting the word out about current offerings. People from out of the area are encouraged to take part in the programs.

And the Results?
Career Counselor Madina says that the programs have had a good effect on the Indian community and that there is good job placement. "Students are really supportive of each other. The students are really enthusiastic about trying to find a job. Before students complete their programs, they work with the Job Placement Coordinator to create a resume. For some programs, like the CNA program, students are guaranteed jobs upon completion in facilities such as the Bishop Care Center. Substance Abuse Counselor students with their California Drug and Alcohol Certification have been employed with Toiyabe Family Services and the Youth Shelter in Bishop."

In the health-related programs and the OVCDC as a whole, there is an admirable determination to overcome what others might think of as barriers: the isolation, the travel distance, and the lack of major educational campuses nearby. In surmounting these factors, the tribes and the staff produce urgently needed professionals. In so doing, they contribute greatly to the health and stability of life in the Owens Valley.