Welcome back to Impact Unfiltered! In this episode, host Philippe is joined by Nanette Starr, MPH, Director of Policy and Planning for the California Consortium of Urban Indian Health. Nanette shares her personal journey from tribal epidemiology to advocating for Native health in California’s urban centers. You’ll hear about the origins and importance of urban Indian health organizations, the innovative ways they serve their communities, and the unique challenges Native people face in accessing care. Nanette also offers insights on leadership, cultural healing, and making a real impact. This is an inspiring, honest conversation you won’t want to miss.

1. Introduction to the Episode and Guest

• Nanette Starr’s background: Choctaw nation, career in tribal and urban Indian health

• Overview of work experience:

• California Consortium of Urban Indian Health (CCUIH)

• Tribal epidemiology centers in California, Portland, and Alaska

• Role during COVID under Governor Newsom and rural county public health

2. Urban Indian Health Centers vs. Tribal Health Facilities

• Structure of the Indian healthcare system (three prongs):

• Indian Health Service (IHS)

• Tribal health programs

• Urban Indian Organizations (UIOs)

• Historical context:

• Federal Indian Relocation Act and its aftermath

• Creation of urban Indian communities and organizations

• Growth and function of UIOs:

• Resource and referral origins

• Inter-tribal make-up and community focus

• Number and type of organizations in California (10 UIOs)

• Range of healthcare services (outpatient, inpatient, dental, screenings, etc.)

• Community activities and ceremonies (e.g., healing for veterans)

3. The Concept of “Impact”

• Nanette’s perspective on “impact” in her role

• The importance of enabling service access rather than self-attribution

• The need for visibility and acknowledgment of urban Native communities

• Dispelling myths about Native healthcare and demographics

• Importance of community presence in urban areas

4. Examples of Consortium Impact and Advocacy

• Organizational structure and leadership at CCUIH

• Case study: Advocacy to save the Indian Health Program in California budget cuts

• Collaboration with tribal and urban leaders

• Importance of education and communication with policy makers

• Broader themes of health equity, trust responsibility, and ongoing presence

5. Team Alignment and Community Outreach

• Strategies for staying connected to member needs:

• Social media (Instagram, Facebook)

• Community presence and listening (showing up in spaces)

• Regular communication with member organizations (calls, texts, ad hoc meetings)

• Importance of direct feedback from UIO leaders and CEOs

• Example of rapid response:

• Social media campaign regarding potential Medi-Cal cuts and misinformation

• Coordinated efforts to clarify timelines and eligibility

6. Innovative Tools, Partnerships, and Expanding Access

• Specific innovations by member organizations:

• Mobile mammography van in Santa Barbara

• Telehealth as a strategy for broader access, especially for vulnerable populations

• The “Redline” resource hotline for assistance and support

• Collaborations and partnerships:

• Involvement in numerous steering committees focused on health equity

• Resource sharing through California Primary Care Association

7. Leadership and Legacy: Advice for Emerging Leaders

• Professional advice to younger self and new leaders:

• Recognizing that systems may not change overnight; working within and understanding existing frameworks

• Balancing passion with practical, informed approaches

8. Evolving Perspectives on Leadership

• Influence of Nanette’s mentor and boss, Virginia Hedrick

• Leading with humility and community grounding

• Importance of advocacy, listening, and making inclusive, nonpartisan decisions

9. Getting Involved, Resources, and Upcoming Initiatives

• Encouragement for community feedback and involvement

• Announcement of recent and future initiatives:

• Native-led messaging workshop and workbook release for community advocacy