gram (SIAP). The SIAP provides the focus in this assessment of Public-Law 100-713.
All Native-Americans who are members of recognized Indian tribes in the United States are eligible to participate in the programs funded by the IHS under the provisions of Public Law 100-713. The SIAP serves a metropolitan area with the seventh largest urban Native-American population concentration in the United States (Sugarman & Grossman, 1996, pp. 321-327).
The SIAP is unique in that Native-Americans designed and implemented the program based on their own perceptions of needs (Kelley, 1992, p. 27). SIAP is a model inter-disciplinary program that draws as much on anthropology as on the science of medicine.
One problem area is the requirement that participants in the SIAP be members of recognized Indian tribes. At times, individuals who are part Native-American experience difficulty in documenting membership status in a recognized Indian tribe. This situation tends to affect women more so than men. Nevertheless, most of these individuals continue to perceive of themselves as Native-Americans, and any behavioral risks that may characterize their lives are consistent with those that tend to characterize Native-American populations. Thus, this eligibility requirement has the potential to exclude some Native-American women who are in need of the services offered by the SIAP.
Policy Provisions and Modes of Service Delivery
The SIAP is comprehensive in approach (Kelley, 1992, p. 27). The program incorporates identification and referral, detoxification, intensive inpatient treatment, intermediate rehabilitation, outpatient treatment, outpatient follow-up, and criminal justice outreach.
By SIAP definition, alcoholism is a social disease (Kelley, 1992, p. 27). Medical assistance and referral are facilitated through close ties with the Seattle Indian Health Board. The SIAP's culturally-sensitive service providers work solely with a Nat...