Federal funds boost Native American health services in San Francisco

Friendship House treatment center plans to buy building in Mission District

One of San Francisco’s premier addiction recovery programs is set to get a major boost thanks to a recently passed amendment to the U.S. Infrastructure Bill, which will allow urban Native American organizations to use the funding on health-related projects.

Leaders at Friendship House, an inpatient drug and health treatment center that works with Native Americans in San Francisco and tribes throughout California, say the funding will go toward a new six-story building in the Mission District that will serve as a one-stop-shop for Native health, housing, culture and spiritual practice. The project, dubbed The Village SF, is in the planning stage and is expected to open in 2025.

“When COVID hit, it pushed Friendship House to develop a more encompassing vision,” said filmmaker and former Friendship House board member Peter Bratt. “The irony and the tragedy is that America’s first peoples have no physical place to call home. The village will offer a physical space for Native people to gather for social services and youth programming and cultural space where we can sing and dance and celebrate.”

An estimated seven out of every 10 Native American and Alaska Natives, representing around 2.8 million people, live in or near cities, according to U.S. Census data. But San Francisco and many other cities lack the resources or attention even on the health needs of the Native communities, said Bratt, who briefly lived on Alcatraz as a child during the Occupation of Alcatraz protest.

Community leaders at Friendship House have had to fill in the gap created and left by traditional health care and safety channels. The center offers a 12-step program and other services to help individuals in recovery, including education and job readiness, but all of the work is centered around Native community building and cultural connections.

That could look like spiritual leaders who come in and conduct ceremonials, such as a sweat lodge ceremony and talking circle or wiping of the tears. Plans and ceremonies are individualized based on what a person might have experienced before finding Friendship House. Many who come through the program have been homeless or incarcerated, or grew up in foster care, Bratt said.

“There’s a huge need for medical and behavioral health services that are rooted in culture. All the data across the country, doesn’t matter if it’s urban or on the reservation, American Indians often don’t go and get their social services from mainstream portals,” said Bratt. “We get better results and more engagement when the services are culturally based.”

The Urban Indian Health Facilities Provider Act, introduced by senators Alex Padilla (D-CA) and James Lankford (R-OK), amended the infrastructure bill signed by President Joe Biden in November to allow organizations like Friendship House to spend the funding on construction projects that improve quality of care for urban Native patients.

Leaders hope the expansion will enable opportunities to not only help bring in more individuals who are struggling but also connect families to basic needs like housing, health care and culture early on to help break the cycle of drug use.

“You can’t isolate an individual; you need to treat them in family and in community. That’s how humans act and interact. Even redwood trees relate to each other,” said Abby Abinanti, president emeritus of the Board of Directors of Friendship House. “Humans, by their nature, need to understand why they are doing something, and if they don’t, it’s really hard to change.”

A major part of the approach at Friendship House involves helping individuals understand and process the trauma that they have experienced directly and through generations of violence their ancestors faced.

“We had boarding schools, indentured slaves and massacres not that far back. Those incidences create trickle-down behavior, and you have to be aware of that. Thousands of years ago, we did not have this problem,” said Abinanti, who is the chief judge of the Yurok tribe and was the first Native American woman admitted to the California state bar.

Those painful memories are still fresh for many who come through Friendship House’s doors.

Helen Devore Waukazoo, at 13 years old, was taken from her family and forced to attend boarding school. It was part of a government plan that moved American Indians off reservations and forced them to integrate into non-American Indian communities. Waukazoo landed in San Francisco and later founded Friendship House in 1963.

After more than 50 years working in San Francisco, the organization now claims 92% of clients that come through the 80-bed facility are clean six months later. And compared with 41% at intake, nearly 92% of Friendship House graduates did not use alcohol or illegal drugs in the past 30 days.

As San Francisco faces down a surging drug overdose epidemic, leaders at Friendship House see an opportunity for its expanded services and the newly formed American Indian Cultural District to share learnings with the broader community.

“The people who came here also have many of the same problems and their solutions aren’t rocking for them,” said Abinanti. “Maybe we can partner and help them, too, and in keeping our responsibility to place.”

That can begin with more open conversations about shared histories. Many communities that came to San Francisco for a variety of reasons are dealing with the repercussions of traumatic pasts, which have been put on display for many across the world to see in the wake of the George Floyd protests and more recently with U.S. Interior Secretary Deb Haaland, who recently visited Alcatraz Island to recognize the Red Power movement and the American civil rights movement.

“It was a real tear-jerker,” said Bratt, who attended Haaland’s visit. “It helped American Indians realize what was happening in Minneapolis was also happening in the Bay Area and it ignited in our imaginations.”


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