After two years of controversy, state health department restores key tribal role

Two years after the state health department controversially eliminated a position that tribes in Montana said was critical to their voices being heard, the role has been restored. 

Heidi DeRoche, who previously held several roles within the Department of Public Health and Human Services’ Office of American Indian Health, will now serve as the tribal relations manager, according to Misty Kuhl, who leads the governor’s Office of Indian Affairs. 

Kuhl told a group of legislators who gathered in Helena on Tuesday for a State-Tribal Relations Committee meeting that DeRoche will bring “a breath of fresh air” to the role and that she will unify the office. The committee meets during the interim between legislative sessions. 

The health department’s tribal relations manager is responsible for communicating changes in state health policy to tribes and serving as a point of contact for tribal leaders who may have questions or concerns. The role, however, has been the subject of controversy since 2023, when the health department quietly eliminated the position. 

Tribal health leaders expressed outrage at the time, saying it’s critical they have a point of contact in the department to ensure tribes have a say in important health policy decisions. They also said they were not consulted when the department eliminated the role.

During the legislative session, which ended in May, state health officials argued that the tribal relations manager position was duplicative of another DPHHS role: the director of the Office of American Indian Health. That job was held by Stephanie Iron Shooter, who, at the time, reported to David Gerard, executive director of Public Health and Community Affairs. As director of the Office of American Indian Health, Iron Shooter told lawmakers that she was responsible for conducting research, incorporating equity into policies and programs, facilitating tribal relations and providing technical assistance. Tribal advocates, however, argued that the work was too much for one person. They also took issue with the fact that she did not report directly to DPHHS Director Charlie Brereton, as the previous tribal relations manager had. Iron Shooter resigned this fall, citing “recent events” in an email, though she did not offer further explanation.

Earlier this year Montana’s American Indian Caucus, a group of Native lawmakers, ultimately added an amendment to the state budget that indicated support for reestablishing the role, though there was no funding attached to the proposal and it did not mandate DPHHS to take action.

DeRoche, who was the programs officer for the Office of American Indian Health, served as acting director of the office when Iron Shooter resigned. She told the State-Tribal Relations Committee on Tuesday that she’s been the tribal relations manager for two weeks and said she’s working to define her role and develop a vision for it. 

She also said the state health department is working to improve tribal consultation and Indigenous maternal health, among other things. She noted that she now reports directly to Brereton, a notable restructuring since Iron Shooter’s departure.

“The tribal relations manager position is executive level,” DeRoche told the committee.