DULUTH -- U.S. Sen. Tina Smith got a look inside two innovative facilities in a Presidents Day swing through Duluth.

Her first stop, the American Indian Community Housing Organization, offers transitional housing and supportive services in a culture-based setting.

The second, the Fond du Lac Center for American Indian Resources, provides a central location for a wide variety of health services aimed at improving the lives of area Native Americans.

In both, Smith said she saw models that she hopes could be replicated in other communities across Minnesota and the nation. But neither will be possible without financial support and regulatory action, she said.

"I can see a lot of innovation happening at the local level," Smith said in a roundtable discussion at CAIR. "But it sort of feels like that innovation is trying to happen underneath this steel mesh of outdated rules and regulation that you're constantly bumping up against."

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Smith was in Duluth to highlight her report on the state's housing challenges, as well as seeking feedback and solutions to struggles in the rural health care system.

Housing system 'struggling' and 'broken'

Smith and her staff held 21 meetings across the state over seven months to identify barriers to housing. The first session, hosted by AICHO, was specific to needs of the Native American community.

Smith said she found a few main themes:

  • The state is unable to meet the demand for housing, with far too many people waiting to get into affordable or supportive housing.
  • Longstanding discrimination has held back people of color, new Americans and people with disabilities from finding housing, leading to serious disparities in income and wealth.
  • The federal government has not been fulfilling its obligation to support state and local governments in creating housing solutions.

"What we found in this report is that really every part of the continuum of housing in Minnesota is struggling and is broken in some way," Smith told reporters.

From left: Economic development director of AICHO LeAnn Littlewolf reads a poem she wrote related to housing shortages in the community as Sen. Tina Smith and Mayor Emily Larson listen Monday at the American Indian Community Housing Organization. (Tyler Schank / tschank@duluthnews.com)
From left: Economic development director of AICHO LeAnn Littlewolf reads a poem she wrote related to housing shortages in the community as Sen. Tina Smith and Mayor Emily Larson listen Monday at the American Indian Community Housing Organization. (Tyler Schank / tschank@duluthnews.com)

Smith, a member of the Senate Banking, Housing and Urban Affairs Committee, blasted a recent budget proposal from President Trump that she said would slash funding for programs that allow for the construction and renovation of affordable housing facilities.

She said federal housing programs are crucial, also pushing legislation that would allow tribal organizations to be eligible for grants.

"If you're a young person, if you don't have a safe place to call home, you're not going to be able to do your job, or even find a job," Smith said. "If you're an employer in a growing community like Duluth, or many other communities around Minnesota, if you don't have good, affordable housing, then the talented people that you want to recruit to work at their businesses aren't going to have a place to live."

Duluth Mayor Emily Larson, who attended last month's State of the Union Address as Smith's guest, said an existing city housing task force will review Smith's findings before releasing a local report in March on the "dire need for housing and affordability" in Duluth.

"What happens in Greater Minnesota is a very strong indicator of what is happening across the region, across the state (and) across the country," Larson said.

Sen. Tina Smith (third from right) listens as health care leaders voice their concerns about shortages in the health care workforce Monday at the Center for American Indian Resources. (Tyler Schank / tschank@duluthnews.com)
Sen. Tina Smith (third from right) listens as health care leaders voice their concerns about shortages in the health care workforce Monday at the Center for American Indian Resources. (Tyler Schank / tschank@duluthnews.com)

Rural health systems face challenges

Two blocks away, some common themes emerged in a roundtable discussion of challenges facing the rural health care workforce.

Experts from the Fond du Lac Band, St. Louis County, area hospitals and other medical fields told Smith that rural facilities need a lifeline from the federal government.

"There's no OB care between here and the Canadian border," noted Paula Termuhlen, dean of the University of Minnesota Medical School in Duluth. "There's really no surgical care between here and the Canadian border. You've got to get to Two Harbors or Duluth on a snowy day on Highway 61."

From left: Sen. Tina Smith, associate director for Fond du Lac human services Nate Sandman and Fond du Lac Band councilman Roger Smith Sr. pause to discuss during a tour of the Center for American Indian Resources Monday before a roundtable discussion about shortages in the health care work force. (Tyler Schank / tschank@duluthnews.com)
From left: Sen. Tina Smith, associate director for Fond du Lac human services Nate Sandman and Fond du Lac Band councilman Roger Smith Sr. pause to discuss during a tour of the Center for American Indian Resources Monday before a roundtable discussion about shortages in the health care work force. (Tyler Schank / tschank@duluthnews.com)

Hospitals are struggling to find workers, services are extremely limited outside major hubs like Duluth and complicated government reimbursement policies are getting in the way of the meaningful care and innovation, panelists told Smith.

Solutions may require thinking outside the box. Increased access to broadband could bring more telehealth opportunities — allowing doctors to treat patients without traveling hundreds of miles. Better access to affordable child care could help recruit professionals to smaller communities.

Introducing health careers to kids as early as kindergarten could help spark interest in future occupations — and not just doctors, but also nurses, dental assistants and other jobs that are difficult to fill.

"We're starting to think about how we can find groups of people who are not incentivized to join the workforce," including people who have been incarcerated, said Dayle Patterson, CEO of the Lake Superior Community Health Center.

Smith said there will not be a "simple fix" to rural health care woes, but told the News Tribune at the end of her visit that the firsthand accounts provide valuable guidance for her work.

"I think one of the biggest things we need to do is figure out how to help young people understand what opportunities there are for really fulfilling and purposeful and profitable careers in health care beyond the idea of going to medical school," she said. "We need people to go to medical school, but we also need physician's assistants and nurse practitioners and nurse assistants and personal-care attendants.

"There's a whole continuum of opportunities that we need to get people interested in."

Sen. Tina Smith responds to concerns from health care leaders during a roundtable discussion Monday at the Center for American Indian Resources. (Tyler Schank / tschank@duluthnews.com)
Sen. Tina Smith responds to concerns from health care leaders during a roundtable discussion Monday at the Center for American Indian Resources. (Tyler Schank / tschank@duluthnews.com)