‘The Medicine My Ancestors Prayed For’: Medi-Cal Now Covers Native Healing Practices

Inside the Friendship House, a rhythmic drum beat fills the air as clients gather in a circle, chanting a Lakota battle song. For Priscilla Lenares, the sound transports her back 11 years to her own time as a patient at the Native-led recovery center in San Francisco.

“I remember hearing the drum for the first time, and tears fell from my eyes,” she recalled.

Today, Lenares’ life is on track, but her childhood in Bakersfield was marked by gangs, violence and pervasive substance use. She told KQED that her parents struggled with addiction, and by middle school, she was smoking methamphetamine on weekends. At 18, she was dealing drugs to support her habit. Over the next decade, Lenares cycled through 10 treatment programs before boarding an Amtrak train to San Francisco, a mother of three children, carrying nothing but hope that her time at the Friendship House would be different.

The treatment center is a unique in-patient program combining Western medicine, like individual counseling, with traditional healing practices like smudging. The staff treated Lenares like family, and she found solace in singing prayers in the sweat lodge.

This month, Medi-Cal began to support more people like her by expanding coverage to include traditional healing practices like music therapy, rituals and ceremonial dances.

The director of the federal Indian Health Service, Roselyn Tso, has praised these practices for helping people for generations and called them a “vital link between culture, science and wellness in many of our communities.”

The Centers for Medicare & Medicaid Services announced the two-year pilot program as a response to the health challenges facing Native Americans, who suffer from some of the highest rates of addiction and overdose death in the country.

Advocates are optimistic that expanding Medi-Cal coverage will increase access to culturally appropriate care and allow facilities to expand. However, that will all hinge on reimbursal rates, which have yet to be released.

Historically, substance use treatment in the U.S. has relied on clinical approaches like medication-assisted treatment, behavioral therapy and standardized detox protocols. However, these methods often fall short when applied to Native American communities.

Damian Chase-Begay, a researcher focused on American Indian health at the University of Montana, explains the difference. “Traditional practices are, by nature, holistic,” he said. “They are treating the person physically, mentally, spiritually and emotionally. They benefit the whole being, not just the physical symptoms.”

Scientific research on these approaches remains limited, but preliminary studies suggest that integrating cultural practices into addiction treatment can lead to higher patient engagement and more positive recovery outcomes. Most existing evidence is qualitative, underscoring the need for more comprehensive research, which has lacked funding, according to Chase-Begay.

“What California is now covering under Medi-Cal is exactly what our Native communities have been asking to be covered for years,” Chase-Begay said. He believes this support could have potentially interrupted cycles of intergenerational trauma and substance use much earlier.

For Lenares, the Friendship House was more than a treatment center — it was a path to self-discovery. “I’m a woman who understands the medicine my ancestors prayed for,” she said. “A woman who knows her song. A woman who knows ceremony.”

Now, Lenares volunteers at the Friendship House and works full-time for a domestic violence agency. Her story is a powerful testament to the potential for healing when culture and medicine intersect.