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Dramatic advances that arrived on the long wave of casino income have transformed the lives of thousands of American Indians in San Bernardino and Riverside counties.

Consider the following.

From his fifth-floor office balcony, James Ramos, San Bernardino's newest county supervisor, can see the 940-acre reservation of his tribe, the San Manuel Band of Serrano Indians, climbing from the valley floor into the mountains.

In a sweat lodge built of oak and willow branches, in the Riverside County hills of the Pechanga Band of Luise? Indians' reservation, Tribal Chairman Mark Macarro exclaimed: "This is amazing. This is what our teens are doing."

And in a medical clinic on the Morongo Band of Mission Indians' reservation in the San Gorgonio Pass, a roomful of doctors studied pain management.

"There have been major changes since gaming emerged," said Clifford Trafzer, director of the UC Riverside California Center for Native Nations. "People lived in abject poverty before gaming."

Casino wealth has opened doors long closed and boosted a growing American Indian influence in the Inland Empire east of Los Angeles.

"It's really enriching and rewarding ... when I drive our (supervisorial) district. It basically is the Serrano territory" of his ancestors, said Ramos, who grew up in a reservation trailer, one of four children of a mechanic and a beautician.

The San Manuel tribe and reservation are named for Ramos' great-great-grandfather, Santos Manuel, who 147 years ago, with his followers, was chased from the mountains to the valley in an attack by a local militia. Today, a photograph of Manuel graces the second-floor lobby of the tribe's 3,000-slot machine casino — and Ramos, 46, has ascended to political power.

That, he said, offers a lesson to upcoming generations of American Indians around the state.

"We have to start building and supporting one another," he said. "We have to speak to kids in Indian communities, let them know that it's not just a dream, that people actually have made it to these positions, and you can make it and go even further."

Casino profits made possible the schooling — from junior college through a master's degree in business administration from University of Redlands — that Ramos credits with his rise.

"It paid for my education. Education is what carried us through that election," he said about the 2012 contest in which he beat an incumbent who called him a "casino boss."

But observers say Ramos also assembled an effective and well-funded campaign supported by his and other tribes, allies on the Board of Supervisors, employee unions and the California Nations Indian Gaming Association.

"Ramos has become a real powerful force in the community and he had a real awesome machine behind him; he had a lot of money," said James Mulvihill, a San Bernardino city planning commissioner and an urban geographer at CSU San Bernardino.

The election made Ramos one of the state's very few American Indian elected officials, if not the first. "This was a major step forward — and James Ramos has aspirations to go forward," Trafzer said.

As the San Manuel tribe's gambling income — first from a bingo hall, then from its casino — grew, so too did its ambitions for its members and in politics.

"The economic base of the reservation rose, and when that starts to rise, your dreams start to get larger," Ramos said.

Today, Ramos said, more American Indians need to seek political office — for the tribes' sake, but also to play a wider role.

"What better place to be to start to shape and mold policy that affects everyone in your community, regardless of race or ethnicity?" he said. "Then you're able to focus once and for all, not on paying for a lobbyist to carry the voice of Indian Country; now you are the voice that is establishing those policies."

The political gains are perhaps the most striking change to have taken place, but other important developments are evident in Indian communities around the region.

Both the San Manuel and Pechanga tribes have invested in reviving their native languages, Serrano and Luise?, paying for programs at CSU San Bernardino that will offer them as for-credit courses.

Grand homes dot the San Manuel's reservation. And the Pechanga reservation is visible evidence of how gambling money has helped preserve and restore elements of cultural heritage.

The tribe has purchased land that it holds to be sacred or part of the tribe's heritage, including 800 acres on which sits the massive Coast Oak that adorns the tribe's crest and for which a nearby high school is named.

Today, the Pechanga reservation includes 7,000 acres, and underway across its breadth are projects to teach young tribal members the ways of the old.

"It's incredible; it wasn't happening before," said Macarro, standing in a clearing dotted with traditional houses that Pechanga youth built from willow branches. The tribe's casino was out of sight, but much in mind.

"Being able to make a difference in our destiny ... this is the kind of thing we dreamed would happen," Macarro said.

From a compound of plaster-walled buildings on the Morongo Band of Mission Indians reservation that overlooks the tribe's casino outside Banning, Jess Montoya directs the Riverside-San Bernardino County Indian Health Clinic, of which he is chief executive officer.

The state's largest such operation, it has eight clinics. Though federally funded, the network has been supported by tribes as they grew in wealth through grants and funding for capital projects — and it has been revived. Fifteen years ago, Montoya said, "the clinics were not very viable."

Today, the clinics see 13,000 patients a year and exceed some national health standards, including the number of eye exams given and cholesterol and prenatal HIV screenings performed. The clinics also have made strides treating diabetes, which has plagued American Indians, Montoya said.

"Where the tribes have done a great job is when they have money they've invested back in education and social services," Montoya said. "It's not solely attributable to gaming, but it's had a major impact."

That is the kind of work Indian leaders should be engaged in, Ramos said.

"If gaming does go down and we revert to 1970s conditions, then what did we do to move our people forward?" he said.

You can reach Staff Writer Jeremy Hay at 521-5212 or jeremy.hay@pressdemocrat.com.