When I took the helm of the Indian Health Service in June as the acting director, I was excited about the opportunity to lead an agency responsible for providing preventive, curative and community health care for approximately 2.2 million American Indians and Alaska Natives.
Leading this agency is more than a job, it’s personal. I was born in an IHS hospital in Shiprock, New Mexico, and grew up as a patient in the IHS health care system. Many of my friends and family use IHS for their health care needs.
I knew I would face many challenges in this role, but working in partnership with tribes, tribal organizations, urban Indian organizations, and Congress, we have made great strides.
Quality Framework
In 2017, we made significant progress in implementing the IHS Quality Framework. The framework outlines how the IHS will develop and sustain an effective quality program. We have worked diligently to accomplish the goals in the framework by updating governing board bylaws, acquiring a credentialing software system, developing a standard patient experience of care survey and developing patient wait times standards.
IHS is also working towards standardizing data and reporting requirements by developing the National Quality Accountability Dashboard, a system to aid in evidence-based strategic decision making. The dashboard will eventually be made available on the ihs.gov website for public viewing.
The framework also calls for us to meet and maintain accreditation for IHS direct service facilities. In 2017, we announced an agency-wide accreditation contract for IHS Direct Service facilities. A single accrediting organization for all IHS hospitals will result in a uniform set of health, quality and safety standards across the organization.
Addressing the National Opioid Crisis
IHS is also addressing the national opioid crisis, one of the top priorities of the administration. Last year, U.S. Department of Health and Human Services Acting Secretary Eric D. Hargan declared a public health emergency to address the crisis. Several months before that announcement, we established the IHS National Committee on Heroin, Opioid, and Pain Efforts (HOPE Committee) to work towards improving the quality of IHS care as we provide safe and effective pain management, aim to prevent opioid misuse, and improve access to treatment for opioid use disorders (OUD). Already, the committee has provided training opportunities for IHS clinicians in pain management and treatment of OUD, supported the implementation of naloxone programs to reduce overdose deaths, and supported improved perinatal response to opiate use.
2017 Accomplishments
I want to thank the dedicated, hardworking team of professionals who work across the Indian health system and highlight some of the other work we have accomplished together in 2017.
- We opened the Desert Sage Youth Wellness Center in Hemet, California, to provide culturally appropriate substance use disorder services to American Indian and Alaska Native youth.
- In partnership with the Centers for Disease Control and Prevention (CDC), we published the January 2017 CDC Vital Signs report about the remarkable decrease in diabetes-related kidney failure among American Indian and Alaska Native people. The report showed that diabetes-related kidney failure among American Indian and Alaska Native people decreased by 54 percent between 1996 and 2013.
- In May, HHS announced the selection of five entrepreneurial projects for investment by the 2017 Secretary’s Ventures Fund . The projects support HHS’ innovation agenda. One of those projects is the Phoenix Indian Medical Center’s electronic signature pad to capture patient signatures electronically. This system will create electronic forms and upload the signed forms directly into the network safely and efficiently.
- In August, the Centers for Medicare & Medicaid Services determined that the Rosebud IHS Hospital completed its Systems Improvement Agreement, restoring it to normal status within the Medicare and Medicaid program.
- We announced the Pediatric Integrated Care Collaborative (PICC) pilot program to provide child trauma-informed integrated care, in partnership with the Johns Hopkins Center for Mental Health Services in Pediatric Primary Care.
- We announced a new funding opportunity, the Zero Suicide Initiative, to assist awardees in improving the care of those at risk of suicide within the Indian health systems by building comprehensive culturally informed systems of care.
- IHS announced 14 awards for two new behavioral health funding opportunities, the Behavioral Health Integration Initiative (BH2I) and Preventing Alcohol Related Deaths (PARD). These awards will address the critical behavioral health needs seen in our tribal clinics, hospitals and Native communities
- We awarded Tribal Management Grants to support tribal self-determination and Planning and Negotiation Cooperative Agreement awards to support tribes and tribal organizations with the planning and preparation necessary to assume responsibility for providing health care to their tribal members.
- The IHS Great Plains and Billings Areas implemented emergency department telehealth consultation. At the push of a button, IHS emergency department staff have immediate tele-video access to a team of highly specialized emergency medicine doctors and nurses.
- The IHS released a plan to guide, support and improve access to high quality health care services for urban Indians. The 2017-2021 Strategic Plan for the Office of Urban Indian Health Programs supports health care solutions that fit the diverse circumstances of urban Indians and their communities.
- We began the process of developing an IHS Strategic Plan for 2018-2022, and sought input from tribes, tribal organizations, urban Indian organizations, and IHS staff as we seek to shape the IHS mission, vision, goals and objectives for the next five years.
- As part of ongoing efforts to provide competitive compensation and provide recruitment and retention tools to managers, we implemented a Title 38 special salary rate pay table for certified registered nurse anesthetists and certified nurses. The Title 38 program provides higher rates of pay to employees in certain health care occupations.
IHS remains committed to our mission of raising the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level. We extend our utmost gratitude to the tribal and urban Indian organization leaders who dedicate time, resources and energy to advance the IHS mission. Their active participation in the tribal advisory committees last year assisted the IHS in making important decisions on issues that impact IHS, tribes, tribal organizations, and urban Indian organizations.
I look ahead to 2018 knowing that we are working to make a difference in the lives of the American Indian and Alaska Native patients we serve.
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