February 2012 Blogs

Indian Health Care Improvement Act (IHCIA) Implementation Update: Access to Federal Insurance

OPM recently announced that Tribes, tribal organizations, and urban Indian organizations may purchase Federal Employees Health Benefits coverage for their employees with the earliest effective start date of May 1, 2012. A tribal technical workgroup is helping OPM finalize the operational details. For some of the eligible entities, this coverage is more affordable and better coverage that will help increase access to care for their employees. It is also one of the benefits of the recent reauthorization of the IHCIA, which was passed as a part of the Affordable Care Act. For more information, visit the OPM website. Exit Disclaimer: You Are Leaving www.ihs.gov 

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Influenza Update

While we have had a mild influenza season so far, recent reports from CDC indicate that influenza activity is starting to increase. It’s not too late to vaccinate! I encourage everyone to protect themselves and their communities from the flu by getting vaccinated. Weekly reports from the IHS Influenza Awareness System (IIAS) are available here, and provide an overview of influenza-like illness activity in the 12 IHS Areas, as well as influenza vaccine coverage estimates. According to the most recent IIAS report, the overall influenza vaccine coverage rate for our patients is lower than the vaccine coverage rate estimate reported by CDC for the general U.S. population (31.6% vs. 36.3%). I encourage all Indian health facilities and providers to continue monitoring flu vaccine coverage and increase your outreach efforts, in order to ensure that our communities are protected against influenza.

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IHS Participating in the Million Hearts™ Campaign and Spreading the Message of "ABCS" for Heart Health

As you may know, February is American Heart Month. In 2011, the Department of Health and Human Services launched the Million Hearts™ campaign to prevent 1 million heart attacks and strokes among American people over a period of 5 years. Heart disease (also known as Cardiovascular Disease or CVD) is a major health problem for individuals with diabetes, and is the leading cause of death in American Indian and Alaska Native populations. The Indian Health Service has partnered with this very important campaign to help promote heart health in the community and clinic setting.

The ABCS for Heart Health are:

• Use Aspirin;
• Control Blood Pressure;
• Control Cholesterol;
• Quit Smoking or Using Tobacco.

To learn more about the Million Hearts campaign and how you can participate as an individual, a health care provider, a community, or an organization, click on the links below:

• Million Hearts Initiative - Remember Your ABCSExit Disclaimer: You Are Leaving www.ihs.gov 
• Million Hearts Initiative Overview - Learn More Exit Disclaimer: You Are Leaving www.ihs.gov 
• Division of Diabetes Instant Downloads: Heart Health, Weight Loss and Nutrition Resources

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Update on the IHS Contract Health Services Program

The Director’s Workgroup on Improving the Purchased/Referred Care (PRC) Program met in January to finalize their previous draft recommendations. The group focused significant discussion on their recommendations to help improve the PRC estimate of Unmet Need. IHS has previously estimated this need to be approximately $861 million. This estimate is primarily based on data related to denied and deferred care from IHS programs, from tribes that have volunteered to submit data, and on estimates of the entire need. The workgroup discussed the GAO Report on PRC Unmet Need and made some additional recommendations, including encouraging Tribally managed PRC programs to submit data on unmet need, and I sent a letter to Tribes served by these programs to encourage their voluntary submission of data. Better estimates of PRC Unmet Need can help us in the budget formulation process and in the operation of the PRC Program. The workgroup previously made recommendations on how to improve the business of PRC, and those recommendations are being implemented by IHS. It is clear that more education and training are needed on CHS for all administrative and clinical staff in our system, and more education and information is needed for Tribes, patients and outsider providers. We will continue to implement these improvements in the CHS program. Here is a picture from the workgroup meeting in January:

Click on the thumbnail for a larger image

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IHS National Combined Councils Meeting

The IHS National Combined Councils Meeting was held in January in Tucson, AZ. The attendees included administrative and clinical leaders throughout the Indian health system. The meeting focused on workforce issues, recruitment, and retention. The meeting also provided an opportunity for the National Councils to meet to work on priority areas for improvement. I met with each of the councils, and given the enthusiasm of the councils to help us change and improve the IHS, we plan to hold another meeting this summer. That meeting will be more of a working session to encourage cross-council work and teamwork in addressing priorities. Here are pictures from the January meeting:

Click on the thumbnails for larger images

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National Tribal Budget Formulation Meeting

The IHS budget formulation process for FY 2014 began in the fall of 2011 with the Area Tribal Budget Formulation Meetings, where each Area’s Tribes met to identify their top priorities for the FY 2014 IHS budget. The National Tribal Budget formulation Workgroup met in the Washington, D.C., area in January to review the Area recommendations and make some national recommendations. The workgroup will present their recommendations to the IHS Director later this month, and then will present their final recommendations at the Department of Health and Human Services Annual Tribal Budget Consultation meeting on March 7, 2012, in Washington, D.C. Here are some pictures from the meeting:

Click on the thumbnails for larger images

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National Indian Health Board – Quarterly Meeting

I attended the Quarterly Meeting of the National Indian Health Board (NIHB) and provided an update on the IHS budget and our progress on IHS priorities. I informed the Board that as a result of tribal consultation input, IHS has decided to restore funding to NIHB that was cut in the FY 2012 budget as a part of proposed small grant savings. IHS values its partnership with NIHB and looks forward to continued collaborations and partnership. Here is a picture from the meeting:

Click on the thumbnail for a larger image

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Tribal Delegation Meetings

Tribal Delegation Meetings were held with three Tribes in January: The Ute Indian Tribe of Uintah and Ouray, the Tohono O’odham Nation, and the San Carlos Apache Tribe. Here are pictures from those delegation meetings:

Click on the thumbnails for larger images

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HHS Secretary’s Tribal Advisory Committee

The Department of Health and Human Services held a meeting of its Secretary’s Tribal Advisory Committee in January. The tribal members reviewed HHS progress on implementing their priorities and recommendations, including improving access to grant funding for Tribes, improving state-tribal relations, expanding self-governance in HHS beyond IHS, and improving tribal consultation. Here are pictures from the meeting:

Click on the thumbnails for larger images

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FY 2013 President's Budget Request Announced

The President's FY 2013 budget request includes a 2.7% increase for the Indian Health Service. The proposed budget includes increases for Purchased/Referred Care (PRC), staffing for new and expanded facilities, contract supports costs for tribal programs, oversight and accountability, implementation of ICD-10 and the electronic dental record program, and maintenance and improvement for health facilities. It also maintains a level for health care facilities construction that allows continued construction on facilities in progress. If the FY 2013 proposed budget is enacted, the IHS budget will have increased 32 percent since the 2008 fiscal year. For more information, see our press release and you can view the budget justification document at: www.ihs.gov/budgetformulation/

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Update: Consultation on Federal Advisory Committee Act

I sent a letter to Tribes in November 2011 initiating a consultation on ensuring all IHS advisory groups, workgroups, and committees are in compliance with the Federal Advisory Committee Act (FACA). After reviewing the initial input, I sent a letter today to Tribes to clarify the Agency’s position and to request further and more specific input on this topic. Here is a copy of the letter. [PDF - 41KB] Comments are due in 30 days from the date of the letter.