February 2014 Blogs

Update: IHS Area Tribal Listening Sessions

I sent a letter to Tribes to notify them of my plan to schedule and personally attend tribal listening sessions in all 12 IHS Areas this year. Area Directors are to work with the Tribes in their Area to schedule a time for the listening session. Here is a copy of the letter [PDF - 26 KB].

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Tribal Consultation Activities Summary Table

I recently sent an update to Tribes on our Tribal Consultation activities that included a Summary Table documenting all tribal consultations since June 2009 and a brief description of current progress or outcomes. This update is posted on our Tribal Leader Letter website.

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Whiteriver Indian Hospital Achieves Baby-Friendly Status

In February, the Whiteriver Indian Hospital in Whiteriver, Arizona, became the 7th Baby-Friendly Hospital in the IHS system. Whiteriver's designation means that 54% of all IHS obstetric facilities are now Baby-Friendly, as Baby-Friendly becomes an official standard of care for American Indian and Alaska Native mothers and babies. Nationally, fewer than 6 percent of all U.S. hospitals are Baby-Friendly designated, making IHS a national leader in the Baby-Friendly field.

The IHS Baby-Friendly Hospital Initiative is part of First Lady Michelle Obama's "Let's Move! in Indian Country" campaign dedicated to solving childhood obesity within a generation. The IHS campaign aims to designate all IHS obstetric facilities as Baby-Friendly. This initiative promotes breastfeeding to reduce the risk that children will develop obesity and diabetes in the future, conditions to which American Indians and Alaska Natives are particularly prone. Baby-Friendly hospitals offer new mothers the information, confidence, and skills they need to initiate and continue breastfeeding their babies.

Other IHS hospitals that have been Baby-Friendly designated are Claremore Indian Hospital (Oklahoma); Phoenix Indian Medical Center (Arizona); Quentin N. Burdick Memorial Health Care Facility (North Dakota); Pine Ridge Hospital (South Dakota); Rosebud Indian Hospital (South Dakota); and Zuni Comprehensive Community Health Center (New Mexico).

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Consultation on CSC Appropriations

On February 12, 2014, Assistant Secretary - Indian Affairs Kevin Washburn and I sent a letter to Tribes to initiate a consultation on Contract Support Costs (CSC) as it relates to the 2014 Consolidated Appropriations Act. Congress requested a workplan from the Bureau of Indian Affairs and the Indian Health Service in 120 days from enactment of the Act to consult with Tribes on determining a long-term solution to CSC appropriations. Here is a copy of the letter [PDF - 55 KB] from our Tribal Leader Letter website. A consultation session will be held at the upcoming NCAI Executive Council Winter Session on Tuesday, March 11, 2014, as a first step in the consultation process on this topic.

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Copper River Native Association Health Facility Grand Opening

The Copper River Native Association held a Grand Opening for its new Health Facility constructed under the IHS Joint Venture Construction Program. Here are pictures from the event.

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NCAI State of Indian Nations 2014

I attended the National Congress of American Indians (NCAI) State of Indian Nations 2014 address in February. Here is a picture of me with the NCAI President Brian Cladoosby at the event. More pictures from the event are available on the NCAI flickr site Exit Disclaimer: You Are Leaving www.ihs.gov .

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CHEF Workgroup Meeting

The IHS Contract Health Service Workgroup charged a group of its members to meet to review and discuss the Catastrophic Health Emergency Fund (CHEF) program. The CHEF Workgroup discussed how to make sure the program is available to Tribes in all IHS Areas and potential improvements to the process. Here is a picture from the meeting.

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Affordable Care Act Webinar

IHS held an Affordable Care Act (ACA) Webinar in January that provided updated information for IHS staff who are conducting outreach and education and assisting patients with enrollment in the Marketplaces, including help with purchasing health insurance, enrolling in Medicaid, or applying for a hardship exemption. IHS now has individuals in every facility who have completed the Certified Application Counselor training and can assist patients with questions about their individual benefits related to the ACA.

Although members of Tribes and those eligible for IHS can apply for a hardship exemption from maintaining health coverage, we want all patients to at least see what their benefits are under the ACA, and to get covered in some manner, since IHS does not count as coverage. Here is a picture taken at IHS Headquarters while we held the webinar.

The deadline for open enrollment is March 31 for everyone but members of Tribes (who can enroll monthly), so make sure you, your family members, and your friends all take a look at the benefits available to you from the ACA as soon as possible. If more of our patients have health insurance or are enrolled in Medicaid, that means more resources locally for all of our patients. It also gives our patients more choices.

If you have questions about the ACA, you can contact our IHS facilities/business offices, go to Healthcare.gov Exit Disclaimer: You Are Leaving www.ihs.gov , call the ACA Call Center at 1-800-318-2596, apply by mail or through a broker/agent or issuer, or find local help Exit Disclaimer: You Are Leaving www.ihs.gov . So we hope everyone takes time to get covered!

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Tribal Delegation Meetings in January

IHS held Tribal Delegation Meetings with the following Tribes in January: Quartz Valley Indian Reservation; Ft. McDermitt Paiute Shoshone Tribe; Alabama-Quassarte Tribal Town; Rosebud Sioux Tribe; Oneida Nation of New York; and Confederated Tribes of Colville. Here are pictures from some of these meetings:

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IHS Tribal Self-Governance Advisory Committee Quarterly Meeting

The IHS Tribal Self-Governance Advisory Committee met for its quarterly meeting in Washington, D.C., in January. I provided an IHS update, and we discussed several topics, including the budget, contract support costs, and the Affordable Care Act. Here are pictures from the meeting.

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Contract Health Service Name Changed to Purchased/Referred Care

The Consolidated Appropriation Act of 2014 that was signed by the President in January included approval of a new name for IHS' Contract Health Service (CHS) Program, which funds referrals for care in the private sector when those services cannot be provided in the IHS facility. Congress requested that IHS propose a new name for the program since it was often confused for other budget items, and the FY 2014 President's Budget proposed that the name be changed to Purchased/Referred Care (PRC). The name change was official with passage of the FY 2014 appropriation, and IHS will transition the name from CHS to PRC during the next year. The transition will take time, since in addition to getting used to the new name, multiple policy and administrative documents must be updated.

The new name better describes the purpose of the program funding, which is for both purchased care and referral care outside of IHS. The name change will not otherwise change the program, and all current policies, practices, and improvements will continue. This year's appropriation also included a $77 million increase for CHS/PRC, which means there is more funding available to pay for the referrals our patients need.

Thank you for your cooperation and understanding as we transition to the new name.

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Contract Support Costs Workgroup

The IHS Contract Support Costs (CSC) Workgroup met in early January to discuss estimates of CSC in the pre-award/negotiation phase. The Workgroup consisted of tribal representatives and federal staff. The workgroup members reviewed how CSC estimates are determined, identified several areas of agreement, and agreed to discuss several other areas to work on towards further agreement. Better agreement on CSC estimates at the beginning of the process will help in many areas.

The workgroup will meet again to continue this conversation on February 24-25, 2014. Here are pictures from the meeting.

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Meeting Update

Due to requests from Tribes to co-locate the IHS Budget Formulation Worksession (2/26-27/14) and the CSC Workgroup Meeting (2/24-25/14), IHS now has the following hotel/meeting location information:

Meeting Location:
Washington Marriott Wardman Park
2660 Woodley Road NW
Washington DC 20008
Phone: 202-328-2000
Fax: 202-234-0015

This link can be used by guests to make their reservations Exit Disclaimer: You Are Leaving www.ihs.gov . Once you click on it, the information regarding our group will automatically populate.

Reservations can also be made by phone: 1-877-212-5752; Mention "Indian Health Service" or conference reference number M-1J5380G.

Please watch the IHS Calendar for other meeting updates.

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IHS Pawhuska Indian Health Center Recognition

CDC and the Million Hearts initiative have recognized the IHS Pawhuska Indian Health Center in Pawhuska, Oklahoma, as one of nine 2013 Hypertension Control Champions. The champions are being recognized for achieving exceptional control rates by using a variety of proven approaches such as evidence-based guidelines and protocols, team-based care, and electronic reminders to track patients' progress.

The Hypertension Control Challenge was developed by CDC to identify health systems that have worked with their patients to successfully reduce high blood pressure and improve heart health. Million Hearts is a national public/private initiative, co-led by CDC and CMS, aimed at preventing one million heart attacks and strokes by 2017.

The Pawhuska Indian Health Center attributes their successful control rate of over 74% to exceptional team work, process improvements based on IPC principals, and the use of tracking tools to identify patients who needed more assistance in reaching their blood pressure goals.

More information about the 2013 Hypertension Control Challenge and the 2013 Champions is available at http://millionhearts.hhs.gov/ Exit Disclaimer: You Are Leaving www.ihs.gov .