March 2010 Blogs

Status of IHS with Passage of Health Reform Legislation

Some have expressed worry that IHS would no longer exist with the passage of U.S. health insurance reform legislation. This is incorrect. The IHS is still here, and the passage of the Indian Health Care Improvement Act reaffirms that IHS is here to stay – permanently. The bill permanently reauthorized the IHS. Health reform just means that in general, American Indians and Alaska Natives can continue to be eligible for and use IHS, Tribal, or urban Indian health programs, but if they want to, they will be able to purchase health insurance through the exchanges, which should have more affordable options. If they don’t want to purchase health insurance, as long as they get their care through our I/T/U system, they won’t have to pay a penalty. The expanded eligibility for Medicaid in the health reform bill will also likely help many of our patients.

This also means that if more American Indians and Alaska Natives have access to health insurance and if we see them in our system, we can bill for third party reimbursements and help better fund our health services. However, they could also choose to leave us and get their healthcare somewhere else. Then we would lose our patients and potential reimbursements. All the more reason for us to change and improve the IHS, and emphasize customer service! We have to remain competitive and be the first and best choice for our patients.

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IHS Director message on passage of the IHCIA and health reform

History was made today, March 23, as President Obama signed Health Insurance Reform legislation, H.R. 3590, which includes the long-sought permanent reauthorization of the Indian Health Care Improvement Act (IHCIA). I am grateful to the President for his strong support of this reauthorization, and to many others who worked so long and hard for this. Since 2000, the IHCIA has not been updated or reauthorized by Congress. Additionally, the passage of H.R. 3590 provides some additional benefits to American Indians and Alaska Natives All of this will do so much to elevate the health status of American Indian and Alaska Native people.

Here's the President's statement:

THE WHITE HOUSE
Office of the Press Secretary

FOR IMMEDIATE RELEASE

March 23, 2010

Statement by the President on the Reauthorization of the Indian Health Care Improvement Act

Earlier today, I signed into law the Patient Protection and Affordable Care Act, the health insurance reform bill passed by Congress. In addition to reducing our deficit, making health care affordable for tens of millions of Americans, and enacting some of the toughest insurance reforms in history, this bill also permanently reauthorizes the Indian Health Care Improvement Act, which was first approved by Congress in 1976. As a Senator, I co-sponsored this Act back in 2007 because I believe it is unacceptable that Native American communities still face gaping health care disparities. Our responsibility to provide health services to American Indians and Alaska Natives derives from the nation-to-nation relationship between the federal and tribal governments. And today, with this bill, we have taken a critical step in fulfilling that responsibility by modernizing the Indian health care system and improving access to health care for American Indians and Alaska Natives.

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We will provide more information about what is in these bills for American Indians and Alaska Natives, Tribes, and the Indian health system in the very near future along with plans for implementation. Check back frequently for announcements.

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IHS Director holds Tribal Consultation meeting with Bemidji Area Tribes

I recently traveled to Minneapolis, MN to meet with the Tribes served by the Bemidji IHS Area as a part of my goal to hold an in-person consultation session in all 12 IHS Areas over the next 3-4 months. The Tribes presented their priority issues and made recommendations for how to improve our Tribal consultation process at the national, Area and local levels. Common priority issues included the need for more funding, especially contract health services funding, recruitment and retention of healthcare providers, and contract support costs. Here are some pictures from the meeting:

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IHS Director holds IHS Portland Area Tribal Consultation Session

I recently traveled to Portland, Oregon to meet and consult with Tribes served by the Portland IHS Area. The Tribes made recommendations on how to improve Tribal consultation at the national, Area and local levels and discussed the following priority areas: more funding, Contract Health Services funding, and a proposal for an innovative regional healthcare facility. Here are some pictures from the meeting:

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IHS Director holds Tribal Consultation meeting with California Area Tribes

I recently traveled to southern California to meet with the Tribes served by the California IHS Area as a part of my goal to hold an in-person consultation session in all 12 IHS Areas over the next 3-4 months. The Tribes presented their priority issues and made recommendations for how to improve our Tribal consultation process at the national, Area and local levels. Common priority issues included the need for more funding, especially for the Contract Health Services Program and the need for progress on the southern and northern Youth Regional Treatment Centers. Here are pictures from the meeting:

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IHS Director holds Tribal Consultation meeting with California Area Tribes

I recently traveled to southern California to meet with the Tribes served by the California IHS Area as a part of my goal to hold an in-person consultation session in all 12 IHS Areas over the next 3-4 months. The Tribes presented their priority issues and made recommendations for how to improve our Tribal consultation process at the national, Area and local levels. Common priority issues included the need for more funding, especially for the Purchased/Referred Care (PRC) and the need for progress on the southern and northern Youth Regional Treatment Centers. Here are pictures from the meeting:

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IHS Director holds IHS Portland Area Tribal Consultation Session

I recently traveled to Portland, Oregon to meet and consult with Tribes served by the Portland IHS Area. The Tribes made recommendations on how to improve Tribal consultation at the national, Area and local levels and discussed the following priority areas: more funding, Purchased/Referred Care (PRC) funding, and a proposal for an innovative regional healthcare facility. Here are some pictures from the meeting:

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IHS Director holds Tribal Consultation meeting with Bemidji Area Tribes

I recently traveled to Minneapolis, MN to meet with the Tribes served by the Bemidji IHS Area as a part of my goal to hold an in-person consultation session in all 12 IHS Areas over the next 3-4 months. The Tribes presented their priority issues and made recommendations for how to improve our Tribal consultation process at the national, Area and local levels. Common priority issues included the need for more funding, especially Purchased/Referred Care (PRC) funding, recruitment and retention of healthcare providers, and contract support costs. Here are some pictures from the meeting:

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Tribal Delegation Meetings

One of the ways we consult with Tribes is to hold Tribal Delegation Meetings at the IHS Headquarters. These meetings are usually at the request of the Tribe when they are in the Washington, D.C., area. This type of meeting allows the Tribe to talk with us about a few pending issues or to provide input. Here are pictures of attendees at recent meetings:

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IHS Director testifies at Senate Committee on Indian Affairs hearing on the FY2011 President’s budget request

I testified at a hearing on the President’s FY2011 budget request held by the Senate Committee on Indian Affairs on February 25, 2010. Click here Exit Disclaimer: You Are Leaving www.ihs.gov  if you are interested in reading testimony or watching the video webcast of this hearing.

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HHS Tribal Consultation held in Washington, D.C.

I attended the Department of Health and Human Services (HHS) Annual Tribal Consultation session on March 4-5, 2010 and listened to Tribal priorities for the FY2012 budget for IHS. The Tribes proposed a $700 million increase in the IHS budget that included priority increases for the Contract Health Service Program, maintaining Clinical Services, Contract Support Costs and a number of other items. They also presented their estimates of the total need for the IHS budget ($21.2 billion). Here’s a link to their budget formulation recommendations for FY2012 Exit Disclaimer: You Are Leaving www.ihs.gov  [PDF- 350K]

Tribal leaders also gave recommendations for the overall HHS Budget and other HHS Operating Divisions at the meeting. Here are pictures from the HHS Tribal Budget Consultation – Secretary Sebelius attended to hear Tribal recommendations and sat next to Reno Franklin, Chair of the National Indian Health Board. Tribal elected officials were at the roundtable during this discussion:

Photos courtesy of the National Indian Health Board

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HHS Secretary meets with Tribal Leaders

A select group of Tribal leaders met with HHS Secretary Sebelius in her office on March 2, 2010 to discuss priority issues. This meeting was historic and the Tribal leaders expressed gratitude for the Secretary’s support of improving the IHS and recent budget increases. Here’s a picture from the meeting:

HHS Photo by Chris Smith

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HHS Secretary presents at NCAI Executive Winter Council meeting

I accompanied Secretary Sebelius as she addressed Tribal leaders at the NCAI meeting on March 2, 2010. She announced her support for consulting with Tribes, the FY2011 budget’s status as the largest percent increase among all HHS operating divisions, and provided an update on health reform activities. Here’s a picture of her presentation at the meeting:

HHS Photo by Chris Smith

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IHS Director Visits IHS Areas to Consult with Tribes: Update

As I have mentioned on this blog, I am visiting all 12 IHS Areas in the next 3 months to consult with Tribes on how we can improve our Tribal consultation process. During these meetings, the basic agenda is for me to meet with the Tribal elected officials as a group in the morning and then individually with Tribes or groups of Tribes in the afternoon. As you can imagine, this results in a very full day of meetings. Therefore, I want everyone to know that I am unable to schedule additional meetings during these visits. The focus of my visit is to meet with Tribal elected officials on a government to government basis and I must reserve all my time for the meeting as scheduled. Thank you to everyone for their understanding.

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IHS Director meets with Direct Service Tribes Advisory Committee

I met with the Direct Service Tribes Advisory Committee (DSTAC) by phone during their quarterly meeting in Nashville, TN, on 2/18/10. This group represents the Tribes who are served by health facilities and programs that are managed directly by the Indian Health Service (IHS). As the Chair stated, “IHS is the only game in town” for these communities, and they value working in partnership with IHS to ensure that their members get the health care they need. They discussed their participation in the interview process for a new Director of the Office of Direct Service and Contracting Tribes here in IHS Headquarters. They also discussed concerns they have about the Purchased/Referred Care (PRC) program and the importance of improvements in customer service by some IHS staff. While I did not get to meet with them in person, I asked them to send me a picture so that I could report about their meeting on this blog.