July 11, 2024: IHS Updates for Tribes and Tribal and Urban Indian Organizations

This bi-weekly update provides up to date information on recent events, meetings, conferences, upcoming deadlines, and recognition of the work being done across the Indian Health Service, other federal agencies, and Indian Country. For more information or questions, email IHSPublicAffairsStaff@ihs.gov.

IHS Recognizes Two New Voter Registration Act Designated Sites

Congratulations to the Santa Fe Indian Health Center and the Crownpoint Health Care Facility for becoming the first federal facilities to earn National Voter Registration Act designation. This milestone is a significant achievement, stemming from Executive Order 14019 on Promoting Access to Voting under the Biden-Harris Administration, which acknowledges the unique voting barriers faced by Native communities. This order emphasizes the crucial role of federal agencies in promoting voter registration, similar to state agencies like motor vehicle departments and public assistance offices. New Mexico now leads as the first state with two IHS facilities designated under the NVRA. NATIVE Health in Phoenix was the first in the Indian health system to be designated as a NRVA site back in October 2023.

IHS and tribally administered health programs serve approximately 2.8 million American Indians and Alaska Natives, many of whom remain unregistered to vote. These new designations are crucial for improving civic engagement, a vital aspect of public health. Kudos to the IHS Albuquerque Area and Navajo Area offices for their dedication to our patients, and special thanks to Senior Advisor to the IHS Director Joshuah Marshall for his steadfast work on this initiative. Well done to all involved!

Joshuah Marshall, top left, and New Mexico State Representative and San Felipe Pueblo Member Charlotte Little, bottom right, were among the IHS, tribal, non-profit, and elected officials that took place in a celebration at the Santa Fe Health Center on July 1

HHS Secretary Xavier Becerra Renews Nationwide Opioid Public Health Emergency

As a result of the continued consequences of the opioid crisis affecting our nation, last week Secretary of Health and Human Services Xavier Becerra renewed the 2017 determination that an opioid public health emergency exists nationwide. The IHS continues to increase awareness of the signs of opioid overdose and equip employees to respond to life-threatening opioid-related overdose events that may occur in the health-system setting or community. I want to remind you that the “IHS Reversing Opioid Overdose with Naloxone Training” is now available in the HHS Learning Management System. All IHS federal employees, contractors, and clinical residents must complete this training course no later than December 31. The training takes approximately 30 minutes to complete and covers risk factors for overdose and signs and symptoms of opioid overdose; best practices for administering naloxone; and identifying naloxone storage locations (if applicable) and ways to obtain naloxone. Thank you for your continued efforts as we respond to this crisis throughout Indian Country.

ORAP and DCC Release Updates to Purchased/Referred Care Program

The Office of Resource Access and Partnership Division of Contract Care released critical updates this week regarding human resources, fiscal intermediary pended claims and referral language. These activities are associated with the two 2024 PRC Agency Priorities for PRC Carryover and PRC Authorization and Payment.

• Standardized Position Descriptions: ORAP/DCC and the PRC Operations Workgroup has worked collaboratively with the IHS Classification Program to develop a strategic set of position descriptions to create consistency, standardization and efficient recruitment activities throughout the Agency. The PDs include medical support assistants, contact representatives (care coordinators), nurse case management and budget analysts. Furthermore, it establishes a hierarchal relationship between multiple position description series to provide promotion potential and maximal retention options within the PRC program. It is our collective goal to create a PRC environment that is rich in development capacity and career potential in order to recruit and retain highly skilled PRC staff. These efforts directly reflect the IHS’ transition to One HR to improve our internal hiring processes and lead to a greater workforce to meet the overall mission of the IHS.
• Pended Claims Status: The PRC Programs are continuing to work diligently in reducing the overall number of pended claims at the fiscal intermediary. These actions began in January 2024 and have resulted in a 23% reduction in the number of pended claims since December 2023. Work continues but significant progress had been made. The goal of the IHS is to be current by the end of December 2024.
• Referral Language Update: ORAP/DCC, PRC Operations Workgroup and the Office of General Counsel has worked together to standardize referral language and include patient protection language within the referral. The inclusion of the No Patient Liability Language from Section 222 of the Indian Health Care Improvement Act [25 U.S.C. 1621u] is vital to ensure any approved referral clearly articulates the patient is not financially liable for the services. The language also provides the vendor with billing instructions to help facilitate payments from the fiscal intermediary. Additionally, standardized language is included for referrals in pending status, denied or Medicaid. Trainings are underway to assist facilities with updating the referral language.

National HIV Testing Day

Each year on June 27, the IHS observes National HIV Testing Day to highlight the importance of HIV testing. Knowing your HIV status helps you choose options to stay healthy. The IHS recommends that everyone 13 years and older should get tested for HIV at least once as part of routine health care. People should get tested more often when they have had more than one sex partner or are having sex with someone whose sexual history they don’t know. Some sexually active gay and bisexual men may benefit from more frequent testing (e.g., every 3 to 6 months).

Patients can click here to Find HIV Services Near You or ask for an HIV test at their local IHS, tribal, or urban Indian clinic. They can also text the words “Native Test” to 55521 or visit the I Want The Kit website for free, accurate, confidential at-home specimen collection and lab-based testing for HIV and STIs. The IHS supports these programs with resources from the Minority HIV/AIDS Fund.

June 2024 Pharmacy Monthly Spotlight – Dr. Whitney Dickson, Cass Lake Indian Hospital (Bemidji Area)

In June, the monthly pharmacy spotlight recognized Dr. Whitney Dickson, a clinical pharmacist at the Cass Lake Indian Hospital, who is actively involved in harm reduction, sexually transmitted infection mitigation, and antimicrobial stewardship on both a local and national level. She currently treats patients with hepatitis C, HIV, and STIs under a collaborative practice agreement with standing orders. She also works closely with tribal health nursing, disease intervention specialists, and the Minnesota Department of Health to optimize community outreach and implement projects for rapid syphilis and HIV testing.

Dr. Dickson is actively involved in national initiatives, including Ending the Syndemic (HIV, STI, Viral Hepatitis, Substance Use) trainings in partnership with the Northwest Portland Area Indian Health Board and IHS headquarters. Through this initiative, she has presented nationally on harm reduction and Cass Lake’s model for ending the syndemic. She is working on expanding access to at-home/mail-in STI testing in tribal communities as an Indigi-IWTK (I Want the Kit) National Advisory Board member and serves on the National Indian Country Congenital Syphilis Taskforce.

Yukon Kuskokwim Health Corporation Recognized as E3 Champion

On behalf of the IHS National E3 Vaccine Strategy Operations Team, IHS Director Roselyn Tso would like to congratulate the Yukon Kuskokwim Health Corporation for their qualification as the agency’s third E3 Champion! The IHS National E3 Vaccine Strategy was first announced in November 2022, with the E3 Champions Challenge and pilot program launching shortly after. As part of the E3 strategy, IHS encourages that Every patient at Every encounter be offered Every recommended vaccine, when appropriate. As we seek to promote routine immunization, increase vaccine coverage rates, and mitigate the risks of vaccine preventable illness in tribal communities, the innovation and successful best practices developed at the local level by vaccine exemplars, such as the YKHC team, are an inspiration. Thank you to the YKHC for your commitment to vaccine excellence in Indian Country!

Office of Urban Indian Health Programs Team Meets in Rockville

Last week, the Office of Urban Indian Health Programs conducted an in-person meeting at IHS headquarters in Rockville, Maryland. The team met to discuss identifying improvement areas for their communication plans, individual strength development inventory, reviewing roles and responsibilities, and employee wellness. Other facilitators from various programs also presented to educate and inform staff of their processes. OUIHP also took some time to visit Native American LifeLines, Inc., an urban Indian organization in Baltimore, Maryland, and explored the new building that NAL bought to expand their services.

First Ever White House Convening Celebrates LGBTQI+ and Two Sprit Indigenous Communities

During the last week of June, IHS Senior Advisor to the Director Joshuah Marshall participated in the first ever White House Convening Celebrating LGBTQI+ and Two Spirit Indigenous Communities. On June 25, more than 80 tribal elected leaders, Native business owners, nonprofit leaders and advocates joined several members of the Biden-Harris Administration at the White House Complex. Secretary of the Interior Deb Haaland and U.S. Rep. Sharice Davids (KS) gave opening remarks and then a panel of LGBTQI+ and Two Spirit Indigenous leaders discussed the current struggles as well as the cultural resilience of LGBTQI+ and Two Spirit Indigenous communities. The following day, Marshall attended the White House Pride Celebration hosted by the President and Dr. Jill Biden on the South Lawn. The annual event celebrates LGBTQI+ leaders across the country and highlights that the Biden-Harris Administration has the most openly LGBTQI+ Americans serving in an Administration in history.

American Association of Nurse Practitioners National Conference

On June 27 – 29, IHS staff members from the Division of Health Professions Support, Division of Nursing Services, Billings Area, and Portland Area recruited at the American Association of Nurse Practitioners National Conference held in Nashville. The event attracted an engaging group of nurse practitioners from across the country, who expressed their interest in employment with the IHS, the Loan Repayment Program, and to provide direct patient care.

National Association of Social Workers Annual Conference

On June 20 – 22, the Headquarters Division of Health Professions Support Branch and the IHS Nashville Area recruiter attended the National Association of Social Workers Annual Conference held in Washington, D.C. The event generated a presence of licensed clinical social workers, graduate school students in the Master of Social Work program, and retirees from across the country. Individuals expressed an interest in employment with the IHS, loan repayment program options, and opportunities to provide direct patient care to American Indians and Alaska Natives.

Ona Charette-Steele, Nashville Area recruiter and Meredith Hunt, HQ recruitment and outreach program coordinator

IHS and CDC Offer Virtual Training for Infection Control

The Indian Health Service has partnered with the CDC to provide virtual infection control training for all health care employees. Topics include Risk Recognition, Hand Hygiene and Personal Protective Equipment, Bloodborne Pathogen Exposure Prevention, Cleaning and Disinfection, IHS Indian Health Manual Chapter 3-33 Infection Control and Prevention Policy, and CDC Infection Prevention and Control Core Practices. This training will be held for five consecutive weeks starting on July 10. Each week, we will cover a different subject, with time for Q&A at the end of each session. Register here.

Telebehavioral Health Center of Excellence Webinar Series

The Telebehavioral Health Center of Excellence Tele-Education Program is hosting the following trainings for health care providers:

• “The Intersection of Behavioral Health and the HIV Syndemic” on July 15 at 12:00 p.m. ET | Register here
• TBHCE Webinar Series: “Lessening Harms and Preventing Future Risk: Teaching Coping and Problem-solving Skills via Safety Planning” on July 16 at 12:00 p.m. ET | Register here
• TBHCE Webinar Series: “Lessening Harms and Preventing Future Risk: Lethal Means Restriction Counseling” on July 30 at 12:00 p.m. ET | Register here
• TBHCE Webinar Series: “Youth Social Media, Suicidality and the LGBTQ Community” on August 13 at 12:00 p.m. ET | Register here
• Behavioral Health Integration Webinar Series: “Evaluation Approaches and Sample Findings: Integrated Care in AI/AN Communities” on August 15 at 12:00 p.m. ET | Register here
• Behavioral Health Integration Webinar Series: “Partnerships for Children and Adolescents in Integrated Care Settings” on August 27 at 12:00 p.m. ET | Register here

AHRQ Hosts TeamSTEPPS Training

The Agency for Healthcare Research and Quality has an available training opportunity. Throughout 2024, AHRQ is offering TeamSTEPPS for Diagnosis Improvement, a comprehensive training that explores how improved communication among team members can help lead to safer, more accurate, and more timely diagnosis in all health care settings. This virtual training opportunity is offered at no charge and is open to teams of three or more across every specialty. There is also an option for those who are interested to earn 8 CEU credits for a fee. Training details are available here. The course calendar and registration are available here.

This training is an excellent opportunity for multi-disciplinary teams to take advantage of expert guidance and gain practical skills that can be immediately implemented to enhance patient care and safety.

Albuquerque Area Service Unit Works to Address Community Needs Arising from Fires in Ruidoso, New Mexico

On June 18, the Mescalero Service Unit in the IHS Albuquerque Area activated their Incident Command System to help address the health and medical needs of the community during the recent fires in Ruidoso, New Mexico, which directly impacted the Mescalero reservation and surrounding area. MSU nursing staff were readily available to provide support at the tribe’s evacuation sites for evacuees and response workers. The MSU Incident Command Team is working diligently with the tribal emergency operations center and Albuquerque Area Office ICS team to develop, plan, and address the needs of the community, in addition to keeping everyone up to date on the ongoing situation. 

As part of the New Mexico wildfire response, Division of Environmental Health Services staff member Kristin Kaydahzinne assisted with a possible foodborne disease outbreak on June 25. She provided on-the-spot food handler training and stressed the need to separate ill responders and evacuees from food service areas at the Inn of the Mountain Gods, which is serving as an evacuation center distributing goods, hot meals, and housing displaced community members. Kaydahzinne worked with Medical Reserve Corps staff Una Smith and Joe Conner to conduct a foodborne illness investigation via triage of

(Photo 1) The South Fork and Salt fire raging in the Mescalero and Ruidoso area
(Photo 2) Members of the Mescalero Incident Command Team
(Photo 3) Mescalero SU nursing staff serve at the Mescalero Community Center
(Photo 4) Kristin Kaydahzinne, left, with Medical Reserve Corps Staff

The Mescalero Service Unit and area incident management system staff also supported a much-needed satellite system due to impacts of the fires. While IMS staff were setting up a satellite system from the MSU rooftop, air support operations were underway.

On June 25, Kaileigh Scott, P.E., senior engineer from the Mescalero Service Unit, performed a water test at the MSU hose bib. She tested for a chlorine residue to ensure the clinic maintains safe water during the wildfires. The chlorine residue was found to be 0.04 mg/L. The CDC considers levels up to 4.0 mg/L or PPM safe to drink and levels at or below this number help assure us that no harmful health effects will occur.

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