On July 12, 2016, the National Indian Health Board 
(NIHB) testified on behalf of all 567 federally recognized Tribes in a hearing held by the U.S. House of Representatives Natural Resource Committee’s Subcommittee on Indian, Insular, and Alaska Native Affairs. The legislative hearing was held on H.R. 5406, the “Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare (HEALTTH) Act”, recently proposed by Representative Kristi Noem (R-SD). The HEALTTH Act is just one of several recent pieces of legislation that aim to address the longstanding, systemic issues within the IHS that have led to crisis situations – especially, in the Great Plains Service Area. In the last year, several hospitals in this region have lost, (or received threats of revocation) their ability to bill Centers for Medicare and Medicaid Services (CMS) due to the failure of federally run sites to comply with basic safety and regulatory procedures.
(NIHB) testified on behalf of all 567 federally recognized Tribes in a hearing held by the U.S. House of Representatives Natural Resource Committee’s Subcommittee on Indian, Insular, and Alaska Native Affairs. The legislative hearing was held on H.R. 5406, the “Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare (HEALTTH) Act”, recently proposed by Representative Kristi Noem (R-SD). The HEALTTH Act is just one of several recent pieces of legislation that aim to address the longstanding, systemic issues within the IHS that have led to crisis situations – especially, in the Great Plains Service Area. In the last year, several hospitals in this region have lost, (or received threats of revocation) their ability to bill Centers for Medicare and Medicaid Services (CMS) due to the failure of federally run sites to comply with basic safety and regulatory procedures.Executive Director of NIHB, Stacy A. Bohlen of the Sault Ste. Marie Tribe of Chippewa Indians, testified before the subcommittee, supporting the intent of the bill and presenting five key recommendations to strengthen the positive impact the legislation could have on the Indian health system. However, NIHB believes that this legislation must get further input from Tribes nationwide and must be a joint, collaborative effort between Congress, the IHS and Tribal stakeholders. Other recommendations include:
- Structural and administrative reform of Service Units and Area offices
- Increased use and standardization of quality assurance measures
- Improved recruitment and retention of quality personnel
- Increased health literacy training for all American Indian and Alaska Natives
- Greater investments in the system, and especially in Native youth
The subcommittee also heard testimony from: William Bear Shield, Chairman of the Rosebud Sioux Tribal Heath Board; Vernon Miller, Chairman of the Omaha Tribe of Nebraska; Victoria Kitcheyan, Secretary of the Winnebago Tribe of Nebraska; Jerilyn Church, Chief Executive Officer of the Great Plains Tribal Chairman’s Health Board; Kristi Noem, Congresswoman from South Dakota, and Mary Smith, Principle Deputy Director of the Indian Health Service.
Although Congress and Tribes continue to pressure the Indian Health Service to implement changes and reforms, Ms. Smith reiterated her commitment to improving and sustaining the delivery of quality health care, stating, “IHS is working to instill a culture of quality care, leadership, and accountability across the agency. We are committed to hearing directly from you and the communities we serve to focus sharply on how to best improve access to quality health care and, most importantly, improve the health status of American Indian and Alaska Native families and communities.” The IHS has already made many positive changes in the past several months – including, most recently, the reopening of the Rosebud Sioux Tribe’s emergency department.
Ms. Church also offered tangible solutions that could be incorporated into the legislation by suggesting more Tribal input into IHS hiring processes and Tribal authority throughout any process that explores alternate delivery of care systems. In addition to echoing the other witnesses’ calls for increased resources for the agency, Ms. Church also advocated for protection of IHS funding from sequestration.
NIHB will continue to monitor and educate Tribes and members of Congress about this important piece of legislation. To that end, NIHB, in partnership with the Great Plains Tribal Chairman’s Health Board, will be hosting a solutions-based meeting of private industry stakeholders, Tribes, and other national and regional allies in Rapid City, SD onAugust 26 to find new creative ways to improve the delivery of quality care, not just in the Great Plains Area, but across the nation.
To read the written statements of all witnesses, please visit the Subcommittee on Indian, Insular and Alaska Native Affairs website. The record will be open for the next week, and we encourage Tribes and Tribal organizations to submit comments to alex.perez@mail.house.gov no later than Tuesday, July 26.
