"Since I was appointed as the IHS Director in May 2009, I have responded to a call from tribal leaders, staff, and patients to change and improve the IHS. I set four priorities to guide the work of the agency over the next few years, and we are making progress in reforming the IHS.

Our first priority is to renew and strengthen our partnership with Tribes. I continue to believe the only way we are going to improve the health of our communities is to work in partnership with them. We have strengthened our partnership with Tribes through formal consultations and numerous tribal meetings. Many of the health challenges we face are caused by factors in our communities that are outside of the control of the health system, including poverty, unemployment, crime, and public safety. The recent passage of the Tribal Law and Order Act highlights how multiple agencies must be involved in the solution to complicated problems such as violence against women in tribal communities. Strengthening our partnership with Tribes is essential to healthier communities and reduced health disparities.

Our second priority is to reform the IHS, in the context of national health reform. Passage of the Affordable Care Act benefits American Indians and Alaska Natives by increasing access to quality and affordable healthcare while reducing healthcare costs. Some American Indians and Alaska Natives do not have access to the Indian Health Service, especially in urban areas, so access to affordable insurance is critically important.

Our internal IHS reform efforts are focusing on improving the way we do business and how we lead and manage our staff. We are working on improvements in managing our finances, shortening our hiring process, managing the performance of our staff, and enhancing overall communication. Improvements in these areas will help us deliver better care by making us better at the business of healthcare.

Our third priority focuses on improving the quality of and access to care for the patients we serve. We are focusing on improving customer service and expanding our efforts to create a medical home for our patients with teams of providers focused on providing patient-centered care. We are expanding these activities to 100 more sites over the next three years.

Our fourth priority is to make all our work more transparent, accountable, fair, and inclusive. Telling the story of what we are doing as an agency to change and improve will help reassure our patient population that health reform is also happening for the IHS. Accountability for our programs and our staff is a fundamental part of our reform efforts. "

Get the Story:
Yvette Roubideaux: A continuing discussion to improve health care for First Americans (Mark Trahant 9/6)

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