Rep. Kristi Noem (R-South Dakota) speaks about H.R.5406, the Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act (HEALTTH Act), at a hearing before the House Subcommittee on Indian, Insular and Alaska Native Affairs on July 12, 2016. Photo from Rep. Kristi Noem / Twitter
No Call to Fully Fund IHS: Native Health Bill Debated
By Brandon Ecoffey
Lakota Country Times Editor
lakotacountrytimes.com WASHINGTON -- South Dakota Representative Kristi Noem's fix to healthcare in Indian Country was debated last week in front of the House Natural Resources Subcommittee on Indian, Insular, and Alaska Native Affairs. "The Indian Health Service is beyond broken and fixing it is literally a matter of life and death,” said Noem. “The HEALTTH Act reforms an agency in desperate need of change by giving tribes a seat at the table, addressing recruitment and retention problems, and ensuring we can get more services out of every dollar, among many other things. All in all, it takes a step toward getting IHS out of the hospital business, which is ultimately what tribal communities want and deserve.” Noem has joined several other of her Republican coworkers in the Senate who have called for massive reforms to how healthcare is delivered in Indian Country. However, absent from these talks has been any attempt to fully fund the program that has for decades operated with insufficient funds and staff as a result of budget constraints created by congress.
Indianz.Com SoundCloud: House Subcommittee on Indian, Insular and Alaska Native Affairs July, 12 2016
The bill itself is intended to streamline care and hiring as outlined by a release from Rep. Noem. The bill is said to: "Give tribes a seat at the table to encourage better, longer-term contracts by allowing for a partnership among IHS, tribal communities and healthcare stakeholders to collaborate throughout the contract negotiating process, rather than leaving those decisions solely to IHS." According to Noem's office, it addresses the current recruitment problem – for both medical staff and hospital leadership – by putting provisions in place to:
• Allow for faster hiring.The bill also reforms the Purchased/Referred Care (PRC) Program by, among other things:
• Make the existing student loan repayment program tax free, as an added incentive for high-quality employees.
• Provide incentives to attract competent and well-trained hospital administrators as well as medical staff.
• Requiring IHS to develop a new formula for allocating PRC dollars. Under Noem’s bill, IHS would be required to develop a formula based on need, population size, and health status to ensure those areas that have the greatest need receive a greater portion of the funding.Finally, according to Noem's office, the bill restores accountability through strategies, such as:
• Requiring IHS to negotiate Medicare-like rates for services it pays for with private providers. IHS currently pays a premium for PRC services. Noem’s proposal would bring payments in line with what Medicare pays to stretch every dollar further.
• Requiring IHS to address the backlog of PRC payments to private providers. Private hospitals in the Great Plains Area have long expressed concern because IHS has failed to pay their bills. Noem would require IHS to put a strategy in place to get these hospitals paid what they are due.
• Require IHS to be accountable for providing timely care.
• Require the Government Accountability Office to report on the financial stability of IHS hospitals that are threatened with sanction from the Centers for Medicare and Medicaid Services.
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The legislation has been endorsed by the Rosebud Sioux Tribe, the National Indian Health Board, Avera, Rapid City Regional Health, Sanford Health, the South Dakota Association of Healthcare Organizations, the South Dakota State Medical Association, the South Dakota Dental Association. Additionally last week Sen. Mike Rounds of South Dakota called for an audit of IHS despite the fact that the organization is routinely audited like all government entities. (Contact Brandon Ecoffey at editor@lakotacountrytimes.com) Find the award-winning Lakota Country Times on the Internet, Facebook and Twitter and download the new Lakota Country Times app today.
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