Indian Health Service back in the hot seat with budget hearing

Tuesday, May 22, 2018  

It's almost been a year since the Indian Health Service came under heavy fire before a panel of powerful lawmakers, the ones who control the agency's funding.

Members of the Senate Committee on Appropriations, however, will find that little has changed since the July 2017 proceeding, which one top Democrat described as "unbelievable." The IHS is still without a permanent leader and the Trump administration continues to make decisions without consulting Indian Country, prompting tribes to rely on Congress to fulfill the federal government's trust and treaty responsibilities.

"We have 200-plus years of recognition of tribes as a political entity, and all of a sudden now, they want to make us race-based," Ron Allen, the longtime chairman of the Jamestown S'Klallam Tribe, said on Capitol Hill earlier this month, summing up one Trump-induced health care crisis that has diverted Indian Country's attention and resources in recent weeks.

Against the backdrop, officials from the IHS are presenting their fiscal year 2019 budget request to the Senate Appropriations Subcommittee on Interior, Environment, and Related Agencies. The key witness is Michael D. Weahkee, a citizen of the Pueblo of Zuni who has been serving as the "acting" director of the agency for almost a year.

Weahkee had barely been on the job for three weeks when he faced angry and upset members of the subcommittee. Inadequate care that has placed tribal citizens in danger, insufficient requests for an already underfunded system and a lack of information about Medicaid -- the very issue that prompted the new "race-based" crisis -- were the major issues last year.

The Trump team, though, seems to have learned one lesson since 2017. Instead of cutting funds from the IHS, the 2019 request seeks an additional $413 million for the agency.

But a big chunk of that increase -- $150 million to be exact -- isn't new funding. It comes from a change in the way popular yet politically sensitive Special Diabetes Program for Indians is treated within the budget. Tribal leaders have already called on Congress to reject the proposal, saying it could bring problems in the future.

"A change from mandatory to discretionary could lessen SDPI as a priority compared to other IHS programs, leading to decreased funding and program stability," Andrew Joseph, Jr., the chairman of the Northwest Portland Area Indian Health Board, said this month.

And despite the overall increase in Trump's proposal, some lawmakers say it's not enough. A funding bill making its way through the House includes $5.9 billion for the IHS, well above current levels.

"Rest assured, this committee will keep our treaty obligations," Rep. Ken Calvert (R-California), whose subcommittee wrote the bill, told tribal leaders this month.

"I know we get recommendations from folks down the street," he added, referring to the White House, "but we'll work together and work this out and I'm sure we'll have a positive outcome."

Calvert's counterparts in the Senate will hear from the IHS at 9:30am Eastern on Wednesday. The witness list follows:

Rear Admiral Michael Weahkee
Acting Director
Indian Health Service

Rear Admiral Michael Toedt, M.D.
Chief Medical Officer
Indian Health Service

Mr. Gary Hartz
Director Of The Office Of Environmental Health And Engineering
Indian Health Service

Ms. Ann Church
Acting Director Of The Office Of Finance And Accounting
Indian Health Service

Senate Committee on Appropriations Notice:
Review of the FY2019 Budget Request for the Indian Health Service (May 23, 2018)