Trump's proposal to cut public health professionals impacts Indian Country

Wednesday, June 27, 2018  

The Indian Health Service could see a dramatic reduction in personnel if the Trump administration goes ahead with a major reorganization.

The Reform Plan and Reorganization Recommendations, released by the White House last week, calls for a reduction in the U.S. Public Health Service Commissioned Corps. Their numbers would be cut from more than 6,500 officers to "no more than 4,000," the document states.

As The Washington Post points out, such a cut would have a huge impact on the IHS. The largest number of officers -- 1,887, according to the paper -- is assigned to the agency.

The White House document does not explain how the IHS would be affected, nor whether tribes will be consulted about the reduction. But the proposal runs counter to the administration's own efforts to deploy more officers in Indian Country.

"The IHS historically has difficulties recruiting and retaining healthcare providers," the fiscal year 2019 budget justification reads.

In order to bring more professionals into the field, the document says the IHS has secured "priority access to expedited commissioning of new Commissioned Corps officers through a partnership with the Office of the Surgeon General."

The Trump administration previously highlighted the efforts in testimony to Congress. The partnership began in May 2017, according to the IHS.

"IHS continues the successful partnership with the Office of the Surgeon General to increase the recruitment and retention of Commissioned Corps officers, and most recently the IHS has been given priority access to new Commissioned Corps applicants," the acting director said during a hearing on a bill to reform the agency. "This allows IHS to make the first contact with these applicants in an effort to recruit them to fill health professional vacancies throughout IHS."

The @IHSgov has always been a troubled agency, its problems have worsened over the last five to ten years even after Congress enacted large increases in its budget. @RepKristiNoem's bill reforms the agency to better serve tribal communities. pic.twitter.com/lxh75AMGLq

— Natural Resources (@NatResources) June 13, 2018

Members of Congress are also taking steps to help IHS bring in more personnel. Just this month, the House Committee on Natural Resources approved H.R.5874, the Restoring Accountability in the Indian Health Service Act (RAISE Act), in order to boost recruitment and retention at the agency.

“Today, tribal members are receiving life-threatening ‘care’ from a broken IHS. That urgently needs to change,” Rep. Kristi Noem (R-South Dakota), the sponsor of the RAISE Act, said after action on her bill.

Noem, who is vacating her seat in Congress to run for governor of South Dakota, wrote the bill in response to the health care crisis in the Great Plains, a region that includes Nebraska and South Dakota. Since 2016, additional Commissioned Corps officers have been deployed to the region in order to improve the quality of care there.

The U.S. Public Health Service Commissioned Corps has a long history in Indian Country. In 1911, the agency conducted the first study on the status of Indian health.

"This study led to the first funding by Congress for American Indian Health," the agency said.

When the Indian Health Service was initially created, it reported directly to the U.S. Surgeon General, according to the Commissioned Corps. The first director of the IHS was a Commissioned Corps physician.

Though the IHS now reports to the Secretary of the Department of Health and Human Services, many of the agency's top leaders have been or are Commissioned Corps officers. They include Michael Weahkee, the Trump administration's "acting" director of the IHS, and Chris Buchanan, who also served as "acting" director for Trump.

Read More on the Story:
White House wants to cut this public health service corps by nearly 40 percent (The Washington Post June 27, 2018)