The Jamestown S’Klallam Tribe operates the Jamestown Family Health Clinic in Sequim, Washington. Photo from Facebook
Republican lawmakers have been battering the Indian Health Service over long-standing problems. But what will it really take to fix the troubled agency? Ron Allen, the chairman of the Jamestown S’Klallam Tribe; Lynn Malerba, the chief of the Mohegan Tribe; and Jefferson Keel, the lieutenant governor of the Chickasaw Nation, say full funding is a start:
Secure Funding: Fully fund Indian Health programs in the federal budget process and make the programs mandatory instead of discretionary. Fund all unfunded mandates in the Indian Health Improvement Act. Establish a high level Indian program position at OMB to educate OMB on program needs. Centralize Funding: Find the funding located in other agencies designated for Indian Health and centralize them for easier access within the I/T/U system. Within IHS alone there are 557 grants available to Indian Tribes. It is impossible to meaningfully address the social determinants of health using competitive grant funding, which does not uphold the trust and treaty obligations of the United States. Centralize Indian Medicaid through CMS: It is estimated that if all states expanded Medicaid another 200,000 Native people would be covered. Tribes have unequal benefits and Medicaid services depending on the State of their residence. The Affordable Care Act now provides Tribes with the opportunity to access health care for all of our Tribal citizens. The Centers for Medicaid and Medicare Services (CMS) must have adequate funding to provide technical assistance to these citizens outside the IHS service area. Recruit and Retain: Aggressively recruit students from reservations into health professions. Provide scholarships or loan forgiveness programs with the promise to return to the reservation to practice. This helps address the recruitment and retention issue and greatly improves cultural sensitivity and accountability within the health care workforce. Provide appropriate housing and support services to make recruitment successful. Control Costs: Work with health economists to understand the true cost of chronic underfunding and to also understand the savings that could be realized by health promotion, care management and prevention. Use telemedicine as a less expensive option for expert consultation. Measure Success: Develop standard metrics to measure progress in improving health status among AI/AN peoples. Encourage and fund sharing of data and distribution of results.Get the Story:
W. Ron Allen, Lynn Malerba & Jefferson Keel: Indian Health Services Can’t Be Fixed Overnight (Indian Country Today 8/12)
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