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President Obama seeks another increase for Indian Health Service budget

Wednesday, February 10, 2016

Officials from the Department of Health and Human Services, the Centers for Medicaid and Medicare Service and the Indian Health Service testify at Senate Indian Affairs Committee hearing in Washington, D.C., on February 3, 2016. Photo by Indianz.Com

The Indian Health Service would see a record $6.6 billion in funding under the fiscal year 2017 budget released by President Barack Obama on Tuesday.

The request represents an increase of $402 million, or 6.5 percent, above the current level. If accepted by Congress, the IHS budget will have grown 53 percent since Obama came on board.

"This budget accurately reflects the challenges the Indian health system faces in providing comprehensive health care and public health services in some of the most remote parts of our country," Robert G. McSwain, the principal deputy director at the IHS, said in a press release.

The proposal includes $800 million for contract support costs, the funds that tribes need to manage federal programs through the self-determination program. The request is $82 million higher than the current level.

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As part of the request, the Obama administration wants to reclassify contract support costs as a mandatory, three-year appropriation. Annual funding increases would be built into the program if adopted by Congress.

"This funding approach continues the policy to fully fund CSC and guarantee program reliability," a budget document states.

Additionally, a different mandatory account is being sought for behavioral health programs throughout the Department of Health and Human Services. The IHS plans to use $25 million to create the $15 million Tribal Crisis Response Fund, which would help tribes respond to issues in their communities, according to the document.

Another $10 million would be used to expand the American Indians into Psychology Program and the IHS Scholarship Program to encourage more Native Americans to enter the behavioral health field.

Tribal leaders from tribes in the Great Plains attended the Senate Indian Affairs Committee hearing in Washington, D.C, on February 3, 2016. Photo by Indianz.Com

"As IHS responds to an expanded mission -- from an increasing patient population to new requirements for health information technology to the federal government's commitment to honor the sovereign rights of tribes by fully funding contract support costs -- these resources are necessary to raise the physical, mental, social and spiritual health of American Indians and Alaska Natives to the highest level," McSwain wrote in a blog post.

The IHS also plans to invest another $46 million other behavioral health services, including several programs to reach Native youth. The figure includes $15 million for Generation Indigenous substance abuse and suicide prevention projects, $21 million for preventive health programs, $4 million to implement Zero Suicide projects at tribal colleges and universities, $2 million to assist youth as they transition treatment centers to their communities and $4 million for domestic violence prevention.

The release of the budget comes after the IHS endured a scathing hearing on Capitol Hill last Wednesday. Members of the Senate Indian Affairs Committee hammered the agency for failing to correct long-standing problems within the Great Plains Area, a region that includes Nebraska and South Dakota.

The budget justification acknowledges that the Winnebago Service Unit in Nebraska, which serves the Omaha Tribe and the Winnebago Tribe lost certification from the Centers for Medicaid and Medicare Service. That means the hospital can't access Medicare , a key source of funding for patient care.

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The hospital had secured accreditation through Det Norske Veritas (DNV), an international certification body that the Great Plains Area used for the first time in fiscal year 2015. Two additional facilities in South Dakota that serve the Oglala Sioux Tribe and the Rosebud Sioux Tribe are also in danger of losing Medicare funds.

"IHS will be re-evaluating accreditation by DNV in FYs 2016 and 2017 to ensure compliance with agency policy and restore the accreditation measure to 100 percent," the justification reads.

The IHS said it has placed a "high priority" on addressing the issues raised by the committee. Prior to the hearing, the agency removed the Great Plains director and announced other changes aimed at improving patient services.

The Sioux San Hospital, an Indian Health Service facility, in Rapid City, South Dakota. Photo by Colorado National Guard Medical Detachment / Flickr

The budget seeks $27.8 million to continue construction of the Rapid City Health Center in Rapid City, South Dakota. The new 200,000 square-foot facility will replace the aging Sioux San Hospital. A completion date for the project was not stated in budget documents.

The Great Plains Area covers Iowa, Nebraska, North Dakota and South Dakota, Nebraska. Facilities in the region provide service to about 122,000 tribal members, according to the IHS.

FY2017 Indian Health Service Budget Documents:
Budget Request | Budget Justification | HHS Budget In Brief