Support needed for Indian Health Care Improvement Act

by Nov 20, 2009NEWS ka-no-he-da0 comments

 Should be included in Senate Health Care Reform Bill


By Vickie L. Bradley
EBCI Healthy & Medical Division

As members of the community it is extremely important that we are aware of national issues that affect our ability to receive health care services. With the impending potential for the reauthorization of the Indian Health Care Improvement Act; it is imperative that our elected officials hear from our community and are asked to support bills that ensure the integrity of the national Indian health system.   The Indian Health Care Improvement Act is a vital piece of legislation that the Health and Medical Division asks you to support by contacting your Senators today. The following information is taken from the National Indian Health Board website to inform you of important aspects of the IHCIA.

What is the Indian Health Care Improvement Act (IHCIA)?
 The Indian Health Care Improvement Act (IHCIA) is the key legal authority for the provision of health care to American Indians and Alaska Natives (AI/ANs). The IHCIA was originally enacted in 1976 to address the deplorable health conditions in Indian Country. As Congress states in the findings of IHCIA:

Federal health services to maintain and improve the health of the Indians are consonant with and required by the Federal government’s historical and unique legal relationship with, and resulting responsibility to, the American Indian people.

Along with the Snyder Act of 1921, the IHCIA forms the statutory basis for the delivery of health care to AI/ANs, by the Indian Health Service (IHS), an agency with the U.S. Department of Health and Human Services. The Indian Health Care Improvement Act is the baseline for all health care for American Indians and Alaska Natives.  Since 1992, when the IHCIA was last overhauled, the American health care system has been revolutionized, but the Indian health care system has not been.  It is imperative that the IHCIA be reauthorized to begin to bridge this gap.  Including IHCIA in a health care reform bill will modernize the Indian health care system at the same time as Congress is reforming health care for all Americans. 

Why is it necessary to reauthorize the IHCIA?
 Congress should act to officially extend the life of the IHCIA authorization and to update the bill to reflect both the current needs of Indian health care and the modern methods of health care delivery.

The IHCIA contains a number of provisions that authorize appropriation of funds to support health care programs set forth in the law; however, the life of these provisions ended in fiscal year 2001.

Fortunately, the Snyder Act of 1921 provides permanent authority for the appropriation of funds for Indian health, so Congress can and does continue to appropriate funds for these programs. IHCIA needs to be reauthorized to supply the baseline authority for providing direct health care to AI/ANs.

Also, since Congress’ last comprehensive review of IHCIA in 1992, the American health care delivery system has been revolutionized while the Indian health care system has not. For example, mainstream American health care has moved out of hospitals and into people’s homes; focus on prevention has been recognized as both a priority and a treatment; and, coordinating mental health, substance abuse, domestic violence, and child abuse services into comprehensive behavioral health programs is now standard practice. Reflecting these improvements in the IHCIA is a critical aspect of reauthorization.

What are the current healthcare needs of American Indians/Alaskan Natives?
 Statistics clearly reflect a critical need for health promotion and disease prevention activities in Indian country which provisions of the IHCIA reauthorization would address this need.
• 13% of Indian deaths occur in those younger than 25, a rate 3 times higher than the U.S population.
• The U.S. Commission on Civil Rights reported in 2003 that “American Indian youths are twice as likely to commit suicide…” Also, suicide ranked as the second leading cause of death for AI/ANs aged 10 to 34 as reported by the Center for Disease Control and Prevention’s National Center for Injury Prevention and Control.
• Indians are 550% more likely to die from alcoholism, 200% more likely to die from diabetes, and 150% more likely to suffer accidental death compared with other groups.

Highlights of what is included in the IHCIA Reauthorization
• Establishes objectives for addressing health disparities of Indians as compared with other Americans.
• Enhances the ability of Indian Health Services (IHS) and tribal health programs to attract and retain qualified Indian health care professionals.
• Updates and modernizes health delivery services, such as cancer screenings, home and community based services and long term care for the elderly and disabled.
• Provides innovative mechanisms for reducing the backlog in health facility needs.
• Establishes a continuum of care through integrated behavioral health programs both prevention and treatment –to address alcohol/substance abuse problems and the social service and mental health needs of Indian people.
• Facilitates greater decision-making regarding program operations and priorities at the local tribal level in order to improve services to tribal populations.

How can I help?
 It is critical that Senate Leadership and your Senators hear from you right away with your message of support that the IHCIA be included in health care reform. Call or write you Senators and ask that they support IHCIA S. 1790. Make your contacts today!

The House of Representatives passed H.R. 3962, the Affordable Health Care for America Act, which included permanent authorization of the Indian Health Care Improvement Act (IHCIA) last week. Attention has now turned to the Senate.

As the Senate prepares to consider health care legislation, Indian Country needs to ensure it includes reforms for all Americans by including IHCIA. Senators need to hear from Indian Country so they know that there is support to include IHCIA.

By including IHCIA in the Senate, it will help strengthen the chances of the bill during conference between the House and Senate before a final bill is sent to President Obama.