The administration is responding to the crisis in three Great Plains health clinics, the Indian Health Service is undertaking a suicide prevention campaign with the Navajo Nation, and a Senate Appropriations subcommittee is recommending a boost in funding for Indian housing programs.

Critical hospital staffing boosted

Following up on the SCIA’s hearing and three-hour roundtable discussion of three Indian Health Service hospitals in serious crisis, the Indian Health Service, with new administrators in place, has taken action. IHS has contracted with AB Staffing Solutions, LLC to provide medical staffing at all levels for the emergency rooms in the three hospitals in the Great Plains region. Staff who are now working in the under-staffed emergency rooms will be transferred to other facilities and clinics, to bolster the quality of care and to extend the hours on weekends and evenings. 

The contracted staffing arrangement is for five years, to give the IHS an opportunity to turn around the quality of the three hospitals. IHS has also signed a “Systems Improvement Agreement” with the Centers for Medicare and Medicaid Services, which had decertified one of the three hospitals, and was threatening similar actions against the others. The agreement calls for this immediate contract staffing, and for other longer term changes. The IHS Great Plains region serves 130,000 patients from 17 tribes in North Dakota, South Dakota, Nebraska and Iowa.

New bill on internal structure of the Indian Health Service

Meanwhile, on May 19, Senators Barrasso and Thune introduced S. 2953, the Indian Health Service Accountability Act of 2016. The bill responds to the concerns heard at the February roundtable and hearing on the Indian Health Service hospitals in the Great Plains region, by introducing both personnel and structural oversights, while permitting more flexibility in the IHS budget so that the agency can offer competitive compensation.

Indian housing

Funding for Indian housing assistance programs is included in the Transportation/ Housing and Urban Development appropriations bill, which the Senate just passed on Friday May 20. The bill included an amendment offered by Senator Barrasso which will permit funds allocated through the Indian Community Development Block Grant program (ICDBG) to be used for the construction of housing facilities for certain skilled professionals, such medical, law enforcement, and educational personnel.

The bill, as reported out of committee, also combined the Indian Community Development Block Grant with the Indian Housing Block Grant. The combined account was increased by about $4 million above the combined 2016 allocations for the two block grants. Provided that the two grants have not been reduced in the final bill that passed the Senate, the combination of the two is likely to provide tribes with more flexibility. A Native Hawaiian Housing Block Grant was also funded at $5 million, which was $5 million more than in the 2016 budget deal.