For years, federal reports have documented shocking cases of mismanagement and poorly delivered care. The Indian Health Service (or IHS) was left to make improvements on its own. The agency was given funding increases almost every year and yet, it produced increasingly poor care to South Dakota’s tribal communities. Enough is enough.
I've introduced comprehensive legislation that offers structural changes to how IHS operates, addressing both medical and administrative challenges. I'm committed to working together to move these legislative reforms forward and make immediate agency-level changes to ensure tribal members finally receive the care their families need.
Noem's HEALTTH Act: What it does
+ Improves IHS’s ability to secure long-term contracts for hospitals in emergency conditions by allowing for a partnership among IHS, tribal communities and healthcare stakeholders to collaborate throughout the contract negotiating process, rather than leaving those decisions solely to IHS.
+ Addresses the current recruitment problem – for both medical staff and hospital leadership – by putting provisions in place to:
- Allow for faster hiring.
- Make the existing student loan repayment program tax free, as an added incentive for high-quality employees.
- Provide incentives to attract competent and well-trained hospital administrators as well as medical staff.
+ Reforms the Purchased/Referred Care (PRC) Program by, among other things:
- Requiring IHS to develop a new formula for allocating PRC dollars. Under Noem’s bill, IHS would be required to develop a formula based on need, population size, and health status to ensure those areas that have the greatest need receive a greater portion of the funding.
- Requiring IHS to negotiate Medicare-like rates for services it pays for with private providers. IHS currently pays a premium for PRC services. Noem’s proposal would bring payments in line with what Medicare pays to stretch every dollar further.
- Requiring IHS to address the backlog of PRC payments to private providers. Private hospitals in the Great Plains Area have long expressed concern because IHS has failed to pay their bills. Noem would require IHS to put a strategy in place to get these hospitals paid what they are due.
+ Restores accountability through strategies, such as:
- Require IHS to be accountable for providing timely care.
- Require the Government Accountability Office to report on the financial stability of IHS hospitals that are threatened with sanction from the Centers for Medicare and Medicaid Services.
What's Being Said about the HEALTTH Act
ROSEBUD SIOUX TRIBE
In a resolution recognizing Rep. Noem’s HEALTTH Act and her fight for additional IHS funding, among other things, the Tribal Council stated: “The Rosebud Sioux Tribal Council wishes to extend its gratitude, thanks, and support for South Dakota Representative Kristi Noem’scontinued commitment in improving the Social, Economic, and Health issues for the Rosebud Sioux Tribe and its members.”
NATIONAL INDIAN HEALTH BOARD
“The spirit and intent of this legislation is clearly aimed at responding to the call of Tribal leaders, patients and the families of those who have had adverse experiences within the IHS system.”
AVERA
“This bill would be instrumental in improving the quality of health care available to American Indians…”
RAPID CITY REGIONAL HEALTH
“The solutions proposed in the HEALTTH Act will help address the fundamental, systemic failures in the Great Plains Area Service Area.”
SANFORD HEALTH
“Sanford Health shares your hope that the HEALTTH Act of 2016 offers meaningful pathways toward enhanced American Indian health care and more efficient utilization of precious health care resources.”
SOUTH DAKOTA ASSOCIATION OF HEALTHCARE ORGANIZATIONS
“We support your innovative and forward thinking in introducing the HEALTTH Act.”
SOUTH DAKOTA STATE MEDICAL ASSOCIATION
“[W]e believe the changes proposed by you via the [HEALTTH Act] will help address the funding and administrative/structural issues currently crippling Native American health care delivery system.”
SOUTH DAKOTA DENTAL ASSOCIATION
“The South Dakota Dental Association greatly appreciates your efforts to improve the health of Native Americans…. Your proposals are a step in the right direction.”
NATIONAL RURAL HEALTH ASSOCIATION
“This important bill will ensure access to timely, quality care and expand hiring authorityfor the Indian Health Service.”
AMERICAN DENTAL ASSOCIATION
“[The] loan repayment program has proven to be one of the IHS's best recruitment and retention tools to ensure an adequate health workforce to serve in the many remote IHS locations…. Changing the tax status of the IHS loans to make them tax free [as Noem’s bill does] would enable the Service to fill two-thirds or more of the loan repayment requests.”
Further Reading
Tribal Members Weigh in on Noem's IHS Reforms during Critical Committee Hearing, July 12, 2016
Noem Column: Treating the Crisis, June 10, 2016
Noem Leads Lawmakers in Introducing Comprehensive IHS Reform Bill, June 8, 2016
Noem Meets with IHS Officials, Tribal Members in Rosebud, June 2, 2016
After Collaborating with Noem, House Proposal Boosts Support for IHS, Preserves SD Priorities, May 25, 2016
Delegation Demands Answers from the Indian Health Service, May 16, 2016
Noem Addresses Tribal Healthcare Crisis with Top IHS Official, February 11, 2016
Noem Presses HHS Secretary on Tribal Healthcare Crisis, February 11, 2016
Noem Column: Raising Standards, Saving Lives, February 5, 2016
Noem Seeks Information on Critical Conditions within Indian Health Service Facilities, December 18, 2015
Noem, Thune Raise Questions about IHS's Approach to Suicide Crisis, November 5, 2015