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This week two Operating Divisions of the Department of Health and Human Services, the Indian Health Service (IHS) and the Health Care Financing Administration (HCFA), entered into an Interagency Agreement with the Social Security Administration (SSA) to establish an education and outreach demonstration program to better serve American Indians and Alaska Natives.
"This initiative does more than just seek to inform the American Indian and Alaska Native community of the services and programs of the Social Security Administration and the Medicare and Medicaid programs of the Health Care Financing Administration," said Dr. Trujillo. "It also is an initiative to identify persons who may be eligible for programs and help them access these services. Another component of the initiative is to have employees from each of our agencies carry out assignments with the other agencies as a way to gain experience and expand our understanding of one another's programs, to determine how we might address issues of possible barriers to access to services or information."
Through this agreement, the three agencies will collaborate on ways to communicate with and provide American Indians and Alaska Natives with information about SSA and HCFA programs. One particular audience will be American Indian and Alaska Native elderly and disabled populations. Because of its location in Indian communities and on reservations, most of which are isolated and remote, the IHS will be the focal point for this education and outreach initiative. Under the terms of the agreement, the initiative will continue for 24 months. The education and outreach framework that will be used for the initiative is based on the National Indian Council on Aging model.
Highlights of the agreement are included with this release.
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Highlights of the
Inter-Agency Agreement (IAA)
among
The Indian Health Service,
The Health Care Financing Administration,
and
The Social Security Administration
I. Purpose
The purpose of this inter-agency agreement (IAA) among the Indian Health Service (IHS), the Health Care Financing Administration (HCFA), and the Social Security Administration (SSA) is to establish an education and outreach demonstration program to better serve American Indians and Alaska Natives (AI/ANs). Through this agreement, HCFA, IHS, and SSA will openly and readily collaborate on ways to communicate with and educate AI/ANs about SSA and HCFA programs. HCFA and SSA will transfer funds to IHS in support of this agreement.
II. Authority
HCFA, IHS and SSA funds are authorized for transfer by legislative authority under the Economy Act of 1932, as amended (31 U.S.C. 1535 and 1536).
HCFA's program authority is 42 U.S.C. 1310. IHS program authority is
42 U.S.C. 2002 and 2201, and 25 U.S.C. 13.
III. Background
Both HCFA and SSA agency strategic plans outline major goals for educating the public. Both HCFA and SSA have made commitments to improve education and outreach within AI/AN tribes and communities. IHS, an agency within the Department of Health and Human Services, is responsible for providing federal health services to AI/ANs. IHS currently provides health services to approximately 1.5 million AI/ANs who belong to more than 557 federally recognized tribes in 34 states. Because of its role, IHS, its agents and contractors are uniquely positioned to be the focal point for carrying out the education and outreach initiative envisioned by HCFA and SSA.
The provision of health and social service information in Indian Country presents a number of unique challenges and opportunities. Indian people encounter cultural, geographic, and language barriers accessing social and health programs and services. To address these special needs, we are undertaking a collaboration among multiple federal agencies, Indian organizations, states, and tribes, to comprehensively address the information needs of AI/AN elderly and disabled populations. The purpose of this agreement includes: A) the creation and provision of benefits education and disease management information in highly targeted, culturally-specific formats, and B) the development of a specific framework, including protocols and outreach techniques that have never been applied on a national scale. These activities are fundamental aspects of the education and outreach framework that is currently used by IHS (see # 1 of addendum). This framework will serve as the initial model for executing this agreement. By establishing a cooperative, well-developed, effective federal collaboration, disease management and benefits enrollment information can be presented in effective, culturally appropriate ways.
IV. Scope of Work and Responsibilities
The major objectives of this agreement are to ensure that AI/ANs:
· receive accurate and reliable Medicare and Social Security information when they need it and use the information to make informed choices; and
· who may be eligible for the benefits are identified.
HCFA, SSA, and IHS will work to assess the detailed communication requirements for AI/ANs. It is understood that using funds transferred from HCFA and SSA, IHS will hire and/or contract with individuals who will be dedicated to education and outreach activities on behalf of HCFA and SSA.
Outreach staff will actively work within tribal communities, including urban areas, to educate groups and individuals about HCFA and SSA programs, and identify persons who may be eligible for these programs. Outreach staff will also work closely with HCFA and SSA federal employees to coordinate and facilitate the actual delivery of service by federal staff. HCFA, SSA, and IHS will work together to implement strategies to reach AI/ANs through the following activities:
· developing a project management plan of deliverables and working relationships for the IAA time period;
· developing programs to educate AI/ANs about HCFA and SSA programs;
· developing methods for assessing and evaluating the effectiveness of the educational programs for the AI/AN populations;
· establishing developmental assignments for employees of each agency to gain experience in other agencies to increase their understanding, i.e., culture competency, of programs affecting AI/ANs.
The following will be considered in developing and executing the project plan:
· solicitation of guidance and direction from AI/AN communities;
· establishment of collaborative partnerships with selected agencies, organizations, tribes and providers;
· utilization of existing networks for outreach and service delivery;
· involvement of the stakeholders and tribal leadership;
· singular focus on AI/AN client preferences as defined by the community; and,
· development/use of culturally specific educational tools and materials.
HCFA, IHS, and SSA agree that the project management plan for this agreement will address implementation details. The attached addendum to this agreement lists additional issues that will be addressed in the plan.
V. Duration of this Agreement
This agreement becomes effective when all signatures are obtained. The term of this agreement is 24 months, subject to the availability of annual funds. FY2000 funds from HCFA and SSA will be transferred to IHS for the initial 12 months of this agreement. Agreement will be renewed for the next fiscal year. Any modification or amendment of this agreement will be agreed to in writing by all parties. HCFA, SSA, or IHS will be notified 60 days prior to the agreement expiration date of any intent to continue the agreement. Any party may terminate their role in this agreement by giving the parties 60 days prior notice in writing.
VI. Participation by Other Agencies
HCFA, IHS, and SSA recognize that from time to time other federal agencies may wish to become a party to this agreement. Such participation is encouraged, and will be accommodated, and will be effected by an amendment to this agreement.
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Addendum to Agreement
among
HCFA, IHS, and SSA
Subject: Issues requiring resolution as part of the project management plan.
In order for this agreement to be as effective as possible, active involvement by officials from each agency is critical. Operating principles will be established at the outset of this education and outreach effort. The operating principles will guide the management plan, and provide information necessary to make adjustments to the project. Some issues which require further description include:
1. The education and outreach framework developed by the National Indian Council on Aging (NICOA) will serve as the initial model for executing this agreement.
2. Contact points within HCFA and SSA must be identified for each outreach staff.
3. Outreach staff must receive training by SSA and HCFA, and have current program information.
4. The relationship between outreach staff, and tribal organizations and members requires additional description.
5. Outreach staff will work closely with local federal officials in a variety of ways. For example, outreach staff will receive the latest information concerning program policies from federal officials, and will work with the local field and regional office management to schedule visits to reservations by field and regional office staff for the actual delivery of service.
6. Performance measures and regular reporting mechanisms required to monitor and ensure the success of the project will be developed. This type of information will be used to assess, evaluate, and allow for necessary adjustments in the project. HCFA, SSA, and IHS will establish an advisory board, which will oversee the performance of this agreement.
7. Funds will be used for the salaries/contracts and the education and outreach activities of staff who will be dedicated to these activities on behalf of HCFA and SSA.
NOTE TO EDITORS: General information about the IHS is available on the IHS website at http://www.ihs.gov.
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