Committee Advances Legislation to Increase Accountability and Transparency at the Indian Health Service

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Apr 11, 2018

WASHINGTON – Senator John Hoeven (R-ND), chairman of the Senate Committee on Indian Affairs, today joined Senators John Barrasso (R-WY) and John Thune (R-SD) to announce the committee’s passage of their Restoring Accountability in the Indian Health Service Act of 2017 (S. 1250).

The legislation, sponsored by Barrasso, would enact comprehensive reforms at the Indian Health Service (IHS) to increase agency transparency and accountability, improve patient care standards and strengthen the recruitment and retention of qualified medical staff.

“The IHS has consistently failed to provide quality health care throughout Native American communities,” said Hoeven. “System-wide reforms are necessary to address these longstanding issues and restore meaningful oversight at the agency. This legislation will improve the delivery of care at IHS facilities and help ensure the federal government is upholding its trust responsibility to provide quality health care for Native Americans.”

“We have heard appalling stories of failures at the IHS that are unacceptable and will not be tolerated. We must reform the IHS to guarantee that all of Indian Country is receiving high-quality medical care,” said Barrasso. “This bill is a critical first step toward reform and reversing IHS dysfunction. It will lay a sound foundation for IHS to actually deliver the healthcare that tribal members deserve.”

“Over the last few years, we’ve become far too accustomed to the horrific stories coming from IHS facilities throughout the Great Plains,” said Thune. “I cannot underscore enough the need for greater oversight and urgent systematic changes. Today, by approving the Restoring Accountability in the Indian Health Service Act, the Indian Affairs Committee took a critical first step toward implementing these changes and reforming the IHS in a meaningful way. It’s time we fix the broken IHS system and give patients the quality care they deserve.”

For years, a lack of oversight, financial integrity and employee accountability at the IHS has led to the delivery of substandard health care services for patients, families and communities.

The bill would improve transparency and accountability at the IHS by:

  • Strengthening removal and discipline authorities for poorly performing employees at the agency.
  • Commissioning Government Accountability Office reports on personnel housing and staffing, whistleblower protections, and patient care and harm occurring at the IHS, among other reports.
  • Instructing the IHS to update their Tribal Consultation Policy.
  • Requiring the IHS to implement a service-wide centralized credentialing system for licensed health professionals seeking to provide health care services at multiple facilities.

The bill would strengthen staff recruitment and retention at the IHS by:

  • Providing the Secretary of the U.S. Department of Health and Human Services (HHS) with direct hiring and other authorities to avoid long delays in the traditional hiring process.
  • Providing authority for health professionals to volunteer their health care services—including dental services—and be provided liability protections when working at an IHS service unit.
  • Addressing gaps in IHS personnel by giving the HHS Secretary flexibility to create competitive pay scales and provide temporary housing assistance for medical professionals.
  • Expanding the eligibility for certain IHS employees to participate in the student loan repayment program by including degrees in business administration with an emphasis in health care management, health administration, hospital administration or public health.

The legislation reflects extensive feedback and information gathered by the committee since 2010, as well as close collaboration between the House, Senate, administration, Indian tribes and tribal organizations. Barrasso, Thune and Hoeven introduced the legislation in May 2017, and a legislative hearing was held in June 2017.

The committee voted to advance the legislation, as amended, to the full Senate. The substitute amendment, offered by Barrasso, incorporates technical corrections developed in consultation with the IHS, Indian tribes and other stakeholders.

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