September 21, 2016

Committee Passes Bill to Reform the Indian Health Service

WASHINGTON, D.C. — Today, Senate Committee on Indian Affairs Chairman John Barrasso (R-WY), Sen. John Thune (R-SD), Sen. Mike Rounds (R-SD), Sen. John McCain (R-AZ), and Sen. Steve Daines (R-MT) praised the committee’s passage of S. 2953, the Indian Health Service Accountability Act of 2016.
The bill was introduced by Chairman Barrasso and Sen. Thune on May 19, 2016, and is cosponsored by Sens. Rounds, McCain, and Daines.
Persistent failures by the Indian Health Service (IHS) to provide tribal citizens with access to safe, quality health care have led to multiple deaths and the unnecessary suffering of patients, families, and whole communities. The act would improve patient safety and care by increasing accountability and transparency at the IHS.
Based on feedback from tribes and the administration, the bill, as amended, was passed by the committee. Introduced by Chairman Barrasso, the amendment sets forth technical and conforming changes to the bill, and the following:
·         requires the IHS to issue a meaningful agency-wide policy on tribal consultation through negotiated rulemaking with Indian tribes;
·         streamlines requirements for reporting to Congress on adverse personnel actions;
·         limits suspension with pay to 365 days; and
·         requires the IHS to create a centralized system to credential licensed health professionals seeking to volunteer at IHS facilities.
“Today, the committee took an important step toward improving the quality of care that tribal citizens receive from the Indian Health Service,” said Chairman Barrasso. “During multiple hearings and roundtables, we have heard appalling accounts of a lack of transparency and competency at the IHS, which is leading to patient suffering. We have also worked with tribal leaders, health care providers, the IHS, and patients to strengthen this legislation. This bill brings accountability to the IHS and gives tribes an important voice in decision making.”
“Creating a culture change at a federal government agency is never an easy task, but that doesn’t mean we should shy away from the hard work that’s required to ensure tribal citizens receive the quality care to which they’re entitled,” said Senator Thune. “In crafting this legislation, we’ve been deliberate in our effort to work with a wide range of stakeholders and take into consideration their feedback and concerns. I’ve said all along that we wouldn’t be able to achieve meaningful reform without this important consultation, and I believe that today more than ever.”
“I thank Chairman Barrasso and Sen. Thune for their work to improve the quality of care at IHS,” said Senator Rounds. “Any time we can make improvements to Native Americans’ access to health care, it’s a good thing, and the Indian Health Service Accountability Act is a step in the right direction as we seek ways to fix the broken IHS system. I’m pleased to see this important bill pass out of committee so we can continue to debate and amend it on the full Senate floor.”
“The federal government has a longstanding obligation to help provide healthcare services to Native Americans,” said Senator McCain. “However, the Indian Health Service is in need of serious reform. This legislation is critical to doing just that by protecting whistleblowers from internal retaliation and stopping government negligence that puts tribal members’ lives at risk.”
“Over the course of the summer, I had the opportunity to meet with a number of Montana’s tribal communities. And the consensus was clear: the Indian Health Service is in disrepair and desperate need of reform,” said Senator Daines. “That’s why I’m proud to offer my strong support for Chairman Barrasso’s Indian Health Service Accountability Act. This legislation makes modest yet meaningful changes to the IHS bureaucracy.”
The act will improve transparency and accountability at the IHS by:
·     expanding removal and discipline authorities to deal with problem employees;
·     requiring tribal consultation before hiring key Area Office and Service Unit leadership;
·    commissioning Government Accountability Office reports on staffing and professional housing;
·     affirming and enhancing whistleblower protections;
·     mandating timely spending reports to Congress and tribes;
·     requiring accountability for patient deaths, including full inspector general investigations for deaths alleged to be the result of potentially criminal conduct by an IHS employee or contractor; and  
·     providing incentives for employees to assist in eliminating agency fraud, waste and abuse.
The act also addresses staff recruitment and retention shortfalls at IHS by:
·     expanding direct hiring, recruitment and retention authorities to avoid long delays in the traditional hiring process;
–          addressing personnel gaps by providing flexibility for competitive pay scales and temporary housing assistance for medical professionals; and
·     improving patient-provider relationships and continuity of care by providing incentives to employees for quality performance and finding innovative ways to improve patient care and safety.
On Feb. 3, 2016, the Senate Committee on Indian Affairs held an oversight hearing on “Reexamining the Substandard Quality of Indian Health Care in the Great Plains.” The committee also held a listening session on “Putting Patients First: Addressing Indian Country’s Critical Concerns Regarding IHS.”
On June 16, 2016, the Senate Committee on Indian Affairs held a town hall in Rapid City, S.D., on “Discussing S. 2953: Improving the Indian Health Service.”
On June 17, 2016, the Senate Committee on Indian Affairs held a field oversight/legislative hearing in Rapid City, S.D., on “Improving Accountability and Quality of Care at the Indian Health Service though S. 2953.”
The Indian Health Service Accountability Act of 2016 is based primarily on feedback and information received by the committee during these hearings and listening sessions, as well as numerous site visits and meetings with Indian tribes.