U.S. House Committee on Natural Resources
April 25, 2007
Washington, D.C. - Legislation that will enhance and expand federal programs to enhance a variety of health and dental care programs for rural Alaska Natives and American Indians was approved by the House Natural Resources Committee today.
Alaska Congressman Don Young, the Ranking Member on the Committee, is one of the main sponsors of the bipartisan legislation - "The Indian Health Care Improvement Act Amendments Of 2007" (H.R. 1328). The other 2 primary sponsors of the bill are:
- Representative Nick J. Rahall II (D-WV), Chairman, Natural Resources Committee
- Representative Frank Pallone, Jr. (D-NJ), Chairman, Subcommittee on Health
The legislation was approved, with some technical and clarifying amendments, by the full Natural Resources Committee by a voice vote.
"As you all know, I have been involved in the last 2 Congresses to move this essential bill forward by introducing a bipartisan bill with my colleagues on this Committee and the U.S. House of Representatives," Young said during the debate on the legislation. "We came very close to finalizing a bill in the last Congress, and I want to thank this Committee for fulfilling its responsibility by favorably reporting my bipartisan bill out of this Committee last year.
"H.R. 1328 responds to the changes that have occurred in the delivery of health services in the decade since the last reauthorization of the Indian Health Care Improvement Act. In this period, in excess of half of the tribes in the have exercised their rights under the Indian Self-Determination and Education Assistance Act to assume responsibility to carry out programs of the Indian Health Service on their own behalf.
"This, along with enhancements in the Indian Health Service direct operations, have led to hospitals being accredited by the Joint Commission on Accreditation of Healthcare Organizations, and health delivery systems expanded so that outpatient and home and community based services have become commonplace. Medicare, Medicaid and other third-party revenue were important to achieving these gains and are crucial for retaining them. Equally important is the need to reinforce the authority provided to tribal health programs under self-determination and self-governance to allow tribes to establish their own priorities and to determine the best ways to respond to the specific needs of their tribal members.
Alaska Has $1.17 Billion In Unmet Needs For Sanitation & Health Facilities
"H.R. 1328 also responds to many of the unmet needs of American Indians and Alaska Natives with regard to the delivery of health care. In Alaska, we have an unmet need of $1.17 billion for sanitation and health facilities - a situation which should not exist in the in the 21st century.
"Additionally, Alaska is currently experiencing a true dental crisis. In excess of one-third of Alaska Native school children have missed school because of dental pain. Recruitment and retention of rural dentists cannot make dental care accessible in most Alaska Native villages except on an itinerant basis. Even if we filled every vacancy in rural Alaska , it would take over ten years to catch up on the accumulation of dental needs.
"Our Dental Health Aide Therapists Plan was initiated in 2003 by the Alaska Native Tribal Health Consortium to address the dental crisis in rural Alaska . Hundreds of Alaska Natives have had the opportunity to be treated by the new dental therapists and report positive experiences with the quality of care.
"I have had several public health organizations, including those of dentists, endorse the Dental Health Aide Therapists Program. Also, I have reviewed and met with participants of the Yukon-Kuskokwim Health Corporation program. I was extremely impressed with the training the dental therapists receive, with their oversight and supervision by a licensed dentist, and with their quality of care. While prevention activities are crucial, they must be coupled with treatment - the kind of treatment that these therapists can provide safely.
"I know that tribes in the lower 48 are also experiencing a dental crisis and will work to try to resolve some of their dental issues as we consider this bill further. I want to thank the Countrywide Steering Committee of the Countrywide Indian health board and the Alaska Native Tribal Health Consortium for their efforts in moving this bill forward and addressing many of Alaska 's concerns," Young said.
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Summary Of The Indian Health Care Enhancements Act
Title I, Indian Health, Human Resources, and Development. The purpose of this is to increase, to the maximum extent feasible, the number of Indians entering the health professions and providing health services, and to assure an optimum supply of health professionals to the Indian Health programs and Urban Indian Organizations involved in the provision of health services to Indians.
Title II, Health Services. This title will establish programs that respond to the health needs of American Indians and Alaska Natives. For example, American Indians and Alaska Natives have a disproportionately high rate of diabetes (death rate for this disease is In excess of 300 percent of the rate of the population generally), so this title has a specific diabetes provision. It also includes the Indian Health Care Improvement Fund through which the Appropriation Act supply funds to eliminate health deficiencies and disparities in resources made accessible to American Indians and Alaska Native tribes and communities.
Title III, Facilities. This title relates to the construction of health facilities including hospitals, clinics, and health stations necessary for staff quarters, and of sanitation facilities for Indian communities and homes.
Title IV, Access to Health Services. This title addresses payments to the IHS and tribes for services covered by the Social Security Act Health Care programs, and to enable Indian health programs to access reimbursement from 3rd party collections.
Title V, Health Services for Urban Indians. This title establishes programs in urban centers to make health services more accessible to Indians who live in urban areas rather than on reservations or Alaska Native villages.
Title VI, Organizational Improvements. This title addresses the establishment of the IHS as an agency of the PHS (Public Health Service). It also authorizes the Secretary to establish an automated management information system and authorizes appropriations to carry out this title.
Title VII, Behavioral Health Programs. This title is revised from current law (which only addresses substance abuse programs) in order to focus on behavioral health. It combines all substance abuse, mental health and social service programs in one title and integrates these programs to enhance performance and efficiency.
Title VIII, Miscellaneous. This title addresses various topics including the Secretary's reporting of the progress made in meeting the objectives of this Act to Congress. It requires the Secretary to develop IHCIA regulations, describes the eligibility of California Indians for IHS, establishes a Countrywide Bipartisan Commission on Indian Health Care, and authorizes appropriations.
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