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Indian Health Service Update

Yvette Roubideaux, M.D., M.P.H.Director, Indian Health Service

Special Diabetes Program for IndiansDiabetes Prevention and Healthy Heart Initiatives

November 16, 2010

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IHS Priorities

• Renew and strengthen our partnership with Tribes

• In the context of national health insurance reform, bring reform to the IHS

• Improve the quality of and access to care

• Ensure that our work is transparent, accountable, fair, and inclusive

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• Renew and Strengthen our Partnership with Tribes

–The only way we are going to improve the health of our communities is to work in partnership with them

– IHS cannot do its work in isolation – we must work together with our communities

–Tribal consultation is a priority

IHS Priorities

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• Renew and Strengthen our Partnership with Tribes

– Current consultations in progress How to improve the tribal consultation process How to improve the Contract Health Services (CHS)

program Priorities for health reform/Indian Health Care

Improvement Act (IHCIA) implementation FY 2012 Budget Other topics for upcoming consultations

Indian Healthcare Improvement Fund (IHCIF), facilities construction, improving quality, VA, Long Term Care

IHS Priorities

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IHS Priorities

• Renew and Strengthen our Partnership with Tribes

– Current consultations in progress Area listening sessions: 11 Areas so far Tribal delegation meetings: more than 270

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IHS Priorities

• In the context of National Health Reform, to bring reform to IHS

─ National Health Reform

─ Internal IHS Reform

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Affordable Care Act

• Signed into law March 23, 2010• Goals

– Increase access to affordable health care– Security and stability for those with insurance– Reduce healthcare costs

• Reauthorization of the Indian Health Care Improvement Act– Permanent reauthorization– New and expanded authorities; modernizes and updates IHS

• Impact– American Indian and Alaska Native individuals– Tribes– I/T/U facilities

• Implementation; consultation– FEHB; State Exchanges; Self-implementing provisions, VA– NIHB/NCAI/NCUIH – tribal outreach/education

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IHS Priorities

• In the context of national health care reform, to bring reform to IHS– Internal IHS reform

Need to demonstrate change and improvement

Gathered a wide range of input

Priorities for change

Aberdeen Area SCIA investigation

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IHS Priorities

• … Bring Reform to IHS

– Tribal Priorities More funding; review allocation formulas Improve Contract Health Service program Improve consultation process

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IHS Priorities

• …. Bring Reform to IHS

– IHS Staff Priorities Improve how we do business and how we lead

and manage people Improving budget planning and financial

management Consistency in business practices Hiring process – more efficient and proactive;

reduced time

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IHS Priorities

• …. Bring Reform to IHS

– IHS Staff Priorities Improve how we do business and how we lead and

manage people SCIA investigation – immediate actions to

address In Aberdeen Area and system-wide

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IHS Priorities

• …. Bring Reform to IHS

– IHS Staff Priorities Improve how we do business and how we lead and

manage people: Management Practices

» Priorities – Customer service, ethics, performance management, professionalism, program integrity

» Performance plans FY 2010 – more focused on priorities

Focus on patient; become first choice for healthcare

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IHS Priorities

• Improve the Quality of and Access to Care

– Upcoming Reform Activities: Customer Service Improving Patient Care – “medical home” Special Diabetes Program for Indians

Diabetes Prevention and Healthy Heart Demonstration Projects – successful results from 5-year project

Reduced risk factors in people at risk for diabetes and heart disease

Collaborations with other agencies

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IHS Priorities

• Ensure Our Work is Transparent, Accountable, Fair, and Inclusive – Transparency/Communication:

Meetings, interviews, outreach Messages from the Director; DTLL Director’s Corner; Director’s Blog Teamwork

– Accountability/Fairness: Program, staff evaluation/performance

Inclusiveness Decisions must include consideration for all patients

served by IHS, tribal, or urban Indian health programs

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Accomplishments

• Increased funding– FY 2010 – 13 percent increase – largest in over 20 years

• $100 million increase in Contract Health Services funding• Means a 13-30 percent increase in IHS Areas

– CHEF funds – instead of running out in June, made it to August

– FY 2011 President’s budget – 9 percent increase• Congressional action pending

– ARRA funding - $590 million • Health facilities construction, sanitation facilities construction,

maintenance and improvement, equipment, HIT

• Progress on IHS reform– Ongoing

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Summary

• We are continuing to make progress on our priorities as we reform the IHS

• We are implementing specific activities to change and

improve IHS • We need your help and guidance as we change and

improve the IHS.

• We must take advantage of support we have now to make as much progress as possible in our IHS reform activities

• Tribal consultation and partnership is essential