Update for Week ending
November 07, 2009
President Addresses Tribes at Conference. President Obama and key members of his administration met with Tribal leaders this week at the Tribal Nations Conference in Washington, D.C. President Obama started the meeting stating that “few have been more marginalized and ignored by Washington for as long as Native Americans -- our First Americans.” This acknowledgment by the administration is a welcome effort as we continue to seek adequate IHS funding so that the Federal government meets its trust responsibility. During the opening session, Clarence Jackson gave the invocation and Bill Martin (CCTHITA) spoke for Tribes in Alaska.
President Obama is “absolutely committed to moving forward with you and forging a new and better future together. It's a commitment that's deeper than our unique nation-to-nation relationship. It's a commitment to getting this relationship right, so that you can be full partners in the American economy, and so your children and your grandchildren can have a equal shot at pursuing the American Dream.”
At the conference opening session, President Obama signed an executive memorandum directing his secretaries to provide a detailed plan within 90 days to fully implement an Executive Order on Tribal Consultation.
He recognizes that any comprehensive plan for change must include the trust responsibility for health services. “We know that as long as Native Americans die of illnesses like tuberculosis, alcoholism, diabetes, pneumonia, and influenza at far higher rates than the rest of the population, then we're going to have to do more to address disparities in health care delivery,” said President Obama.
Representatives of our Tribes were present in Washington, D.C., and many were online watching the webcast across our nation. The President’s opening session can be viewed at www.whitehouse.gov.
Breaking News – U.S. House Passes Health Reform Measure – Includes IHCIA Reauthorization. The U.S. House of Representatives passed HR 3962, the Affordable Health Care for America Act. This important measure includes the Indian Health Care Improvement Act (IHCIA). Efforts have continued over the last decade to reauthorize the IHCIA. Last year, the IHCIA made it through the Senate as S.1200 and languished in the House. HR 3962, presented on October 29th, is viewed as a compromise health reform bill and includes the permanent reauthorization of IHCIA.
There are some exceptions favorable to Tribal members in the bill related to Health Reform. Section 545 includes an exception from taxation on Tribal and Indian Health Services for Alaska Native/Native Americans. This provision makes clear that Tribal Health services provided directly or through contract cannot be counted as gross income for an individual. The bill exempts Tribal members from a proposed 2.5% income tax if not enrolled in a qualified plan. For the purposes of this bill, Tribal members are considered in a qualified plan.
Part D of the Act encompasses the IHCIA and is many pages long. A summary of the act provided through the National Indian Health Board and Congressional offices says that in addition to reauthorizing and making the IHCIA permanent, the act:
- Reforms the Tribal health system, and adds Tribal-specific provisions into the Social Security Act.
- Describes the government’s trust responsibility, addresses consultation/participation, and reaffirms that national policy is to assure the highest health status.
- Establishes an office of men’s health to complement the office of women’s health.
- Allows for delivery demonstration alternatives settings including telehealth, modular component facilities, mobile facilities, Tribal management of quarters, and transfer of federal and state funds/supplies for construction or operation of facilities.
- Improves collection and enrollment for Medicare, Medicaid, Children’s Health Insurance Program and Veteran’s Affairs.
- Allows collaborative arrangements with Veteran’s Affairs/DOD on sharing facilities.
- Allows Tribal providers to purchase coverage for employees from the Federal Employees Health Benefits Program.
- Continues the Community Health Aide Program and authorizes development in the lower 48.
- Expands practical experience to medical students and alternative providers.
- Provides authorization for Tribally-operated hospice, assisted living, long-term, home, and community-based care.
- Continues to authorize increased patient travel costs, epidemiology centers, and expands school health education programs.
- Expands the definition of Behavioral Health versus the current narrow focus of substance abuse.
- Expands behavioral health providers including mental health technicians and increases licensure requirements for workers.
- Authorizes Indian women treatment and youth programs.
- Establishes a FASD program to train providers and child sexual abuse prevention/treatment programs, and programs to prevent/treat domestic and sexual violence.
- Authorizes demonstration project for Indian youth telehealth and school-based suicide prevention.
- Removes barriers to Tribal organizations to apply for SAMSHA grants.
- Improves medical quality assurance processes.
- Requires that President’s budget to include costs for medical inflation and population growth.
- Includes amendments to other acts including Social Security to improve Tribal health services such as allowing greater payments under these programs or the ability to take advantage of negotiated rates to lower the costs of contract program providers (expands Medicare-like rates beyond hospitals).
Flu Vaccine Priorities for H1N1 & Seasonal Flu. Supplies of vaccine from the government for the H1N1 (swine) and seasonal flu have been very limited or not available in facilities. We are using priorities established by the Centers for Disease Control and Prevention (CDC) for offering vaccinations to patients during a time of limited vaccine availability. If the supply situation improves and the vaccines become widely available, patients will be notified through the local media and Tribal groups that they can be immunized. SEARHC is in regular contact with state and federal health officials to stay updated on the current situation, including vaccine supplies.
The CDC lists five priority groups for the H1N1 (swine) flu vaccine during a time of limited vaccine availability:
- Pregnant women;
- People who live with or provide care for children younger than 6 months old (e.g., parents, siblings or daycare workers);
- Health care and emergency service workers who have direct contact with patients or infectious material;
- Children ages 6 months through 4 years old; and
- Children and adolescents ages 5-18 who have medical conditions that put them at higher risk for influenza-related complications.
The CDC lists eight priority groups for the seasonal flu vaccine based on their risk for complications from influenza or because they are in close contact with someone at higher risk of influenza complications:
- Children ages 6 months old through their fifth birthday;
- Pregnant women;
- People age 50 and older;
- People of any age with certain chronic medical conditions (such as asthma, diabetes or heart disease);
- People who live in nursing homes or other long-term care facilities;
- Household contact with people at high risk for complications from influenza;
- Household contact with, and out-of-home caregivers of children ages 6 months or younger; and
- Health care workers.
Southeast Alaska residents can help prevent the spread of flu by washing their hands frequently with soap and water or using an alcohol-based hand sanitizer (especially after coughing or sneezing). Other ways to prevent the spread of flu include coughing into sleeves or a tissue instead of coughing into hands, staying home from work or school when sick with flu-like symptoms (don’t go back to work or school until at least one full day has passed without a fever, with no fever-reducing medication), and using sanitary wipes to wipe down high-traffic surfaces such as computer keyboards, stair railings, doorknobs, telephones and light switches.
Updated information on the flu can be found online at www.pandemicflu.alaska.gov (state site), or at www.flu.gov or ww.cdc.gov/h1n1flu/ (national sites). SEARHC also has information posted about H1N1 flu at www.searhc.org/h1n1/.
Just a reminder. . .
SEARHC frequently brings in traveling medical specialists to hold specialty clinics at its various facilities, saving you the expense and inconvenience of flying to Anchorage or Seattle for services not available in Southeast. Some SEARHC medical providers who work at larger facilities make regular trips to our village clinics to provide specialty services that aren't normally available in those communities. All specialty clinics, except for medical field trips and specified dental clinics, must be referred through a SEARHC provider. Links to our upcoming specialty clinic schedules are at www.searhc.org/common/pages/specialtyclinics/index.php.
Regards,
Roald
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