Indian Health Service Reform Bill Approved By Committee, Heads to Full Senate

Legislation Would Bring Accountability to IHS, Greater Peace of Mind to Tribal Citizens

September 21,2016

WASHINGTON  Today the Senate Committee on Indian Affairs approved the Indian Health Service (IHS) Accountability Act of 2016, introduced earlier this year by U.S. Sens. John Thune (R-S.D.) and John Barrasso (R-Wyo.), chairman of the Indian Affairs Committee. Thune’s bill, which is cosponsored by U.S. Sens. Mike Rounds (R-S.D.), John McCain (R-Ariz.), and Steve Daines (R-Mont.), represents one of the most comprehensive IHS reform bills introduced in the Senate this Congress, and if enacted, would bring some much-needed change and accountability to the federal agency responsible for providing quality health care to tribal citizens in South Dakota and around the United States.

“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 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 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 IHS Accountability Act of 2016 would improve transparency and accountability at the IHS by:

  • Expanding removal and discipline authorities for problem employees at the agency;
  • Providing the HHS secretary with direct hiring and other authorities to avoid long delays in the traditional hiring process;
  • Requiring tribal consultation prior to hiring area directors, hospital CEOs, and other key leadership positions;
  • Commissioning Government Accountability Office reports on staffing and professional housing needs;
  • Streamlining the volunteer credential process and providing federal liability insurance to those providers who volunteer their time at an IHS service unit;
  • Mandating that the HHS secretary provide timely IHS spending reports to Congress; and
  • Requiring IHS to engage in a negotiated rulemaking to develop a rule regarding tribal consultation policy for IHS.

The IHS Accountability Act also addresses staff recruitment and retention shortfalls at IHS by:

  • Addressing gaps in IHS personnel by giving the HHS secretary flexibility to create competitive pay scales and provide temporary housing assistance for medical professionals;
  • Improving patient-provider relationships and continuity of care by providing incentives to employees; and
  • Giving the HHS secretary the ability to reward employees for good performance and finding innovative ways to improve patient care, promote patient safety, and eliminate fraud, waste, and abuse.  

In June, at Thune’s request, the Indian Affairs Committee held an oversight and legislative field hearing in Rapid City, South Dakota, on the IHS Accountability Act. Prior to the field hearing, committee staff led a town hall meeting to hear firsthand from stakeholders about the IHS and receive feedback on the bill.

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