For years, federal reports have documented shocking cases of mismanagement and poorly delivered care. The Indian Health Service (or IHS) was left to make improvements on its own. The agency was given funding increases almost every year and yet, it produced increasingly poor care to South Dakota’s tribal communities. Enough is enough.
I've introduced comprehensive legislation that offers structural changes to how IHS operates, addressing both medical and administrative challenges. I'm committed to working together to move these legislative reforms forward and make immediate agency-level changes to ensure tribal members finally receive the care their families need.
Noem's Restoring Accountability in the IHS Act
OFFERS BETTER TOOLS FOR RECRUITING COMPETENT MEDICAL STAFF & LEADERSHIP
- Provides incentives to health care professionals to serve in the IHS, including pay flexibility and relocation reimbursements when employees move to high-need areas, as well as a housing voucher program for rental assistance to employees.
- Allows managers to be eligible for the IHS student loan repayment program to incentivize more competent managers to join the agency.
- Provides flexibility for the IHS in hiring and firing.
- Makes volunteering at IHS facilities easier by providing liability protections for medical professionals who want to volunteer at IHS hospitals or service units and centralizing the agency’s medical credentialing system.
IMPROVES PATIENT CARE STANDARDS
- Requires the IHS to develop standards to measure wait times.
- Requires IHS employees to attend culture training annually that teaches them about the tribe(s) they serve.
INCREASES ACCOUNTABILITY
- Enhances fiscal accountability by ensuring reports and plans are completed in a timely manner. Failure to comply with the requirements will restrict the IHS' ability to provide salary increases and bonuses.
- Increases congressional oversight by requiring reports that assess staffing needs, existing protections against whistleblowers, and the frequency and causes of patient harm events.
- Reiterates IHS employees’ right to petition Congress and requires HHS to notify all employees of the IHS of their statutory right to speak with Members of Congress and their staffs.
What's Being Said about Noem's Reforms
ROSEBUD SIOUX TRIBE
In a resolution recognizing Rep. Noem’s HEALTTH Act and her fight for additional IHS funding, among other things, the Tribal Council stated: “The Rosebud Sioux Tribal Council wishes to extend its gratitude, thanks, and support for South Dakota Representative Kristi Noem’s continued commitment in improving the Social, Economic, and Health issues for the Rosebud Sioux Tribe and its members.”
In June 2017, the Tribe issued a letter in support of H.R.2662, the Restoring Accountability in the Indian Health Service Act.
NATIONAL INDIAN HEALTH BOARD
“The spirit and intent of this legislation is clearly aimed at responding to the call of Tribal leaders, patients and the families of those who have had adverse experiences within the IHS system.”
AVERA
“This bill would be instrumental in improving the quality of health care available to American Indians…”
RAPID CITY REGIONAL HEALTH
“The solutions proposed in the HEALTTH Act will help address the fundamental, systemic failures in the Great Plains Area Service Area.”
SANFORD HEALTH
“Sanford Health shares your hope that the HEALTTH Act of 2016 offers meaningful pathways toward enhanced American Indian health care and more efficient utilization of precious health care resources.”
SOUTH DAKOTA ASSOCIATION OF HEALTHCARE ORGANIZATIONS
“We support your innovative and forward thinking in introducing the HEALTTH Act.”
SOUTH DAKOTA STATE MEDICAL ASSOCIATION
“[W]e believe the changes proposed by you via the [HEALTTH Act] will help address the funding and administrative/structural issues currently crippling Native American health care delivery system.”
SOUTH DAKOTA DENTAL ASSOCIATION
“The South Dakota Dental Association greatly appreciates your efforts to improve the health of Native Americans…. Your proposals are a step in the right direction.”
NATIONAL RURAL HEALTH ASSOCIATION
“This important bill will ensure access to timely, quality care and expand hiring authorityfor the Indian Health Service.”
AMERICAN DENTAL ASSOCIATION
“[The] loan repayment program has proven to be one of the IHS's best recruitment and retention tools to ensure an adequate health workforce to serve in the many remote IHS locations…. Changing the tax status of the IHS loans to make them tax free [as Noem’s bill does] would enable the Service to fill two-thirds or more of the loan repayment requests.”
Further Reading
Debate Begins on Noem's IHS Reform Bill, June 21, 2017
Noem Leads Colleauges in Introducing IHS Reform Bill, May 25, 2017
Tribal Members Weigh in on Noem's IHS Reforms during Critical Committee Hearing, July 12, 2016
Noem Column: Treating the Crisis, June 10, 2016
Noem Leads Lawmakers in Introducing Comprehensive IHS Reform Bill, June 8, 2016
Noem Meets with IHS Officials, Tribal Members in Rosebud, June 2, 2016
After Collaborating with Noem, House Proposal Boosts Support for IHS, Preserves SD Priorities, May 25, 2016
Delegation Demands Answers from the Indian Health Service, May 16, 2016
Noem Addresses Tribal Healthcare Crisis with Top IHS Official, February 11, 2016
Noem Presses HHS Secretary on Tribal Healthcare Crisis, February 11, 2016
Noem Column: Raising Standards, Saving Lives, February 5, 2016
Noem Seeks Information on Critical Conditions within Indian Health Service Facilities, December 18, 2015
Noem, Thune Raise Questions about IHS's Approach to Suicide Crisis, November 5, 2015