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Director's Blog

IHCIA Implementation Update: Access to Federal Insurance

On October 5, OPM and IHS mailed a letter to all Tribes initiating a consultation on the IHCIA, Section 157, access to federal insurance. This provision authorizes Tribes operating programs under the ISDEAA and urban Indian organizations operating programs under Title V of IHCIA to purchase federal insurance for their employees (FEHB, FEGLI). The letter included a call for consultation as well as a call for specific information to assist OPM with implementation.

We have heard concerns regarding the format of the consultation and the inclusion of survey-like questions. OPM and IHS combined two purposes in one letter - the call for consultation and a request for information to help OPM implement the provision. We have been sensitive to input from Tribes to move quickly and we did not want to send two separate letters.

I want to reassure everyone that we did not intend to consult by survey and understand that is not preferable. Tribes are encouraged to comment on any aspect of this new provision as in any consultation. The information requested by OPM is helpful in order to accurately determine timing and resources for implementation. OPM wants to respond to Tribes and the detailed information will help the agency implement as quickly as possible. We have received feedback from many Tribes already with very useful information. We urge all tribes to reply to OPM so that planning can continue to make these programs available for enrollment.

We have engaged Tribes and gathered input in other ways, including: participation in a number of national outreach calls; conference attendance, such as the NIHB conference and several other meetings; and there will be other opportunities this fall. OPM and IHS are partners in this effort and will continue working together as we determine next steps for implementation. We are considering other opportunities to engage tribes to ensure all tribes learn more about this new option available to them. As indicated in the letter [PDF - 562K], if you have not already responded, please respond to OPM with comments on the consultation and/or the request for information as soon as possible. Thank you for your input as we move forward.

IHS Director meets with Tribal Consultation Workgroup

I met with the IHS Director’s Tribal Advisory Workgroup on Consultation on October 14-15, 2010, in Denver to review progress on their recommendations to improve the tribal consultation process. The workgroup felt that progress has been made and is committed to working with me to continue to improve the tribal consultation process. We drafted a letter together at the meeting to update tribes on progress and additional recommendations from the workgroup. Comments on their recommendations are welcome at consultation@ihs.gov. Here’s a link to the letter we are sending out this week [PDF - 39K] and pictures from the meeting.

Tribal Advisory Workgroup meeting

Tribal Advisory Workgroup

IHS Reform Update: Addressing Issues raised in the SCIA Hearing

During the Senate Committee on Indian Affairs Hearing on the Aberdeen Area, the Office of Inspector General (OIG) reported that there were a few instances where employees were hired in the Aberdeen Area despite being on the OIG Exclusion List. This means that they had a past offense that the OIG determined excluded them from federal hire. This was clearly unacceptable and cannot happen again. Our staff has reviewed the recommendations of the OIG and is implementing a process where we will check each potential hire against the OIG Exclusion List as a part of the initial routine background clearance for all employees. This will be accomplished by the responsible HQ or Area personnel security staff, who will document that the OIG Exclusion List was checked.

In addition, supervisors must also certify that they have conducted reference checks, and ensure that the OIG Exclusion list was checked in each case before making a selection. If any individuals are hired that appear on the OIG Exclusion List, the supervisor that hired them will be held accountable. We must make sure that we ensure a safe environment for our patients and our staff; implementing this process system-wide will help us improve and avoid this problem from occurring in the future.

Yvette Roubideaux, M.D., M.P.H.
Director

IHS Director attends the National Indian Health Board Annual Consumer Conference

I attended the National Indian Health Board Annual Consumer Conference in Sioux Falls, SD in September. I presented an update on our activities to reform the IHS and also presented an overview of the Affordable Care Act. We also held a session with the Office of Personnel Management on the Indian Health Care Improvement Act provision on Access to Federal Insurance and answered questions. Here are some pictures from the conference:

Panelists from Affordable Care Act/IHCIA presentations
Panelists from Affordable Care Act/IHCIA presentations

NIHB Culture Night Celebration
NIHB Culture Night Celebration

Jodi Gillette, White House Intergovernmental Affairs
Jodi Gillette, White House Intergovernmental Affairs

Reno Franklin, Chair, National Indian Health Board
Reno Franklin, Chair, National Indian Health Board

South Dakota Urban Indian Program Site Visit
South Dakota Urban Indian Program Site Visit

Navajo Tribal Delegation Meeting
Navajo Tribal Delegation Meeting

Alaska Tribal Delegation Meeting
Alaska Tribal Delegation Meeting

IHS Director meets with Chief Executive Officers

I met with representatives from the National Council of Chief Executive Officers at their CEO Summit meeting in September in Denver, CO. The purpose of the meeting was to develop recommendations to better support them as they work in one of the most difficult and most critical positions in the Indian health system. If a Service Unit has a good CEO, the facility usually thrives. If a Service Unit has a poor performing CEO, then everything else can be impacted. The group discussed many recommendations for support, training, recruitment, and retention. I am committed to helping this group because they are critical to implementing the agency’s priorities at the local level and to making the improvements we need in our IHS reform efforts. Here’s a picture from the meeting:

NCCEO meeting

IHCIA Implementation Update: Access to Federal Insurance and Urban Indian Organizations

The Access to Federal Insurance provision also applies to urban Indian organizations that operate health programs under Title V of the Indian Health Care Improvement Act (IHCIA). The law requires that we “confer” with urban Indian organizations while carrying out the IHCIA. Here’s the letter (PDF - 541K) we just sent to all urban Indian organizations operating Title V programs requesting their input on this provision.

IHCIA Implementation Update: Consultation on Access to Federal Insurance

Today, we are mailing a letter to all Tribes to initiate a consultation on Section 157, Access to Federal Insurance, in the recent reauthorization of the Indian Health Care Improvement Act. This provision authorizes Tribes that operate programs under the Indian Self-Determination and Educational Assistance Act and urban Indian organizations that operate programs funded under Title V of the IHCIA to purchase insurance for their employees from the Federal Employees Health Benefits Program and the Federal Employees Group Life Insurance Program. Tribes have told us that this provision is a priority for implementation and want access to these federal insurance programs as soon as possible. The Office of Personnel Management (OPM) is implementing this provision with assistance from the Indian Health Service and the Department of Health and Human Services. OPM needs to hear from Tribes as soon as possible as it implements this provision. The letter is attached here. OPM has also provided an updated slide set from the NIHB conference overview of FEHB with 2011 rates – the slides are attached here. The letter indicates that Tribes should send all comments to OPM at the address listed in the letter.

IHS Director attends Direct Service Tribes Annual Conference

I attended the Direct Service Tribes Annual Conference in August in Billings, MT. The conference was well attended and presentations focused on the needs of Tribes that receive healthcare services from facilities directly funded and operated by the Indian Health Service. Here are some pictures from the conference:

Direct Service Tribes Annual Conference
Direct Service Tribes Annual Conference

Direct Service Tribes Annual Conference
Direct Service Tribes Annual Conference

Direct Service Tribes Annual Conference
Direct Service Tribes Annual Conference

Direct Service Tribes Annual Conference
Direct Service Tribes Annual Conference

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Dr. Yvette Roubideaux
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