Yesterday, the Senate Committee on Indian Affairs held a hearing on their investigation into management of the Aberdeen Area. While many of the problems mentioned occurred over the past several years and are very serious, we are committed to using our IHS reform efforts to address them. This includes improving the way we do business and holding employees accountable for poor performance. A webcast of the hearing is available on the SCIA website and a press release from HHS is available at this link. HHS fully supports our efforts to change and improve the IHS. Implementing our priorities will address many of these issues and, as I have communicated previously, I will be holding managers and employees accountable to help us make improvements. Our patients deserve our best efforts. Thank you to all the hard-working employees who help us meet our mission every day.
HHS press release (PDF - 30K)
As a part of our continuing efforts to reform the IHS, we are making significant progress in the areas of financial management and accountability. I have directed all senior leadership to manage their program and facility budgets in a more accountable manner, and I have included accountability measures on specific financial indicators in their performance plans. I am requiring more consistency in how we monitor and track our budgets throughout the system, implementing more consistent business practices and decision-making around the budget process, and addressing problems in our financial accounting system.
In addition, I have begun a process to review every line item and every program for evidence of their effectiveness and relevance to the agency priorities as we move forward. Finally, I have consulted with the Department of Health and Human Services to give us more ideas on how to improve our financial management and accountability. The Department has given us many good suggestions that we are currently working to implement.
I am committed to ensuring that we use this agency’s resources in the best possible way to improve health care services for our patients. While these efforts won’t address every issue overnight, we continue to make meaningful progress toward strengthening financial management and accountability throughout the IHS.
IHS continues to work with HHS and OPM on planning for implementation of the provision in the IHCIA that authorizes access to federal insurance programs. Section 157 authorizes a Tribe or tribal organization carrying out a program under the Indian Self-Determination and Education Assistance Act or an urban Indian organization carrying out a program under Title V of the IHCIA to purchase coverage for its employees from the Federal Employees Health Benefits Program or the Federal Employees Group Life Insurance Program. A formal letter initiating a consultation on implementation of this provision will be sent to Tribes soon with specific policy questions for Tribes to provide input. We will also confer with urban Indian organizations. I, along with representatives from OPM, will preview this call for consultation this week at the NIHB Annual Consumer Conference in Sioux Falls, SD. OPM, with assistance from HHS and IHS, is working to implement this provision as soon as possible. Tribal consultation is critical as implementation moves forward, especially since we have heard from Tribes that this provision is a top priority.
In light of recent news reports about Senator Dorgan’s investigation of the Aberdeen Area, I wanted to clarify that, as I mentioned in a previous blog post, IHS is cooperating fully with the investigation. Since receiving Senator Dorgan’s letter in June, we have provided numerous documents in response to the Senator’s requests, as well as to follow-up requests from his staff, in the timeframe requested. As we have since the beginning of this investigation, IHS will continue to respond to requests from the Senator and his staff in a timely manner, and to cooperate fully with the investigation.
As a part of my efforts to change and improve the IHS, I have addressed concerns about staff performance by implementing a stronger performance management process. All employees have been notified that staff performance and accountability are top priorities for reform, and expectations about how we manage performance have been issued to all staff. Hard-working employees should be praised and rewarded; poor-performing employees should be held accountable. Our performance management plans this year contain more specific measures that require leadership and staff to demonstrate how they are helping advance the priorities of the agency. We also are following policies and regulations to ensure that employee performance issues are dealt with in a fair manner and allowing employees due process. Allegations are made all the time; some are true and some are not. Our managers must investigate these allegations, and, if true, take appropriate action.
While we implement these reforms, I want to thank all IHS employees who work hard to provide health care under very challenging circumstances. I am grateful for their efforts. And as we improve employee performance, we will see results in even better care for our patients.
I will provide more updates on our IHS reform activities on this blog on an ongoing basis. We are working hard to change and improve the IHS in a fundamental way; while this type of change takes time, we are making progress every day.
I recently traveled to Alaska to meet with the Tribes in the IHS Alaska Area as a part of my goal to hold an in-person consultation session in all 12 IHS Areas. The Tribes presented their priority issues and made recommendations for how to improve our tribal consultation process at the national, Area, and local levels. Common priority issues included the need for more funding, self-governance issues, the challenge of remoteness and distance in delivering healthcare services, and how to improve consultation. I then met with tribal delegations throughout the afternoon, such as the Nome and the SouthEast Alaska Regional Health Consortium (SEARHC) delegations pictured below. I then visited the Alaska Area Office, the Dental Health Aide Therapist Program run by the Alaska Native Tribal Health Consortium (ANTHC), the Alaska Native Medical Center, and the Southcentral Foundation’s Traditional Healing Clinic. I also participated in the HHS Tribal Resource Day at which several HHS representatives met with Tribes. Here are some pictures:
Attendees of the Director’s Tribal Listening Session in Anchorage, AK.
Nome Tribal Delegation
Alaska Area Office Staff
Dental Health Aid Therapist Training Program
Alaska Native Medical Center, with Chris Mandregan, IHS Area Director
Traditional Healing Clinic, Southcentral Foundation