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August 3, 2009 email inviting all IHS employees to submit views on IHS Reform

From: Roubideaux, Yvette (IHS/HQE)
Sent: Monday, August 03, 2009 12:31 AM
Subject: Message from the Director - IHS Reform - Input requested*

This email is an update on our process for gathering input on national health reform and our first request for input on internal Indian Health Service (IHS) reform.

First, I would like to thank you for your input and ideas on national health reform. I appreciate the time people took to respond to my email message on health reform in June and to send their comments to healthreform@ihs.gov. We will be posting a summary of these comments on our website in the near future – we are creating a new website on which to post information and updates – the URL www.ihs.gov/reforms should be active by mid-month. I am also grateful to the tribal leadership who participated in our Department of Health and Human Services (HHS) tribal consultation listening session on health reform on July 7, 2009 in Denver, CO. As you may know, Congress is currently discussing a number of options for national health reform that may impact the Indian health system. We have reviewed all of the input so far and are working with HHS to develop our department’s position on national health reform and its impact on Indian country. When Congress asks us to weigh in on their proposed legislation, I am confident that we have a good understanding of the issues and can provide comments to help underscore how important it is that national health reform positively impact the Indian health system and our patients.

Second, I would like to begin the process for bringing reform to the IHS. As I stated in my Senate confirmation speech, in order the get the support we so dearly need, we need to demonstrate change and improvement in the Indian health system. We need to look at what we are doing well, and do more of it, as well as be honest about what we are not doing well, and take steps to develop solutions for these problem areas. As you can imagine, there are a number of areas where we could start. We could discuss whether large system changes are needed, and/or whether certain specific areas need to improve, such as hiring, contracting, recruitment/retention, contract health services, customer service, clinical services, administrative practices, etc. I need your help now to determine where we begin.

I am writing today to request your input, as an individual or as part of a group (your department, office, program, Service Unit or Area, clinical team or professional group, etc), on your top three priorities for where we should begin our work to bring reform IHS. I would you hear from you to get a sense of what areas people think we are in most need of improvement. I encourage you to do the following: 1) get together with the people you work with; 2) list all your ideas for where we need to improve; 3) decide on your top three areas for improvement; and 4) email them to me at IHSReform@ihs.gov. We will compile all the answers and look at the most commonly mentioned areas as possible areas to begin our reform efforts. This will help us get started on areas that are in most need of improvement based on your input. I could certainly pick the areas myself, but it is much better to involve you all in the process. You are the experts on this system and where it needs to improve.

Please email your top three priorities for IHS reform to IHSReform@ihs.gov by August 30, 2009. We need to have a quick turnaround so that we can get started on this important work. I will also be issuing a formal call for a tribal consultation on priorities for reform and will review your priorities with them as we move forward.

Thank you in advance for your input on this important work ahead.

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

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