U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Internal IHS Reform

As I stated in my Senate confirmation speech, in order to get the support we so dearly need, we need to demonstrate change and improvement in the Indian health system. On August 3, 2009, I invited you to send thoughts on your top three priorities for where we should begin work on internal reforms for the Indian Health Service. We will post below analysis and compilation of suggestions that we receive. As the process for bringing reform to IHS develops, we will begin to post options and plans here.

Contact Us With Your Comments and Questions

Input on Internal IHS Reforms

RESULTS - 567 IHS and Tribal employees suggested priorities for internal IHS reforms and improvements
Analysis of Employee Input   arrow Download
A summary of the types of employees that responded by email   EmployeeRespondents (PDF - 69k)
Employees identified a wide array of priorities for internal IHS reforms which are grouped into several broad categories   WideArrayofProbsImprv (PDF - 63k)
Priorities within several broad categories are displayed in rank order   PrioritiesGroupedbyCategory (PDF - 244k)
A roll-up of top priorities for internal reform – topics mentioned by at least 50 employees   LeadingPriorities (PDF - 92k)
The Director’s grouping of the top priorities for internal reform   DirectorsGroupingofLeadingPriorities (PDF - 91k)
Priorities of employees in each IHS Area are grouped and compared side-by-side   LeadingPrioritiesbyArea (PDF - 581k)
Priorities of headquarters employees are compared to overall priorities of all respondents   HQComparedtoIHS (PDF - 348k)
RESULTS - 51 Tribal officials and/or Tribal Organizations submitted priorities for internal IHS reforms
Director’s Note
Special thanks to Tribal officials and organizations who responded to my invitation to submit ideas. We compiled your suggestions and have posted several charts summarizing the results. Compared to employee suggestions, which often focused on internal nuts and bolts of IHS work, Tribal suggestions more often addressed wide-spectrum, systemic, and cross-cutting issues. 
  • Inadequate resources and funding, as expected, was the leading priority
  • Contract Health Services reforms is a priority and was mentioned almost as frequently as funding
  • Tribes more often identified reforms requiring changes in laws, authorities and full tribal consultation
  • A focus on prevention and wellness programs was a high priority of Tribes as it was among employees
  • Issues relating to health information technology was another tribal priority also shared by employees
Analysis of Tribal Input   arrow Download
Tribal suggestions were classified by category and topic. This chart shows the relative frequency of all reforms mentioned by Tribes   Chart-TribalPrioritiesbyCategory (PDF - 217k)
This chart shows the top 10 reforms suggested by Tribal officials   Chart-Top10TribalPriorities (PDF - 144k)
This chart compares the reforms suggested by Tribal officials to those suggested by employees   Chart-TribalPrioritiesComparedToEmployees (PDF - 278k)
This text table (18 pages) summarizes suggestions from each of the 51 Tribal submissions   TextSummaryofTribalInput (PDF - 291k)
9/4/09 Dear Tribal Leaders Letter   44544-1Signed (PDF - 129k)
August 3, 2009 Invitation to Employees to Comment on Internal IHS Reforms
Read the text of the Director’s Email Invitation

Papers, Presentations and Events

Director’s Presentation to American Association Of Indian Physicians
A broad overview entitled The Future of American and Alaska Native Healthcare (PDF - 464k) was given by Yvette Roubideaux, Director, IHS to AAIP in July, 2009.

A Town Hall Meeting - September 14, 2009 - National Museum of the American Indian
Read text of the Agenda (PDF - 12k)

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