Indian Health Service (IHS) Director's Corner Bloghttps://www.ihs.gov/newsroom/directorsblog/IHS updates on important issues affecting the Indian Health Service.en-usIHS Engineers Recognized at Public Health Service Awards Ceremonyhttps://www.ihs.gov/newsroom/ihs-blog/february2017/ihs-engineers-recognized-at-public-health-service-awards-ceremonyhttps://www.ihs.gov/newsroom/ihs-blog/february2017/ihs-engineers-recognized-at-public-health-service-awards-ceremonyTuesday, February 21, 2017 ]]>Two of the Indian Health Service’s many dedicated and talented engineers were recognized during the United States Public Health Service Exit Disclaimer: You Are Leaving www.ihs.gov Engineer Category Awards Ceremony.

The annual award ceremony coincides with National Engineers Week Exit Disclaimer: You Are Leaving www.ihs.gov to recognize the role of U.S. Public Health Service engineers who create safer, healthier and more productive environments in which to live and work.

Capt. Steven Raynor, acting deputy director of the IHS Headquarters Division of Facilities Planning and Construction, was named IHS Engineer of the Year for his work in planning direct service health care facility construction. He analyzes population demographics to determine the required number of medical exam rooms, dental chairs, and spaces for pharmacy, imaging, wellness, eye care, audiology, etc. for new healthcare facilities. His contribution is vital in providing state-of-the-art facilities to meet the healthcare needs of American Indians and Alaska Natives.

Capt. Steven Raynor, Acting Deputy Director of the IHS Headquarters Division of Facilities Planning and Construction, receives the IHS Engineer of the Year Award from Rear Adm. Randall Gardner.
Capt. Steven Raynor, Acting Deputy Director of the IHS Headquarters Division of Facilities Planning and Construction, receives the IHS Engineer of the Year Award from Rear Adm. Randall Gardner.

Lt. Melissa de Vera, IHS Bemidji Area field engineer, received the Rear Adm. Jerrold M. Michael Award, for her service, demonstrated leadership and outreach that has impacted the next generation of US Public Health Service Commissioned Corps engineers through her role leading the Engineer Professional Advisory Committee Exit Disclaimer: You Are Leaving www.ihs.gov (EPAC) Connectors and through her informal mentoring of other young engineers. She has supported collaborative learning and engagement that has improved the work of other engineers in her office and the delivery of the public health program where she is stationed.

Lt. Melissa de Vera, IHS Bemidji Area field engineer, receives the Rear Adm. Jerrold M. Michael Award from Rear Adm. Randall Gardner. The award recognizes outstanding leadership and dedication to the education, training and/or mentoring of present and future USPHS engineers.
Lt. Melissa de Vera, IHS Bemidji Area field engineer, receives the Rear Adm. Jerrold M. Michael Award from Rear Adm. Randall Gardner.

USPHS engineers Exit Disclaimer: You Are Leaving www.ihs.gov design, construct and provide technical assistance to local operators of water supply and waste disposal systems serving Native American homes and communities. They also manage a wide array of facility design, constructions, renovation, operation and maintenance activities in Indian country and at PHS research/laboratory and public health centers.

Rear Adm. Randall Gardner is the chief engineer of the United States Public Health Service Exit Disclaimer: You Are Leaving www.ihs.gov and works for the Indian Health Service Headquarters Office of Environmental Health and Engineering. He is a graduate of Howard University and the George Washington University.


Related Content:

Public and Environmental Health Improves with the First Vacuum Sewer System on the Navajo Nation

IHS and Navajo Nation dedicate new Arizona rural hospital

IHS/Tribal team recognized for emergency water connection in Tucson Area

Engineer of the Year recognized


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IHS Celebrates National Children's Dental Health Monthhttps://www.ihs.gov/newsroom/ihs-blog/february2017/ihs-celebrates-national-children-s-dental-health-monthhttps://www.ihs.gov/newsroom/ihs-blog/february2017/ihs-celebrates-national-children-s-dental-health-monthTuesday, February 14, 2017 ]]>Each February, IHS, tribal and urban dental programs celebrate National Children's Dental Health Month (NCDHM). The American Dental Association held the first national observance of Children's Dental Health Day on February 8, 1949, and in 1981 it was extended to a month-long observance to show the importance of children's oral health.

The theme for the 2017 NCDHM is "Choose Tap Water for a Sparkling Smile." The ADA has developed posters and promotional materials Exit Disclaimer: You Are Leaving www.ihs.gov that adopt this theme and encourage parents and children to avoid sugary drinks, which can cause cavities, and to drink tap water, which may contain cavity-fighting fluoride.

The program also encourages children to eat "healthy for a healthy smile" and to brush their teeth for two minutes twice daily - "2min2x!"

Despite the efforts of 320 individual dental programs and almost 500 individual IHS and tribal dental clinics, American Indian/Alaska Native (AI/AN) children have less access to dental care than the general U.S. population. Not surprisingly, then, is that AI/AN children suffer more dental disease. For example, AI/AN preschool children ages 2-5 have four times more decayed or filled teeth than U.S. white children and more than double that of the next highest minority, U.S. Hispanic children.

In response, IHS and tribal dental programs all over the country are prioritizing children's dental health in February. Many programs will make special efforts to provide community-based services such as dental screenings, fluoride varnish applications, dental sealant applications, and oral health education in elementary and middle schools, Head Start centers, at health fairs and at other community events.

The IHS Division of Oral Health has created a series of educational presentations that can be shown in patient waiting rooms and at community events. These presentations, which are available to dental staff on the login-accessible IHS Dental Portal, will also be sent out through various e-mail distribution lists to all IHS, tribal, and urban dental programs. Presentations include:

  • Are you prepared for a dental emergency?
  • Will fluoride varnish help my teeth?
  • Dental Sealants
  • Sippy Cups
  • Teens and Oral Health

In addition, the IHS Division of Oral Health Continuing Dental Education Program will focus on children's health in February with four national webinars on early childhood caries, dental erosion in children's teeth, and overall management of pediatric dental patients. For more information on these continuing education opportunities, please send an e-mail to IHSCDECoordinator@ihs.gov. For more information on NCDHM, please go to http://www.ada.org/en/public-programs/national-childrens-dental-health-month Exit Disclaimer: You Are Leaving www.ihs.gov.

Capt. Timothy Ricks, DMD, MPH, is the deputy director in the IHS Division of Oral Health and the IHS Continuing Dental Education Coordinator.


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IHS Highlights Importance of Vaccination and Regular Cancer Screenings to Prevent Cervical Cancerhttps://www.ihs.gov/newsroom/ihs-blog/january2017/ihs-highlights-importance-of-vaccination-and-regular-cancer-screenings-to-prevent-cervical-cancerhttps://www.ihs.gov/newsroom/ihs-blog/january2017/ihs-highlights-importance-of-vaccination-and-regular-cancer-screenings-to-prevent-cervical-cancerTuesday, January 31, 2017 ]]>Human papillomavirus, or HPV, is a common virus that can affect both boys and girls. HPV causes a variety of cancers, including most cervical cancers. In 2013, cervical cancer killed over 4,217 women. It is a significant health issue for all women, but especially for American Indian and Alaska Native (AI/AN) women. Studies have shown that from 1999-2009, AI/AN women were at a higher risk for developing cervical cancer Exit Disclaimer: You Are Leaving www.ihs.gov than white women. 1

The best way to prevent HPV, infection and HPV related-cancers is by getting the HPV vaccine. The HPV vaccine is recommended for all boys and girls 11-12 years of age, and can be given through age 26. The HPV vaccine is a series of either two or three shots depending on the age of the adolescent when they start the series. For more information on the HPV vaccine schedule visit Use of a 2-Dose Schedule for Human Papillomavirus Vaccination Exit Disclaimer: You Are Leaving www.ihs.gov.

Despite this recommendation, coverage with the first dose of HPV vaccine Exit Disclaimer: You Are Leaving www.ihs.gov lags behind coverage with the Tdap and meningococcal vaccines, which are also recommended for 11-12 year olds. At the end of fiscal year 2016, 82% of IHS adolescent patients between the ages of 13 – 17 years received their first HPV vaccine, compared to 92% who received the Tdap vaccine. Fifty-six percent of adolescent IHS patients received all three doses of HPV vaccine, which means 44%, or 30,465 patients, did not receive all three doses of the HPV vaccine. 2 That’s a large number of adolescents who are now at risk for developing HPV related cancers.

The second step in prevention for cervical cancer is staying up to date on regular cervical cancer screenings. When cervical cancer is found early, it is highly treatable and associated with long survival and a good quality of life.3  After turning 21, every woman should be seeing her healthcare provider for regular Pap screenings. The Pap test detects cell changes on your cervix that in time may develop into cervical cancer. Patients should discuss the test results with their healthcare provider so they are aware of what they mean and when their next pap test should be.

IHS is proud to have dedicated staff in the field working to improve HPV vaccination rates. From 2013-2015 the IHS immunization program partnered with 10 sites interested in undertaking an initiative to improve HPV vaccine coverage Exit Disclaimer: You Are Leaving www.ihs.gov. Using multi-faceted approaches, which included expanding reminder recall efforts, conducting community education, and implementing standing orders to establish nurse only and walk in immunization clinics to increase access to HPV vaccines, participating sites were able to increase coverage with the first dose of HPV vaccine an average of 24% over a two-year period, and increase coverage with three doses of HPV vaccine by an average of 22%. For more information on one facility’s experience, please see the recorded webinar here– CMEs and CEUS are available!

IHS Glaucoma Awareness Month

References:

  1. Watson, M., et al., (2014). Cervical Cancer Incidence and Mortality among American Indian and Alaska Native Women, 1999-2009. American Journal of Public Health, Supplement 3 2014:104, S415-S422
  2. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2014). How Many Cancers are Linked with HPV Each Year? See the CDC’s cervical cancer statistics page Exit Disclaimer: You Are Leaving www.ihs.gov.
  3. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2015). See the CDC’s cervical cancer informational page Exit Disclaimer: You Are Leaving www.ihs.gov.

Amy Groom is a Public Health Advisor with the Centers for Disease Control and Prevention, and has served as the Immunization Program Manager for the Indian Health Service since 2001. She serves as a subject matter expert for IHS and CDC on immunization issues that impact American Indian and Alaska Native communities, and provides technical support to IHS to ensure AI/AN people have access to all recommended vaccines.


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National Glaucoma Awareness Monthhttps://www.ihs.gov/newsroom/ihs-blog/january2017/national-glaucoma-awareness-monthhttps://www.ihs.gov/newsroom/ihs-blog/january2017/national-glaucoma-awareness-monthFriday, January 27, 2017 ]]>January is National Glaucoma Awareness month, an important time to learn about this sight-stealing disease. Glaucoma is a condition in which elevated eye pressure may damage the optic nerve, which connects the eye to the brain.  Damage to this nerve may lead to permanent vision loss. 

Glaucoma often goes undetected because it is a painless condition. Vision loss may progress slowly and not be noticed until the condition is advanced.  This is why it is so important to have a screening eye examination. If caught early, treatment may be as simple as using a medicated eye drop to control eye pressure. In this way, vision loss may be prevented. If damage has already occurred, treatment may prevent further damage from occurring. 

IHS Glaucoma Awareness Month

Individuals with high blood pressure, diabetes, hypertension, or those with a family history of glaucoma are at higher risk for glaucoma. Near-sightedness may increase the risk of glaucoma as well. At the Indian Health Service, we recommend that American Indians and Native Alaskans over 50 years of age have an eye examination to screen for glaucoma.

For patients diagnosed with glaucoma, regular eye clinic follow-up is needed to ensure that the eye pressure is controlled. It is important to understand that only an eye doctor can measure eye pressure, screen for glaucoma, and determine which treatment is appropriate for you.

Don’t be blindsided by glaucoma. Schedule an eye examination, today!

Dr. Dara Shahon is the Chief of Ophthalmology at the Phoenix Indian Medical Center. She is certified by the American Board of Ophthalmology and is a Fellow of the American Academy of Ophthalmology. Prior to joining the Indian Health Service in 2015, Dr. Shahon practiced general ophthalmology in Scottsdale, Arizona.


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IHS is Selected as a CSO50 Award Winner for Cybersecurity Excellencehttps://www.ihs.gov/newsroom/ihs-blog/january2017/ihs-is-selected-as-a-cso50-award-winner-for-cybersecurity-excellencehttps://www.ihs.gov/newsroom/ihs-blog/january2017/ihs-is-selected-as-a-cso50-award-winner-for-cybersecurity-excellenceFriday, January 27, 2017 ]]>For the first time, Indian Health Service (IHS) is selected as one of 50 organizations (and people within them) to win a CS050 award for developing and implementing security initiatives that drive business value. IHS was selected due to the value of our cybersecurity program and security initiatives that demonstrate outstanding business value and thought leadership. IHS will be recognized at the CSO50 Security Conference + Awards on May 1-3, 2017, focusing on "Aligning Proactive Security with Modern Threats", at the Scottsdale Resort at McCormick Ranch in Scottsdale, Arizona. CSO provides news, analysis and research on a broad range of security and risk management topics and has been producing award winning content serving information needs of top security executives, since 2002. Areas of focus include information security, physical security, business continuity, identity and access management, loss prevention and more. CSOonline.com is published by (International Data Group) Enterprise, which is an IDG company.

IHS Division of Information Security staff.
IHS Division of Information Security staff.

The IHS Cybersecurity Program's goal is to continually strengthen the cybersecurity posture of IHS by establishing an enterprise-wide secure environment to protect the confidentiality, integrity, availability and resiliency of all health information systems. In addition, instituting an organizational culture of responsible stewardship, promoting governance, providing expertise, and fostering awareness of Tribes to support the improvement and quality of access to care for approximately 2.2 million American Indians and Alaska Natives. Establishing cybersecurity governance as well as protection from cyber threats, is an effort to raise the health status to our vast healthcare network spanning over 420 hospitals, clinics, and health stations across 38 states and 567 sovereign nations to the highest possible level. The Division of Information Security is continually adapting to newly discovered cyber-threats to ensure that IHS systems and information are protected.

2017 CSO50 Award Honorees:

  • AECOM
  • Aflac
  • Amkor Technology
  • AstraZeneca
  • AT&T
  • Banesco Banco Universal, Venezuela
  • Beebe Healthcare
  • Blackstone
  • Blue Cross and Blue Shield of North Carolina (BCBSNC)
  • BNY Mellon
  • Cancer Treatment Centers of America® (CTCA)
  • Celgene Corporation
  • Creative Artists Agency
  • Department of Homeland Security
  • Educational Testing Service
  • Esri
  • FICO
  • Flowserve Corp.
  • Food and Drug Administration
  • Genpact
  • GoDaddy
  • Grand Canyon University
  • Health Management Systems
  • Hershey Company
  • HITRUST Business Associate Council
  • Horizon Blue Cross Blue Shield of New Jersey
  • INC Research
  • Indian Health Service
  • International Association of Certified ISAOs (IACI)
  • Jackson Health System
  • John Muir Health
  • Kimberly-Clark Corporation
  • Los Angeles World Airports
  • MasterCard
  • Monsanto
  • Nexteer Automotive
  • ProQuest
  • Quest Diagnostics
  • Rapid7
  • Sallie Mae
  • State of Michigan
  • State of Missouri Office of Administration
  • The MITRE Corporation
  • The Nature Conservancy
  • TransUnion
  • United Airlines
  • United Nations International Computing Centre
  • USAA
  • Viewpost
  • Voya Financial

For more information, read the CSO50 press release Exit Disclaimer: You Are Leaving www.ihs.gov

Robert Collins is the Chief Information Security Officer (CISO) and Director of Information Security for the Indian Health Service. Mr. Collins has over 10 years of experience developing, implementing and reengineering security programs and nine of these directly involved international and domestic health organizations.


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Sustaining Quality Health Care Delivery at Indian Health Servicehttps://www.ihs.gov/newsroom/ihs-blog/january2017/sustaining-quality-health-care-delivery-at-indian-health-servicehttps://www.ihs.gov/newsroom/ihs-blog/january2017/sustaining-quality-health-care-delivery-at-indian-health-serviceThursday, January 19, 2017 ]]>It’s been quite a year at the Indian Health Service. During my tenure leading here, I met with patients and tribal and community leaders to hear ideas on how the patient experience could be improved, specifically how the agency could work with tribes to raise the quality of care and expand access to services.  In these conversations, I was also reminded of the long-standing systemic problems that often made it difficult for IHS to provide its patients with the best care possible.

Some of these challenges include a rapidly growing service population, medical inflation, aging infrastructure, difficulties attracting and retaining staff in rural areas, and the impact of behavioral health issues affecting the population. For example, limited capital investment means IHS faces a significant backlog in health care facilities maintenance and construction – over $14 billion -- and so the age of our facilities continues to increase. IHS hospitals are now almost four times older than U.S. hospitals.

Aging facilities translate into lower productivity as the space is not designed for current needs which makes it more difficult to attract staff. Ultimately, this affects the quality of care and the patient experience.

I knew confronting these challenges would require a sustained investment of resources and funding over time, something the agency could not change wholly on its own. But when I took the helm early last year, I also knew that with some creative thinking and determination, there was much IHS could do to address these problems and forge a new way of doing business.

Throughout 2016, IHS was proactive and relentless in its confrontation of the severe operational, budgetary, and staffing challenges we faced.

With the support across the U.S. Department of Health and Human Services, including the Executive Council on Quality Health Care, IHS executed a bottom to top review, working with top managers, clinicians, and program experts who took a fresh look at long-standing obstacles to jumpstart a multitude of initiatives to improve the quality of care delivered to patients and enact sustainable reforms. 

As we learned lessons in one area, we shared it across our facilities on how we could improve our operations to better serve our patients. And we are already making strides to strengthen IHS’ quality of care delivery and instill a culture of quality care, leadership and accountability across the agency. Collaboration through the Executive Council also led to the development of the 2016-17 Quality Framework [PDF - 147 KB] that IHS will use to establish and implement a sustained, effective quality program.

New partnerships with the Centers for Medicare & Medicaid Services and the Joint Commission – an independent organization that accredits and certifies nearly 21,000 health care organizations and programs – were also established to support best health care practices and other operational improvements for IHS hospitals. This means our IHS teams, who are making a medical decision for a patient, can ask for daily advice from CMS partners, an outside organization like the Joint Commission, or use telemedicine to get a second opinion from another doctor. This is part of ongoing work to prevent quality issues in hospitals before they affect patients.

Reducing staffing shortages is also linked to improving quality of care for patients, and we continue to pursue a mix of short- and long-term solutions to build the IHS workforce. Over 160 U.S. Public Health Service Commission Corps officers were deployed in 2016 to IHS facilities most in demand of staff to meet immediate workforce needs. To promote sustainable workforce development, IHS expanded the number of its facilities eligible to participate with the National Health Service Corps, a program that provides student loan assistance in exchange for working in areas with staffing shortages.

IHS also refocused its scholarship and loan repayment program on the most-needed disciplines in Indian health programs such as physicians, nurses, pharmacists, and behavioral health providers among others to provide patients with more service options.

Improving the patient experience also means making it easier for patients to access specialty services perhaps not readily available in their neighborhood clinic. This spring, IHS will begin implementing telemedicine services to more than 100,000 patients in the Great Plains Area service units in North Dakota, South Dakota, and Nebraska. Patients will be able to visit a nearby facility and using technology, they can have one-on-one time with a health care provider without traveling long distances to see the physician in person.

As my time leading the agency comes to a close, I look ahead knowing that IHS is better positioned to provide its patients with quality care and possesses the momentum to keep improving and moving forward. There is still a lot of work to be done; however, if there is anything I learned throughout my time, it is that it is only through sustained effort over time working side-by-side with our tribal partners and with Congress that we will be able to achieve real and sustainable change to transform health care for the American Indians and Alaska Natives across the country.

Ms. Smith, a member of the Cherokee Nation, leads IHS, a nationwide health care delivery program responsible for providing preventive, curative and community health care to approximately 2.2 million American Indians and Alaska Natives.


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IHS and VA Renew, Expand Partnershiphttps://www.ihs.gov/newsroom/ihs-blog/january2017/ihs-and-va-renew-expand-partnershiphttps://www.ihs.gov/newsroom/ihs-blog/january2017/ihs-and-va-renew-expand-partnershipThursday, January 19, 2017 ]]>I am pleased to share with you two new developments regarding IHS’ ongoing collaboration with the Veterans Affairs (VA). This partnership aims to provide eligible American Indian and Alaska Native veterans with access to care closer to their homes; promote cultural competence and quality health care; and focus on increasing care coordination, collaboration, and resource-sharing between the agencies.

In 2010, the IHS and the VA signed a Memorandum of Understanding with the goal of improving the health status of American Indian and Alaska Native veterans. In 2012, this was augmented with a reimbursement agreement allowing the VA to financially compensate IHS for direct health care provided to American Indian and Alaska Native veterans that are eligible for and enrolled in the VA's health care system.

Last week, I signed an amendment with the VA to extend the period of a national reimbursement agreement [PDF] for direct health care services through June 30, 2019. Extending the reimbursement agreement has been a major priority for tribes and the IHS this past year. Between 2012 and 2015, the VA reimbursed over $16.1 million for direct care services provided by the IHS and tribal health programs covering 5,000 eligible Veterans. I encourage you to read more about the results of this partnership in the IHS-VA MOU Annual Report that is available on the VA website at: http://www.ruralhealth.va.gov/docs/2015_VA-IHS_Report.pdf Exit Disclaimer: You Are Leaving www.ihs.gov [PDF].

I am also excited to announce a new Interagency Agreement with the VA authorizing the IHS to use the VA’s Consolidated Mail Outpatient Pharmacy (CMOP) [PDF]. This program benefits veterans and non-veterans alike.

The VA CMOP is a sophisticated mail order pharmacy program which uses 7 highly automated facilities to efficiently and safely deliver filled prescriptions directly to patient homes across the U.S. The IHS began using the CMOP on a trial basis in 2010. Since then, approximately 60 IHS pharmacies have filled more than 2 million prescriptions, increasing access to care, decreasing wait times and improving the patient experience.

Under the newly signed agreement, eligibility for accessing the CMOP will be expanded to tribes and tribal organizations with Indian Self-Determination and Education Assistance Act agreements. This is an exciting development, and the IHS is assisting tribes as they work to meet technical requirements and implement the program.

The collaboration between the IHS and the VA is a great example of how the IHS is innovating and maximizing resources to meet needs and overcome challenges, and I want to thank the VA for their continuing support.

Ms. Smith, a member of the Cherokee Nation, leads IHS, a nationwide health care delivery program responsible for providing preventive, curative and community health care to approximately 2.2 million American Indians and Alaska Natives.


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Improving Tribal Solid Waste Program Capacity and Closing Solid Waste Open Dumpshttps://www.ihs.gov/newsroom/ihs-blog/january2017/improving-tribal-solid-waste-program-capacity-and-closing-solid-waste-open-dumpshttps://www.ihs.gov/newsroom/ihs-blog/january2017/improving-tribal-solid-waste-program-capacity-and-closing-solid-waste-open-dumpsTuesday, January 17, 2017 ]]>The Indian Health Service and the U.S. Environmental Protection Agency (EPA) are committed to reducing the number of solid waste open dump sites because they threaten the health and safety of residents of Indian and Alaska Native lands. We are working together with tribal leaders to strengthen tribal government capacity to implement effective solid waste management programs and reduce solid waste open dumps throughout Indian country. 

A new January 2017 Memorandum of Understanding (MOU) [PDF - 937 KB] establishes the role of each agency in this effort. The IHS has committed to improve the accuracy and completeness of data characterizing open dumps impacting tribal communities, and the EPA has committed to complete regular assessments, evaluations and reporting on tribal solid waste programs, including their effectiveness in reducing open dumping activities. IHS will utilize the improved open dumps data and EPA tribal solid waste program assessments to develop, prioritize and fund projects to close the open dumps. 

Also included in the MOU is a joint commitment by IHS and EPA to develop and deliver training and technical assistance to improve the effectiveness of tribal solid waste management programs.  This work is already underway through a 2016 interagency funding agreement [PDF - 1.79 MB] between EPA and IHS to support a multi-year training effort to help tribes develop and implement effective solid waste enforcement codes and ordinances that are appropriate for their communities.

I would like to extend my gratitude to the tribal, IHS, EPA and State of Alaska staff of the interagency waste work group that assessed current open dump data and developed the actions included in the MOU. Read more about the IHS commitment to environmental health in Indian country on our IHS Office of Environmental Health and Engineering page.

Ms. Smith, a member of the Cherokee Nation, leads IHS, a nationwide health care delivery program responsible for providing preventive, curative and community health care to approximately 2.2 million American Indians and Alaska Natives.


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IHS Celebrates World AIDS Dayhttps://www.ihs.gov/newsroom/ihs-blog/december2016/ihs-celebrates-world-aids-dayhttps://www.ihs.gov/newsroom/ihs-blog/december2016/ihs-celebrates-world-aids-dayFriday, December 9, 2016 ]]>On the first day of December, and along with the rest of the world, the Indian Health Service (IHS) commemorated World AIDS Day Exit Disclaimer: You Are Leaving www.ihs.gov. The IHS is committed to working in partnership with tribes to deliver high quality health care to the people we serve and we are strongly devoted to our HIV/AIDS program.

IHS, along with our tribal and urban partners, has long valued the strength of our communities and we have been working to prevent HIV infection and to treat AIDS since the earliest days of the epidemic. For the most part, IHS clinics have only a handful of current HIV patients, or none at all. However, two large programs in the Southwest treat upwards of 200 HIV patients each. Each have populations that can be hard to reach due to geography and lack of phones.

But through locally managed, comprehensive programs run by the most devoted care providers in the country, recognized protocols are being followed and culturally relevant services are offered to our Native clients. My sincere gratitude goes out to the tireless front-line health professionals in our IHS clinics - working sometimes seven days a week - to diagnose and compassionately treat the hundreds of Native people living with HIV.

Employees from several HHS agencies at the 5600 Fishers Lane building celebrated World AIDS Day with a program titled, Leadership, Commitment, Impact, through Collaboration.
Employees from several HHS agencies at the 5600 Fishers Lane building celebrated World AIDS Day with a program titled, "Leadership, Commitment, Impact, through Collaboration."

I want to point out that much of the success we see in our HIV treatment programs is owed to our Community Health Technicians. Health reps are community members trained in HIV who speak the local language, and will travel to homes or shelters of HIV patients who are deemed at high risk for non-adherence due to their recent HIV diagnosis, behavioral health issues, denial, lack of understanding, being overburdened by new medicines, and many other factors.

Statistics show that early screening has made a difference. HIV screening - as per national recommendations - is now a core measure of quality of care. This year IHS tied the screening of 13-64 year olds for HIV to a core GPRA measure - as was suggested by the Centers for Disease Control and Prevention- and we expect this move to help prioritize screening in all of our IHS clinics.

I want to bring your attention to a relatively new development in the prevention of HIV. Pre-Exposure prophylaxis, or PrEP, is a way for people who don't have HIV, but who are at very high risk of getting it, to prevent HIV infection by taking a pill every day. In October IHS sent out PrEP Guidelines to our Area chief clinical directors in order to expand access to PrEP. These guidelines are now posted to our IHS website.

Finally, we turn to what the future holds and therefore, we have initiated the "Indian Country Emergent HIV Strategies Collaborative." The aim of the Collaborative is to improve, promote, and facilitate adoption of emergent HIV strategies for prevention, screening, management and treatment in Indian Country, and specifically targets clinicians.

IHS and American Indian/Alaska Native communities acknowledge the complex problems of HIV, and we at IHS continue to look for opportunities to work with and learn from our HHS sister agencies, and to see what more we can do and how we can share our knowledge and experience. We are learning best practices from the field and from people on the ground. We are embracing new frameworks for treatment and learning networks. IHS is continuing to work to ensure HIV/AIDS care is delivered consistently across all facilities in the Indian health system while working to infuse quality into everything we do.

As IHS Acting Chief Medical Officer, RADM Linde, M.D., provides medical advice and guidance to the Office of the Director and staff on American Indian and Alaska Native health care policies and issues. She serves as the primary liaison and advocate for IHS field clinical programs and community-based health professionals.


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American College of Emergency Physicians Shares Emergency Room Expertise with IHS Staffhttps://www.ihs.gov/newsroom/ihs-blog/december2016/american-college-of-emergency-physicians-shares-emergency-room-expertise-with-ihs-staffhttps://www.ihs.gov/newsroom/ihs-blog/december2016/american-college-of-emergency-physicians-shares-emergency-room-expertise-with-ihs-staffThursday, December 8, 2016 ]]>The American College of Emergency Physicians (ACEP) and Indian Health Services’ Work Session was held at the IHS Omaha-Winnebago Hospital in Winnebago, Nebraska on November 17, 2016, the day before our first snowfall in Nebraska. The meeting was attended onsite in person by over 30 IHS and AB Staffing physicians, nursing, quality and leaders from IHS facilities throughout the nation. Several sites called into the session individually and with colleagues from conference rooms. Overall this initiation of the collaboration between IHS and ACEP was well attended.

This work session allowed top-level physicians and emergency medical professionals the ability to share knowledge, training regarding emergency care.
This work session allowed top-level physicians and emergency medical professionals the ability to share knowledge, training regarding emergency care.

The agenda included opening remarks from Mr. Gary Wabaunsee, CEO Omaha Winnebago Hospital, Ms. Mary L. Smith IHS Principal Deputy Director, Dr. Lee Lawrence, Great Plains Area CMO and Dr. Vindell Washington, HHS National Coordinator for Health IT. Dr. Jay Kaplan provided a dynamic engaging presentation about leadership, responsibility and workflow in the emergency room. Dr. Robert Galli talked about the importance and capacity for emergency telemedicine. Dr. Thomas Wyatt a Native physician and past president from the ACEP Minnesota Chapter shared his experiences working in rural hospitals for IHS and other facilities. Dr. Wyatt offered support for the Comprehensive Advanced Life Support (CALS) as an appropriate training program for emergency medical education for rural and remote locations. Dr. Wyatt encouraged cultural training for providers and briefly reviewed EMTALA regulations. Finally, Dr. Vindell Washington offered a wrap up and next steps session to close the work session. The whole day stirred a lively discussion about key IHS Emergency Department and provider issues.

Participants from the American College of Emergency Physicians and Indian Health Service at the work session held on November 17, 2016 at the Omaha-Winnebago Hospital in Winnebago, Nebraska.
Participants from the American College of Emergency Physicians and Indian Health Service at the work session held on November 17, 2016 at the Omaha-Winnebago Hospital in Winnebago, Nebraska.

ACEP advocates for physicians, patients and the public for the highest quality emergency care. The ACEP and IHS collaborative work session brings together top physicians and emergency medical professionals to share telehealth information, training resources and emergency care knowledge. The goal of this innovative work will be to improve the quality of care and management of patient care in the 26 emergency departments at IHS operated facilities throughout Indian health communities in the nation which further advances the IHS mission to raise the health status of American Indian and Alaska Native people. Additionally, this collaboration will allow sharing of best practices, models of care and policies throughout the Indian healthcare system for stronger partnerships with Tribes, local communities and broader health care systems.

The Great Plains Area Office would like to express our appreciation for the ACEP contributors, the Office of the National Coordinator for Health IT and everyone who was able to attend the work session.

Dr. Lee Lawrence is the Chief Medical Officer for the Great Plains Area. He serves as the lead regional expert on IHS medical and public health services, providing technical leadership and guidance to facility CMO’s and clinical staff in the region.


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