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December 12, 2023: IHS Updates for Tribes and Tribal and Urban Indian Organizations

This bi-weekly update provides up to date information on recent events, meetings, conferences, upcoming deadlines, and recognition of the work being done across the Indian Health Service, other federal agencies, and Indian Country. For more information or questions, email

IHS Announces Reimbursement Agreement with Department of Veterans Affairs

Last week, the IHS announced it had completed negotiations with the Department of Veterans Affairs for a Reimbursement Agreement that facilitates repayment for health care and related services provided by the IHS to eligible American Indian and Alaska Native veterans. This replaces the prior agreement that was finalized on December 5, 2012, and secures the maximum amount for our veterans. Since that time, health care programs operated by the IHS and tribal health programs have received over $186 million from the VA for care to more than 15,000 American Indian and Alaska Native veterans enrolled in VA health care, across 74 participating IHS sites and 116 tribal health program sites.

The announcement is the result of the agencies’ continued collaboration and shared commitment to ensure that American Indian and Alaska Native veterans have access to the highest quality care they deserve. This agreement will expand the ability of the IHS and VA to care for greater numbers of American Indian and Alaska Native veterans – a longstanding priority of not just the respective agencies, but one that holds personal significance to IHS Director Roselyn Tso, the daughter of a Korean War veteran.

Director Roselyn Tso with VA Secretary

IHS Director Roselyn Tso at a video shoot with VA Secretary Denis McDonough to highlight the ongoing partnership between the IHS and the VA

Nashville Area Visits

Director Tso visited the Nashville Area last week to meet with tribal leaders and health directors across Louisiana and East Texas to see the great work being done, including the Chitimacha Tribe of Louisiana, Tunica-Biloxi Tribe of Louisiana, Jena Band of Choctaw Indians, Coushatta Tribe of Louisiana, and the Alabama-Coushatta Tribe of Texas. She took great notice of each health center’s unwavering commitment to providing exceptional services to our patients and the communities that we serve, giving thanks for all they do.

Director Tso is the first IHS director in recent history to visit the Tunica-Biloxi Tribe of Louisiana. Chairman Marshall Pierite presented her with a blanket that was displayed, along with other blankets graciously provided by tribes, at the IHS Director’s Awards ceremony on December 8. Thank you to the Tunica-Biloxi Tribe of Louisiana for the generous gift.

Alabama Coushatta-Tribe of Texas and Tunica Tso

(Photo 1) Ms. Tso receives a Tunica-Biloxi blanket from Tribal Chairman Marshall Pierite
(Photo 2) Visit with Alabama-Coushatta Tribe of Texas

Visit with Coushatta Tribe of Louisiana
Visit with Jena Band of Choctaw Indians

(Photo 1) Visit with Coushatta Tribe of Louisiana
(Photo 2) Visit with Jena Band of Choctaw Indians

Visit with the Tunica-Biloxi Tribe
Visit with Chitimacha Tribe of Louisiana

(Photo 1) Visit with the Tunica-Biloxi Tribe
(Photo 2) Visit with Chitimacha Tribe of Louisiana

White House Tribal Nations Summit

On December 7 Director Tso participated in the White House Tribal Nations Summit Fireside Chat on “Protecting and Supporting Native Families and Children.” The gathering spoke volumes about our unwavering commitment to empowering and amplifying the voices of our Indigenous families and children – a commitment that resonates deeply with Tso as the director of the Indian Health Service. As part of the event, she joined a breakout session with Department of Health and Human Services Secretary Xavier Becerra for nation-to-nation talks with tribal leadership on a variety of important topics in Indian Country. The expertise and commitment represented at the summit has the power to drive positive change and transformation, not only for Native youth and families, but for all of us.

Director Tso participating in the Fireside Chat
The breakout session with HHS Secretary Xavier Becerra

(Photo 1) Director Tso participating in the Fireside Chat
(Photo 2) The breakout session with HHS Secretary Xavier Becerra

Senate Committee on Indian Affairs Hearing on Fentanyl in Native Communities

On December 6, Director Tso had the opportunity to provide testimony before the United States Senate Committee on Indian Affairs. The title of the hearing was “Fentanyl in Native Communities: Federal Perspectives on Addressing the Growing Crisis.” The opioid epidemic continues to place a strain on public health facilities across Indian Country. To combat the fentanyl crisis, the IHS has worked collaboratively on opioid related strategies with the HHS, VA, U.S. Department of Agriculture, Department of Justice, and others, in addition to extensive participation on multiple interagency workgroups. The IHS shared written accomplishments from the field including efforts surrounding safe opioid prescribing, expanding access to naloxone, and supporting treatment and recovery.

Senate-Committee on Indian Affairs Hearing

HHS Secretary’s Tribal Advisory Committee

Recently, Director Tso had the opportunity to address the Secretary’s Tribal Advisory Committee to provide an update on the work being done across the Indian Health Service. She appreciates the opportunity to engage with committee members and to express the gratitude of the IHS for their outstanding leadership. Thank you to HHS Secretary Xavier Becerra, Deputy Secretary Andrea Palm, STAC Chairman Victor Joseph, the Office of Intergovernmental and External Affairs team, and other colleagues across HHS for their continued commitment to improving health care across the country for tribal communities. Our collective efforts are making a profound impact on the health and well-being of American Indian and Alaska Native communities, and the IHS is honored to be a part of this mission.

HHS-Secretary Tribal Advisory Committe

HHS Native American Heritage Month Event

On November 27, Director Tso attended the HHS Native American Heritage Month Celebration and participated in a panel discussion on advance appropriations for the Indian health system. She is grateful to have been invited to be part of such an important conversation. As we all work together to ensure health equity for Native Americans and Alaska Natives, we remain unwavering in our commitment to upholding and honoring the federal government's obligation to protect the inherent sovereign rights of tribal nations.

Victor Joseph and Stacy Bohlen

(Left to right) Victor Joseph, executive director, Village of Tanana; Stacy Bohlen, CEO, National Indian Health Board; Elizabeth Carr, tribal advisor to the Office of Management and Budget director; and Director Tso

IHS Externship Program

Applications are now being accepted for the IHS 2024 Summer Externship Program. This paid externship offers students the opportunity to gain working knowledge and experience in their chosen health profession or field with the Indian Health Service. Externships will be from May through August of 2024. The IHS continues to seek the next generation of leaders committed to improving the health of Native communities. The deadline to apply is January 8, 2024. Please share this widely with any parents or students who may be interested in this opportunity.

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IHS Publishes IHM Chapter 3-42, Patient Safety

In January, IHS leadership implemented the 2023 Agency Work Plan, which includes the publication of a standardized IHS Patient Safety policy. On November 30; the IHS published IHM Chapter 3-42, Patient Safety, which establishes the policies, procedures, and responsibilities required to ensure that a comprehensive, systems-based, patient safety program exists in all IHS health care facilities. The Office of Quality collaborated with IHS areas, IHS Chief Medical Officer Dr. Loretta Christensen, and key stakeholders to draft the new agency-level patient safety policy. It supersedes all local and area-level patient safety policies. Further information regarding policy training will be forthcoming from the IHS Office of Quality.

IHS Health Information Technology Modernization

As announced November 8, the Indian Health Service electronic health record contract was awarded to General Dynamics Information Technology and Oracle Technology. The Office of Information Technology held its initial contract kick-off meeting December 4-5 at IHS headquarters in Rockville, Maryland. The meeting helped introduce IHS-OIT leadership to GDIT and Oracle staff. The meeting also focused on reviewing organizational processes and identified established processes to manage the overall modernization investment and planning activities between the teams. It is an exciting time to support HIT modernization at the IHS.

Health Information Technology Modernization

Health Information Technology Modernization Virtual Summit December 13

The Virtual Summit on December 13 is an opportunity to enhance partner awareness of the new enterprise Electronic Health Record solution. A tribal caucus will be held during the Virtual Summit to provide an opportunity for tribal and urban attendees to independently discuss questions and issues and present those to the IHS. Register here.

Virtual Summit December

IT Modernization Program Tribal Consultation and Urban Confer

The Health IT Modernization Program hosted "The Path Forward” tribal consultation and urban confer on November 8. IHS leadership provided updates regarding the program status, including the announcement of General Dynamics Information Technology, Inc., which uses Oracle Health Technology, being named the new enterprise Electronic Health Record solution provider. Read more about opportunities to partner in the November blog posted here.

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Director’s Workgroup Seeks Tribal Guidance on Definition of “Indian Tribe”

On November 27, the co-chairs of the IHS Director's Advisory Workgroup on Tribal Consultation issued a letter to tribal leaders to initiating tribal consultation on the definition of "Indian Tribe" to use in the updated IHS Tribal Consultation Policy. Tribal leaders are encouraged to register to attend one or more of the virtual tribal consultation sessions scheduled to share input and recommendations on the definition of Indian Tribe that should be included in the updated policy. Written comments and recommendations are due on February 20, 2024.

Staff Quarters Construction Program Funding Available

In an attempt to address a shortage of staff quarters units throughout the Indian Health Service, the IHS Division of Facility Planning and Construction will be allocating annual funds to federal and tribal health care facilities towards the planning, design and construction of staff quarters units. Proposals for the Staff Quarters Construction Program are due by February 1, 2024. For additional information, contact Peter Nachod.

Zero Trust Architecture at IHS Featured in TribalHub Magazine

TribalHub published an article by IHS Chief Information Officer Mitchell Thornbrugh on how IHS works to implement Zero Trust Architecture principles across the agency to fulfill Executive Order 14028. He wrote, “The implementation of ZTA across IHS will help the agency (1) better protect against cybersecurity attacks and (2) help ensure only authorized users have access to information they need to conduct their job responsibilities. The adoption of ZTA principles will help to better secure the electronic health records for millions of patients, protect our healthcare facilities from cybersecurity attacks, and help ensure only authorized users have access to the information they need.” Read more here.

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Naloxone Safety Net Announcement

The Indian Health Service supports expanded harm reduction activities and works to promote low-barrier access to naloxone. As part of a collaborative pilot project between the IHS National Committee on Heroin Opioids and Pain Efforts and the Division of Behavioral Health, a limited amount of naloxone became available on December 1 for federal sites and will be available on January 2, 2024, for tribal and urban sites struggling to meet naloxone needs. These doses are meant to augment existing program naloxone forecasting and should be used to fill unexpected IHS, tribal, and urban shortfalls resulting from increased utilization. If you meet IHS National Supply Service Center requirements, please email Capt. Cynthia Gunderson or Kateri Fletcher-Sahmaunt for requests.

November 2023 Monthly Spotlight - Navajo Language Interpretation Classes at Northern Navajo Medical Center Pharmacy

The National Pharmacy Council Awards Committee is recognizing IHS, tribal, and urban pharmacy staff through a monthly spotlight program to highlight innovation, accomplishments, exceptional initiative, leadership, or outstanding efforts across our programs. Each month, a different area will select a pharmacy team, pharmacist, tech or aid to be recognized in the Monthly Spotlight. It is our pleasure to share our November pharmacy spotlight with you.

Beginning on August 2, the Northern Navajo Medical Center Pharmacy began conducting weekly Navajo language tutorials to improve the translation skills for pharmacy technicians. These classes are currently being led by Pharmacy Technician Ramona Yazzie and Pharmacist Terry Teller. The weekly courses are approximately 30 minutes to one hour, based on the lesson content and the workload of the day. This project is a part of a three-month trial covering basic phrases specifically related to pharmacy work.

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NNMC staff at a Navajo language class

Division of Diabetes Treatment and Prevention

The IHS Division of Diabetes Treatment and Prevention: Advancements in Diabetes Webinar Series is hosting the following webinar for health care providers:

  • “Mindful Exercise in Health and Disease: The Science (Part 2)” on December 20 at 3:00 p.m. ET. Click here to attend.

Telebehavioral Health Center of Excellence

The Telebehavioral Health Center of Excellence Tele-Education Program is hosting the following training for health care providers:

  • “Behavioral Health Integration Webinar Series: Brief Interventions for Integrated Care Settings: A Review of Best Practices” on December 14 at 12 p.m. ET. Register here.

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