Indian Health Service (IHS) Director's Corner Bloghttps://www.ihs.gov/newsroom/directorsblog/IHS updates on important issues affecting the Indian Health Service.en-usTribal Management Grants Available for Tribes and Tribal Organizationshttps://www.ihs.gov/newsroom/ihs-blog/april2016/tribal-management-grants-available-for-tribes-and-tribal-organizationshttps://www.ihs.gov/newsroom/ihs-blog/april2016/tribal-management-grants-available-for-tribes-and-tribal-organizationsFriday, April 29, 2016 ]]>The Indian Health Service is now accepting applications for the Tribal Management Grant Program Exit Disclaimer: You Are Leaving www.ihs.gov, a competitive grant for federally recognized Tribes and Tribal organizations that is administered by the Office of Direct Service and Contracting Tribes (ODSCT).

The intent of the grant program is to prepare Tribes and Tribal organizations for assuming all or part of exiting IHS programs, functions, services and activities, and further develop and improve their health management capabilities.

Approximately 16-18 awards will be issued to assist Tribes and Tribal organizations to establish goals and performance measures; assess current management capacity; analyze programs to determine if management is practicable; and develop infrastructure systems to manage or organize the programs, function, services and activities of the current health programs.

The Tribal Management Grant Program consists of four project types with funding amounts and project periods.

  • Feasibility Study: $70,000 (maximum funding) for 12 months
  • Planning: $50,000 (maximum funding) for 12 months
  • Evaluation Study: $50,000 (maximum funding) for 12 months
  • Health Management Structure: $100,000 (average funding) for 12 months; $300,000 (maximum funding) for 35 months

Important deadlines to remember:

  • Applications due: June 8, 2016
  • Review dates: June 20-24, 2016
  • Earliest anticipated start date: September 1, 2016

For more information about Tribal Management Grant Program, contact the Office of Direct Service and Contracting Tribes or at 301-443-1104.

CAPT Chris Buchanan, an enrolled member of the Seminole Nation of Oklahoma, is the Director, Office of Direct Services and Contracting Tribes (ODSCT), for the Indian Health Service. The ODSCT is the focal point for Title I Indian Self-Determination and Education Assistance Act activities and support for Direct Service Tribes. CAPT Buchanan directs this national program with responsibilities which include policy development concerning Title I Indian Self-Determination contracting and the integration of newly recognized Tribes into the IHS system.


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Lawton Service Unit celebrates 100 years of caringhttps://www.ihs.gov/newsroom/ihs-blog/april2016/lawton-service-unit-celebrates-100-years-of-caringhttps://www.ihs.gov/newsroom/ihs-blog/april2016/lawton-service-unit-celebrates-100-years-of-caringFriday, April 29, 2016 ]]>The Lawton Indian Hospital is celebrating 100 years of caring for patients in the Lawton-Ft. Sill area, 85 miles southwest of Oklahoma City. Today, the hospital provides care to more than 23,000 patients.

In the early 1900s, Kiowa tribal leaders lobbied for a hospital. In 1914, Congress approved funding for the Kiowa Indian Hospital. Construction was completed in 1915 and the Kiowa Indian Hospital opened in early 1916. In 1967, the Lawton Indian Hospital was built and most of the original Kiowa Indian Hospital structures were demolished.

The Kiowa Indian Hospital in Lawton, Okla., in 1929.
The Kiowa Indian Hospital in Lawton, Okla., in 1929.

The hospital has seen significant enhancements in the years since, one of the most significant projects was the 2007 addition of an outpatient clinic. This new space houses doctors’ offices, a pharmacy, a chapel and a conference room. In the past 4 years, several departments have been renovated. Just in the last year, the Lawton Indian Hospital has added new modular dental, behavioral health, and public health nursing buildings. The facility is now triple the size of the original 1916 hospital.

Throughout the years several specialized service lines have been established such as dental care, oral maxillary surgery, audiology, optometry, podiatry, ophthalmology, behavioral health and Diabetes treatment and prevention. In the last ten years, services were further expanded to include: CT scan, bone scan, ultrasound, mammography, MRI, wound care, rheumatology, endocrinology, psychiatry, infusion therapy, physical therapy, respiratory therapy and most recently otorhinolaryngology.

The Lawton Indian Hospital is a full service hospital situated in Oklahoma's third largest metropolitan area. The hospital provides over 800 admissions and 100,000 outpatient visits per year.
The Lawton Indian Hospital is a full service hospital situated in Oklahoma's third largest metropolitan area. The hospital provides over 800 admissions and 100,000 outpatient visits per year.

The Lawton Indian Hospital is licensed for 24 inpatient beds. In recent years, the hospital's reputation for providing special services such as long-term antibiotic therapy and end-of-life care has grown to a degree that our services are in very high demand. This extension of our inpatient services, including case management, has helped to improve our average daily patient load as well as our relationships with the tribal social services liaisons and with staff from the surrounding area hospitals.

The Lawton Service Unit has partnered with the seven tribes of Southwest Oklahoma (Apache, Fort Sill Apache, Caddo, Comanche, Kiowa, Wichita, and Delaware), the Veterans Health Administration, Oklahoma Healthcare Authority, Oklahoma Department of Human Services, Bureau of Indian Education, and the Bureau of Indian Affairs to improve the access, continuity of care, and resources utilization for all American Indian and Alaska Native patients.

Capt. Greg Ketcher, Lawton Indian Hospital chief executive officer, speaks during a centennial celebration at the Lawton Indian Hospital in Lawton, Okla., April 27, 2016.
Capt. Greg Ketcher, Lawton Indian Hospital chief executive officer, speaks during a centennial celebration at the Lawton Indian Hospital in Lawton, Okla., April 27, 2016.

Quality and patient safety are the key values and drivers of all patient care provided at the Lawton Service Unit. By implementing initiatives such as: Improving Patient Care, Partnership for Patients Exit Disclaimer: You Are Leaving www.ihs.gov, The Joint Commission survey process, College of American Pathologist survey, Hospital Consumer Assessment of Healthcare Providers and Systems, and Inpatient Quality Reporting Exit Disclaimer: You Are Leaving www.ihs.gov we continually strive to improve health outcomes for Native American populations.

Capt. Greg Ketcher, OD, is a member of the Cherokee Nation of Oklahoma. He received both his Bachelor of Science degree in 1987 and his Doctor of Optometry degree in 1988 at Northeastern State University in Tahlequah, Oklahoma.


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IHS/Tribal team recognized for emergency water connection in Tucson Areahttps://www.ihs.gov/newsroom/ihs-blog/april2016/ihs-tribal-team-recognized-for-emergency-water-connection-in-tucson-areahttps://www.ihs.gov/newsroom/ihs-blog/april2016/ihs-tribal-team-recognized-for-emergency-water-connection-in-tucson-areaTuesday, April 26, 2016 ]]>A team of IHS engineers, technicians and environmental health staff and personnel from the Tohono O'odham Utility Authority have been recognized by the National Indian Health Board, the Tohono O'odham Nation Legislative Council and the IHS Tucson Area for their work to complete an emergency water project serving 336 homes.

In late 2013, elevated levels of uranium were discovered in ground water supplying the San Xavier West community water system on the Tohono O'odham Nation. Team members completed an engineering report to seek funding for an emergency water connection to a municipal water provider.

IHS Project Engineer Michael Alshuk and IHS Deputy District Engineer John Kathol perform the final inspection for the emergency water connection project in the San Xavier District of the Tohono O'odham Nation, Ariz.
IHS Project Engineer Michael Alshuk and IHS Deputy District Engineer John Kathol perform the final inspection for the emergency water connection project in the San Xavier District of the Tohono O'odham Nation, Ariz.

The team was also required to obtain environmental clearances (archaeological, threatened and endangered species, and flood evaluation), resolve easement issues, reach an agreement with the municipal water supplier and coordinate with county officials regarding pending road improvements in the project area. This project was particularly challenging because of the number of agencies involved in the project, including tribal, county, and city governments and potential funding sources.

Project staff overcame these obstacles through communication, established relationships, and the development of new ones to move the project through its various stages including design, special permitting, obtaining agreements and construction. In addition, the team was in regular contact with community leaders and residents to address concerns associated with their drinking water supply. Despite enormous funding and other obstacles, in May 2014, the San Xavier West system was connected to the municipal water supply. Because of the timely actions and efforts of the team, the San Xavier West Water System remained in compliance with the Safe Drinking Water Act.

John Kathol, Myrt McIntyre, Cauy Washburn and Christopher Caler accept the Tucson Area IHS Director's Award on behalf of the team. Michael Alshuk, Shari Windt and Steve Williams were also recognized with the award.
John Kathol, Myrt McIntyre, Cauy Washburn and Christopher Caler accept the Tucson Area IHS Director's Award on behalf of the team. Michael Alshuk, Shari Windt and Steve Williams were also recognized with the award.

The team of individuals who worked tirelessly to protect human health and urgently address water quality issues associated with drinking water supplied to the San Xavier West community consisted of the following individuals: Michael Alshuk, IHS project engineer, Myrt McIntyre, TOUA Water/Wastewater Department manager, Shari Windt, IHS district engineer, John Kathol, IHS deputy district engineer, Cauy Washburn, TOUA superintendent, Christopher Caler, IHS environmental health officer, and Steve Williams, IHS Construction Inspector.

Gary J. Hartz, P.E. leads IHS efforts to provide functional, well maintained health care facilities and staff quarters, technical and financial assistance to tribes on safe water and wastewater systems and a broad range of environmental health and injury prevention activities.


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Let's make every day Earth Dayhttps://www.ihs.gov/newsroom/ihs-blog/april2016/let-s-make-every-day-earth-dayhttps://www.ihs.gov/newsroom/ihs-blog/april2016/let-s-make-every-day-earth-dayFriday, April 22, 2016 ]]>The IHS mission is to raise the physical, mental, social, and spiritual health status of the American Indian and Alaska Native people to the highest possible level. That includes doing our part to preserve the environment.

Today, you can’t walk down the street without some indication that environmental protection is here to stay: separate bins for trash and recyclables, bike lanes and bike share programs, hybrids and EVs, organic or locally grown food in restaurants and markets, sustainably-made apparel and other goods, LEED certified buildings, etc. Governments, nonprofits, and businesses have collaborated to establish policies curbing climate change, fighting species’ extinction, and ensuring access to clean water.

The Acoma-Canoncito-Lagunita Hospital in Acoma, N.M. has a roof-top solar system that will supply 253,000 kilowatt hours (kWh) of electricity per year, significantly reducing the overall amount purchased from the local utility provider and saving $47,000 annually.
The Acoma-Canoncito-Lagunita Hospital in Acoma, N.M. has a roof-top solar system that will supply 253,000 kilowatt hours (kWh) of electricity per year, significantly reducing the overall amount purchased from the local utility provider and saving $47,000 annually.

For IHS, that means implementing sustainable practices into standard agency operations and energy and water conservation measures in facilities nationwide. For example, a retrofit at the Feather River Tribal Health Clinic will install 1,697 LED lighting fixtures to reduce the facility’s electricity use by approximately 38 percent (an estimated 266,304 kWh per year). The Fort Yuma Health Center will incorporate a rooftop and parking photovoltaic system that will provide half of the facility’s total energy needs. Water use is minimized with Xeriscape techniques to reduce or eliminate the need for irrigation, by planting indigenous species that are compatible with the local climate. The rainwater recovery system at the Kayenta Health Center includes underground holding tanks that store the captured rainwater to be used for irrigation. For more examples, see the Sustainability in Action webpage.

Let’s determine what else we can do to have a positive impact on the environment. Let's change one aspect of our lifestyle, whether it’s biking to work instead of driving, using reusable shopping bags and water bottles. For ideas on how you can do your part, see What Can I Do. The Sustainability Program also posts bi-monthly Green Tips. If you’re already doing your part, keep on, and encourage others to do more.

Let’s make every day Earth Day.

Gary J. Hartz, P.E. is the IHS chief sustainability officer. He leads IHS efforts to provide functional, well maintained health care facilities and staff quarters, technical and financial assistance to tribes on safe water and wastewater systems and a broad range of environmental health and injury prevention activities.


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National Infant Immunization Weekhttps://www.ihs.gov/newsroom/ihs-blog/april2016/national-infant-immunization-weekhttps://www.ihs.gov/newsroom/ihs-blog/april2016/national-infant-immunization-weekFriday, April 22, 2016 ]]>During National Infant Immunization Week, April 16-23, IHS encourages every parent to double check their child’s immunization record to see if their child is up to date on recommended vaccines, and to discuss with neighbors, friends, and family the importance of vaccinating their children. Call your local clinic today to make an appointment to get your child vaccinated or to discuss childhood immunizations.

HHS, CDC National Infant Immunization Week April 16-23, 2016 button

Immunization against childhood disease is one of the greatest public health achievements in the United States and worldwide. This week is an annual observance to highlight the importance of protecting infants from vaccine preventable diseases (VPD) and to celebrate the achievement of immunization programs and their partners. IHS is proud of the strong work the IHS/Tribal/Urban immunization programs have done and continue to do to increase vaccine uptake in infants.

Currently VPD rates in the United States are at or near record lows. Similar to the U.S., rates of VPDs in American Indian/Alaska Native (AI/AN) communities have decreased dramatically due to vaccines. Before vaccines, many children died from diseases, such as whooping cough, measles and polio. Since infants are protected by vaccines, we don’t see these diseases nearly as often.

The benefits of childhood immunizations are particularly notable for AI/AN children, who have suffered disproportionately from infectious diseases compared with the U.S. general population. Certain VPDs occur at higher rates for AI/AN infants than in their non-Native counterparts, due in part to issues such as household crowding, lack of indoor plumbing, poverty and poor indoor air quality. Though infections such as whooping cough, measles and polio are not as common as they were before vaccines, it is still critical that parents vaccinate their children because the germs that cause those diseases still exist.

As shown in the graph, there has been a steady decline in infant immunization rates across IHS. A decline in immunization coverage results in more children in your community being at risk for VPDs. It is especially important that parents vaccinate their children according to the recommended vaccine schedule to ensure they are fully protected from VPDs.

The graph represents all IHS Areas combined age appropriate immunization coverage for ages 3 months to 27 months from quarter one in fiscal year 2004 through 2016.  Immunization rates have been steadily declining, increasing the risk for vaccine preventable diseases.
The graph represents all IHS Areas combined age appropriate immunization coverage for ages 3 months to 27 months from quarter one in fiscal year 2004 through 2016. Immunization rates have been steadily declining, increasing the risk for vaccine preventable diseases.

View the easy to read vaccine schedules for parents Exit Disclaimer: You Are Leaving www.ihs.gov.

Dr. Steve Holve, is the Chief Clinical Consultant in Pediatrics at the Tuba City Regional Health Care Corporation for the Indian Health Service.


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Special Diabetes Program for Indians Releases Interim Report to Congresshttps://www.ihs.gov/newsroom/ihs-blog/april2016/special-diabetes-program-for-indians-releases-interim-report-to-congresshttps://www.ihs.gov/newsroom/ihs-blog/april2016/special-diabetes-program-for-indians-releases-interim-report-to-congressThursday, April 21, 2016 ]]>The Indian Health Service has just released the Special Diabetes Program for Indians 2014 Report to Congress, Changing the Course of Diabetes: Turning Hope into Reality publication. This document provides a concise update on the Special Diabetes Program for Indians (SDPI) and is available online [PDF - 472 KB].

This Report to Congress highlights the SDPI’s ongoing and outstanding accomplishments in helping to improve the quality of diabetes care and health outcomes for American Indian and Alaska Native (AI/AN) people. It reviews recent data that show the following successes:

  • Increases in diabetes prevalence rates in adults are slowing
  • In youth, diabetes remains rare and prevalence rates are not increasing
  • Long-term control of key diabetes clinical measures is being sustained
  • The end-stage renal disease incidence rate in people with diabetes is decreasing

The SDPI program recently awarded grant awards totaling approximately $138 million to prevent and treat diabetes in AI/AN people. Grant funds went to a total of 301 Tribes, Tribal organizations, Urban Indian organizations and IHS facilities. View the list of awardees [PDF - 398 KB].

SDPI grantees have successfully implemented innovative interventions in AI/AN communities across the nation to address the epidemic of diabetes. Guided by both the scientific literature and community-driven priorities, the SDPI has helped the grantees, Tribal leaders and IHS collectively build one of the most strategic and comprehensive diabetes treatment and prevention programs in the United States.

For more information on the Division of Diabetes Treatment and Prevention visit http://www.diabetes.ihs.gov Exit Disclaimer: You Are Leaving www.ihs.gov.

Dr. Ann Bullock is board-certified Family Physician and the Director of the IHS Division of Diabetes Treatment and Prevention (DDTP). DDTP provides information and resources to strengthen clinical, public health, and community approaches for diabetes treatment and prevention in AI/AN communities throughout the United States.


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Tribal Consultation on Updated Contract Support Cost Policyhttps://www.ihs.gov/newsroom/ihs-blog/april2016/tribal-consultation-on-updated-contract-support-cost-policyhttps://www.ihs.gov/newsroom/ihs-blog/april2016/tribal-consultation-on-updated-contract-support-cost-policyThursday, April 14, 2016 ]]>One of my priorities is to implement the Indian Self-Determination and Education Assistance Act (ISDEAA) in a manner consistent with the principles of self-determination and self-governance. To improve our work on this priority, IHS has focused its attention on updating its Contract Support Costs policy, which was last updated in 2007.

Our goal is to implement a new policy in 2016. To accomplish this goal, the CSC Workgroup [PDF - 67 KB] and IHS staff have met several times over the past three months and completed their work in drafting a revised policy. This week, IHS announced a 60-day tribal consultation through a letter to Tribal Leaders that includes a copy of a draft revised policy [PDF - 757 KB] for review.

In addition to the 60-day open comment period, IHS will conduct three in-person sessions on the revised policy scheduled over the next two months. Two of the sessions will be held in conjunction with the U.S. Department of Health and Human Services’ regional Tribal consultation. One session will take place during the Annual Tribal Self-Governance Consultation Conference Exit Disclaimer: You Are Leaving www.ihs.gov.

Here is detailed information for each session:

2016 U.S. Department of Health and Human Services Region IX Tribal Consultation

Date: Friday, April 15, 2016

Time: 3:00-3:45 pm

Location: Acacia Ballrooms B/C/D

Wild Horse Pass Hotel and Casino

5040 Wild Horse Pass Blvd.

Chandler, Arizona 85226

2016 Annual Tribal Self-Governance Consultation Conference

Date: Tuesday, April 26, 2016

Time: 2:30-4:30 pm

Location: Great Hall North

Buena Vista Palace and Resort

1900 E Buena Vista Drive

Lake Buena Vista, Florida 32830

2016 U.S. Department of Health and Human Services Region X Tribal Consultation

Date: Friday, May 13, 2016

Time: 10:45 am-12:00 pm

Location: Salmon/Whale Room, 4th Floor Tower Building

Suquamish Clearwater Casino Resort

15347 Suquamish Way NE

Suquamish, Washington 98392

The government’s trust responsibility to provide access to health care extends equally to all American Indian and Alaska Native Tribes and Tribal Organizations. We fully support the decisions made by American Indian and Alaska Native Tribes and Tribal Organizations to meet their health care goals and objects either through direct services provided by IHS or through self-determination and self-governance ISDEAA authorities.

For more information about the Contract Support Costs Workgroup or the in-person sessions, please contact the IHS Office Direct Service and Contracting Tribes at 301-443-1104 or the IHS Office of Tribal Self-Governance at 301-443-7821.

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. Read more.


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Meetings with Tribal Leaders in the Great Plains Area Focus on Quality of Carehttps://www.ihs.gov/newsroom/ihs-blog/april2016/meetings-with-tribal-leaders-in-the-great-plains-area-focus-on-quality-of-carehttps://www.ihs.gov/newsroom/ihs-blog/april2016/meetings-with-tribal-leaders-in-the-great-plains-area-focus-on-quality-of-careWednesday, April 13, 2016 ]]>I have only served as Principal Deputy Director for a little over a month, but, in that time, it has become clear to me that, while the IHS is firmly committed to the mission of providing quality health care for American Indians and Alaska Natives, we face steep operational and quality of care challenges.

The current situation is unacceptable, as I have written.

In my short time in my new role, I have been working diligently on the challenges we have in the Great Plains, including the systemic issues that face IHS, such as staff and shortages of living quarters for our health professionals. I am committed to making sustainable changes to ensure that we are providing quality health care to the patients we serve, not only in the Great Plains but throughout the country. I fully support our treaty obligations and our responsibility to provide access to health care in direct-service facilities and through Tribal and Urban centers.

Ms. Smith greets Catherine Wooden Knife, Rosebud Sioux Tribal Council Member and Tribal Health Board Vice Chair
Ms. Smith greets Kathleen Wooden Knife, Rosebud Sioux Tribal Council Member and Tribal Health Board Vice Chair

So, it was important to me to travel to the Great Plains last week to meet with many Tribal leaders in the Great Plains Area and to listen to their concerns about access to and quality of health care for their Tribal members. My visit especially focuses on quality of care issues at three of our facilities in the Great Plains Area - Omaha Winnebago, Rosebud, and Pine Ridge Indian hospitals. Discussions with our Tribal partners were productive, but they were also tough, and we listened to hard truths from Tribal members who were justifiably frustrated. Although I fully support the work of dedicated IHS staff throughout the country, it is also true that we must be accountable to the people we serve and acknowledge that the deficiencies found by the Centers for Medicare and Medicaid Services (CMS) at the three hospitals are unacceptable.

With the full support of the Department of Health and Human Services (HHS), of which IHS is a part, we are working aggressively to address quality of care issues in the Great Plains Area, both short term and long term. The challenges there are long-standing. We have an intense effort underway right now to address the problems cited by CMS at these three hospitals.

We brought in independent third-party reviewers to advise us on addressing the specific deficiencies found by CMS. We are focusing additional human resources personnel on the Area and successfully bringing onboard new hires and needed health professionals. Additional U.S. Public Health Service Commissioned Corps Officers are also supplementing IHS personnel in the Great Plains Area. The Acting HHS Deputy Secretary, Dr. Mary Wakefield, is leading a Department-wide Executive Council on Quality Care to leverage strategies, tools, expertise and other resources from across HHS to strengthen and sustain quality of care at IHS facilities, with an immediate focus in the Great Plains Area and longer term across other IHS regions.

More broadly, we are redoubling efforts to ensure that sustained, quality care is delivered consistently across IHS facilities. As part of a longer-term effort to make sustained change, we transformed our Hospital Consortium into a Quality Consortium. We have a new deputy, Dorothy Dupree, who is focused on quality in addition to her work as the deputy director. Ms. Dupree is overseeing the work on challenges at the hospitals in the Great Plains, and she is working closely with CMS.

We are also developing sustainable plans for quality improvements for the Great Plains Area, the focus of my visit to South Dakota last week. During our trip to the Great Plains, IHS leaders from the Area and Headquarters also attended the meetings with Tribal leaders and led sessions on staffing, staff quarters, telemedicine, delivery of services, behavioral health and quality and governing boards. Having all the necessary people at the table will help ensure that improvements are both implemented and sustained over time.

I believe that partnership is the key to transforming IHS. IHS is committed to listening to concerns and to working with the Tribes to explore options. IHS respects treaty rights and the government-to-government relationship with Tribes. IHS has the utmost respect for Tribal member perspectives and opinions. Our meetings with Tribal leaders are part of our commitment to partnership and transparency.

Working together, I am confident that we will be able to chart a course forward to sustained improvements at IHS to furthering our mission of providing access to quality health care to Native Americans 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. Read more


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Service Delivery Area Expansion Proposed for Wampanoag Tribe of Gay Head (Aquinnah) in Massachusettshttps://www.ihs.gov/newsroom/ihs-blog/april2016/service-delivery-area-expansion-proposed-for-wampanoag-tribe-of-gay-head-aquinnah-in-massachusettshttps://www.ihs.gov/newsroom/ihs-blog/april2016/service-delivery-area-expansion-proposed-for-wampanoag-tribe-of-gay-head-aquinnah-in-massachusettsThursday, April 7, 2016 ]]>The Indian Health Service proposes in a recent Federal Register Notice Exit Disclaimer: You Are Leaving www.ihs.gov to expand the geographic boundaries of the Service Delivery Area for the Wampanoag Tribe of Gay Head (Aquinnah). Since 1987, when the Bureau of Indian Affairs recognized the Tribe, the Service Delivery Area has been comprised only of the island of Martha’s Vineyard in Dukes County, Massachusetts. At the request of the Tribe, IHS reexamined this Service Delivery Area. If the Service Delivery Area is expanded, the Tribe estimates that 268 enrolled Aquinnah members will gain access to the Purchased/Referred Care Program as a result of this change. These members reside in Barnstable, Bristol, Norfolk, Plymouth and Suffolk counties in Massachusetts.

Indian Health Service Principal Deputy Director Mary Smith met with the Wampanoag Tribe of Gay Head (Aquinnah) tribal leadership on March 30, 2016 in Washington, DC.
Indian Health Service Principal Deputy Director Mary Smith met with the Wampanoag Tribe of Gay Head (Aquinnah) tribal leadership on March 30, 2016 in Washington, DC.

IHS Service Delivery Area boundaries help to determine which individuals receive IHS-funded purchased/ referred health care. This program funds primary and specialty health care services purchased from private health care providers because they are not available at IHS or tribal health care facilities. American Indians and Alaska Natives who reside in an approved Service Delivery Area may be able to access this type of care. However, members of the Tribe who reside off the island of Martha’s Vineyard have been ineligible.

The Tribe will use its existing federal allocation for Purchased/Referred Care Program funds to provide services to the expanded population. No additional financial resources will be allocated by IHS to the Tribe to provide services to tribal members residing outside the existing service area.

Terri Schmidt, R.N. is the Acting Director of the Office of Resource Access and Partnerships for the Indian Health Service where she is responsible for providing direction and leadership in the areas of purchased/referred care, business office/third-party collections and partnerships with other Agencies and organizations. Ms. Schmidt is Arapaho and a member of the Cheyenne and Arapaho Tribes of Oklahoma.


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Hospital Consortium changes name, revises charter to focus on quality of carehttps://www.ihs.gov/newsroom/ihs-blog/april2016/hospital-consortium-changes-name-revises-charter-to-focus-on-quality-of-carehttps://www.ihs.gov/newsroom/ihs-blog/april2016/hospital-consortium-changes-name-revises-charter-to-focus-on-quality-of-careMonday, April 4, 2016 ]]>At the Indian Health Service, improving the quality of care and governance of our federal hospitals is critical for our patients. Quality care reduces disparities and promises a future that assures excellence for our patients across the IHS delivery system.

The Indian Health Service Hospital Consortium is now referred to as the Quality Consortium, emphasizing its role in quality improvement and removing the reference to only include hospitals. Also part of the name change is the revision of Consortium’s charter to better represent its current structure and function.

The work of the Quality Consortium is some of the most vital work of the Indian Health Service. Our patients rely on us to provide them with the highest quality care, the same as they would receive at the best hospitals in the country. After all, our patients are our first priority.

The Quality Consortium’s Executive Council comprised of the Director of the Office of Clinical and Preventive Services, Area Directors, Area Chief Medical Officers and quality improvement and safely staff, agreed to broaden the scope of the Consortium’s improvement work to include all IHS hospitals, IHS free-standing ambulatory care facilities and IHS Youth Regional Treatment Centers.

The Executive Council also outlined specific functions that the Consortium oversees, including:

  • Prioritizing quality improvement activities across the domains of care delivery, support functions, management and administration;
  • Coordination of improvement activities as system of care;
  • Enhancing the function of governing boards;
  • Promoting effective training programs focused on competency development and quality performance standards;
  • Providing consultative services to Areas and facilities for quality improvement;
  • Recommending standardized quality processes and procedures across the IHS health care system; and
  • Identifying or developing quality measures, performance criteria and strategies to support facilities in achieving standards.

The effort to define the Consortium’s purpose and direction is important to achieving meaningful improvements among the 28 IHS hospitals and other IHS-operated facilities. Our patients enter the hospital with the expectation of being healed and not harmed. They rely on the Indian Health Service to provide quality care and safety, and the Quality Consortium is the skilled and knowledgeable group to guide that delivery.

As IHS Chief Medical Officer, Dr. Susan V. Karol (Tuscarora Nation) 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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