IHS Reports on the Past Year's Implementation of the Permanent Reauthorization of the Indian Health Care Improvement Act

The Indian Health Service (IHS) reported, in a May 5, 2011, letter to tribal leaders, on the implementation of the Indian Health Care Improvement Act (IHCIA) since it was permanently reauthorized in March 2010 as part of the Affordable Care Act (PL 111-148). The attached letter from IHS Director Roubideaux focuses on those provisions which were required to be implemented within a year of enactment.

None of the reports or assessments which the IHS was required to produce were provided, either by attachment or as links. Two of the seven items are in the form of reports to Congress: an initial facilities needs assessment and a plan for establishing a Nevada Area IHS Office. The Act further required that the annual budget submission include information on the cost of health care inflation and the size of the IHS service population, both of which were included in FYs 2011 and 2012 (and prior) budgets submitted to Congress.

The IHS reports that it has created an initial plan and strategy for the Act’s requirement to increase staffing for behavioral health services, but there is no indication with whom the plan may have been shared, nor any date associated with it.

The IHS reports that an assessment of the need for inpatient mental health care and the availability and cost of facilities to provide such services was completed on March 17, 2011, but the Director’s letter provides no indication on how to access this report.

An amendment to the Memorandum of Agreement between the Indian Health Service and the Department of Interior was signed on March 1, 2011, and published in the Federal Register on March 23, 2011 (See our General Memorandum 11- 036 of March 25, 2011).

On March 23, 2011, the IHS Director signed a Sexual Assault Policy which had been developed in conjunction with the Department of Justice and the HHS Office of the General Counsel. In a letter to tribal leaders on March 28, 201l, the IHS Director asked for comments and recommended changes to the policy. The policy can be found in the Indian Health Service Manual, Part 3, Chapter 29.

Please let us know if we may provide additional information regarding Indian Health Care Improvement Act implementation matters.