Indian Health Service Update
Yvette Roubideaux, M.D., M.P.H.
Director, Indian Health Service
National Council of Urban Indian Health
Annual Leadership Conference
April 25, 2012
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IHS Priorities
• Renew and strengthen our partnership with
Tribes
• Bring reform to the IHS
• Improve the quality of and access to care
• Ensure that our work is transparent,
accountable, fair, and inclusive
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IHS Budget
• FY 2009 – 7% increase
• FY 2010 – 13% increase
• FY 2011 – 0.4% increase ($17 million)
• FY 2012 – 5.8% increase ($237 million)
– $4.3 billion overall budget
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IHS Budget
• FY 2013 proposed budget has an increase of $116 million
(2.7%):
– Total budget authority = $4.42 billion. This includes:
 CHS funding increase of $54 million
 An increase of $49 million to support staffing and operating costs for six new and
expanded health facilities
 $81 million total for health care facility construction
 $1.7 million increase for facility maintenance and improvement
 CSC funding increase of $5 million
 An additional $6 million for IHS Health IT
• FY 2014
– Area budget formulation and national budget sessions completed
– Tribes proposed 22% increase at HHS Tribal Budget
Consultation; included $1.6 million increase for UIHP.
– Urban Indian Health Needs Assessment
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IHS Priorities
• Renew and Strengthen our Partnership with
Tribes/Urban Indian organizations
– IHS Tribal Consultation Policy
– Urban Confer Policy
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IHS Priorities
• Renew and Strengthen our Partnership with Tribes
– Current/recent consultations
 How to improve the tribal consultation process
 How to improve the CHS Program
 Priorities for health reform/IHCIA implementation
 Budget formulation
 IT Shares
 Evaluation of the 2007 CSC Policy
 Federal Advisory Committee Act
 How to improve the IHCIF – data/formula
 TEC Data Sharing Agreement
 Long-Term Care
 VA reimbursement of IHS for services to eligible veterans
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IHS Priorities
• Bring Reform to the IHS
─ Affordable Care Act
─ Internal IHS Reform
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Affordable Care Act
• Impact of the Affordable Care Act for AI/ANs
– Can still use IHS – permanent IHCIA reauthorization
– Greater access to health insurance with more
coverage and choices,
– Increased services at Indian health facilities due to
increased reimbursements.
• Repeal Efforts - Affordable Care Act
– Supreme Court Case – decision expected by June
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Implementation
• HHS lead on ACA; IHS lead on IHCIA
• Tribal consultation
– White House/HHS outreach calls/Meetings
– consultation@ihs.gov
– Tribal leader letters
• Education and outreach
– www.healthcare.gov
– IHS Director’s blog – www.ihs.gov
– NCAI/NIHB/NCUIH
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IHS Priorities
• Bring Reform to the IHS
– IHS Staff Priorities
 Improve how we do business and how we lead and
manage people:

Consistency in business practices

Improving budget planning and financial

Human Resources

Performance management

Senate Committee on Indian Affairs/Area Reviews
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IHS Priorities
• Improve the quality of and access to care
– Customer Service
– Improving Patient Care Initiative
– Accreditation/Certification
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IHS Priorities
• Improve the quality of and access to care
– Special Diabetes Program for Indians
– Healthy Weight for Life initiative

http://www.ihs.gov/healthyweight
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IHS Priorities
• Improve the quality of and access to care
̶
Million Hearts Campaign
– Partnership for Patients
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IHS Priorities
• Improve the Quality of and Access to Care
– EHR certification of RPMS
• Meaningful use
• EHR Incentive payments (Medicare, Medicaid)
– ICD-10 Implementation
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IHS Priorities
• Ensure that our work is transparent, accountable,
fair, and inclusive
– Communication/Transparency
 Messages from the Director
 Director’s Blog/Director’s Corner
– Accountability
 Performance management (SES, CC, PMAP)
 Evaluation/measurement/outcomes
– Inclusiveness – I/T/U
 Conferring with Urban Indian Organizations
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Summary
• We are working to change and improve the IHS
through our reform efforts.
• The Affordable Care Act (and reauthorization of the
IHCIA) will help Tribes and the IHS provide better care
to American Indian and Alaska Native people.
• Help us continue to change and improve the IHS.
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