Council gives green light for IHS <br>negotiations

By Janel States James

The Observer

On January 25, the Navajo Nation Council passed a resolution allowing the Navajo Health Care System Corporation (NHCS) to begin negotiations with Indian Health Services.

The move is the next step in the Navajo Nation’s bid to take over the Nation’s health care services from the IHS under the Indian Self Determination Act (ISDA), P.L. 93-638.

“By passing this resolution, the Navajo Nation Council has authorized the Navajo Health Care System Corporation to officially submit a proposed ‘638’ application to the Indian Health Service,” said NHCS Chief Executive Officer, Lydia Hubbard-Pourier. “It is not the final approval of a’638’ contract.”

The Council approved the resolution 47-31-0 after hearing presentations from both the Corporation and a representative of the “638 Doo’ Da” group. In an effort to address the concerns of both sides, the Council passed the resolution, but only on the condition that the application will come back before the full council for final approval when negotiations with the IHS are complete.

Speaker Edward T. Begay said he was pleased with the Council’s approval of the ISDA contract. Begay said in a Navajo Nation press release that he was aware that the funding received by the NAIHS addresses only about 67 percent of the Navajo Nation’s total health care needs. In addition, he pointed out, “The Navajo people receive about $1,400 per year for healthcare while the United States average is at about $3,200 per year.”

Members of the NHCSC believe that assumption of services from the IHS will help rectify this problem. Others, however, are concerned that the Navajo people have not been given enough say in the process. Some delegates also expressed concern that not all of the Navajo people were made aware of the proposed 638 contract.

According to Hondo Louis, Public Information Officer for the Corporation, a member of the opposition group stated before the council that planning has gone forward without the input and without the blessing of the people and should be put to referendum. While Delegate Wallace Charley (Shiprock) proposed an amendment calling for such a referendum vote, the measure was voted down.

Louis said that the Council felt that, historically, referendum votes can be problematic and very costly—a quarter of a million dollars. Nonetheless, said Louis, the Council recognized that this is a pressing and complicated issue and the people must be informed.

Hubbard-Pourier said that “the Board is aware and sensitive to the many questions and concerns from interested parties,” and indicated that the Corporation’s public education efforts, which have been taking place on the chapter level, will continue to address these concerns.

“We give the people accurate and up-to-date information and we are very clear on what is fact and what is recommendation,” said Louis. “The Corporation is willing to talk to any and all groups who have an interest in the ways to improve health care.”

With respect to employment concerns, the Board stated that it has made decisions to assure employee security and equal or better salaries and benefits.

The NHCSC will now take the resolution to the IHS. Said Louis, “Once the resolution is on their doorstep, we have 90 days for negotiations.”

Teams from the Navajo Nation and the Navajo Area Indian Health service will conduct the negotiations, discussing what the Navajo Nation will or will not contract. In essence, said Louis, the Corporation wishes to contract for all direct health care services and functions, and their related administrative services. Services under the Navajo Tribal Utility Authority and Navajo Engineering Construction Authority are likely to remain under federal control, he said, adding that “At some point, they may decide to contract on their own.”

Should the Council approve the contract once negotiations with the IHS are complete, “people in the system will do as they’ve always done,” said Louis. “There will be no big, re-design within two years. Everything will slide over to the new system gradually.”

Louis also said that assumption of the health care system will in no way change the federal government’s trust responsibility to the Navajo Nation. The government will still provide Congressional funds for health care, but the Corporation will decide how the money should be used, giving health care facilities more local control. “The trust responsibility will always be there,” said Louis. “It will just be manifested differently.”