Tribes unite at national health care conference<br>

ALBUQUERQUE, N.M. – Indian Health Services director Dr. Charles Grim and other top officials, met with hundreds of tribal health care leaders from across the country for three days during the second annual Direct Service Tribes conference held here.

Some 400 attendees received updates about health issues, health care funding, legislation, the reauthorization of the Indian Healthcare Improvement Act effort, and even a recent ruling by the U.S Supreme that impacts funding for tribes regarding contract support cost.

Over 45 people from area health boards, Navajo Division of Health staff, and P.L. 638 health care corporations from the Navajo area attended the conference.

But the conference highlight, participants say, was the signing of a charter by Grim – while tribal leaders looked on – that creates an advisory committee for tribes who have opted to continue receiving their primary health care from the IHS – known as the Direct Service tribes.

“The signing of this charter was a long time coming,” Carole Ann Heart, co-chairwoman of the conference planning committee, told Grim. “Now, the voice of the direct services tribes will be heard at the table.”

Upon becoming director, Grim said that he was approached by a number of tribes to which IHS still provides services.

“They didn’t feel they had an adequate communication methodology with me and my senior leadership to raise issues of concern for programs that serve tribes still managed by the federal government,” Dr. Grim said. “That is how this all started. We had meetings and after that they wanted to be more formally recognized.”

Grim said they have created a senior position that will work exclusively with Direct Service tribes.

“Now they will have a single point of contact at a high-level in the organization to make sure things get done,” he said.

Navajo leaders also praised the signing. Navajo Nation Vice President Frank Dayish Jr. thanked Grim for signing the charter.

“I am reminded by Dr. Grim’s statement that IHS is obligated to provide health care services to Indian tribes,” Dayish said.

“The signing of the Direct Services Tribe’s charter is not only historical, but places us at the same table as that of the National Congress of American Indians, the National Indian Health Board, Self-Governance tribes, and others,” said Navajo Councilwoman Alice Benally, a member of the planning committee.

Tribes who sign P.L. 638 contracts or compacts with the government already have an office within the IHS, said Anslem Roanhorse Jr., Navajo Division of Health executive director

“This should have been done along time ago,” Roanhorse said. “In time, Navajo could go completely 638, but for now we still have most of our direct services still being provided by IHS. Nationally, nine out of 12 area offices still serve as primary care provider for respective Indian tribes.”

Some of the topics and speakers were also very good, said Emmett Temple Jr, tribal health director for the Standing Rock Sioux tribe. “Like Methamphetamine and how unprepared we are. There were also good discussions about behavioral health.”

Winslow Indian Health Care Corporation chief executive Sally Pete said, “The conference was well-organized. I am from a (P.L.) 638 organization, but I’m here because I’m interested in some of the presentations,” she said. “This is a good learning experience.”

Pete said she also wanted to meet with some of the people from IHS headquarters in Rockville, Md.

“This is really for direct service tribes, but it is helpful for everyone involved in health care,” Pete said.

Roanhorse said he was “impressed” with the turnout.

“This is a forum where tribal leaders, staff, and IHS come together as one group to collectively review their accomplishments, discuss existing and emerging health care concerns and issues affecting all Indian people,” Roanhorse said.

Day one of the conference focused on updates of national health issues, while the second day had workshops and discussion groups on various topics such as contract health, facility construction, and Medicaid/Medicare issues. Day three ended with an update on the reauthorization of the Indian Healthcare Improvement Act (P.L 94-437). Tribes have been seeking reauthorization of the act since 1999. Last year, it appeared the act was going to pass, but at the last minute the Bush administration had problems with certain sections in the act.

“At this point a ‘437’ reauthorization bill has not been re-introduced in Congress. But we were encouraged to hear that a bill could be introduced sometime in May,” Roanhorse said.

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