Navajo lawmakers consider health division overhaul

FLAGSTAFF - Naabik'iyátí' Committee members met with the Navajo Division of Health, Vice President Rex Lee Jim, and health providers from across the Navajo Nation Jan. 3 to discuss the proposed Navajo Department of Health Act of 2013, which aims to rename the Nation's current Division of Health and to consolidate certain responsibilities and authorities under the proposed department.

According to the proposed Health Act, health care, public health programs and activities including monitoring, evaluation, regulatory, enforcement, and coordinating functions "should be placed within the Navajo Department of Health to appropriately meet the public health needs of the Navajo Nation and the Navajo people."

On Jan. 6, legislation sponsor Council Delegate Dwight Witherspoon (Black Mesa, Forest Lake, Hardrock, Pinon, Whippoorwill) reiterated the need for the proposed Department of Health.

"The establishment of an entity to which will be given responsibilities to address health care across all of the Navajo Nation is very much needed, because no entity currently has the responsibility to monitor, evaluate, regulate and protect Diné citizens regarding quality and culturally appropriate health care," Witherspoon said.

The Law and Order Committee and the Health, Education, and Human Services Committee both previously voted down the legislation. On Dec. 5, the Naabik'iyátí' Committee voted 11-0 to table the legislation, which included a directive to conduct a work session to address the bill.

The majority of discussion on Jan. 3 centered on the potential impact on "638 programs" currently operating on or near the Navajo Nation, including the Navajo Utah Health System, Inc. which is a non-profit health care system that operates four health care facilities in Navajo Mountain, Monument Valley, Montezuma Creek and Blanding because of an agreement with the federal government.

Navajo Utah Health System, Inc. CEO Donna Singer and board member Robert Whitehorse expressed skepticism over certain parts of the legislation that they say may cause delays in submitting grant proposals and may interfere with funding received through "638 contracts."

638 programs are defined under Public Law 93-638, the Indian Self-Determination and Education Assistance Act of 1975, which authorizes the U.S. Secretaries of the Interior, Health, Education, and other government agencies to enter into contracts with federally recognized tribes to allow tribes to administer funds, giving them greater control over their welfare.

Council Delegate Jonathan Nez (Shonto, Navajo Mountain, Oljato, Ts'ah Bii Kin) advocated for the 638 programs. He said such programs should be exempt from the proposed law if they choose to do so.

"These local health care facilities throughout Navajo have the ability to run their own and be self-sufficient based on self-determination and we've supported that before," said Nez. "We supported regionalization/decentralization to bring services closer to the people, but this legislation before us is kind of going backwards now."

Council Delegate Leonard Tsosie (Baca/Prewitt, Casamero Lake, Counselor, Littlewater, Ojo Encino, Pueblo Pintado, Torreon, Whitehorse Lake) spoke in support of the legislation.

"I support Navajo sovereignty and I think we should pass this, but with amendments," Tsosie said, prior to offering a number of recommendations to amend the current bill.

Tsosie later suggested that Witherspoon withdraw the legislation, and that a task force be created to work with all sides to develop a more comprehensive legislation that could be brought to the Council for consideration during its spring session.

Witherspoon indicated that he would not withdraw the legislation immediately and would first seek to amend the current bill, adding that he is open to creating a task force if the task force focuses on amendments that improve the legislation.