A Renewed Era of Federal-Tribal Relations: White House released a report outlining some of the successes of this Administration while working on behalf of Tribes
Today, the White House is releasing a report outlining some of the successes of this Administration while working on behalf of Tribes. The report sets a baseline of progress for Tribal Nations to reference in their ongoing work with the federal government, and outlines the priorities that the White House Council on Native American Affairs (WHCNAA) will continue to work on based on Tribal leaders’ recommendations.
While the Administration and Tribes have partnered for historic achievements, there is still much more to do. President Obama signed Executive Order 13647 on June 26, 2013, establishing the WHCNAA, which represents a path to a more effective federal government for Indian Country, bringing together federal Departments and Agencies from across the Executive Branch to “break down siloes” and coordinate for more effective programs.
As demonstrated over the past eight years, when Tribal Nations and the federal government work together in a true spirit of nation-to-nation cooperation, momentous progress can be achieved.
Read the full report HERE.
Karen Diver is the Special Assistant to the President for Native American Affairs in the White House Domestic Policy Council
U.S. Senators John Hoeven (R-N.D.) and Tom Udall (D-N.M.) today issued the following statements after being elected Chairman and Vice Chairman of the Senate Committee on Indian Affairs for the 115th Congress.
“I am honored to serve as the Chairman of the Senate Committee on Indian Affairs and look forward to working with Vice Chairman Udall and members of the Committee to pass legislation that helps improve the lives of people across Indian Country. In our roles, we will address the issues of job creation, natural resource management, health care, education, public safety and housing in Indian communities,” said Chairman Hoeven. “We will also make it a priority to promote economic growth. Jobs and economic growth are the priorities that will help Indian families, communities and businesses succeed.”
“I am enormously honored to become the Vice Chairman of the Senate Committee on Indian Affairs, a role that will strengthen my ability to fight for and defend the sovereignty of New Mexico’s 23 tribes and all Native American communities,” said Vice Chairman Udall. “With the Indian Affairs Committee’s proud tradition of bipartisan cooperation in mind, I am very much looking forward to working with Chairman Hoeven and all our committee members to help secure progress for Indian Country. Throughout my career, I have been committed to working alongside tribes to uphold our trust responsibility. The U.S. Senate has a duty to support tribal communities in their work to build sustainable economies and good schools, provide quality health care, maintain access to clean air and water, and protect the deep Native American connection to culture and tradition. Native Americans have faced, and continue to face, great challenges and injustices – and while we have made progress, it is abundantly clear that we have much work to do to improve government-to-government consultation with tribes and to ensure environmental justice. I am proud of my long record as a strong defender of Native American rights, and this new position will enable me to work more closely with tribal communities in New Mexico and across our nation.”
“I want to congratulate Chairman Hoeven and Vice Chairman Udall on their elections,” said former committee Chairman John Barrasso. “I look forward to working closely with them both, and with all the committee members, to pass legislation that will empower tribal communities and will strengthen the government-to-government relationship the United States shares with tribes.”
“I look forward to working with Chairman Hoeven and Vice Chairman Udall to ensure that our nation’s trust and treaty responsibilities are upheld across all of Indian Country,” said former committee Vice Chairman Jon Tester. “I am confident that during this session of Congress the Senate Indian Affairs Committee will continue its long history of working across the aisle to promote tribal sovereignty and strengthen economic opportunities, health care and education for all Native American and Alaska Native families.”
The National Indian Health Board (NIHB) convened over 170 Tribal leaders from across the nation to establish united Indian health priorities for the new Congress and Administration at the Native Health Presidential Transition Summit on Thursday, December 8 in Washington, DC.
The all-day event consisted of bipartisan engagement with Members of Congress, including long-time Republican Indian health advocate, Representative Tom Cole (R-OK), as well as Vice Chairman and previous Chairman of the Senate Committee on Indian Affairs, Senator Jon Tester (D-MT). The Summit also featured discussion-based sessions with policy experts and Tribal leaders on the American Indian and Alaska Native priorities for the Trump Administration to advance Indian health.
For more information, click on this link.
The Indian Health Service (IHS) and the Health Resources and Services Administration (HRSA) recently announced that 27 additional IHS and tribal hospitals are eligible for selection by health care providers in both their outpatient and inpatient settings under the National Health Service Corps (NHSC) program. This announcement means recruitment opportunities at NHSC-approved outpatient care sites including health care facilities that provide ambulatory and primary health services in urban and rural communities with limited access to health care.
“This announcement puts IHS on par with critical access hospitals for the first time and expands the resources of the NHSC to tribally-operated hospitals,” said IHS Principal Deputy Director Mary L. Smith. “Recruiting and retaining qualified health care providers at rural hospitals, including IHS facilities, is a major challenge. Programs such as the National Health Service Corps help us attract talented doctors, dentists, behavioral health providers, nurse practitioners and other health professionals to serve our patients.”
This expands the current list of 12 IHS and tribal hospitals that participate as eligible inpatient and outpatient sites for NHSC member clinicians through the Critical Access Hospital designation. The participating hospitals can utilize this expansion to provide enhanced staffing throughout their hospital service delivery system. Strengthening and growing the primary care workforce at IHS and tribal facilities is a priority and this expansion will allow qualified health care providers to serve at additional hospitals and assist in recruiting and retaining these providers beyond their two-year commitment.
The NHSC helps bring health care to those who need it most by awarding scholarships and loan repayment to primary care clinicians who commit to serving for at least two years at an approved site located in a Health Professional Shortage Area. Health Professional Shortage Areas are designated by HRSA as having shortages of primary care, dental care or mental health providers and may be geographic (a county or service area), population (e.g., low income or Medicaid eligible) or facilities (e.g., federally qualified health centers, or state or federal prisons).
There are more than 10,400 NHSC professionals throughout the U.S., some of whom commit to fulfilling their service at IHS sites such as the Northern Navajo Medical Center in Shiprock, New Mexico. The site serves as the only medical center in its area and having the NHSC-eligible designation has allowed it to recruit and retain providers who may not have considered rural locations previously. With the expansion of the site’s eligibility extended to its inpatient setting, opportunities to increase the number of NHSC member clinicians will continue to bring quality health care to this underserved area. Current NHSC-site vacancies are also listed on the NHSC site .
List of 27 IHS and Tribal Hospitals that will be added:
- Acoma-Canoncito-Laguna Hospital
- Blackfeet Community Hospital
- Chinle Comprehensive Health Care Facility
- Claremore Indian Hospital
- Crownpoint Health Care Facility
- Eagle Butte Indian Hospital
- Fort Yates PHS Indian Hospital
- Gallup Indian Medical Center
- Lawton Indian Hospital
- Mescalero Indian Hospital
- Northern Navajo Medical Center
- Omaha-Winnebago PHS Indian Hospital
- Phoenix Indian Medical Center
- Pine Ridge Indian Hospital
- Quentin N. Burdick Memorial Hospital
- Redlake Hospital
- Rosebud Indian Hospital
- Santa Fe Hospital
- Sioux San PHS Indian Hospital
- Sells Indian Hospital
- Whiteriver Indian Hospital
- Zuni IHS Hospital
- Alaska Native Medical Center
- Mt. Edgecumbe Hospital
- San Carlos Apache Healthcare Corporation
- Tsehootsooi Medical Center
- Tuba City Regional Health Care
IHS Hospitals will become eligible sites for new NHSC awardees when the 2017 NHSC Loan Repayment Application and Program Guidance is released in early 2017. Information on eligibility and application deadlines is available at https://www.hrsa.gov/loanscholarships/hrsaapplicationbulletin.pdf [PDF]
The last walls have been built and the final touches are being prepared for the six-story, 202-room patient housing facility to welcome its first guests in January 2017. Earlier this month, ANTHC obtained the certificate of occupancy from the Municipality of Anchorage, which has allowed ANTHC staff to begin filling the guest rooms with the amenities that will truly make it a home away from home for the 60 percent of ANMC patients that travel to Anchorage for their care.
The facility is currently being provisioned, including bedding and linens, coffee cups, rocking chairs for family rooms, appliances for communal kitchens and “wiggle walls” – 90-inch interactive video screens that can recognize the movements of children, installed in play areas on the first and sixth floors.
“We are especially excited for the amenities designed for families and kids, since these are not typically found in the lodging where our people would stay before,” said Phil Degnan, ANTHC’s Housing General Manager. “These family-friendly spaces will provide moments of fun during their health treatment.”
In addition to the final furnishings, new ANTHC staff for the patient housing facility have started training. These staff include the general manager, assistant general manager, front desk supervisors and agents, security officers, facilities supervisor and maintenance technicians. Housekeeping and cafeteria operations will be managed by contract with NANA Management Services, which also operates the ANMC Cafeteria.
The final construction to connect the sky bridge from the patient housing facility to the north side of ANMC hospital began this week and will open Jan. 2.
Since the project broke ground in May 2015, it has been exciting to see the patient housing facility rise on the Alaska Native Health Campus and we commend the ANTHC Strategic Access staff that have seen the project through since it was an idea in a boardroom.
For more information about the project, visit http://anmc.org/new-anmc-patient-housing/.
The curriculum for Alaska’s Dental Health Aide Therapist (DHAT) program was recently approved by the Northwest Commission on Colleges and Universities, through ANTHC’s partnership with Iḷisaġvik College in Barrow. This newly accredited degree program offers DHAT students the opportunity to earn an Associate of Applied Science (AAS) degree.
In addition to the two-year AAS degree, which helps create broader career pathways for DHAT graduates, Iḷisaġvik will award a DHAT certificate upon completion of the first year of study. The program will still operate out of the existing instructional sites in Anchorage and Bethel, but will now benefit from the institutional support available through Iḷisaġvik. During their course of study, DHAT students have access to the full range of student services at the Tribal college, including financial aid, scholarship resources, academic support and tutoring.
The process to accredit the DHAT program began last year when ANTHC and Iḷisaġvik staff collaborated on the project by outlining shared program goals. The partnership was formally announced at the DHAT graduation ceremony in June. DHAT students who started in July are enrolled in the first cohort of students in the Iḷisaġvik degree program.
“We are happy about this partnership with the DHAT program, as it is uniquely suited to meet health care needs of rural Alaska as well as provide access to education for students in rural communities,” said Dr. Birgit Meany, Iḷisaġvik College Dean of Academic Affairs.
DHATs make important contributions to the oral health and well-being of Alaska Native people in rural areas of our state through culturally appropriate dental education and routine dental services within the scope of their training. This model of dental care increases preventative care necessary for the reduction of cavities and other dental issues that lead to oral diseases.
Since 2004, these mid-level providers have expanded much-needed access to dental care and prevention services for more than 40,000 Alaska Native people living in 81 rural Alaska communities.
For more information about the DHAT program, visit http://anthc.org/dental-health-aide/.
When Gov. Walker expanded Medicaid in Alaska last year, there was also a push to reform the program to better meet the health needs of those being served.
Representatives of the Alaska Tribal Health System (ATHS) have been key partners with the Alaska Department of Health and Social Services (DHSS) to jointly develop a package of Tribal Medicaid Reform recommendations that both improve the quality of care and create efficiencies in costs of the program. The recommendations are driven by a need to provide Alaska Native people access to the highest quality health care possible in their own community. When a higher level of care is necessary, it will be coordinated and made readily available through the ATHS. This will allow all health care to be provided by or through the ATHS, meaning patient care will be culturally appropriate and address the needs of our people.
Our work on Medicaid reform in the Tribal health system will address the unique health needs of our people and help the State support its recent Medicaid expansion to sustain basic Medicaid services for all recipients especially in these difficult budget times.
The ATHS and DHSS Tribal Medicaid reform recommendations include the following:
- For medically necessary travel, Tribal organizations will be able to arrange non-emergency transportation services to improve the patient experience and create efficiencies.
- Alaska Native patients needing overnight accommodations to receive care will have patient-friendly and culturally appropriate lodging operated by the ATHS and reimbursed by Medicaid at the appropriate federal per diem rate.
- An expanded role and more appropriate reimbursement rates for Community Health Aides and other certified Tribal community health providers to furnish services to Alaska Native people in their home communities earlier and more effectively, and ultimately at a reduced cost.
- Behavioral health services available in more villages and Tribal Clinics, including at-risk children, as well as more integration with other health services.
In the coming months, we will continue to work with the State of Alaska to seek Centers for Medicare & Medicaid Services (CMS) approval of the proposed Medicaid State Plan Amendments to implement these innovative, flexible, and culturally appropriate solutions to Medicaid care in the ATHS.
For more information on the recommended initiatives or the Medicaid reform work, contact Jim Roberts with ANTHC’s Intergovernmental Affairs department at email@example.com.
Heitkamp, Murkowski Bill to Stand up for Native Children Unanimously Passes in U.S. House of Representatives
FOR IMMEDIATE RELEASE
Tuesday, September 13, 2016
Julia Krieger (Heitkamp) – (202) 224-8898
Karina Petersen (Murkowski) – (202) 224-9301
Heitkamp, Murkowski Bill to Stand up for Native Children Unanimously Passes in U.S. House of Representatives
Senators’ Bill Continues to Gain Momentum after Unanimously Passing in Senate Last Year, and in U.S. House of Representatives Committee in July
WASHINGTON, D.C. – U.S. Senators Heidi Heitkamp (D-ND) and Lisa Murkowski (R-AK) today announced that their bipartisan bill to improve the lives of Native American children unanimously passed in the U.S. House of Representatives – bringing their legislation one step closer to reaching the president’s desk for his signature. Their bill passed in the U.S. Senate last year.
In July, Heitkamp and Murkowski’s bill unanimously passed in the U.S. House Committee on Natural Resources. The vote followed Heitkamp’s testimony before the Committee in May about the urgent need to pass their bill to implement solutions that would address the overwhelming obstacles Native children face – including experiencing levels of post-traumatic stress similar to newly returning veterans from Iraq and Afghanistan dramatically increased risks of suicide, and lower high school graduation rates than any racial or ethnic demographic in the country. Heitkamp and Murkowski’s bill would work to address these and other challenges to promote better outcomes for Native youth.
Specifically, Heitkamp and Murkowski’s bill would create aCommission on Native Children to identify the complex challenges facing Native children in North Dakota, Alaska, and across the United States by conducting an intensive study on these issues – including high rates of poverty, staggering unemployment, child abuse, domestic violence, crime, substance abuse, and dire economic opportunities – and making recommendations on how to make sure Native children get the protections, as well as economic and educational tools they need to thrive.
“Every day, children across Indian Country wake up with the odds stacked against them – but the U.S. Congress spoke with one resounding voice to change that,” said Heitkamp. “For generations, young people living on tribal lands have been exposed to some of the most insurmountable barriers to their success – from living in dilapidated homes, to experiencing abuse and severe lack of educational and economic opportunity. Our Native youth have had much to overcome without much help from the federal government. But by unanimously passing our bipartisan bill, the U.S. House of Representatives and U.S. Senate have united to change course – and to help light a better path for our Native young people. It’s been my priority since before I came to the Senate to work to urgently improve outcomes for our Native youth – that’s why this legislation was the first I introduced as a U.S. Senator. I’ll keep fighting to make sure our Native young people are heard, and given the opportunities that every American child deserves.”
“I can cite many examples of young Native people who are living healthy lives and doing great things for their people. Yet far too have found themselves in a world of despair,” said Murkowski. “There is an urgent need for a broad range of stakeholders to come to the table and formulate plans to give every young Native person a fighting chance at a productive life. This ‘high energy’ commission, established in memory of the late Dr. Walter Soboleff, a treasured Alaska Native elder and culture bearer and a champion for Native youth moves the needle in a new and badly needed direction.”
The Alyce Spotted Bear and Walter Soboleff Commission on Native Children, named for the former Chairwoman of Mandan, Hidatsa & Arikara Nation in North Dakota, and Alaska Native Elder and statesman, respectively, has gained widespread praise by a cross-section of tribal leaders and organizations from North Dakota, Alaska, and around the country. It has been lauded by former Chairman of the Senate Committee on Indian Affairs Byron Dorgan, the National Congress of American Indians, and the National Indian Education Association, among others.
Conditions for young people in Indian Country are tragic. For example:
- More than one in threeAmerican Indian and Alaska Native children live in poverty.
- Suicide rates for Native children ages 15-24 years old are 2.5 times the national averageand is the second-leading cause of death in that age group.
- While the overall rate of child mortality in the U.S. has decreased since 2000, the rate for Native children hasincreased 15 percent.
- At 67 percent, American Indian and Alaska Native students had the lowest four year high school graduation rate of any racial or ethnic groupin the 2011-2012 school year.
- 60 percent of American Indian schoolsdo not have adequate high-speed internet or digital technology to meet the requirements of college and career ready standards.
Tribal governments face numerous obstacles in responding to the needs of Native children. Existing programmatic rules and the volume of resources required to access grant opportunities stymie efforts of tribes to tackle these issues. At the same time, federal agencies lack clear guidance about the direction that should be taken to best address the needs of Native children to fulfill our trust responsibility to tribal nations.
To help reverse these impacts, the Commission on Native Children would conduct a comprehensive study on the programs, grants, and supports available for Native children, both at government agencies and on the ground in Native communities, with the goal of developing a sustainable system that delivers wrap-around services to Native children. Then, the 11-member Commission would issue a report to address a series of challenges currently facing Native children. A Native Children Subcommittee would also provide advice to the Commission. The Commission’s report would address how to achieve:
- Better Use of Existing Resources– The Commission will identify ways to streamline current federal, state, and local programs to be more effective and give tribes greater flexibility to devise programs for their communities in the spirit of self-determination and allow government agencies to redirect resources to the areas of most need.
- Increased Coordination– The Commission will seek to improve coordination of existing programs benefitting Native children. The federal government houses programs across numerous different agencies, yet these programs too often do not work together.
- Measurable Outcomes– The Commission will recommend measures to determine the wellbeing of Native children, and use these measurements to propose short-term, mid-term, and long-term national policy goals.
- Stronger Data– The Commission will seek to develop better data collection methods. Too often Native children are left out of the conversation because existing data collection, reporting, and analysis practices exclude them.
- Stronger Private Sector Partnerships– The Commission will seek to identify obstacles to public-private partnerships in Native communities.
- Implementation of Best Practices– The Commission will identify and highlight successful models that can be adopted in Native communities.
For a summary of the bill, click here. For quotations from the five Native American tribes in North Dakota, as well as Senator Byron Dorgan, strongly supporting the bill click here, and for quotations from national supporters, click here.
President Barack Obama and his administration have a couple of announcements for tribal leaders or representatives looking to attend the 2016 White House Tribal Nations Conference on September 27. Deadline for registering to attend has been extended and meetings with the White House Council on Native American Affairs have been added.
For any tribal leader looking to attend the eighth and final conference, they have until Wednesday, September 14 to register here. The conference will be held at the Andrew W. Mellon Auditorium, 1301 Constitution Ave. NW, Washington, D.C., with President Obama, cabinet members and senior administration officials scheduled to attend.
Over the first seven years of Obama’s run as Commander and Chief, he’s established the Tribal Nations Conference as an opportunity to strengthen the nation-to-nation relationship while addressing and celebrating accomplishments and progress being made throughout Indian country.
Following the Monday conference, there will be meetings throughout the day Tuesday, September 27, at the U.S. Department of the Interior, that the White House Council on Native American Affairs will host for tribal leaders. These meetings will address an array of topics, including policies, health, economic development and infrastructure, education and energy development.
This week, the U.S. Department of Agriculture-Rural Development (USDA-RD) announced several grants and loan funding for rural Alaska communities and organizations to address rural sanitation issues. ANTHC is among the grantees, as well as many of our Tribal health partners, which total $27 million in USDA-RD Water and Environmental Programs funding.
The funding ANTHC received will support sanitation projects in Adak, Akiak, Chignik, Eek, Golovin, Hydaburg, Kasaan, Kiana, Kivalina, New Stuyahok, Oscarville, Port Graham, Saxman, Teller, Toksook Bay and Twin Hills. Funding will also be used for technical assistance and training for communities across the state. Projects include planning and assessment for first time water service, necessary water service upgrades and energy efficiency upgrades.
The USDA-RD funding recognizes the incredible impact that access to water and sewer facilities can have on the health of our communities and the health of our people. ANTHC’s Environmental Health and Engineering staff have worked with numerous communities and Tribal partners to find solutions that bring these basic sanitation services that reduce the incidence of respiratory and skin conditions in children.
For more information, see the USDA-RD press release: USDA Awards $27 Million in Water and Environmental Program Funding to Alaska.