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 firstname.lastname@example.org.
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.
U.S. Senator John Barrasso (R-WY), chairman of the Senate Committee on Indian Affairs, and former vice chair and current member Sen. Lisa Murkowski (R-AK), participated in a robust roundtable discussion focusing on health care issues facing Alaskans and Alaska Natives. The roundtable took place on Friday, August 12th at the Gorsuch Building at the University of Alaska in Anchorage, AK.
The roundtable featured experts from across the state that provided their input and experience on the issues. The participants included:
· Lori Wing-Heier, director of the Alaska Division of Insurance;
· Valerie Davidson, commissioner of the Alaska Department of Health and Human Services;
· Leonard Sorrin, vice president at Premera Blue Cross Blue Shield;
· Dr. Lisa Parady, executive director of the Alaska Superintendents Association;
· Dr. Deena Paramo, superintendent of the Anchorage School District;
· Becky Hultberg, president and CEO of the Alaska State Hospital and Nursing Home Association;
· Roald Helgesen, CEO of the Alaska Native Tribal Health Consortium and hospital administrator;
· Dr. Robert Onders, medical director for the Community Health System Improvement;
· Katherine Gottlieb, president and CEO of the SouthCentral Foundation;
· April Kyle, vice president of behavioral health for the SouthCentral Foundation;
· Jennifer Meyhoff, chair of Legislative Affairs Committee for the Alaska Association of Health Underwriters; and
· Jeff Ranf, former president and current board member for the Alaska Association of Health Underwriters.
The discussion focused on the Affordable Care Act’s employer mandate, rural and telehealth, the Indian Health Service, and specific issues facing Alaska Natives.
Patients will benefit from increased access to health care workers and paraprofessionals
The Community Health Aide Program Certification Board, a federally authorized organization managed by the U.S. government’s Alaska Area Native Health Service in partnership with tribal health organization representatives, certified 171 behavioral health, dental health and community health aides and practitioners during a recent meeting. Of these, 28 were certified for the first time, while 143 were certified at a higher lever or renewed their certification.
“Community health aides are proven partners in health and I am very happy to congratulate the newly certified health aides on their hard work to gain the skills necessary for this achievement,” said Mary L. Smith, IHS principal deputy director. “This program to bring more health workers to Alaska Native communities has proven to be very successful. We are currently consulting with tribal leaders about the possibility of increasing the use of community health aides as part of IHS’s ongoing commitment to provide access to quality health care to Alaska Native and American Indian patients.”
“Community health aides are the back bone of care in remote Alaska and are selected by their communities to receive training,” said Andrew McLaughlin, Community Health Aide Program certification board chair. “The CHAP program is proof that under geographical constraints, the Indian Health Service and tribal programs together accomplish and deliver a higher standard of medical care to underserved and remote populations.”
Community health aides include workers in health education, communicable disease control, maternal and child health, dental health, family planning, environmental health and other fields. There are currently 489 certified health aides or practitioners in Alaska, all of them certified by the Alaska Area Native Health Service. Many community health aides filling jobs in the Native health system come from the local communities and immediate surrounding areas where job opportunities can be limited.
The Community Health Aide Program Certification Board was created in 1998 by the federal government and charged with formalizing the process for maintaining community health aides/practitioners, dental health aides and behavioral health aides/practitioners training and practice standards and policies. As the governing board of the community health aide, dental health aide and behavioral health aide programs, its function is to certify training centers and individual health aides at all levels of training. Members represent the Indian Health Service, state of Alaska, community health aide training centers, community health aide program directors and community health aides.
Examples of health aides across the national Indian health system include:
- A Dental Health Aide Program operated by the Alaska Native Tribal Health Consortium is a community-driven program providing culturally appropriate dental education and routine dental services in 81 Alaska Native communities serving over 40,000 Alaska Native people since 2004: http://anthc.org/dental-health-aide.
- The principal provider of health services at the village level in Alaska is the community health aide/practitioner. Chosen by the village council, the community health aide/practitioner is responsible for giving first aid in emergencies, examining the ill, reporting their symptoms to a physician, carrying out the recommended treatment, instructing the family in giving nursing care and conducting preventive health programs in the villages. Community health aides also store and dispense prescription drugs with physician instructions:http://www.ihs.gov/alaska/includes/themes/newihstheme/display_objects/documents/hf/area.pdf.
- A behavioral health aide is a counselor, health educator and advocate. Behavioral health aides help address individual and community-based behavioral health needs, including those related to alcohol, drug and tobacco abuse as well as mental health problems such as grief, depression, suicide and related issues:http://anthc.org/behavioral-health-aide-program.
As part of ongoing IHS efforts to increase access to quality health care, IHS has proposed a draft policy statement to expand its community health aide program, including exploring administrative requirements for this expansion. This could include the creation of a national certification board for community health aides in the IHS system.
The Alaska Area Native Health Service, one of 12 regional offices of the IHS, works in conjunction with Alaska Native tribes and tribal organizations to provide comprehensive health services to approximately 150,000 Alaska Natives and American Indians. At one time, IHS provided direct medical care services in Alaska. Through the provisions of self-governance, tribes and tribal organizations have assumed operation of all patient care facilities. IHS-funded, tribally-managed hospitals are located in Anchorage, Barrow, Bethel, Dillingham, Kotzebue, Nome and Sitka. There are seven tribally managed hospitals, more than 20 tribal health centers, more than 160 tribal community health aide clinics and five residential substance abuse treatment centers.
The IHS, an agency in the U.S. Department of Health and Human Services, provides a comprehensive health service delivery system for approximately 2.2 million American Indians and Alaska Natives.
Registration is now open for conference attendees and Marketplace exhibitors for the 2016 National Tribal Health Conference (33rd Annual Consumer Conference).
September 19-22, 2016
This annual conference is the premier Indian health event that attracts over 500 Tribal health professionals, elected leaders, advocates, researchers, and community-based service providers. This year’s conference theme, “Achieving and Sustaining Quality Health Care in Indian Country” will provide a framework for robust discussions and training on how to move forward with a quality Indian health system for our next generations.
For more information about the National Tribal Health Conference please click on this link.
We look forward to seeing you in September!
Questions? Contact NIHB at 202-507-4070 or email
IHS Issues Multiple ‘Dear Tribal Leader Letters’ initiating Tribal Consultation on Several Initiatives
On July 29th, the Indian Health Service (IHS) released several ‘Dear Tribal Leader Letters’ updating Tribes on several Tribal consultation opportunities regarding recent policy proposals put forth by IHS.
First, IHS has extended the consultation period for its Tribal Premium Sponsorship Draft Circular. Tribal Premium Sponsorship occurs when a Tribe pays health insurance premiums on behalf of its IHS eligible members. By enrolling members in health insurance, it increases third party revenue to the IHS/Tribal facility which allows them to extend the services that they provide. Tribes have until October 31, 2016 to provide comment on this draft circular. In addition, an in-person Tribal consultation opportunity will be available at NIHB’s National Tribal Health Conference on September 19, 2016.
Second, IHS has extended the consultation period for its Community Health Aide Program (CHAP) draft policy until October 27, 2016. IHS proposes to expand the CHAP program that has been so successful in Alaska to the lower 48 states. NIHB has held several calls on the CHAP program to provide more information to Tribes and assist in the comment making process. Further webinar opportunities are in development and will be shared as soon as we have more information. IHS will have an in-person consultation opportunity for Tribes at NIHB’s National Tribal Health Conference on September 19, 2016.
Third, IHS has confirmed several consultation opportunities for Tribes to engage with IHS on its proposed new Catastrophic Health Emergency Fund (CHEF) policy, including several telephone sessions and an in-person session at NIHB’s National Tribal Health Conference on September 19, 2016.
A summary of the new deadlines and consultation activities is below.
- Tribal Premium Sponsorship Consultation – Tribal Comments Due October 31, 2016
- The 1st consultation session will be held at the National Indian Health Board Annual Consumer Conference in Scottsdale, Arizona, on September 19, 2016, from 11:00 a.m. to 11:50 a.m.
- The second consultation session will be held at the National Congress of American Indians 73rd Annual Convention and Marketplace in Phoenix, Arizona, on October 9, 2016, from 3:45 p.m. to 5:00 p.m.
- Community Health Aide Program (CHAP) – Tribal Comments Due October 27, 2016
- Telephone Tribal Consultation/Urban Confer session Call Date: October 4, 2016 (Tuesday)
Call Time: 3:00 p.m. – 4:30 p.m.
Eastern Call In Number: 1-888-955-8942 Participant Passcode: 9659843
- In Person Tribal Consultation/Urban Confer sessions
National Indian Health Board Consumer Conference on September 19, 2016, from 1:00 p.m. – 2:30 p.m., in
- Scottsdale, Arizona.
National Congress of American Indians 73rd Annual Convention and Marketplace scheduled for October 9, 2016, from 2:15 p.m. – 3:30 p.m. in Phoenix, Arizona.
- Scottsdale, Arizona.
- Catastrophic Health Emergency Fund (CHEF)
Telephone Tribal Consultation Sessions
- Call Date: Tuesday, August 16, 2016
- Call Time: 3:00 p.m. – 4:00 p.m. (Eastern Time)
- Call In Number: (888) 790-3108
- Participant Passcode: 4110567
- Call Time: 1:00 p.m. – 2:00 p.m. (Eastern Time)
- Call In Number: (888) 790-3108
- Participant Passcode: 4110567
- Call Date: Monday, October 24, 2016
In Person Tribal Consultation Sessions
- National Indian Health Board Consumer Conference on September 19, 2016, from 9:00 a.m. – 9:50 a.m., in Scottsdale, Arizona.
- National Congress of American Indians 73rd Annual Convention and Marketplace scheduled for October 9, 2016, from 1:00 p.m. – 2:00 p.m., in Phoenix, Arizona.
For more information, click on this link.
Four groups in Alaska will soon receive federal funding for telemedicine and distance learning projects.
The U.S. Department of Agriculture said Thursday that it will award $23.4 million in grants to such projects across the country, with about $1.4 million of that going to Alaska.
Telemedicine and distance learning services can help “connect rural communities with medical and education experts in other parts of the country” to improve access to health care and educational opportunities, the USDA said in a statement.
The Copper River School District will get $488,558 to provide distance learning services to five primary schools in extremely remote Alaska villages, the USDA said.
The other three groups in the state will use the grants for telemedicine: The Tanana Chiefs Conference will get a $375,000 award to expand its telemedicine program; Anchorage nonprofit Hope Community Resources Inc. will get $279,820 to buy video-conferencing equipment for mental health and disability counseling, training and support services; and Barrow nonprofit Arctic Slope Native Association Ltd. will get $287,198 to buy a tele-pharmacy remote dispensing system. (Right now, medication can only be flown into remote clinics.)
“Using technology for educational opportunities and medical care can provide services that are often unavailable in rural areas,” Agriculture Secretary Tom Vilsack said in a statement.
Jacoline Bergstrom, executive director of health services at the Tanana Chiefs Conference, said the money will be used to upgrade and buy equipment that’s particularly useful in a large swath of the Interior where many of the villages are especially remote.
“Our doctors travel on a regular basis, but sometimes weather is an issue and sometimes planes don’t always make it in,” she said. “That’s another benefit to telemedicine — you can still have a physician engage with a patient.”
The Tanana Chief Conference’s telemedicine services help to connect the village-based clinics with doctors in Fairbanks.
The grants from the USDA will support 45 distance learning and 36 telemedicine projects across the U.S.
Source: Alaska Dispatch News
Published on July 17, 2016
The Alaska Native Tribal Health Consortium is announcing an expansion of service by providing prior authorization and travel coordination for Alaska Native and American Indian Medicaid beneficiaries through the ANMC Travel Management Office by the end of July.
ANTHC is pleased to partner with the State of Alaska in this change to Medicaid travel management that will better serve our people. By elevating ANTHC’s role in coordination and management of Medicaid-approved travel, our intention is to provide a higher level of customer service and create efficiencies in travel.
This new service has been years in the making and is now an important part of the State of Alaska’s Medicaid reform plans. Many patients must travel to Anchorage for their care at ANMC; we hope that our management will be able to better serve our people during their stays.
For our Tribal health partners that have opted in to this service, the most important change will be that if a Medicaid beneficiary’s care is scheduled through ANMC, then the travel will be coordinated through ANMC. At this time, this does not include travel from villages to regional hubs.
Individuals with travel arrangements in progress will continue to work with Xerox and the State travel office through the completion of these scheduled trips. If you have questions regarding existing trips, please contact Xerox at (907) 644-6800, option 5.
ANTHC staff in the Travel Management Office will be available to help guide you through the new process and answer questions you may have. To contact the ANMC Travel Management Office, call 1-866-824-8140 or (907) 729-7720, option 1. You may also email the ANMC Travel Office at email@example.com.
For more information, visit http://anmc.org/patients-visitors/travel-lodging/#tmo.