1 Indian Health Service Update Yvette Roubideaux, M.D., M.P.H. Director, Indian Health Service National Council of Urban Indian Health Annual Leadership Conference April 25, 2012

2 IHS Priorities Renew and strengthen our partnership with Tribes Bring reform to the IHS Improve the quality of and access to care Ensure that our work is transparent, accountable, fair, and inclusive

3 IHS Budget FY 2009 – 7% increase FY 2010 – 13% increase FY 2011 – 0.4% increase ($17 million) FY 2012 – 5.8% increase ($237 million) – $4.3 billion overall budget

4 IHS Budget FY 2013 proposed budget has an increase of $116 million (2.7%): – Total budget authority = $4.42 billion. This includes :  CHS funding increase of $54 million  An increase of $49 million to support staffing and operating costs for six new and expanded health facilities  $81 million total for health care facility construction  $1.7 million increase for facility maintenance and improvement  CSC funding increase of $5 million  An additional $6 million for IHS Health IT FY 2014 – Area budget formulation and national budget sessions completed – Tribes proposed 22% increase at HHS Tribal Budget Consultation; included $1.6 million increase for UIHP. – Urban Indian Health Needs Assessment

5 Renew and Strengthen our Partnership with Tribes/Urban Indian organizations – IHS Tribal Consultation Policy – Urban Confer Policy IHS Priorities

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8 Renew and Strengthen our Partnership with Tribes – Current/recent consultations  How to improve the tribal consultation process  How to improve the CHS Program  Priorities for health reform/IHCIA implementation  Budget formulation  IT Shares  Evaluation of the 2007 CSC Policy  Federal Advisory Committee Act  How to improve the IHCIF – data/formula  TEC Data Sharing Agreement  Long-Term Care  VA reimbursement of IHS for services to eligible veterans IHS Priorities 8

9 Bring Reform to the IHS ─Affordable Care Act ─Internal IHS Reform

10 Affordable Care Act Impact of the Affordable Care Act for AI/ANs –Can still use IHS – permanent IHCIA reauthorization –Greater access to health insurance with more coverage and choices, –Increased services at Indian health facilities due to increased reimbursements. Repeal Efforts - Affordable Care Act –Supreme Court Case – decision expected by June 10

11 Implementation HHS lead on ACA; IHS lead on IHCIA Tribal consultation –White House/HHS outreach calls/Meetings –Tribal leader letters Education and outreach – –IHS Director’s blog – –NCAI/NIHB/NCUIH 11

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14 IHS Priorities Bring Reform to the IHS –IHS Staff Priorities  Improve how we do business and how we lead and manage people:  Consistency in business practices  Improving budget planning and financial  Human Resources  Performance management  Senate Committee on Indian Affairs/Area Reviews

IHS Priorities Improve the quality of and access to care –Customer Service –Improving Patient Care Initiative –Accreditation/Certification 15

IHS Priorities Improve the quality of and access to care –Special Diabetes Program for Indians –Healthy Weight for Life initiative 

IHS Priorities Improve the quality of and access to care ̶ Million Hearts Campaign –Partnership for Patients 17

18 IHS Priorities Improve the Quality of and Access to Care –EHR certification of RPMS Meaningful use EHR Incentive payments (Medicare, Medicaid) –ICD-10 Implementation 18

IHS Priorities Ensure that our work is transparent, accountable, fair, and inclusive –Communication/Transparency  Messages from the Director  Director’s Blog/Director’s Corner –Accountability  Performance management (SES, CC, PMAP)  Evaluation/measurement/outcomes –Inclusiveness – I/T/U  Conferring with Urban Indian Organizations 19

20 Summary We are working to change and improve the IHS through our reform efforts. The Affordable Care Act (and reauthorization of the IHCIA) will help Tribes and the IHS provide better care to American Indian and Alaska Native people. Help us continue to change and improve the IHS.