1. 1 Indian Health Service Update Yvette Roubideaux, M.D., M.P.H. Director, Indian Health Service Special Diabetes Program for Indians Diabetes Prevention and Healthy Heart Initiatives November 16, 2010

2. 2 IHS Priorities Renew and strengthen our partnership with Tribes In the context of national health insurance reform, bring reform to the IHS Improve the quality of and access to care Ensure that our work is transparent, accountable, fair, and inclusive

3. 3 Renew and Strengthen our Partnership with Tribes – The only way we are going to improve the health of our communities is to work in partnership with them – IHS cannot do its work in isolation – we must work together with our communities – Tribal consultation is a priority IHS Priorities

4. 4 Renew and Strengthen our Partnership with Tribes – Current consultations in progress  How to improve the tribal consultation process  How to improve the Contract Health Services (CHS) program  Priorities for health reform/Indian Health Care Improvement Act (IHCIA) implementation  FY 2012 Budget  Other topics for upcoming consultations  Indian Healthcare Improvement Fund (IHCIF), facilities construction, improving quality, VA, Long Term Care IHS Priorities

5. 5

6. 6

7. 7

8. 8 Renew and Strengthen our Partnership with Tribes – Current consultations in progress  Area listening sessions: 11 Areas so far  Tribal delegation meetings: more than 270

15. 15 IHS Priorities In the context of National Health Reform, to bring reform to IHS ─National Health Reform ─Internal IHS Reform

16. 16 Affordable Care Act Signed into law March 23, 2010 Goals –Increase access to affordable health care –Security and stability for those with insurance –Reduce healthcare costs Reauthorization of the Indian Health Care Improvement Act –Permanent reauthorization –New and expanded authorities; modernizes and updates IHS Impact –American Indian and Alaska Native individuals –Tribes –I/T/U facilities Implementation; consultation –FEHB; State Exchanges; Self-implementing provisions, VA –NIHB/NCAI/NCUIH – tribal outreach/education

17. 17

18. 18 IHS Priorities In the context of national health care reform, to bring reform to IHS –Internal IHS reform  Need to demonstrate change and improvement  Gathered a wide range of input  Priorities for change  Aberdeen Area SCIA investigation

19. 19 IHS Priorities … Bring Reform to IHS – Tribal Priorities  More funding; review allocation formulas  Improve Contract Health Service program  Improve consultation process

20. 20 IHS Priorities …. Bring Reform to IHS –IHS Staff Priorities  Improve how we do business and how we lead and manage people  Improving budget planning and financial management  Consistency in business practices  Hiring process – more efficient and proactive; reduced time

21. 21 IHS Priorities …. Bring Reform to IHS –IHS Staff Priorities  Improve how we do business and how we lead and manage people  SCIA investigation – immediate actions to address  In Aberdeen Area and system-wide

22. 22 IHS Priorities …. Bring Reform to IHS –IHS Staff Priorities  Improve how we do business and how we lead and manage people:  Management Practices »Priorities – Customer service, ethics, performance management, professionalism, program integrity »Performance plans FY 2010 – more focused on priorities  Focus on patient; become first choice for healthcare

23. 23 IHS Priorities Improve the Quality of and Access to Care –Upcoming Reform Activities:  Customer Service  Improving Patient Care – “medical home”  Special Diabetes Program for Indians  Diabetes Prevention and Healthy Heart Demonstration Projects – successful results from 5-year project  Reduced risk factors in people at risk for diabetes and heart disease  Collaborations with other agencies

30. 30 IHS Priorities Ensure Our Work is Transparent, Accountable, Fair, and Inclusive – Transparency/Communication:  Meetings, interviews, outreach  Messages from the Director; DTLL  Director’s Corner; Director’s Blog  Teamwork – Accountability/Fairness:  Program, staff evaluation/performance  Inclusiveness  Decisions must include consideration for all patients served by IHS, tribal, or urban Indian health programs

33. 33 Accomplishments Increased funding –FY 2010 – 13 percent increase – largest in over 20 years $100 million increase in Contract Health Services funding Means a 13-30 percent increase in IHS Areas –CHEF funds – instead of running out in June, made it to August –FY 2011 President’s budget – 9 percent increase Congressional action pending –ARRA funding - $590 million Health facilities construction, sanitation facilities construction, maintenance and improvement, equipment, HIT Progress on IHS reform –Ongoing

36. 36 Summary We are continuing to make progress on our priorities as we reform the IHS We are implementing specific activities to change and improve IHS We need your help and guidance as we change and improve the IHS. We must take advantage of support we have now to make as much progress as possible in our IHS reform activities Tribal consultation and partnership is essential