Today during a Senate Indian Affairs Committee hearing, Chairwoman Maria Cantwell (D-WA) urged President Obama's Indian Health Service Director nominee, Dr. Yvette Roubideaux, to continue efforts to ensure adequate health care to Tribes across the country.
"One thing has remained constant throughout this long history of Indian health care, and that is that the federal government acknowledges the unique legal responsibilities and moral obligations to provide health care and welfare for Indian people," said Cantwell at today's hearing, examining Roubideaux's nomination. "The position of Director of the Indian Health Service is vital in developing and implementing policies and programs that are necessary to meet the serious health care needs of Native Americans."
On May 7, 2013, with her first term expired, Roubideaux was designated by the President to serve as Acting Director of the Indian Health Service while her re-nomination is being considered by the Senate. If confirmed, Roubideaux would head the primary agency charged with ensuring the physical, mental, social, and spiritual health of American Indians and Alaska Natives throughout the United States.
The Committee heard testimony from Dr. Roubideaux, who pledged to continue her efforts to improve Indian Health Service programs and facilities in Tribal communities. "The problems and challenges we have in the Indian Health Service are enormous," Roubideaux said. "We've made some progress but I feel we're just beginning to get to the important work of changing and improving the Indian Health Service." Roubideaux continued: "These improvements won't happen in days, weeks, months or years, but it's time to begin those improvements."
The Committee will consider today's testimony and responses to questions and schedule a vote on whether to report Roubideaux's nomination to the full Senate.
During the hearing, Cantwell highlighted the need to address health care disparities in Tribal communities. American Indian and Alaska Native populations have long experienced higher rates of heart disease, unintentional injuries, and diabetes compared to the general population. Reasons include poverty, the delivery of health services, cultural differences, and economic adversity. High rates of disease present unique challenges to the Indian Health Service and to the Tribal governments that provide health care services to their members.
Cantwell also emphasized the Indian Health Service's responsibility to help Tribes take advantage of new health care laws. "In the past several years, Congress has passed two pieces of legislation that are critical to improve the health care of American Indians," said Cantwell. "The Indian Health Care Improvement Act was made permanent as part of the Affordable Care Act, and the Special Diabetes Program for Indians was reauthorized." Cantwell continued: "The Committee will closely follow Indian Health Service's implementation of these two pieces of legislation."
Under questioning from Committee members on the agency's progress on conducting meaningful dialogue with Tribes, Roubideaux reaffirmed her commitment to honor the government-to-government relationship that exists between Tribes and the United States. "I plan to strengthen our partnership with Tribes by continuing the improvements we have made in our Tribal consultation process and by working with Tribes to make further improvements," said Roubideaux. "We know we have more work to do to make this partnership stronger."
Committee members also urged Roubideaux to provide the Committee with the findings from the Indian Health Service's investigation of its 12 Area Offices. The comprehensive Indian Health Service investigation came after an Indian Affairs Committee investigation of the Aberdeen, SD, Area Office in 2010 that found serious deficiencies in management, employee accountability, financial integrity, and oversight of facilities. Roubideaux confirmed the Indian Health Service investigation was concluded in December 2012, although it had not yet been provided to the Committee. Senator Cantwell stated that "the Committee would be expecting the Indian Health Service to provide the requested information prior to moving forward with Dr. Roubideaux's nomination."
The Indian Health Service, one of 11 agencies located within the U.S. Department of Health and Human Services, provides basic health care to more than two million American Indians and Alaska Natives from 566 federally-recognized Tribes in 35 states. There are over 670 Indian Health Service health facilities across the country that perform general health and behavioral health services.