[Congressional Record (Bound Edition), Volume 152 (2006), Part 6]
[Extensions of Remarks]
[Pages 7515-7516]
[From the U.S. Government Publishing Office, www.gpo.gov]




   INTRODUCTION OF INDIAN HEALTH CARE IMPROVEMENT ACT REAUTHORIZATION

                                 ______
                                 

                             HON. DON YOUNG

                               of alaska

                    in the house of representatives

                          Tuesday, May 9, 2006

  Mr. YOUNG of Alaska. Mr. Speaker, I am pleased today to introduce 
legislation to reauthorize the Indian Health Care Improvement Act 
Reauthorization (IHCIA) with my fellow colleagues.
  The Indian Health Care Improvement Act (IHCIA) requires 
reauthorization. It became Public Law 94-437 in the 94th Congress 
(September 30, 1976), and has been amended seven times. The IHCIA 
provides for health care delivery to over 2 million American Indians 
and Alaska Natives. Congress enacted a one-year extension to extend the 
life of the Act through FY 2001 but efforts at further extensions were 
interrupted due to the events of 9/11. Appropriations for the Indian 
health have continued through authorization of the Snyder Act, a 
permanent law authorizing expenditures of funds for a variety of Indian 
programs, including health.
  This bill responds to the changes that have occurred in the delivery 
of Indian Health services in the decade since the last reauthorization 
of the IHCIA. In this period, more than half of the tribes in the 
United States have exercised their rights under the Indian Self-
Determination and Education Assistance Act to assume responsibility to 
carry out programs of the Indian Health Service (lHS) on their own 
behalf. This, along with improvements in the IHS direct operations, 
have led to hospitals being accredited by the Joint Commission on 
Accreditations of the Healthcare Organizations, and health delivery 
systems being tailored to expanded outpatient and home and community 
based services had become commonplace in the private sector. Medicare, 
Medicaid and other third party revenue were important to achieving 
these gains and are crucial for retaining them. Equally important is 
the need to reinforce the authority provided to tribal health programs 
under self-determination and self-governance to establish their own 
priorities and to determine the best way to respond to the specific 
needs of their tribal members.
  Some highlights of the ways this bill addresses these changes:
  Section 3. Declaration of Health Policy. Declares that it is the 
priority of the United States that the health status of American 
Indians and Alaska Natives should be raised by 2010 to the same level 
as is set for other Americans, instead of establishing lower thresholds 
as has previously been accepted, and establishes a policy requiring 
``meaningful consultations'' with Indian tribes, tribal health 
organizations and urban Indian programs.
  Section 4. Definitions. Modernizes current IHCIA definitions and 
makes them consistent with the Indian Self-Determination and Education 
Assistance Act. Definitions of ``health promoting'' and ``disease 
prevention'' are expanded to encompass the full scope of these 
activities as recommended by the World Health Organization. Includes a 
definition of

[[Page 7516]]

``traditional health care practices'' that reflects the value of Native 
health practices.
  Title I, Indian Health, Human Resources, and Development. The purpose 
of this title is to increase, to the maximum extent feasible, the 
number of Indians entering the health professions and providing health 
services, and to assure an optimum supply of health professionals to 
the Indian Health programs and Urban Indian Organizations involved in 
the provision of health services to Indians.
  Title II, Health Services. The purpose of this title is to establish 
programs that respond to the health needs of American Indians and 
Alaska Natives. For example, American Indians and Alaska Natives have a 
disproportionately high rate of diabetes (death rate for this disease 
is generally more than 300% of the rate of the U.S. population), so 
this title has a specific diabetes provision. It also includes the 
Indian Health Care Improvement Fund through which the Appropriation Act 
supply funds to eliminate health deficiencies and disparities in 
resources made available to American Indians and Alaska Native tribes 
and communities.
  Title III, Facilities. The purpose of this title relates to the 
construction of health facilities including hospitals, clinics, and 
health stations necessary for staff quarters, and of sanitation 
facilities for Indian communities and homes.
  Title IV, Access to Health Services. This title addresses payments to 
the IHS and tribes for services covered by the Social Security Act 
Health Care programs, and to enable Indian health programs to access 
reimbursement from third party collections.
  Title V, Health Services for Urban Indians. This title establishes 
programs in urban centers to make health services more accessible to 
Indians who live in urban areas rather than on reservations or Alaska 
Native villages.
  Title VI, Organizational Improvements. This title addresses the 
establishment of the IHS as an agency of the PHS (Public Health 
Service). It also authorizes the Secretary to establish an automated 
management information system and authorizes appropriations to carry 
out this title.
  Title VII, Behavioral Health Programs. This title is revised from 
current law (which only addresses substance abuse programs) in order to 
focus on behavioral health. It combines all substance abuse, mental 
health and social service programs in one title and integrates these 
programs to enhance performance and efficiency.
  Title VIII, Miscellaneous. This title addresses various topics 
including the Secretary's reporting of the progress made in meeting the 
objectives of this Act to Congress. It requires the Secretary to 
develop IHCIA regulations, describes the eligibility of California 
Indians for IHS, establishes a National Bipartisan Commission on Indian 
Health Care, and authorizes appropriations.
  I urge my esteemed colleagues to act quickly to reauthorize the IHCIA 
to ensure we raise the health status of American Indians and Alaska 
Natives.

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