[Congressional Record (Bound Edition), Volume 154 (2008), Part 2]
[Senate]
[Page 2553]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   INDIAN HEALTH CARE IMPROVEMENT ACT

  Mr. LIEBERMAN. Mr. President, I regret having missed the final vote 
for the Indian Health Care Improvement Act of 2007. I support the 
passage of this bill and would have voted in the affirmative.
  It has been over 15 years since the Indian Health Care Improvement 
Act has been reauthorized. It is critical to strengthen the provision 
of care, through the Indian Health Service, IHS, to American Indian and 
Alaska Native populations, who suffer from significant health 
disparities compared to the general U.S. population, including a life 
expectancy that is 2.4 years lower, and significantly higher death 
rates from tuberculosis, alcoholism, diabetes, suicide, and infant 
mortality.
  The Indian Health Service derives its authorities from the Indian 
Health Care Improvement Act and its mission is to improve the health 
status of American Indians and Alaskan Natives by constructing, 
maintaining, and managing health care delivery and sanitation systems 
through a network of 49 hospitals, 6,500 IHS, tribal, and private 
contract facilities. The IHS provides ambulatory, emergency, dental, 
and preventative health services to 58 percent of the 3.3 million 
American Indians and Alaska Natives; however, it is confronting these 
challenges with significant health care workforce shortages. Anywhere 
from 12 to 32 percent of positions for dentists, nurses, optometrists, 
physicians, and pharmacists, among other health professionals, are 
currently vacant. Thus, the passage of this legislation is critical to 
strengthening the IHS and providing critical services to American 
Indians and Alaskan Natives.
  Specifically, the reauthorization will improve the recruitment and 
retention of health providers in the IHS, provide support for American 
Indians and Alaska Natives to enter the health professions, provide 
funds for the construction of health and sanitation facilities, expand 
Medicare, Medicaid, and CHIP reimbursement and enrollment to all 
American Indians and Native Alaskans health programs, eliminate 
Medicare and CHIP cost-sharing and premiums for American Indians and 
Native Alaskans served by tribal health programs, improve IHS 
information systems, billing, and patient care and training, mandate 
that the Departments of the Interior and Health and Human Services 
design a comprehensive approach to behavioral health assessment, 
treatment, and prevention services, establish a National Bi-Partisan 
Commission on Indian Health Care to study the delivery of services to 
American Indians and Native Alaskans, require an annual report to 
Congress on the enrollment and health status of American Indians and 
Native Alaskans served by Federal health programs, reauthorize the 
Indian Health Care Improvement Fund to support health promotion and 
disease prevention programs, cancer screenings, epidemiological and 
health services research, and catastrophic healthcare, and modernize 
health care delivery for American Indian and Native Alaskan seniors 
requiring long-term care, hospice, home/community-based care, and 
assisted living.
  I commend the work of both the Senate Indian Affairs and Finance 
Committees and, most importantly, Senators Dorgan and Murkowski for 
their leadership and commitment to this bill.

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