Dr. Yvette Roubideaux, U.S. Director of Indian Health Services (AP Images)

Indian Health Service Steadily Improves Direct Health Care Delivery

Lee Allen
9/21/12

By 5:30 a.m. on August 14-16, the lobby of the Tohono O’odham Desert Diamond Hotel in Tucson, Arizona was full. Attendees of the 9th Annual Direct Service Tribes (DST) National Meeting were ready for their morning fitness walk.

And each evening, participants competed in basketball and volleyball games.

During the day, they learned about the status of health care delivery in Indian country and how it has improved.

“Our theme of ‘Together We Will’ exemplifies our commitment to gather input on future goals and take these priorities forward in continued advocacy for an improved Indian health care system,” said Sandra Ortega, chairwoman of the DST Advisory Committee.

The annual DST meeting aims to educate tribes that have elected to receive primary care direct from the Indian Health Service (IHS) as well as contract health programs under Title I of the Indian Self-Determination and Education Assistance Act. The meeting provides an open forum to discuss issues relating to Indian health and direct health care delivery.  “Special emphasis was given to health literacy, partnership activities that improve and expand services, and traditional medicine,” said event planner Amanda Hurt.

“We take this issue seriously and we rely on tribal input to improve,” said Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services (HHS), via videotape. Sebelius pointed to a 29 percent increase in HHS funding for Native health care over the last four years, and promised the department's commitment “to making  IHS a priority through continuing consultation to improve health services in the future.”

On hand to discuss details of past, current and future IHS efforts was department director Dr. Yvette Roubideaux, a decade-long former Tucson native, prior to moving to Washington in 2009 to accept her current post. She told members of the Tohono O’odham host tribe that, “Once I heard chicken scratch music, I knew I was home," she said of the localized Tohono musical creation, similar to a Mexican-style polka.

Roubideaux took to the podium for an hour. “Health care has improved for American Indians and Alaskan Natives because of a collective effort of everyone acknowledging we need to change and improve. The need for health care among our patients is documented and we’re all working together for a common goal,” she said while admitting the current climate was a tough one for budget discussions.  “Across the board, budget cuts are scheduled for 2013, but we’re optimistically looking forward to the budget formulation process for 2014 and beyond. In the meantime, IHS should meet most of its mission objectives in 2012.

“We all want to see positive outcomes to our discussions, and there are a lot of common issues we can work on together. Reformation is taking place within the IHS. We are good stewards of federal resources, and we will continue to improve our performance accountability. Overall, things are better, but I also acknowledge there’s more to do.”

Following her prepared remarks, the IHS Director spoke with Indian Country Today Media Network:

“Our health care needs are changing,” she said. “We’re facing different health challenges than we did 20 and 30 years ago: obesity, diabetes, chronic diseases, misuse of prescription drugs, and just the pure challenge of delivering health care in rural areas, accompanied by a looming shortage of primary care doctors. All these things together really paint a challenging environment in which we’re trying to put changes in place.

“Changes that have already occurred or are now in progress will mean some patients can more readily get appointments and medicines, some will get more referrals paid for, and day-in and day-out, clinics are more coordinated and clinic staffs a little nicer. In the past, there has always been a barrier between tribes and the federal government, but we’re now working better together to give patients the care they need. Patients can see an improvement has been made, but we have such a level of enormous need that it’s going to take awhile. It’s nothing you can fix overnight.”

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