Kathleen Sebelius, the 21st Secretary of the Department of Health

Secretary of the Department of Health, Sebelius’ Remarks at White House Tribal Nations Conference

December 06, 2012

The following are remarks from Kathleen Sebelius, the 21st Secretary of the Department of Health, during President Barack Obama’s fourth annual White House Tribal Nations Conference on December 5.

Good Morning. The Department of Health and Human Services is proud to be partners with you in working to open new doors of opportunity across Indian country.

During a recent visit to tribal communities in South Dakota, I saw some great examples of our work together.

At Sinte Gleska University on the Rosebud Sioux Indian reservation, I met young people served by a unique children’s mental health program that blends Western and traditional Lakota cultural approaches to healing.

I met students at the Red Cloud Indian School on the Pine Ridge Indian reservation where the Administration is supporting a Lakota Language Program which teaches the Lakota traditions through a rich K-12 curriculum.

And I met community members who had begun to eat healthier and increase their physical activity with support from the Special Diabetes Program for Indians.

There are rich partnerships like these all across Indian country. And they are giving more First Americans reason to feel hope for the future instead of despair.

To be sure, we face incredibly persistent challenges today: high unemployment, energy costs, suicide, chronic disease and federal resources stretched thin.

But I also know that smart investment has allowed us to make real progress. Programs like those I visited in South Dakota were made possible by a strong collaboration between tribes and the Obama Administration.

They are also part of something bigger happening across Indian country.

When President Obama took office, he recognized that we needed more than a series of individual success stories. We needed a comprehensive approach. And if you look back over the last four years, you can begin to see what that has meant for Indian country.

Four years ago, the Indian Health Service [IHS] had a budget of $3.8 billion. Today, it’s 29 percent larger at $4.3 billion.

Four years ago, the Contract Health Service budget was $579 million. In most places, IHS could fund only life or limb referrals. Today, the Contract Health Service budget is $843 million, a 46 percent increase that has allowed many more patients to get the referrals they need.

And it’s not just the budget.

Four years ago, the reauthorization of the Indian Health Care Improvement Act was hopelessly stuck in Congress. Today, after more than a decade of trying, it has been permanently authorized. The Indian Health Service is here to stay. The law also means that tribes can get coverage for their employees through the Federal Employees Health Benefits Program. More than 10,000 are already enrolled.

And by approving every single Tribal Facility for the National Health Service Corps, we’re bringing more providers to communities in need. As you know this is a program that says to doctors, nurses, and dentists: “If you go practice in an underserved community, we’ll give you a scholarship or help pay your loans.” Four years ago, because of the complicated certification process, fewer than 60 IHS and tribal facilities were eligible for Corps members. Today, there are 587.

I am also proud to say that after close consultation with tribes, the VA and IHS will announce a national agreement [December 6] for the VA to reimburse IHS for the direct care it provides veterans. This agreement includes the outpatient all-inclusive rate that tribes preferred. Implementation will begin soon at federal sites. This agreement will make it easier for tribes to enter their own agreements with VA for the health services they provide.

Now at HHS, the well-being of the American Indian and Alaska Native people is a priority that extends beyond the IHS to reach every operating division and program office. We recognize that giving people the opportunity to thrive requires more than just access to quality care. It also comes from investing in whole families and strong communities.

Four years ago, American Indian and Alaska Natives in the foster care and child welfare system had to go through large state programs and outside groups. Today, we have created a process for tribes to operate their own Title IV-E programs. The Port Gamble S’Klallam Tribe was the first. And right now we continue to process additional agreements with other tribes.

Four years ago, we were seeing a steady decline in the number of children in Head Start who spoke a tribal language at home. Today, we’re using Head Start’s new performance standards to begin integrating tribal language and culture into their classrooms and curricula.

Four years ago, tribal nations were largely on their own in the ceaseless fight against alcohol and substance abuse. Today, our department has a dedicated office working with tribes as they develop detailed action plans and coordinate resources from across the federal government.

All of this progress is built on a strong foundation of consultation. And we’ve made progress here too.

Four years ago, HHS had an outdated consultation policy on its books. Today with your guidance it has been updated, and seven agencies within the department have their own new or updated consultation policies. Our new department-wide policy calls for us to regularly evaluate our progress. So we recently sent each of you a letter asking for your input. And I look forward to your perspective.

Four years ago, our department’s leadership was receiving irregular updates about its work in Indian country—often only when there was a crisis to solve. Today, our senior leaders and I meet regularly with the Secretary’s Tribal Advisory Committee or STAC—the first cabinet level committee of its kind. And we have charged the STAC not only with addressing today’s biggest problems but also with making the most of tomorrow’s opportunities.

One of the biggest of those opportunities is our ongoing work to implement the Affordable Care Act. We need your help to make sure people are taking advantage of the law which includes many important benefits for American Indians and Alaska Natives.

It puts in place new rules prohibiting insurers from imposing lifetime dollar limits on your benefits. Young adults who would otherwise be uninsured, can now stay on their parents insurance until they turn 26. And key preventive services like diabetes screening and mammograms, now cost nothing out of pocket for most people in private plans and elders on Medicare.

In 2014, more of Indian country’s most vulnerable may be covered by Medicaid. States will receive federal funding assistance to extend their programs to uninsured adults with incomes below 133 percent of the Federal Poverty Level. That’s about $15,000 a year for an individual and $31,000 for a family of four.

At the same time, new competitive insurance marketplaces will allow hundreds of thousands of American Indians and Alaska Natives to purchase quality, affordable health coverage for the first time.

But we need your partnership to educate tribal communities about the law’s new benefits and protections—and to identify everyone who is eligible and help them enroll.

And together, we need to hold our partners in the states accountable. Last year, I wrote a letter to governors reiterating my full commitment to strong government-to-government relationships with tribes. And I will continue to remind states that they must consider tribes full partners during the design and implementation of any programs that use HHS funds.

Looking back, it’s clear that we are in a much better place today than we were four years ago. But the time is now to look forward.

The journey ahead will not be easy. But it is possible to envision an Indian country four years from now where everyone has access to the quality care they need to get healthy and stay well; where more children have the chance to follow his/her dreams; and where every community can protect its culture and traditions while creating new opportunities for work and growth.

We can fulfill that great promise by continuing our work together. We have made great progress, but we have much more work to do. And this Administration is committed to working hand-in-hand with you to improve lives for the better in Indian country.”


Two Bears Growling's picture
Submitted by Two Bears Growling on

How many promises have we First Nations all heard through the past few hundred years from the invaders? How many of them were ever kept? Let's see how this all plays out again. Anyone taking any bets? Watching & listening......

Two Bears Growling Buffalo's Thunder

Anonymous's picture
Submitted by Anonymous on

I think Ms.Kathleen Sebelius, needs to learn to use a proper language, Like Lakota, that will remind her, that she hasn't given us First Nation People's any but Modern Day Genocide. She need to understand and know her own nation legacies and BIA and IRA Tribal Gatekeepers of her so-called nation that continue to be as arrogant, ignorance, foolish to really think she and her government are given us some kind of hand out. Its time, for her and her kind, to grow up and to stop denying the truth and to know the truth, that it was us that saved, taught and fed and to know how human beings really live upon our consecrated divine red sovereign homelands, called Turtle Island. She and her leaders need to know that to authentic red sovereign nationhood's, don't like liars!!!! That continue to pat themselves on the back for they're false charities to Indian People within a unjust order of BIA and IRA corruption, manipulations, disinformation and secrets of its real agenda, is to take, not honor and steal more Tribal Treaty Lands for the scum's of earth, the mining, timber, and oil corporations. The U.S. Economy sense its hideous occupation on red sovereign soil was and steal is built on US political modern day thievery. The historical truth, now and when they destroy themselves and the so-called love ones, they work and suffered so hard for and so called loved, was, built on murdering and stealing and lying and destroy our red sovereign nations and people's. The historical truth of America in the heart of the Son of God, is this,Our Red Sovereign Nationhood's, our old traditional ancestors of old gave these ungrateful and wicked white race, this generation of white superiority imperialist invasive domination to a authentic free world; "Life", then, it wasn't enough, so they raped it! Now, all are children throughout the world are sick, homeless, hungry , unloved and destroyed.... So Remember she lives in her imaginary eurocentric world of they're, lies, delusions, not repentful. Full of the "Pride of Life', and just national imperialist greed!!! So we all traditional sovereign first nation people's, we are the power, authority and dominion upon this sacred red soil, called, Turtle Island. You gave us nothing but hell, so in the next world as world leaders of this abomination of a empire, called the United States of America, owe us not only every thing they have illegally stolen but they owe us they're souls. They belong to us now, they always have, for the trespass and sinned against the Creator and his Son, the Christ and every red human being and nationhood they keep institutionally and political and economically enslaved, oppressed and colonized! This was and is not the will of any loving Creator!!!! Never was.

Wanbli 2012

Anonymous's picture
Submitted by Anonymous on

Yes they do like to pat themselves on the back don't they. ! lol

Anonymous's picture
Submitted by Anonymous on

One of the major issues is the parade of new doctors and dentists that the (The Indian Health Service) provides on a rotating basis. These are not community members that establish long term relationships with the patients thereby earning trust and establishing the basis for having their medical/dental advice and teaching become the healthy practice that prevents disease. Long term 30 to 40 years is the community member doctor relationship. The thing that the government is missing is the study and selection of the right fit of people to train as doctors/dentists to provide the long term service in the same community. Industrial psychology has techniques of studying and finding the right people for specific types of employment. The government needs to stop wasting money on programs that do not select the right people to train for the job they need to fill.

Healthcare Provider's picture
Submitted by Healthcare Provider on

Working for the past three years in the Navajo Nation, I find that the patients are not coming to the clinic. The services are here, the staff is here, the patients are not. I cannot assist my patient in the healthcare services provided, if they do not come for the care. It seems that the priority of healthcare is not first. What is the answer?

Anonymous's picture
Submitted by Anonymous on

Maybe you should encourage your own children to become doctors or dentist and come back and work with their people. I do know other tribes have had members enter the medical profession.

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