Sen. Baucus supports recommendations to Indian Country healthcare

Baucus’s office is currently working with the Indian Health Service (IHS) to support the agency’s efforts to implement these recommendations and improve access to care.

“Uncle Sam made a promise to provide health care for Native Americans, and we need to make sure the folks in charge of keeping that promise have the tools they need to do the best job possible,” Baucus said. “We can’t ignore the fact that economic challenges are among the biggest roadblocks to folks in need of care, so our efforts to improve health care and our efforts to create jobs and support education in Indian Country must go hand-in-hand.”

Legislative Context

Baucus first requested these reports from the Department of Health and Human Services (HHS) Inspector General in 2008. Since then, the passing of the Affordable Care Act included several provisions to improve tribal access to care by expanding the Indian Health Care Improvement Act.

• [Link: Archived Summary of ACA Tribal Provisions]
• [Link: OIG Letter Accompanying Tribal Health Reports]

Mental Health Report

Summary of Findings

• Limited Scope: While 82% of IHS and tribal facilities provide some type of mental health service, the range of available services is limited at many locations.
• Staffing Shortages: A lack of highly skilled providers significantly limits access to care.
• Socioeconomic Barriers: Physical distance, personal/social challenges, and economic hardships remain major obstacles to accessing services.

Recommendations

• Partnerships: IHS should provide technical assistance to help tribes explore partnerships with non-Native providers of community mental and behavioral health services.
• Telemedicine: IHS must continue to expand telemedicine capabilities and guide tribal providers in implementing these technologies.
• Data Centralization: IHS should develop a plan to create a single, unified database of all IHS and tribal health care facilities.

Dialysis Report

Summary of Findings

• Service Gaps: Only 20 out of 506 IHS and tribal facilities provide dialysis services on-site; most rely on outside facilities.
• Geographic Hardship: The remoteness of existing facilities creates severe hardships for Native patients traveling for treatment.
• Resource Constraints: Most facilities cite a lack of resources and small local patient populations as the primary reasons for not offering dialysis.
• Support Efforts: Many facilities currently assist members by providing transportation and expanding access to outside specialists.

Recommendations

• Expansion Expertise: IHS should develop a plan to provide expertise and assist tribes in expanding local dialysis services.
• Alternative Treatments: IHS must develop guidance and technical resources to help facilities offer alternative treatments (such as home dialysis).
• Data Centralization: (Identical to Mental Health) IHS should develop a single database of all IHS and tribal health care facilities.

Status: The Indian Health Service has indicated they agree with all recommendations outlined in both reports.

Media Contacts:

Kate Downen: 406-224-5056

Jenny Donohue: 202-224-2651

Kathy Weber: 406-329-3123