On July 14, the Senate Indian Affairs and Health, Education, Labor and Pensions (HELP) Committees held a joint hearing on a bill (S. 1057) to reauthorize the Indian Health Care Improvement Act. In his opening remarks, HELP Committee Chair Michael Enzi (R-WY) stated, “There is no greater challenge before us in Congress than the work we must do to continue to improve the quality of health care that is available to those living on Reservations. Unfortunately, it seems that no matter how much progress we make, there is always more to do. Today’s hearing will enable us to chart our current progress and discuss what we can do to increase the services that are available to address the physical and emotional problems that continue to plague American Indians and Alaska Natives.”
Sponsored by Sen. John McCain (R-AZ), the Indian Health Care Improvement Act Amendments of 2005 would reauthorize programs administered by the Department of Health and Human Services’ Indian Health Service (IHS) through FY2015. The measure would include a number of provisions specific to women’s health, including funding “to monitor and improve the quality of health care for Indian women of all ages.” Specifically, the bill would authorize coverage for mammography screening, child sexual abuse treatment and prevention, substance abuse treatment specially designed for women, and fetal alcohol disorder programs.
IHS Director Charles Grim outlined the administration’s concerns regarding S. 1057. He expressed support for language authorizing a comprehensive behavioral health prevention and treatment program, but voiced his opposition to provisions that would single out expansion of services for Indian women, establish a fetal alcohol disorders program, and increase services for the treatment and prevention of child sexual abuse. “The Department [of Health and Human Services] should be given the flexibility to provide for all Behavioral Health Programs in a manner that supports the local control and priorities of Tribes, and to address their specific needs within IHS overall budgetary levels,” he stated.
Rachel Joseph, co-chair of the National Steering Committee for the Reauthorization of the Indian Health Care Improvement Act, addressed the health care disparities among American Indian and Alaska Native (AI/AN) populations: “Public health indicators, such as morbidity and mortality data, continue to reflect wide disparities in a number of major health and health-related conditions, such as Diabetes Mellitus, Tuberculosis, alcoholism, homicide, suicide and accidents. These disparities are largely attributable to a serious lack of funding sufficient to advance the level and quality of adequate health services for AI/AN. Recent studies reveal that almost 20 percent fewer AI/AN women receive prenatal care than all other races and they engage in significantly higher rates of negative personal health behavior, such as smoking and the consumption of alcohol and illegal substances during pregnancy.” She expressed support for elevating the position of IHS director to assistant secretary, stating that this “would facilitate the development of AI/AN health policy throughout the Department and provide greater collaboration with other agencies and programs of the Department concerning matters of Indian health.” Ms. Joseph also expressed concern with the administration’s opposition to a fetal alcohol disorders program, arguing that there is a great need among AI/AN populations to encourage pregnant women to abstain from drugs and alcohol.
Northern Arapaho Tribe Chair Richard Brannan stressed the need for gender-specific health programs in AI/AN communities, including breast, cervical and prostate cancer screening. He also noted the importance of STD and HIV/AIDS awareness programs. Finally, he stated that community-based health programs should address the specific needs of both women and men.
