INDIAN HEALTH POLICY 109TH Congress

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INDIAN HEALTH POLICY109TH Congress

• Aberdeen Area Tribal Chairmens Health Board
  (AATCHB)
• October 25, 2006

Deborah A. Broken Rope
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Indian Health Policies

• Who Decides when/what to Craft?
• Federal Court Decisions
• Federal Regulatory Scheme
• Congressional, Statutory Fixes
• Tribal Specific Action

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Current Authorities

• Hill Burton
• Social Security
• Medicaid
• SCHIP
• EMTALA
• HIPPA
• PHS Acts
• ERISA

• Tribal Codes
• Tribal Treaties, Eos
• Snyder Act
• Transfer
• Health Facilities Act
• Sanitation Facilities
• PL 94-437
• PL 93-638
• Indian Diabetes

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Health Law Objectives

• TRIBAL
• Federal Preemption
• U.S. and Tribal Relationship
• Snyder w/o Sunset
• Community Facility Infrastructure and
  Responsibility
• Comprehensive Scope acute togtgtprevention

• PUBLIC HEALTH
• Underserved, low-income individuals
• Individual focus by categorical status
• Anti-dumping as civil rights protectionist
  measure
• Portability of individual health benefits

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FACTORS, CONTEXT SHAPING INDIAN HEALTH POLICY
TODAY

• LEGISLATIVE PROCESS, PRIORITIES
• PRESIDENTS AGENDA
• CABINET INITIATIVES
• ELECTORAL, POLITICAL DYNAMICS
• DEFICITS

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109TH PRIORITIES

• ANNUAL SPENDING BILLS
• DISASTER RELIEF,
• DEFICIT REDUCTION
• TAX CUTS
• DEFENSE, HOMELAND SECURITY
• FOREIGN AFFAIRS
• ENERGY PRODUCTION

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National Issues w/Tribal Concerns

• Budget Reconciliation
• Social Security Reform (HR3304/S1302)
• Medicaid Reform
• Welfare Reauthorization (S.1021)
• Headstart (S1107/HR2123)
• Rural Water Supply (S895)

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National Issues w/Tribal Concerns

• Child Care Develop Block Grants (S5250)
• Childrens Safety Act (HR3132)
• Veterans Health Care (S1182)
• S.1177, S.1189, S.1190
• Veterans Benefits Improve.(S1235)
• S.151, S.1259, S.1271
• VA Stand Alone S.716, S1234
• Violence Against Women (S1197)
• Includes Tribal Set-aside 100M
• House passed Bill (HR3402) contains VAWA but no
  tribal set-asides

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INDIAN HEALTH AND RELATED LEGISLATION

• S.1057 IHCIA Reauthorization
• S.972 Albuq Indian Health Center
• S.987 Restoring Indian Womens Safety (in
  S.1197)
• S.1239 AI/AN Elderly Disabled (Medicare Part
  D Premium Co-Pay)

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INDIAN HEALTH ANDRELATED LEGISLATION

• S.103 Combat Meth Act
• S.536/H.R.3351 NA Omnibus Act
• S.611/H.R.1240 EMS Support Act
• S.898 Patient Navigator (PL109-18)
• S.1049 Covering Kids Act

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CONTEXT, PROCESS

• CONGRESSIONAL AND
• POLITICAL DYNAMICS

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OVERVIEW
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OTHER DYNAMICS

• CONGRESSIONAL ELECTIONS
• COMMITTEE ASSIGNMENTS
• CONGRESSIONAL LEADERSHIP
• PARTY INITIATIVES
• EMERGENT ISSUES (9/11, Katrina)
• HOUSE, SENATE RULES

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INDIAN HEALTH CARE IMPROVEMENT ACT

• Goal Achieve Health Parity w/ Nation
• How Identify "Unmet Health Needs"
• Method Fair Resource Allocation