The federal Government Accountability Office has rapped the Indian Health Service for not setting national standards or overseeing waiting times at its facilities, meaning it cannot assure timely access to health care.
IHS “has not conducted any systematic, agency-wide oversight of the timeliness of primary care,” GAO found in its report to Congress. Instead, it has delegated the responsibility to its area offices and has not set any nationwide standards for waiting times.
The stakes could not be any higher. “American Indian/Alaska Native people die at higher rates than other Americans from conditions that could be mitigated by access to preventative primary care,” according to the Congressional watchdog’s findings. Natives have experienced “longstanding problems accessing healthcare services.”
GAO recommended IHS establish and monitor nationwide wait time goals in its federally-operated facilities. But there isn’t much chance the agency will comply anytime soon, so Congressional waiting time may be lengthy. GAO reported that IHS said it wants to track patient wait times “eventually” but for now has higher priorities, such as making sure their facilities are accredited.
The Congressional unit visited seven IHS facilities and found they “have taken various steps to help ensure that their patients have access to timely primary care, but obstacles remain.” Some have undertaken a modified open-access appointment scheduling that keeps times open for same-day service. And some have beefed up outreach to tribal communities to lessen missed appointments.
But, GAO reported, these tribal facilities staff said “a lack of sufficient primary care providers, as well as aging infrastructure and equipment, are significant obstacles.”
One IHS facility reported that as a result of not having enough health care providers, some patients have had to wait three or four months to get an initial appointment. IHS staff also complained about “working in outdated facilities with insufficient space to accommodate additional providers and with outdated medical and telecommunications equipment.”
GAO reported to the Senate Indian Affairs Committee that Native lifespans are more than four years shorter than all other races, and that Natives suffer from a high rate of liver disease, suicide, respiratory disease and diabetes.
GAO said it wasn’t possible to determine if IHS has made any progress in delivering timely access to health services due to its lack of national monitoring.
The federal Department of Health and Human Services, which administers IHS, said it is in the process of setting up an Office of Quality Management in its Washington, D.C. headquarters.
It said it would boost recruitment and retention efforts in an attempt to cut waiting times in IHS facilities.
As of October 2015 IHS operated 27 federal and 18 tribal hospitals, according to the GAO. It also ran 59 federal and 284 tribal health centers as well as 163 Alaska Native clinics. In addition, there are 32 federal health stations and 79 tribally-operated ones.