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Secretary of Department of Health and Human Services Sees More Opportunity in Indian Country

A column by Kathleen Sebelius about her recent trip through South Dakota.

Last week, I toured the new Indian Health Service (IHS) Cheyenne River Health Center. The center, which opened last year, includes a new dental clinic, CT scanner and a Spiritual Room where patients and family can practice their traditions.

Over the past few years, the Department of Health and Human Services has made it a priority to strengthen its partnership with Tribal nations. And each year, I schedule visits to Tribal communities to review the work we are doing together and to understand the needs of the people we serve.

During my recent visit to Tribal communities in South Dakota, 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.

At Sinte Gleska University on the Rosebud Sioux Indian reservation, I met young people served by Tiwahe Glu Kini Pi or “Bringing the Family Back to Life.” This unique children’s mental health program, also supported by the Administration, blends Western and traditional Lakota cultural approaches to healing. And I visited the IHS Rosebud Service Unit—the first IHS hospital to complete all the steps toward certification as a Baby-Friendly Hospital, the gold standard recognizing best practices in support of new mothers and children through breastfeeding education and counseling.

Each of these accomplishments was built on a strong partnership between the Obama Administration and Tribal nations. It is a testament to the progress we’ve made, but also a reminder of how much work remains to be done.

This Administration believes that everyone should have the opportunity to achieve their full potential, no matter whom they are or where they live. For too long, tribal nations have not gotten the support they need to fulfill that promise, especially in the face of high unemployment, energy costs, suicide, chronic disease, and federal resources stretched thin. But over the last three years, we’ve worked together with Indian country to change that.

First, we’ve started to target resources where they have been lacking. That began with the Recovery Act—one of the biggest investments in Indian country in our history. It included $500 million for the Indian Health Service—vital funds that went toward health care clinics like the new Cheyenne River Health Center.

This wasn’t just a one-time boost either. Since 2008, IHS has seen its total budget increase 29 percent. At a time of an overall federal budget freeze, these increases show this Administration’s continued commitment to improving the quality of and access to health care for Indian Country.

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Nowhere is that more clear than in the impact these funds have had on IHS Contract Health Services. In the past, only the highest priority referrals were paid for. With limited funds and rising costs, a lot of people were forced to wait or put off the care that they needed.

Since 2008, we have increased the budget for Contract Health Services by 46 percent, allowing many more patients to get the referrals they need before their cases become dire. There is still a significant need, but we are finally beginning to stem the tide.

We’ve taken additional steps to increase access to care and services. Two years ago, President Obama signed the Affordable Care Act, which contains important benefits for First Americans, starting with the long-overdue permanent reauthorization of the Indian Health Care Improvement Act. These provisions give IHS better tools to modernize its services and allow Tribes to purchase health care coverage for their employees as part of the Federal Employees Health Benefits Program.

The rest of the health care law is just as important, especially for the nearly 50 percent of American Indians who don’t have access to an IHS facility. In 2014, new transparent and competitive insurance marketplaces known as Affordable Insurance Exchanges will ensure every American Indian and Alaska Native has access to quality, affordable health coverage.

Health care is just one of the areas in which we’re working to increase support for tribal nations and communities. Across Indian Country, we’re investing in high quality Head Start and child care programs, innovative substance use and mental health initiatives, job training and economic development campaigns.

Driving all of these efforts is this Administration’s commitment to strengthening our partnership through ongoing consultation. Soon after taking office, I formed the Secretary’s Tribal Advisory Committee, the first Cabinet-level advisory group of its kind, where Tribal Leaders can provide me and my staff firsthand advice on how we can make decisions that benefit Indian Country.

Challenges remain, but together we are making progress. Over the last three years we have built a historic partnership with tribes that has begun to bring better health, stronger services and more opportunity to Indian country.

Kathleen Sebelius is Secretary of the Department of Health and Human Services. She served as Governor of Kansas from 2003 until her Cabinet appointment in April 2009.