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Health care gets new scrutiny

WASHINGTON - Late last year, the law which authorizes federal health care for all Indians expired. Since then, Congress, the administration and the tribes have worked to redraft and update new legislation.

The result of that work was introduced as a bill, along with other Indian health care initiatives, by Sen. Ben Nighthorse Campbell, R-Colo., chairman of the Senate Committee on Indian Affairs.

The Indian Health Care Improvement Act was initially authorized by Congress in 1976 and enables the Indian Health Service (IHS), to provide a variety of health care services to Indian people.

"American Indians rank at or near the bottom of every health care indicator in the United States today," Campbell said. "Infant mortality, diabetes, substance abuse and cancer rates plague Native people at rates much higher than any racial or ethnic group in the nation. I am hoping that by incorporating the lessons we have learned over the past 30 years we can help turn this situation around."

In 1999, the administration, through the IHS, sponsored a number of regional meetings between tribal health care providers, both on reservation and in urban areas, to discuss various health care concerns and to gather recommendations on the reauthorization of the Indian Health Care Improvement Act. Following initial meetings, tribes, tribal organizations, and urban Indian organizations formed a National Steering Committee.

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Given the ultimate responsibility of addressing recommendations and conflicts from the regional meetings, the steering committee drafted the proposed reauthorization legislation now before Congress.

"This bill developed by tribes over the last year is a good example, or perhaps model is a better word, of a good consultation process," said Julia Davis, Nez Perce council member who served on the steering committee. "This bill was developed by tribes and urban Indian groups and reviewed and commented on by American Indian and Alaska Natives nationwide."

Campbell said there were three major areas of increased concern: urban Indians, diabetes and facilities construction. The new act considers the definition of Indian and who is eligible for health care entitlements; the incorporation of traditional healing practices and cultural sensitivity training for all health care providers. It would also implement a number of scholarship programs to provide greater educational opportunities to Native Americans and more professional health care workers for tribal communities.

The Native American Alcohol and Substance Abuse Program Consolidation Act, introduced by Campbell along with the reauthorization bill, builds on previous efforts to integrate and consolidate services from across the federal government to achieve more efficient and effective services.

The committee is expected to hold hearings on both bills before final approval.