Branch of the United States Health Department regarding the health of Native Americans
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Armand Harpin, Director of Federal Healthcare at IMEG, joins this episode to discuss the firm's extensive work with the U.S. Department of Veterans Affairs (VA), Defense Health Agency (DHA), and Indian Health Services. Under Armand's leadership, IMEG has been ranked the top Veterans Affairs engineering firm by BD+C Magazine. “We serve the VA across probably 75 percent of the campuses throughout the country,” Armand says. These projects span a range of services, from facility condition assessments and master planning to infrastructure upgrades like boiler and chiller plants. “We've also spent a great deal of time over the last few years and are still involved in electronic health record projects for the VA,” Armand adds. For most of the firm's federal healthcare projects, IMEG collaborates closely with more than 20 service-disabled veteran-owned small businesses—partnerships that are extremely valued. “It's a real pleasure to support those architectural and AE firms,” says Armand. On larger projects, those $100 million and above, the firm partners with national AEC firms across the country. Armand says the federal healthcare market is currently experiencing a transitional period, with shake-ups in leadership within the VA's Office of Construction and Facilities Management (OCFM). “They've lost their senior director, they've lost a good portion of their associate directors, and so they're in the process of rebuilding,” he says. This comes as the VA continues to face major issues with its building stock; most VA facilities are 50 to 60 years old, creating significant operational challenges. “It's becoming more and more difficult... to provide for today's healthcare needs,” Armand says. Some major campuses, he adds, are being “decanted,” with their services being moved to leased, community-based outpatient clinics in more population-dense areas. “That's called ‘commercialization,' and it's been a critical piece for bringing services and positive outcomes to veterans in underserved areas.” Speed and efficiency in project delivery have become top priorities, with Armand citing increased use of design-build and integrated delivery approaches to accelerate project timelines. One such example is a $600 million healthcare center project in El Paso, Texas, currently being executed by IMEG in partnership with Clark Construction. Armand has been involved in the federal healthcare market for many years and his work in the sector hits close to home. “My brother served in the Air Force. My father served as a Marine... and passed away in the VA hospital in San Diego,” he says. “This is an incredibly personal mission.” His passion also dovetails with IMEG's stated purpose to create positive outcomes for people, communities, and the planet. “It's a mission of stewardship, of accountability, and trying to provide the healthcare outcomes that VA and active military patients need,” he says.
Simon and Julie join John for another segment of We're Still Here. They dig into a disturbing new report revealing that Trump-era officials pushed to remove books on slavery, Native history, and even George Washington from national park gift shops, all in the name of “patriotism.”Then they turn to Arkansas, where a whites-only settlement is quietly building a “fortress for the white race” under the banner of “returning to the land.” Yes, it's 2025. No, you didn't misread that.But it's not all grim news: the House has approved $8.4 billion for the Indian Health Service, with advance appropriations that could offer much-needed stability for Native healthcare—if it survives the political storm ahead.They unpack all of it with humor, fire, and a healthy dose of listener calls.Simon Moya-Smith - instagram.com/simonsaidtakeapic threads.com/@simonsaidtakeapicJulie's Substack “The Fire I Keep” https://substack.com/@juliefrancella?r=1u83jb&utm_medium=iosCheck out Julie's artwork on her website - juliefrancella.com See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Simon and Julie went live with John to explore powerful stories from Indian Country. They covered the Miccosukee Tribe's lawsuit over “Alligator Alcatraz”; reflected on 80 years since the U.S. detonated the first nuclear bomb on stolen Mescalero Apache land; and discussed how Medicaid cuts threaten Native healthcare. They also highlighted the water crisis on reservations, where half of households still lack reliable clean water. Listeners called in to share their stories—one even asked about burning sage (smudging) at an Indian Health Services clinic.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
The Congressional Budget Office estimates the spending bill just signed by President Donald Trump will increase the number of people without health insurance by 16 million over the next ten years. The $1.1 trillion cuts to Medicaid will also affect Native Americans who rely on it to pay for health care through the Indian Health Service and threatens rural hospitals with a high rate of Medicaid-dependent patients. The new spending plan also substantially reduces the number of people who will collect food assistance through the federal government. We'll get insights on what these numbers mean for Native Americans who disproportionately rely on these two federal government programs. We'll also find out about the significance of the new Indigenous head of Mexico's Supreme Court. GUESTS A.C. Locklear (Lumbee), CEO of National Indian Health Board Aaron Payment (Sault Ste. Marie Tribe of Chippewa Indians), tribal councilman and former chairperson for the Sault Ste. Marie Tribe of Chippewa Indians Kelli Case (Chickasaw), senior staff attorney for the Indigenous Food and Agriculture Initiative Gaspar Rivera-Salgado (Mixteco), director for the UCLA Center for Mexican Studies
The Congressional Budget Office estimates the spending bill just signed by President Donald Trump will increase the number of people without health insurance by 16 million over the next ten years. The $1.1 trillion cuts to Medicaid will also affect Native Americans who rely on it to pay for health care through the Indian Health Service and threatens rural hospitals with a high rate of Medicaid-dependent patients. The new spending plan also substantially reduces the number of people who will collect food assistance through the federal government. We'll get insights on what these numbers mean for Native Americans who disproportionately rely on these two federal government programs. We'll also find out about the significance of the new Indigenous head of Mexico's Supreme Court.
The Indian Health Service (IHS) remains largely misunderstood by those not directly connected to it, and often derided as a bureaucratic and confusing system by those who are. IHS marks its 70th anniversary, providing care to all Native citizens. Of course, the agency's history is also documented in the hundreds of treaties over almost 200 years in which the U.S. Government explicitly signed on to its responsibility. We'll trace the history of IHS from the first immunizations to Public Law 638, and chart its future amid a major reassessment of federal government services.
The Indian Health Service (IHS) remains largely misunderstood by those not directly connected to it, and often derided as a bureaucratic and confusing system by those who are. IHS marks its 70th anniversary, providing care to all Native citizens. Of course, the agency's history is also documented in the hundreds of treaties over almost 200 years in which the U.S. Government explicitly signed on to its responsibility. We'll trace the history of IHS from the first immunizations to Public Law 638, and chart its future amid a major reassessment of federal government services.
House Committee on Natural Resources Subcommittee on Indian and Insular Affairs Legislative Hearing on H.R. 411, H.R. 2916, H.R. 3620 & H.R. 3670 Wednesday, June 11, 2025 | 10:00 AM On Wednesday, June 11, 2025, at 10:00 a.m., in room 1324 Longworth House Office Building, the Committee on Natural Resources, Subcommittee on Indian and Insular Affairs will hold a legislative hearing on the following bills: H.R. 411 (Rep. Bergman), “Keweenaw Bay Indian Community Land Claim Settlement Act of 2025” H.R. 2916 (Rep. Stefanik), To authorize, ratify, and confirm the Agreement of Settlement and Compromise to Resolve the Akwesasne Mohawk Land Claim in the State of New York, and for other purposes H.R. 3620 (Rep. Begich), “Southcentral Foundation Land Transfer Act of 2025” H.R. 3670 (Rep. Stansbury), “IHS Provider Expansion Act” More on Indianz.Com: https://indianz.com/News/2025/06/10/house-subcommittee-on-indian-and-insular-affairs-schedules-hearing-on-four-bills/
This week on The Health Advocates, Steven Newmark, Chief of Policy at GHLF, breaks down two major stories: sweeping proposed cuts to key federal health agencies in the 2026 U.S. budget, and a new national partnership between GHLF and Walgreens aimed at improving care for chronic skin conditions. Steven explains what’s at stake, how advocacy can influence policy decisions, and why pharmacists are essential allies in supporting skin health. Among the highlights in this episode: 00:34: Steven breaks down the proposed 26% cut to the U.S. Department of Health and Human Services, including a 40% cut to NIH and 44% to CDC 01:00: Steven explains the impact of these cuts on medical research, vaccine surveillance, and chronic disease care 01:56: Steven discusses how Indian Health Services and HRSA programs would also be severely reduced, putting vulnerable populations at further risk 02:43: Steven emphasizes that this is a proposed budget and not a done deal—public advocacy still has power 03:10: Steven urges listeners to contact their members of Congress and help make budget policy personal for patients 03:40: The episode pivots to good news: GHLF’s new campaign with Walgreens: Your Skin, Your Health: How Pharmacists Help You Take Control To watch the videos from the campaign and explore more resources from GHLF and Walgreens, visit: https://linktr.ee/YourSkinYourHealth 03:58: Steven introduces the campaign’s focus on empowering patients with HS, psoriasis, atopic dermatitis, and alopecia through pharmacist guidance 04:28: Steven explains why pharmacists are ideal allies in chronic skin care—offering support from symptom recognition to navigating insurance 05:01: Steven outlines how the campaign will reach millions across GHLF and Walgreens channels, with weekly videos and actionable resources 05:40: He reflects on why this campaign matters: for many patients, it provides long-overdue validation and support from trusted professionals Contact Our Host Steven Newmark, Chief of Policy at GHLF: snewmark@ghlf.org A podcast episode produced by Ben Blanc, Director, Digital Production and Engagement at GHLF. We want to hear what you think. Send your comments in the form of an email, video, or audio clip of yourself to podcasts@ghlf.org Catch up on all our episodes on our website or on your favorite podcast channel.See omnystudio.com/listener for privacy information.
House Committee on Appropriations Subcommittee on Interior, Environment and Related Agencies Budget Hearing – Indian Health Service Meeting Status: Scheduled Hearing Date: Thursday, June 5, 2025 - 1:30 PM Location: Capitol Complex, 2008 RHOB, Washington, DC, 20515, USA Witnesses Mr. Benjamin Smith Acting Director, Indian Health Service Ms. Jillian Curtis Director, Office of Finance and Accounting, Indian Health Service Committee Notice: https://appropriations.house.gov/schedule/hearings/budget-hearing-indian-health-service
The Theology, Medicine, and Culture Initiative (TMC) live-streamed this seminar from the annual Practice & Presence gathering at Duke Divinity School on September 23rd, 2022. Brian Volck was interviewed by TMC Faculty member Dr. Martha Carlough for this conversation, entitled "The Art of Living as Creatures." Dr. Volck is a pediatrician and writer with an MD from Washington University in St. Louis and an MFA in creative nonfiction from Seattle Pacific University. He has provided pediatric care at an Indian Health Service hospital on the Navajo Reservation, at an inner-city community health center in Kentucky, rural clinics in Honduras, a storefront pediatric office, a university-affiliated combined internal medicine-pediatrics teaching practice, and a major teaching hospital. He currently divides his time working in Cincinnati as a pediatric hospitalist, the Navajo Reservation as a pediatrician and writer, and Baltimore, Maryland, where he lives.
Dr. Molly Fuentes is medical director at the inpatient rehabilitation unit at the Seattle Children's Hospital. Dr. Fuentes is an assistant professor of rehabilitation medicine at the University of Medicine. She also is a pediatric physiatrist. She completed her undergraduate degree at Stanford University and is a graduate of the School of Medicine at the University of Michigan. She completed her residency at the University of Washington and later completed a pediatric fellowship at the Seattle Children's Hospital. She then completed a research fellowship in pediatric injury at the Harborview Injury Prevention and Research Center at the University of Washington. She is the medical director at the inpatient rehabilitation unit at the Seattle Children's Hospital. Part 2 She indicated that the Indian Health Service per capita receives half of what Medicaid receives. Treaty-bound trusts for providing health care are chronically underfunded. The Indian Health Service operates under a funding cap, which is annually appropriated. In contrast, Medicare and Medicaid are entitlement programs. She then returned to looking back at the injury-equity framework. She wanted to dive into the pre-event phase factors for native children and teens. An example pertains to motor vehicle injuries. Tribal sovereignty means that tribal laws are what is important to safety on reservations roads, e.g., speed limits and seat belt use. She described various programs that aim to improve safety on tribal roads. She then discussed the post-event phase involving rehabilitation and the golden hour that affects health outcomes. Where native people mostly reside in the U.S., there are fewer trauma centers. A related topic is models of access to health care services. The acceptability of these services by patients is a key element in the quality of health care provided. High rates of health uninsurance affect this population negatively.
Opportunity in America - Events by the Aspen Institute Economic Opportunities Program
Lauren Starks, Director of Good Companies/Good Jobs at the Economic Opportunities Program, recently sat down with two Shared Success grantees—Felicia Ravelomanantsoa, Chief Operating Officer/Chief Financial Officer at African Development Center (ADC), and Elaine Neigel, Business Loan Officer at Four Bands Community Fund—to discuss how job quality work needs to be connected to the unique challenges, assets, and strategies of the local community. ADC, based in Minneapolis where there is a large Somali community, has many clients considering job quality improvements that are aligned with workers' cultural and religious identities. Four Bands, which works with Native American business owners off and on the Cheyenne River Sioux Tribe Reservation, has found that workers on the Reservations prioritize benefits such as affordable housing and flexible schedules for caretaking more than employer-sponsored healthcare plans because of the availability of healthcare through Indian Health Services. About Shared SuccessShared Success, a project of the Economic Opportunities Program, works with community lenders to integrate job quality programming into their small business support services, demonstrating that improved job quality can support the needs of employees while helping small businesses succeed.About the Economic Opportunities ProgramThe Aspen Institute Economic Opportunities Program hosts a variety of discussions to advance strategies, policies, and ideas to help low- and moderate-income people thrive in a changing economy. To learn about upcoming events and webinars, join our mailing list and follow us on social media.
More than a fifth of Indigenous Oklahomans are counted by the U.S. Census Bureau as uninsured – including those who solely use the Indian Health Service as health care coverage. For some, having no insurance can be costly.Mentioned in this episode:Social Media tags
The 2023 FBI Internet Crime Report reveals that nearly 21% of ransomware attacks targeted the healthcare and public health sectors—making them the top victims. This week on Feds At The Edge, we explore how agencies can defend against these growing threats. Benjamin Koshy, Chief Information Security Officer and Director, Division of Information Security of Indian Health Service, explains the unique identity management challenge in healthcare: balancing open patient access with strict data protection. Keith Busby, Acting CISO at CMS, outlines how to go beyond Zero Trust with real-world risk assessments and robust incident response plans - not just a three-ring binder gathering dust on a shelf. And Alec Lizanetz, Identity Protection Specialist from CrowdStrike, emphasizes the importance of prioritizing threats and using frameworks like CISA's to respond efficiently. Tune in on your favorite podcasting platform today to hear practical, high-impact strategies to secure critical systems and protect patient care, perfect for healthcare leaders who must protect both data and lives.
Today, Dr. Katie Burden-Greer, founder of Outlaw Medical, highlights her unique path from her rural Oklahoma roots through her comprehensive medical education and training, which included a residency at the prestigious Mayo Clinic. She discusses her choice to establish a Direct Primary Care (DPC) practice on the Muskogee or Creek Nation Reservation. Despite access to Indian Health Services, Outlaw Medical is building stronger physician-patient relationships and overcoming the access challenges posed by IHS. Already, Dr. Burden-Greer's patient panel is composed of over 20% Native People. Dr. Burden-Greer shares compelling stories from her journey, insights into her practice, and her motivations, including a deep connection to her community. The episode also touches on broader issues in healthcare accessibility and the impact of the DPC model in a rural setting.Hint Summit @ Rosetta Fest 2025! Take $50 off your RosettaFest 2025 registration through May 31st with code HINT50. Register HERE! The DPC Directory: If you're a DPC doctor, you'll find resources to grow your practice! If you serve the DPC world, grab a FREE listing today and get discovered by doctors who need your services.
Think of a mother living in a remote village in Alaska. It's a cold morning, temperatures well below freezing, and she needs urgent medical care for her child—but there's no road connecting her village to any hospital. Her only hope is a plane or a boat, neither of which might arrive in time. Across America, thousands of Native Americans face similar hurdles every day—lack of access to basic healthcare, clean water, and enough nutrition. This is not a challenge of the distant past; it's happening today, in the wealthiest country in the world. I first met Roselyn Tso at last year's Rosenman Symposium, where her talk left a profound impression on me. Her insights into the healthcare barriers that tribal communities face struck a deep chord, highlighting an urgent issue that many of us rarely think about. Stepping forward to tackle these issues head-on is Roselyn, a proud Navajo Nation citizen who has dedicated her life to improving healthcare for American Indians and Alaska Natives. As Director of the Indian Health Service (IHS) from 2022 to 2025, Roselyn managed healthcare delivery to approximately 2.8 million individuals, becoming the first Navajo citizen and second woman to ever hold this role. Her career spans more than four decades, each day driven by a deep personal commitment shaped by her own upbringing on the Navajo reservation. Roselyn believes real solutions require more than just medicine—they demand community engagement, cultural sensitivity, and innovation. Under her leadership, Indian Health Service championed initiatives addressing food insecurity, transportation challenges, and infrastructure gaps, fundamentally reshaping what healthcare means in tribal communities. In our conversation, Roselyn shares her powerful personal journey, the realities faced by Native communities, and her visionary approach to leadership and collaboration. She offers compelling insights into the systemic changes needed to make healthcare truly equitable and effective. Do you have thoughts on this episode or ideas for future guests? We'd love to hear from you. Email us at hello@rosenmaninstitute.org.
Loma Linda University's ethical care for the San Manuel tribe contrasted with the U.S. government's forced sterilizations, fostered a long-term relationship of trust. This culminated in a $25 million gift from the tribe in gratitude for the university's compassionate service.
U.S. Health and Human Services Secretary Robert Kennedy Jr. is overseeing an unprecedented cut of nearly a quarter of the department's staff, drawing widespread concerns about possible adverse affects for thousands of Native Americans who depend on those services. Everything from bill processing to testing and research to prevent lead contamination in children could be constricted. At the same time, Sec. Kennedy successfully reversed Elon Musk's termination of 900 Indian Health Service employees by the Department of Government Efficiency. Kennedy is also reaching out to tribes and maintaining contact through the department's Tribal Self Governance Advisory Committee. We'll look at the latest word on what some of the potential effects of the federal actions are on Native health and health care. GUESTS A.C. Locklear (Lumbee), CEO of the National Indian Health Board Kristen Bitsuie (Navajo), tribal health care outreach and education policy manager for the National Indian Health Board Kim Russell (Navajo), policy advisor for Sage Memorial Hospital
U.S. Health and Human Services Secretary Robert Kennedy Jr. is overseeing an unprecedented cut of nearly a quarter of the department's staff, drawing widespread concerns about possible adverse affects for thousands of Native Americans who depend on those services. Everything from bill processing to testing and research to prevent lead contamination in children could be constricted. At the same time, Sec. Kennedy successfully reversed Elon Musk's termination of 900 Indian Health Service employees by the Department of Government Efficiency. Kennedy is also reaching out to tribes and maintaining contact through the department's Tribal Self Governance Advisory Committee. We'll look at the latest word on what some of the potential effects of the federal actions are on Native health and health care. GUESTS A.C. Locklear (Lumbee), CEO of the National Indian Health Board Kristen Bitsuie (Navajo), tribal health care outreach and education policy manager for the National Indian Health Board Kim Russell (Navajo), policy advisor for Sage Memorial Hospital
The Department of Health and Human Services underwent an unprecedented purge this week, as thousands of employees from the National Institutes of Health, the FDA, the Centers for Disease Control and Prevention, and other agencies were fired, placed on administrative leave, or offered transfers to far-flung Indian Health Service facilities. Altogether, the layoffs mean the federal government, in a single day, shed hundreds if not thousands of combined years of health and science expertise. Lauren Weber of The Washington Post, Rachel Cohrs Zhang of Bloomberg News, and Sarah Karlin-Smith of the Pink Sheet join KFF Health News' Julie Rovner to discuss this enormous breaking story and more. Also this week, Rovner interviews KFF Health News' Julie Appleby, who reported and wrote the latest “Bill of the Month” feature about a short-term health plan and a very expensive colonoscopy. Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too: Julie Rovner: Stat's “Uber for Nursing Is Here — And It's Not Good for Patients or Nurses,” by Katie J. Wells and Funda Ustek Spilda. Sarah Karlin-Smith: MSNBC's “Florida Considers Easing Child Labor Laws After Pushing Out Immigrants,” by Ja'han Jones. Lauren Weber: The Atlantic's “Miscarriage and Motherhood,” by Ashley Parker. Rachel Cohrs Zhang: The Wall Street Journal's “FDA Punts on Major Covid-19 Vaccine Decision After Ouster of Top Official,” by Liz Essley White. Hosted on Acast. See acast.com/privacy for more information.
Send us a textThe transformative power of lived experience drives Monique Allen's mission to revolutionize healthcare access for Native American communities. As a woman who defied doctors' predictions that she wouldn't survive past age 12, Monique has channeled her personal health journey into founding Ma'at Enterprises, a tribally-owned healthcare staffing company serving Indian Health Service facilities nationwide.Named after the Egyptian concept representing truth, balance, and justice, Ma'at embodies Monique's servant leadership philosophy. Her connection to this work deepened upon discovering her own Native American heritage through her mother's tribal connections in Oklahoma, bridging her healthcare expertise with a profound understanding of tribal communities' needs and historical challenges.What sets Ma'at Enterprises apart is Monique's nuanced approach to partnership. Rather than imposing solutions, she builds trust by respecting tribal sovereignty and ensuring communities maintain ownership of their healthcare journey. This stands in stark contrast to broken promises that have characterized much of the historical relationship between government agencies and Native Nations. As Monique powerfully states, "We are not just trying to colonize your data... we want to partner with you."The innovative services Ma'at provides extend beyond traditional staffing to include partnerships with Hospitals Without Borders for rapidly deployable modular clinics, telehealth solutions for remote communities, and connections to cutting-edge diagnostic technologies. These approaches address the stark reality that in 2025, many tribal reservations still lack basic infrastructure like clean water and reliable internet access.Guided by her faith and commitment to authentic service, Monique carefully vets potential collaborations to ensure alignment with Ma'at's mission. Her goal is clear: to become a trusted resource for Native American communities by proving reliability through demonstrated action rather than empty promises. Through this work, she's not just delivering healthcare services – she's helping to heal historical wounds while building pathways to a healthier future for Indigenous communities across America.Thanks for tuning in to this episode of Follow The Brand! We hope you enjoyed learning about the latest marketing trends and strategies in Personal Branding, Business and Career Development, Financial Empowerment, Technology Innovation, and Executive Presence. To keep up with the latest insights and updates from us, be sure to follow us at 5starbdm.com. See you next time on Follow The Brand!
Minnesota has seen a drop in money available for a new budget and could face an even larger projected shortfall down the road. The Department of Management and Budget says lawmakers have just $456 million available for setting the next two-year budget — about 25 percent worse than before.U.S. Senators Tina Smith and Amy Klobuchar are pressing federal agencies for answers regarding the potential termination of the Bemidji Area Indian Health Service's lease.Those stories and more in Thursday's afternoon update.Find these headlines and more at mprnews.org.Minnesota's budget situation worsens in the near and long term with possible deficit growingKlobuchar, Smith call for answers about potential Indian Health Service office lease terminationSubscribe on Apple Podcasts, Spotify, YouTube or RSS.
Senate Committee on Indian Affairs Business Meeting to consider several bills Date: March 5, 2025 Time: 2:30 PM Location: Dirksen Room: 628 H.R.165, To direct the Secretary of the Interior to complete all actions necessary for certain lands to be held in restricted fee status by the Oglala Sioux Tribe and Cheyenne River Sioux Tribe S.105, To direct the Secretary of the Interior to complete all actions necessary for certain lands to be held in restricted fee status by the Oglala Sioux Tribe and Cheyenne River Sioux Tribe S.240, To amend the Crow Tribal Water Rights Settlement Act of 2010 S.241, To provide for the settlement of the water rights claims of the Fort Belknap Indian Community S.390, To require Federal law enforcement agencies to report on cases of missing or murdered Indians S.546, To amend the Omnibus Public Land Management Act of 2009 to make a technical correction to the water rights settlement for the Shoshone-Paiute Tribes of the Duck Valley Reservation S.550, To provide for the equitable settlement of certain Indian land disputes regarding land in Illinois S.562, To approve the settlement of water rights claims of the Pueblos of Acoma and Laguna in the Rio San José Stream System and the Pueblos of Jemez and Zia in the Rio Jemez Stream System in the State of New Mexico S.563, To approve the settlement of water rights claims of Ohkay Owingeh in the Rio Chama Stream System, to restore the Bosque on Pueblo Land in the State of New Mexico S.564, To approve the settlement of water rights claims of the Zuni Indian Tribe in the Zuni River Stream System in the State of New Mexico, to protect the Zuni Salt Lake S.565, To approve the settlement of water rights claims of the Navajo Nation in the Rio San José Stream System in the State of New Mexico S.612, To amend the Native American Tourism and Improving Visitor Experience Act to authorize grants to Indian tribes, tribal organizations, and Native Hawaiian organizations S.620, To provide public health veterinary services to Indian Tribes and Tribal organizations for rabies prevention S.621, To accept the request to revoke the charter of incorporation of the Lower Sioux Indian Community in the State of Minnesota at the request of that Community S.622, To amend the Leech Lake Band of Ojibwe Reservation Restoration Act to provide for the transfer of additional Federal land to the Leech Lake Band of Ojibwe S.632, To amend the Indian Health Care Improvement Act to allow Indian Health Service scholarship and loan recipients to fulfill service obligations through half time clinical practice S.637, To amend the Northwestern New Mexico Rural Water Projects Act to make improvements to that Act S.640, To make a technical correction to the Navajo Nation Water Resources Development Trust Fund, to make technical corrections to the Taos Pueblo Water Development Fund and Aamodt Settlement Pueblos' Fund S.642, To provide compensation to the Keweenaw Bay Indian Community for the taking without just compensation of land by the United States inside the exterior boundaries of the L'Anse Indian Reservation that were guaranteed to the Community under a treaty signed in 1854 S.673, To amend the Miccosukee Reserved Area Act to authorize the expansion of the Miccosukee Reserved Area and to carry out activities to protect structures within the Osceola Camp from flooding S.689, To approve the settlement of the water right claims of the Tule River Tribe S.719, To amend the Tribal Forest Protection Act of 2004 to improve that Act S.723, To require the Bureau of Indian Affairs to process and complete all mortgage packages associated with residential and business mortgages on Indian land by certain deadlines S.748, To reaffirm the applicability of the Indian Reorganization Act to the Lytton Rancheria of California S.761, To establish the Truth and Healing Commission on Indian Boarding School Policies in the United States More on Indianz.Com: https://wp.me/pcoJ7g-w6g
The current flu season is the worst in 15 years in terms of doctor's visits. Tuberculosis cases are rising. On the horizon is a possible bird flu outbreak that is already affecting millions of livestock birds and it's starting to make the jump to humans. This is all happening with the backdrop of lapsed information from the Centers for Disease Control and Prevention, confirmation of a federal health secretary who openly expressed skepticism about vaccines, and unprecedented cuts in the works for the Indian Health Service. We'll get a gauge of the current threats to the health of Native Americans. GUESTS Dean Seneca (Seneca), CEO and founder of Seneca Scientific Solutions+ Katherine Minthorn (Umatilla), an owner of Rez Chicks Co-Op Aiono Dr. Alec Ekeroma (Samoan), director general of Samoa's Health Ministry Chanda Hesson, nurse consultant for the State of Alaska's section of epidemiology and the lead nurse consultant for the Alaska Department of Health's tuberculosis team Dr. Robert Belknap, executive director of the Public Health Institute at Denver Health
Indian Health Service director could become an assistant secretary Murkowski seeks to ensure tribes during federal funding uncertainty Whale of a Good Time: ANSEP celebrates 30th anniversary with students
One possible change to Medicaid being floated in Congress right now includes a $2.3 trillion cut over the next 10 years. Other potential changes include adding certain work requirements and shifting costs and distribution of Medicaid funds to states, which have no trust obligations to tribes. As it is, Medicaid provides direct support to at least one million Native Americans. It's also one of the secondary sources that help provide health care through the Indian Health Service. Advocates are bracing for changes as they continue to make the case for the program's life-and-death importance in Indian Country. GUESTS Dr. Damian Chase-Begay (Mandan and Arikara), associate research professor of public health at the University of Montana Kristen Bitsuie (Navajo), tribal health care outreach and education policy manager for the National Indian Health Board Nanette Star (Choctaw descendant), director of policy and planning at the California Consortium of Urban Indian Health Winn Davis, congressional relations director at the National Indian Health Board
According to recent government reporting, Native Americans have medical debt that is double the national average. That’s despite the fact that the federal government is under a legal and moral obligation to provide healthcare to registered members of federally recognized tribes. In many cases, the debt stems from medical care the Indian Health Service was unable to provide but was supposed to pay for when members sought care elsewhere. The resulting debt damages credit scores and adds to health disparities that impact many indigenous communities, including high costs and poor access to care. Indigenous Affairs reporter Melanie Henshaw has been covering problems with healthcare access for InvestigateWest and joins Libby to share her reporting. Guest: Melanie Henshaw, InvestigateWest Indigenous Affairs Reporter Relevant Links: Native Americans face double the average medical debt, report finds — often for bills that aren’t their responsibility | InvestigateWest Colville tribal citizens left on the hook when Indian Health Service doesn’t pay medical bills | InvestigateWest Report lays bare stark disparities in health care outcomes for Native Americans in Washington | InvestigateWest Thank you to the supporters of KUOW, you help make this show possible! If you want to help out, go to kuow.org/donate/soundsidenotes Soundside is a production of KUOW in Seattle, a proud member of the NPR Network. See omnystudio.com/listener for privacy information.
Native American oncologist Dr. Amanda Bruegl and Dr. Noelle LoConte discuss culturally tailored interventions and the importance of community engagement to advance cancer prevention, diagnosis, and treatment for Native communities. TRANSCRIPT ASCO Daily News: Hello and welcome to the ASCO Daily News Podcast. I'm Geraldine Carroll, a reporter for the ASCO Daily News. On today's episode, we'll be discussing cancer care for Native American communities who face unique challenges and disparities in accessing and receiving cancer care. I'm delighted to be joined by two oncologists who will be sharing their insights on ways to advance cancer prevention, diagnosis, and treatment through culturally tailored interventions and community-based programs for high-risk Native Americans whose issues are chronically overlooked in the healthcare system, according to experts. Dr. Amanda Bruegl is an associate professor of obstetrics and gynecology at the Oregon Health and Science University School of Medicine. She is a gynecologic oncologist at the OHSU Knight Cancer Institute and a citizen of the Oneida Nation and descendant of Stockbridge-Munsee. Dr. Noelle LoConte is an associate professor of medicine at the University of Wisconsin Madison Carbone Cancer Center where she also serves as a GI medical oncologist, geriatrician and leads community outreach. Full disclosures are available in the transcript of this episode. Dr. LoConte and Dr. Bruegl, it's great to have you on the podcast today. Dr. Noelle LoConte: Thanks so much for having me. Dr. Amanda Bruegl: Thank you for having us. ASCO Daily News: Dr. Bruegl, I'd like to start by asking you to tell us a bit about your background and how it has influenced your career and interests as a gynecologic oncologist. Dr. Amanda Bruegl: I grew up in Wisconsin and I have a Native parent and a non-Native parent. And so having an awareness of both cultural influences in my life has really shaped my interest in cancer prevention. Seeing the high rates of preventable death in cancer among Native populations in gynecologic cancers, in particular, has really driven me to dedicate my research career toward decreasing the morbidity and mortality of cervical cancer among Native women. ASCO Daily News: Well, can you tell us about your work in cancer prevention, specifically cervical cancer? The data shows that Native Americans in Oregon get cervical cancer one and a half times more than the general state population and die from it two times more often. What are the factors, the barriers, that are contributing to these high rates of cervical cancer? Dr. Amanda Bruegl: The data in Oregon is actually not just limited to Oregon. Our group did some work in collaboration with the Northwest Portland Area Indian Health Board Tribal Epidemiology Center, and we found that, as you stated, the rates of cervical cancer are one and a half times that of non-Hispanic Whites and the rate of death is about twice. And that's true for the Pacific Northwest. And if you dig deeper into the literature, you see that these rates are true across Indian Country, sometimes worse. When we looked at the age groups, we found that older women had three times the rate of mortality. So looking at like 45 to 65. As I was looking through the literature to figure out, well, why is this, we found that there are very, very few funded studies that even look at this. We have a known persistent disparity that is chronically understudied and underfunded. And so I'm trying to do work in this arena to explore this further. A follow up study that we did was looking at whether we are using the prevention tools. So it's common across the United States that we have two very powerful prevention tools. So participation in cervical cancer screening doesn't necessarily prevent cervical cancer, but you can have early detection of pre-invasive disease or detection of early-stage disease, which is highly curable. And then we also have HPV vaccination, something geared towards the youth in our communities across the U.S. HPV vaccination starting at age 9 with a goal of complete vaccination by the age of 12. So we looked at: Are we using these two tools in Indian Country? And what we found was that participation in cervical cancer screening, looking at who is up-to- date among Natives, and we found that overall the population had about 60% rates of up-to- date on cervical cancer screening compared to general US rates, which are in like the high 70s or low 80s. And then when we looked at that age group that has higher rates of mortality, we actually found that there's only about a 50% rate of up-to-date screening. So we know in one arena people aren't participating in screening. And there's a variety of different contributors to that. There's access to care. How far do you have to travel to get to a provider who will provide cervical cancer screening? Among Native women, there's an over 50% rate of history of sexual trauma, sexual violence, pelvic exam trauma. It's a huge barrier to coming in for this very sensitive exam. There is also mistrust with the medical system in general. There's high turnover of providers at Indian Health Service Clinics. The clinic that I'm currently working at now, so I do outreach at a clinic one day a month and I'm the longest standing doc at that clinic and I'm a consultant who comes one day a month. I've been there since 2016. And so when you can't develop a relationship with a provider and develop trust and there's just this churn of new people every three to six months, developing a relationship to allow someone to feel comfortable with a very personal and private examination can be a huge barrier. On the HPV vaccination side, we found that the numbers for HPV vaccination were pretty optimistic. So the numbers have been going up since our study period started in 2015. The clinics in the Pacific Northwest that are serving Native populations are doing a great job with education, outreach and increasing the numbers. The group with the greatest rates of HPV vaccination are for people assigned female at birth in the 13-18 age group. They are the only group that is approaching the Healthy People 2030 goal. But there's still work to be done in this arena. Those are some big drivers of why this persistent disparity continues. ASCO Daily News: Absolutely. You mentioned some very serious barriers. Sexual trauma, mistrust, long distance to travel to clinics. Looking ahead, can you tell us about potential screening tools that could improve screening? And I also wanted to ask you about innovations you're excited about that could be potentially incorporated into practice to increase the ability and comfort of your patients to screening and access to HPV vaccination. Dr. Amanda Bruegl: So, in terms of cervical cancer screening and how to increase the rates, there are a number of different things in the literature broadly across populations that really show that knowledge and awareness of cervical cancer and cervical cancer screening guidelines is associated with guideline concordant care. And so ensuring that our patients in our communities know and understand what the recommendations are is very important. Efforts to provide education to women in the community, community stakeholders, and culturally tailored content can all be important for increasing the rates of cervical cancer participation. Another thing that has the potential to really help improve screening rates is HPV self-collection. The FDA just recently approved HPV self-collection which can help empower an individual to do their own testing on their own body and not have someone else place a speculum in a private personal area where they're not comfortable. Some of the tribes in our region are starting to adopt this practice. And I just gave a talk to the regional Indian Health Service medical directors and have had really positive feedback about clinics working towards bringing this into their practice. I hope that the FDA can move forward with allowing patients to do this in the comfort of their own home. Sadly, the FDA in their evaluations decided it had to be a clinic administered test. So someone still has to go through the barrier of finding time to, if they have caregiver responsibilities or work, to have these responsibilities taken care of for someone else so they can drive to a clinic. So these barriers of transportation and caregiving are not addressed by this. It addresses some of the trauma, that barrier. And so I think in the US, we can do better about bringing this like FIT testing to our patients. I really hope and challenge our country to move forward with that a bit more. Geraldine Carroll: Thanks, Dr. Bruegl. I'll come back to you in a moment, but first I'd like to switch gears and address some of the challenges faced by Native communities in Wisconsin that were featured in a fascinating study presented by our guest, Dr. Noelle LoConte, at the recent ASCO Quality Care Symposium. The study found that radon levels in Native lands in Wisconsin were much higher than anticipated and may explain higher rates of lung cancer among Native communities in the state. Radon is the second leading cause of lung cancer in the U.S. So, Dr. LoConte, can you tell us more about this study and your incredible partnership with the Stockbridge-Munsee Band of the Mohican Nation Health Center in this work? Dr. Noelle LoConte: You bet. Thanks for the interest. First of all, I think it's just an incredible privilege to work with all of these communities. So, I wanted to say at the jump that this was a joint project led by the cancer center that I'm affiliated with, but also with the Stockbridge-Munsee community. They approved the project and they designed it with us, and they retain ownership of the data. Data sovereignty is an important issue when you're doing this work. But we came to them wanting to work on something around cancer. I actually thought maybe colorectal cancer screening. But in meeting with the health center and the tribal community members, it became clear that they were more concerned that they had intergenerational rates of cancer, and they felt that they were being poisoned by their land. And that brought me to the state Environmental Health Program. And we looked at some data and realized, one, their lung cancer rates were quite high, but two, their radon testing rates were quite low. And that that was a place where we thought we couldn't make some forward momentum. So, we designed a program to educate around radon and radon testing and mitigation and then tested all the homes on the reservation. And we successfully tested all homes for radon and then successfully mitigated all the homes that tested over four picocuries per liter, which is the recommended level at which you should mitigate per the EPA, the Environmental Protection Agency. The statewide average for Wisconsin is 10% positive. And amongst homes that had a basement, which is thought to be the highest risk kind of dwelling in the Stockbridge-Munsee Reservation community, the positive rate was 77%. And when you take all the homes together because we had some homes with crawl spaces or slab foundation, it was around, I believe, 55% positive, so much higher than 10%. ASCO Daily News: Well, that data is just striking. Your study certainly illustrates the vital role that cancer centers can play in mitigating structural determinants of health among Native communities, such as with housing quality. Do you think this will inspire a similar approach in other regions of the country? Dr. Noelle LoConte: Yeah, I think this work was possible because of philanthropy. It is very, very hard to get grant funding for mitigation, in particular. Mitigation is usually done once in the life of the dwelling, but it is very, very expensive. A cheap mitigation is $750, and many are many thousands of dollars especially when you're looking at very rural communities where there's not really a mitigator within hundreds of miles and you have to really negotiate to get somebody to come out there. Every cancer center that's designated by the National Cancer Institute has to have a community outreach and engagement unit or program. I would argue that rather than us generating reports describing disparities, that this kind of work to actually dismantle these determinants of health and move power back into the community is an ideal role for a cancer center. But the funding was definitely a tricky piece of it. And I would hope that we could either envision funding mechanisms that allow for this kind of direct service to communities, or we can continue to work with philanthropic agencies to fund this. ASCO Daily News: Well, looking through a wider lens at the experience of Native communities navigating cancer care, I'd like to ask each of you to comment on how you think the oncology community can better support and serve high-risk Native populations. What message would you like oncologists to take away from this discussion today? Dr. Bruegl, would you like to respond first? Dr. Amanda Bruegl: There's so many layers to needs in our communities. First and foremost, it's important to understand that American Indians and Alaska Natives are sovereign people, sovereign nations. We've been written into the US Constitution as citizens of our own tribes. And it's important to remember that when working with our populations. I think it's also really important to remember that there's treaty law that promised healthcare to our communities. And you see that we are underfunded in all aspects of healthcare, and it's a driver. And people on the healthcare side of things need to remember we represent the failures of the healthcare system to care for our Native communities. Whether or not you wake up in the morning with a goal to help, you have to remember that you represent the institution and the history of this country and are going to be asked to prove yourself in a genuine fashion. And that takes time. I think for people who are in research, it's really important to think about how do you engage and partner with tribal communities so that we're not chronically left behind and left out of study? We seldom show up in the data, and we have to find our own data. Tribal epidemiology centers have been really paramount in helping tribes get access to their data and analyze their data. But you can see in trial after trial after trial, we're sort of shoved into the other box. And so it's so difficult to understand how the cancer story relates to us and how do we improve it? ASCO Daily News: Thank you, Dr. Bruegl. Dr. LoConte, would you like to comment on this as well? Dr. Noelle LoConte: Yeah. I had jotted down a few points. Many are going to be a little bit of a repetition here, but I think the overarching theme is that the goals for academic medicine often are not the goals of the community that you may be seeking to work in, and so being able to pivot was key to the success of my project, I think. Can't underestimate the importance of trust. And trust takes a lot of time and a lot of showing up and a lot of being consistent and delivering on what you say you're going to do. And there's a lot of turnover in academic medicine. People leave institutions, move on for promotions. None of that is going to help strengthen these relationships. So I think institutions would be wise to invest in people that stay. I think there should be things like retention bonuses for those of us that stay in places and do community work. It's certainly not the sexy stuff. It's not what gets you in the Plenary at the ASCO Annual Meeting, for example, but I was beyond delighted that I was on the podium for the ASCO Quality Care Symposium. And I think continuing to elevate this work as meaningful and important work, just as important as clinical trials and new drugs, is really important. I would like to second the motion or the thought that we need to support full funding for the Indian Health Services. It is a promise we made that we continue to underdeliver on that continues to harm patients every day, particularly in the latter half of the year when they run out of funding pretty consistently. For those of us that are non-Native doing this work, to know the history of the community that you're working in and be really mindful of that but also know the role that your institution played in propagating some of these harms. And I think we need more Native physicians that really will help to have concordance with patients and physicians. And so as much as we can support getting more Native folks starting really early – high school, middle school, interested in medicine and biomedical research, all the way through medical school residency fellowship would be really, really impactful. We have a program here founded by Amanda's husband called the Native American Center for Health Professions, or NACHP. It's really a feather in our cap here and I would love to see all medical schools have some sort of pathway program like that. We won't get out of this hole until we start to really take that seriously. ASCO Daily News: Well, thank you so much, Dr. LoConte and Dr. Bruegl for taking the time and showing up for Native communities, and all your work to advance cancer care. We are certainly very grateful for your time today and we will embed links to all of the studies discussed in the transcript of this episode. So thank you again, Dr. LoConte and Dr. Bruegl. Dr. Noelle LoConte: You're welcome. Dr. Amanda Bruegl: Thank you for having us. ASCO Daily News: And thank you to our listeners for your time today. Again, you'll find links to the studies we discussed today in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review and subscribe wherever you get your podcasts. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement. Follow today's speakers: Dr. Amanda Bruegl Dr. Noelle LoConte @noelleloconte.bsky.social Follow ASCO on social media: @ASCO on Twitter ASCO on Facebook ASCO on LinkedIn Disclosures: Dr. Amanda Bruegl – No relationships to disclose Dr. Noelle LoConte: Consulting or Advisory Role: Abbvie, PDGx Research Funding: Exact Sciences
Roselyn Tso (Diné) spent just over two years as director of the Indian Health Service. But her career at the agency spanned more than three decades, most recently as the IHS Navajo Area Director. As her term comes to an end, we'll hear about her call to provide health care for Native Americans, food as medicine, and the immediate and long-term hurdles for IHS. We'll also get an update on efforts by IHS to head off RSV infections that are putting Native children in the hospital as much as ten times more frequently than other populations.
In this powerful episode, we meet Alastair Lee Bitsóí from Naschitti, Navajo Nation, New Mexico, a water clan storyteller whose journey weaves together traditional Indigenous wisdom and modern advocacy. From the challenges of water access affecting one-third of Navajo households to the unexpected healing power of an ancient Four Corners potato, Alastair shares how returning to the land has become a path toward personal and community healing.
In the wake of the recent presidential election, we're revisiting one of our favorite podcast episodes from 2023 about the hurdles America's Indigenous peoples face in accessing health care. What's being done to help elder Native Americans receive culturally competent long-term care? Would it surprise you to learn that relying on the Indian Health Service may not be enough to meet their needs? Why are some members of this highly vulnerable population buying health insurance too? To find out, we spoke to Elder Billie Tohee, executive director of the Albuquerque-based National Indian Council on Aging (NICOA) and former chair of the board.
THIS TIME ON CODE WACK! In the wake of the recent presidential election, we're revisiting one of our favorite podcast episodes from 2023 about the hurdles America's Indigenous peoples face in accessing health care. What's being done to help elder Native Americans receive culturally competent long term care? Would it surprise you to learn that relying on the Indian Health Service may not be enough to meet their needs? Why are some members of this highly vulnerable population buying health insurance too? To find out, we spoke to Elder Billie Tohee, executive director of the Albuquerque-based National Indian Council on Aging (NICOA) and former chair of the board.
THIS TIME ON CODE WACK! In the wake of the recent presidential election, we're revisiting one of our favorite podcast episodes from 2023 about the hurdles America's Indigenous peoples face in accessing health care. What's being done to help elder Native Americans receive culturally competent long term care? Would it surprise you to learn that relying on the Indian Health Service may not be enough to meet their needs? Why are some members of this highly vulnerable population buying health insurance too? To find out, we spoke to Elder Billie Tohee, acting executive director of the Albuquerque-based National Indian Council on Aging (NICOA) and former chair of the board. Check out the Transcript and Show Notes for more!
Donald Trump targeted trans issues during his presidential campaign. He promised to take aim at gender-affirming care early in his upcoming term in office, including restricting federal funds for trans medical support. That could have a major effect on such care within the Indian Health Service. In addition, at least half of all states now ban gender affirming care for minors. A pending U.S. Supreme Court decision will determine the future of such care in those states. We'll gauge the direction for trans issues and find out how trans advocates are preparing both politically and personally for the next few years. GUESTS Shelby Chestnut (Assiniboine), executive director of the Transgender Law Center Dr. Itai Jeffries (Occaneechi), program director for the Northwest Portland Area Indian Health Board's Paths (Re)Membered Project Dr. Hannah Wenger, clinical consultant and contractor at the Northwest Portland Area Indian Health Board's Trans and Gender Affirming Care ECHO Program and Paths (Re)Membered Project
Personal stories of pregnancy-related complications by Indigenous women are the centerpiece of a new informational campaign by the Centers for Disease Control and Prevention (CDC). The CDC wants to raise awareness about the high rate of pre- and post-natal complications among Native women. The effort comes just as the March of Dimes launched its own initiative to improve poor maternal care outcomes. It includes a map of "maternity care deserts", many of which are in areas with high Native populations. We'll talk about these and other efforts to improve care for pregnant Native women. GUESTS Dr. Jennifer Richards (Diné, Oglala Lakota, and Taos Pueblo), assistant professor at Johns Hopkins Center for Indigenous Health Crystal Austin (Diné), director of external affairs for the Johns Hopkins Center for Indigenous Health Dr. Brian Thompson (citizen of the Oneida Nation), physician, obstetrician gynecologist, and member of the national board of March of Dimes Vanessa Sanchez (member of the Shoshone Bannock Tribes), mother from the HEAR HER video campaign Dr. Tina Pattara-Lau, maternal child health consultant at Indian Health Service headquarters
Nurses trained to administer anesthesia to Veterans Affairs patients require supervision from a physician. That's the rule, but their counterparts in the Military Health System or the Indian Health Service, not so for them, and that's prompted the American Association of nurse anesthesiology to urge VA to get on with standards, to let its nurses provide care to more veterans with less supervision. For more Federal News Network's Jory Heckman spoke with the association president. Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Nurses trained to administer anesthesia to Veterans Affairs patients require supervision from a physician. That's the rule, but their counterparts in the Military Health System or the Indian Health Service, not so for them, and that's prompted the American Association of nurse anesthesiology to urge VA to get on with standards, to let its nurses provide care to more veterans with less supervision. For more Federal News Network's Jory Heckman spoke with the association president. Learn more about your ad choices. Visit podcastchoices.com/adchoices
Welcome to Supreme Court Opinions. In this episode, you'll hear the Court's opinion in Becerra v San Carlos Apache Tribe. In this case, the court considered this issue: Must the Indian Health Service pay “contract support costs” not only to support IHS-funded activities, but also to support the tribe's expenditure of income collected from third parties? The case was decided on June 6, 2024. The Supreme Court held that the Indian Self-Determination and Education Assistance Act (ISDA) requires the Indian Health Service (IHS) to pay contract support costs for activities tribes carry out under self-determination contracts, including costs incurred when spending program income from third-party payers. Chief Justice John Roberts authored the opinion of the Court, affirming the decisions of the Ninth and Tenth Circuits. ISDA Sections 5325(a)(2) and (a)(3)(A) require the Indian Health Service (IHS) to pay “contract support costs” to tribes that take over healthcare programs the IHS previously operated. These costs cover reasonable expenses tribes incur to ensure they comply with their contracts with IHS. The tribes' contracts require them to collect and spend “program income” (like insurance payments) to carry out the healthcare programs they took over. When tribes use this program income as required and incur administrative and overhead costs as a result, those costs fit squarely within what the law defines as reimbursable “contract support costs.” The Court rejected IHS's arguments that Section 5326 prohibits paying these costs. That provision was meant to prevent IHS from paying costs related to separate contracts tribes have with other parties, which isn't the situation here. Rather, here, the contract support costs are directly attributable to and associated with the tribes' contracts with IHS, because those contracts themselves require the tribes to collect and spend the program income that generates the costs. Therefore, ISDA requires IHS to pay the contract support costs the tribes incur from spending program income as their IHS contracts demand. Justice Brett Kavanaugh authored a dissenting opinion, joined by Justices Clarence Thomas, Samuel Alito, and Amy Coney Barrett. The dissent argued that ISDA's contract support cost provisions do not extend to the costs associated with spending third-party income, emphasizing that the majority's interpretation could lead to significant financial implications and potentially disrupt the allocation of federal funds. The opinion is presented here in its entirety, but with citations omitted. If you appreciate this episode, please subscribe. Thank you. --- Support this podcast: https://podcasters.spotify.com/pod/show/scotus-opinions/support
The Indian Health Service finds Native Americans and Alaska Natives are two and a half times more likely to report serious psychological distress than other populations. Psychiatry experts say intergenerational trauma may be one factor. There are steps both employers and employees can do to avoid the effects of stress and burnout in the office. There are additional steps that may be beneficial specifically for Native employees. On World Mental Health Day, we'll find out ways to build a healthy workplace. GUESTS Dr. Jillian Fish (Tuscarora Nation of the Haudenosaunee Confederacy), owner of Fish Psychotherapy & Consulting and professor in the Department of Psychology at Macalester College Haley Laughter (Diné), owner of Hozho Total Wellness D.J. Eagle Bear Vanas (Odawa Nation), motivational storyteller; host of the PBS special, Discovering your Warrior Spirit; and author of Warrior Within published by Penguin Random House
In this episode of The Dish on Health IT, Tony Schueth, CEO of Point-of-Care Partners, and Kim Boyd, Regulatory Resource Center Lead, are joined by Pam Schweitzer, former Assistant Surgeon General of the United States and current Chair of the NCPDP Foundation Board of Trustees. Together, they deliver an in-depth discussion on critical topics impacting the health IT landscape, including interoperability, public health data modernization, and evolving healthcare regulations.The episode begins with introductions from Tony and Kim, highlighting Pam's extensive career in healthcare, ranging from her leadership roles in the Indian Health Service and the Veterans Affairs (VA) system to her current position as chair of the NCPDP Foundation. Pam reflects on her experience overseeing the transition from paper to electronic health records and how this complex shift required the coordination of multiple healthcare departments, including radiology and labs.Pam shares her insights into how policy changes, such as CMS 0057 and the HTI-2 proposed rule, are shaping the future of healthcare interoperability. The trio discusses how these regulations, aimed at improving data sharing between payers, providers, and public health systems, will ultimately drive real-time data exchange. They also emphasize the importance of infrastructure, standards, and innovation to support these efforts.As the discussion moves forward, Pam talks about her work on public health initiatives, particularly around pharmacy interoperability, maternal health, and the broader impacts of nutrition and food supply on community health. Kim and Pam also explore the evolving role of pharmacists in public health, especially in rural areas where they often serve as the primary healthcare providers.The conversation includes key steps for modernizing public health data systems, such as addressing the data silos between healthcare and public health systems. Pam emphasizes the need for greater collaboration and data sharing to enable a more effective public health response, especially during crises like pandemics or natural disasters.Pam, Kim, and Tony also touch on the role of the Trusted Exchange Framework and Common Agreement (TEFCA) in promoting data fluidity and expanding the integration of pharmacists and other healthcare stakeholders into the broader healthcare ecosystem.The episode wraps up with Pam expressing her optimism for the future of health IT and public health interoperability, while stressing the importance of ongoing collaboration between stakeholders, from policymakers to healthcare technology vendors. Kim adds that the evolution of pharmacy practice and regulatory changes are driving significant improvements in patient care and medication management.Listeners can tune in for a deep dive into the intersections of health IT policy, pharmacy standards, and public health modernization, with practical insights from leaders in the field. This episode is a must-listen for those interested in healthcare interoperability, the impact of CMS and ONC policies, and the future of public health and pharmacy integration.Catch the full episode on your preferred podcast platform, including Apple Podcasts, Spotify, and Healthcare Now Radio, or watch the video version on YouTube.Other resources you may be interested in:Healthy People 2030 – Data and Information Systemshttps://health.gov/healthypeople/objectives-and-data/browse-objectives/public-health-infrastructurePublic Health Infrastructure - Healthy People 2030 | health.govhttps://health.gov/healthypeople/objectives-and-data/browse-objectives/public-health-infrastructureStrategies for Public Health Interoperability | PHDI | CDChttps://www.cdc.gov/data-interoperability/php/public-health-strategy/index.htmlMarch 27, 2024 – Draft 2024-2030 Federal Health IT Strategic Planhttps://www.healthit.gov/sites/default/files/page/2024-03/Draft_2024-2030_Federal_Health_IT_Strategic_%20Plan.pdf2023 – Infrastructure for Scaling and Spreading Whole Health – Health Informaticshttps://www.nationalacademies.org/our-work/transforming-health-care-to-create-whole-health-strategies-to-assess-scale-and-spread-the-whole-person-approach-to-health
host Dave Sobel interviews RJ Kedziora, the co-founder of Estenda Solutions, a company specializing in software, data analytics, and AI for the healthcare industry. RJ shares insights into the innovative work his firm does, focusing on digital health solutions that aim to improve the health and wellness of individuals. He highlights two key projects, including a diabetic retinopathy surveillance program in partnership with the Joslin Diabetes Center and the Indian Health Services, as well as the development of digital weight loss solutions for startups.The conversation delves into the evolution of AI technology and its impact on the healthcare sector. RJ emphasizes the shift towards making AI more accessible to non-technical users, enabling them to leverage data analytics and AI tools without deep technical expertise. He discusses the importance of structured data and data strategy in preparing for AI implementation, emphasizing the need for a solid foundation in data management and privacy compliance within the healthcare industry.RJ also shares insights into the practical applications of AI in software development and product development processes. He highlights the efficiency gains and productivity enhancements that AI tools bring to the table, enabling developers to streamline tasks such as data querying, report generation, and user interviews. The conversation underscores the importance of understanding AI frameworks and tools to maximize their benefits in various development workflows.The episode concludes with a focus on the current customer conversations around AI adoption in healthcare. RJ notes that many customers are eager to explore AI solutions but often require guidance on where to start and how to leverage data effectively. The discussion highlights the healthcare industry's gradual embrace of data-driven technologies and the ongoing challenges in integrating AI into existing workflows. Supported by: https://getthread.com/mspradio/ All our Sponsors: https://businessof.tech/sponsors/ Do you want the show on your podcast app or the written versions of the stories? Subscribe to the Business of Tech: https://www.businessof.tech/subscribe/Looking for a link from the stories? The entire script of the show, with links to articles, are posted in each story on https://www.businessof.tech/ Support the show on Patreon: https://patreon.com/mspradio/ Want our stuff? Cool Merch? Wear “Why Do We Care?” - Visit https://mspradio.myspreadshop.com Follow us on:LinkedIn: https://www.linkedin.com/company/28908079/YouTube: https://youtube.com/mspradio/Facebook: https://www.facebook.com/mspradionews/Instagram: https://www.instagram.com/mspradio/TikTok: https://www.tiktok.com/@businessoftechBluesky: https://bsky.app/profile/businessoftech.bsky.social
Syphilis is relatively easy to treat. But that fact hasn't stopped an unremitting increase in the disease that is hitting Native Americans hardest. Public health officials say American Indian and Alaska Native people currently suffer the highest syphilis infection rates of any group in the country – and the highest recorded since the cure was discovered in 1941. The Indian Health Service warns cases of congenital syphilis have resulted in stillbirths or infant deaths shortly after birth. Medical officials have a series of detection and treatment recommendations. We'll revisit the problem of syphilis infections and discuss the strategies for solving it. GUESTS Dr. Naomi Young (Navajo), family medicine physician and director of medical services at the Fort Defiance Indian Hospital Dr. Loretta Christensen (Navajo), chief medical officer for the Indian Health Service
Crown Council Mentor of the Month | Helping Dental Teams Build a Culture of Success
Dr. Kemmet grew up on a farm near Tappen, ND where his father farms and runs a water/irrigation well drilling company. His father jokes that he stayed in the family business drilling holes. The rest of Dr. Kemmet's family, his mother and sister, are registered nurses. It is easy to see why dentistry, with its hands-on, practical application to medicine was a draw to him with his solid North Dakota born and bred background! Uniquely, Dr. Kemmet attended a boarding high school in West St. Paul, MN, St. Croix Lutheran High School, then received his degree in Chemistry from NDSU in Fargo. He went on to receive his degree in Dental Surgery from the University of Minnesota in Minneapolis in 2007. Dr. Kemmet initially practiced in South Dakota for nearly 3 years with the Indian Health Service before joining a residency program in Oklahoma for an additional year after that. He then moved back to Minneapolis for 2 years and worked for a large private practice group dental office, as well as for Children's Dental Services, a low-income high-need dental service where he practiced throughout the Minneapolis/St. Paul area in Head Start facilities, grade schools, and middle schools. In 2012, Dr. Kemmet made the decision to move back “home” to North Dakota. To him, Minot was the perfect blend of city and country. He purchased the dental practice of Dr. Curtis Kumpf, and within 18 months had relocated his practice, freshly redesigned by his friend Chris Hawley, to its current location in the heart of the Town & Country Center Mall. Dr. Kemmet loves family time with his wife Grace and their three children, two dogs and cat. They are always finding ways to road trip for a hike in the mountains, fishing with his friends for charity, or finding a concert to attend. His life hobby has been prairie dog “hunting” which really is just long-distance precision shooting. They are currently enjoying gardening, home renovations, and anything else they can do together. Professionally Dr. Kemmet doesn't seem to know the meaning of slowing down. He is always looking to advance not only his own knowledge, but the field of dentistry itself in the rapidly changing field of airway related dentistry and growth and development, where his passion lies. He has mentored classes at Spear Education in Scottsdale Arizona since 2010 in areas from same-day crowns with CEREC technology, to treatment planning, and now focusing on Airway. In addition to running Kemmet Dental Design, Dr. Kemmet is working to change how dentistry is taught in ND. It was Dr Kemmet's vision of helping our community of dentistry in ND through increased access to dental hygiene and assistant training. He believes we have just scratched the surface of where we need to be. He has a goal to double our Nursing classes in Minot as well as triple our Dental Hygiene and assisting classes to help alleviate our national shortage and grow our community. To accomplish this, he envisions a full dental hygiene clinic where extern dentists from regional dental schools can complete their training and current dental assistants and hygienists from other areas in our country can also learn expanded function dentistry. This would help alleviate the demand for dental services in west and northwest ND and help our city and state residents with the best care possible. Fires start with a spark, and he has no shortage of fire in his passion for dentistry. Marvel Comics has pitched a new superhero movie, though Dr Kemmet doesn't want anyone to think that this is fantasy. It's for real life, as Bluey would say.
Send us a Text Message.Today, we have the pleasure of welcoming Dr. Sonny Miles, a specialist in integrative medicine and palliative care, to our podcast. Dr. Miles focuses on a holistic approach to health and comfort care, making her insights particularly valuable for our discussion today. Thank you, Dr. Miles, for joining us and sharing your expertise on lightening the load.Dr. Miles begins by sharing her journey into palliative care, which she discovered during her residency at UCSF. Initially, she didn't see herself in this field, opting instead for hospital medicine at Indian Health Services in Northwest New Mexico. However, she quickly realized the importance of honest and open conversations about patient care. These conversations often revealed a mismatch between medical expectations and patient desires, leading her to pursue further training in palliative care. This field emphasizes early and meaningful conversations that allow patients to make informed decisions about their lives and care, focusing on quality of life and personal choices.Dr. Miles reflects on the profound impact of these conversations, both on her patients and on her own life. Discussing what matters when time is short has made her live more intentionally, choosing what truly matters to her. She notes that while the work is challenging, it is also deeply enriching and meaningful.Dr. Miles offers practical advice for caregivers, including a mantra from her acupuncturist: "I give you back to you, and I give me back to me." This practice helps in separating oneself from the emotional burdens of others. She also highlights the importance of mindfulness and somatic exercises, which help reconnect the physical and emotional bodies. These practices, such as craniosacral therapy, can release stored trauma and emotions, facilitating healing.Thank you, Dr. Miles, for joining us and sharing your wisdom. About Dr. Miles: Dr. Sonny Miles practices integrative medicine and palliative care. Her experience taking care of those with serious illness have fostered a special interest in intentional living and connecting our physical health and our emotional journey.Websites:http://sonnymilesmd.com/https://www.healingwithintentionim.com/Social Media Links:https://www.instagram.com/healingwithintentionim/ https://www.facebook.com/healingwithintentionintegrativemedicine#IntegrativeMedicine #PalliativeCare #HolisticHealth #CaregiverSupport #MindfulLivingThe Power of Peacefulness and Stress Relief Podcast was created by Sharon McLaughlin MD FACS to help normalize mental health. If you need help creating peace in your life be sure to download our peacefulness workbook.https://sharonmclaughlinmd.com/workbookI would love to hear your thoughts.Instagram-https://www.instagram.com/sharonmclaughlinmd/Tik Tok-https://www.tiktok.com/@sharonmclaughlinmdLinkedin -https://www.linkedin.com/in/sharonmclaughlinmd/Facebook-https://www.facebook.com/sharon.t.mclaughlin/Email sharon@sharonmclaughlinmd.com
On Wednesday, July 24, 2024, at 10:15 a.m., in Room 1334 Longworth House Office Building, the Committee on Natural Resources, Subcommittee on Indian and Insular Affairs will hold a legislative hearing on the following bills: H.R.6489, the Alaska Native Village Municipal Lands Restoration Act of 2023 H.R.8942, the Improving Tribal Cultural Training for Providers Act of 2024 H.R.8955, the IHS Provider Integrity Act H.R.8956, the Uniform Credentials for IHS Providers Act of 2024 Witness List Mr. Benjamin Smith [H.R. 8955, H.R. 8942, and H.R. 8956] Deputy Director Indian Health Service U.S. Department of Health and Human Services Rockville, Maryland The Hon. Jarred-Michael Erickson [H.R. 8955, H.R. 8942, and H.R. 8956] Chairman Confederated Tribes of the Colville Reservation Nespelem, Washington Ms. Amber Torres [H.R. 8955, H.R. 8942, and H.R. 8956] Chief Operating Officer National Indian Health Board (NIHB) Washington, D.C. Ms. Jerilyn Church [H.R. 8955, H.R. 8942, and H.R. 8956] Executive Director Great Plains Tribal Leader's Health Board (GPTLHB) Rapid City, South Dakota Mr. Ben Mallott [H.R. 6489] [Minority Witness] Vice President for External Affairs Alaska Federation of Natives (AFN) Anchorage, Alaska More Info: https://indianz.com/News/2024/07/22/legislative-hearing-on-h-r-6489-h-r-8942-h-r-8955-h-r-8956/
Mental health conditions tops the list of causes for pregnancy-related deaths over a three-year period in a recent study by the Centers for Disease Control and Prevention. Calling the problem an “urgent public health crisis”, the Biden Administration is forming a task force to report to Congress about ways to turn the statistics around. We'll get reports from those who know about mental health treatments for pregnant Native Americans. GUESTS Dr. Jennifer Crawford, clinical psychologist and assistant professor in Psychiatry and Behavioral Sciences at the University of New Mexico School of Medicine with a secondary appointment in obstetrics and gynecology Dr. Tina Pattara-Lau, maternal child health consultant at Indian Health Service headquarters Dr. Jennifer Richards (Diné, Oglala Lakota and Taos Pueblo), assistant professor at Johns Hopkins Center of Indigenous Health
Melissa, Kate, and Leah recap the oral arguments in the case challenging the FDA's approval of mifepristone, one of the drugs used in medication abortion. They also recap arguments in cases about the Armed Career Criminal Act and Indian Health Services, and give some updates on cases they're watching in the lower courts, ranging from immigration, to guns, to Title IX.Get your tickets to Strict Scrutiny Live HERE, or head to crooked.com/events for more info.ICYMI, we did a quick reaction episode on Tuesday right after the mifepristone case was argued Follow us on Instagram, Twitter, Threads, and Bluesky
A case in which the Court will decide whether the Indian Health Service must pay “contract support costs” not only to support IHS-funded activities, but also to support the tribe's expenditure of income collected from third parties.
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