Senator Murkowski Chairs Hearing On Indian Health Service Budget

Calls on Agency to Address Alaska Specific Needs

U.S. Senator Lisa Murkowski (R-AK) chaired an Interior Appropriations Subcommittee hearing recently, examining the Fiscal Year 2019 budget request for the Indian Health Service (IHS). During the hearing, Senator Murkowski addressed budget priorities from opioid funding and the Prescription Drug Monitoring Program to maintenance backlogs and the need for staffing quarters for healthcare professionals.

The hearing featured Indian Health Service Acting Director Rear Admiral Michael Weahkee, Rear Admiral Michael Toedt, M.D., Chief Medical Officer, Gary Hartz, Director of Office of Environmental Health and Engineering, and Ann Church, the Acting Director for the Office of Finance and Accounting.

During the hearing Senator Murkowski commended funding for contract support costs within the budget request which would provide certainty for tribes and specific IHS programs, but expressed her concern that the FY 2019 budget request would not adequately meet the needs for healthcare delivery in Indian Country and that more needs to be done to meet our trust responsibilities and meet the needs of American Indians, Alaska Natives and Native Hawaiians.

“For the last 2 years at these budget hearings, I have asked what steps the agency is taking to address the chronic problems with health care delivery in the Great Plains region.  I have yet to be convinced that the Service has put in place an effective plan to address this issue,” said Senator Murkowski. “I’m also concerned that the budget does not adequately address the opioid epidemic, which has been especially acute for American Indians and Alaska Natives.  The statistics are shocking.  According to the Service’s budget justification, American Indians and Alaska Natives had the highest drug overdose death rates in 2015.  Equally distressing, the justification shows a 519 percent increase in drug overdose deaths from 1999-2015, the largest percentage increase of any population.” 

During the hearing, Senator Murkowski discussed specific topics which impact Alaskans including high suicide rates and behavioral health issues among Alaska Native communities, difficulties in Indian Health Service Data Collection, and funding for sufficient staffing packages for the Yukon-Kuskokwim Health Corporation facility being built in Bethel.

Senator Murkowski also asked questions and raised concerns regarding specific topics which impact Alaskans: (Click headlines to watch videos)

  • Village Built Clinics: In the FY 2018 government funding bill, $11 million was included to help address the issue of the Village Built Clinics. Senator Murkowski asked how that funding would be allocated, when it would be distributed and raised her concern for the amount of money that is being used from these funds to pay for leasing costs as a result of the Maniilaq court decision, which mandates payments of leasing costs under section 105(l) of the Indian Self Determination Act when tribal facilities are used to operate IHS programs. She asked what resources were needed to adequately address these new leasing obligations, and whether IHS had a plan to address these increasing costs moving forward.
  • Small Ambulatory Clinic Program: As the budget request did not include funds for the program, Murkowski made clear her commitment to continue to fight for future funding for the program that has been used to construct facilities throughout Alaska villages. In the latest round of grant awards announced last week funding was provided for Shishmaref, Ninilchik, New Kongiganak Village, Tok, and Tatitlek.  
  • Opioid Funding: Murkowski asked what steps IHS is taking to address the opioid epidemic.
  • Prescription Drug Monitoring Program: Murkowski discussed the Prescription Drug Monitoring Program (“PDMP”) to help address the problem of opioid over-prescription, and asked for clarification on whether IHS funded facilities are utilizing the program.
  • Special Diabetes Program: Murkowski asked for an update on the Special Diabetes Program and diabetes rates among American Indians and Alaska Natives and raised her concern for the potential reduction of funding as outcomes improve.
  • Community Health Aid (CHAP) Program Funding: Murkowski asked the IHS Acting Director to confirm that funding for the Community Health Representative Program will not affect (CHAP) funding, a program essential to Alaska.
  • Facilities Construction and Maintenance Reductions: Murkowski addressed her concern with the suggested 40% reduction in funding for Facilities Construction and Maintenance Reductions, in light of a sizeable, current backlog.
  • Staffing Quarters: As recruiting and retaining providers in rural Alaska is a difficult task, increasingly so because of subpar facilities and inadequate housing facilities, Murkowski asked for an update on staffing quarters for healthcare professionals. $11.5 million was provided in the FY 2018 government funding bill and the Indian Health Service indicated $5.5 million of this was allocated to Alaska.

Related Issues: Health, Alaska Natives & Rural Alaska