On May 16th, CCUIH Board President Sonya Tetnowksi, CEO of IHCSCV testified during the Committee of Appropriations AIAN Public Witness Hearing. She underscored the vital role California Urban Indian Health Programs (UIHPs) play in the Indian Health Service health care delivery system. We thank Sonya for her leadership and representing the UIHP American Indian patient population.
An excerpt from Sonya Tetnowski’s testimony: “Federal support remains critical to ensure the delivery of essential health services both on and off reservation land…. We ask that while you are considering appropriations for FY 2018 consider an increase for I/T/U system of care, (“I- Indian Health Service, T- Tribal Health providers (Tribal 638), and U- Urban Indian Health Providers) with a formulary that takes into account the entire AI/AN population and steps to create network capacity and infrastructure to meet our health needs wherever we are.”
California is home to 10 Urban Indian Health Organizations, representing nearly one-third of all Title V programs nationwide. According to the 2010 Census, nearly 90% of American Indian Alaska Native (AIAN) in California live in urban areas, compared to 78% nationwide. Because the majority of the Urban Indian population in California is unable to access their Tribes for health and wellness services, UIHPs are a key lifeline to the population.
Today Congressman Valadao introduced H.R. 1842 The Indian Health Service Health Professions Tax Fairness Act of 2015, which amends the tax code to provide healthcare professionals who receive student loan repayments from the Indian Health Service the same tax free status enjoyed by the National Health Service Corps.
H.R. 1842 would help recruit and retain health professionals to serve in underserved American Indian communities throughout the nation. Our Urban Indian communities in California could greatly benefit from this legislation, particularly those in the Fresno American Indian Health Projects and the Bakersfield American Indian Health Project service areas.
This bill is extremely bipartisan with support from Republicans and Democrats in the House, Senate, and language from the Executive Branch.
Allows funds from the Indian Health Service Professions Scholarships Program to be excluded from gross income under Section 117(c)(2) of Internal Revenue Code and allows participants in the IHS Loan Repayment Program to exclude from gross income loan amounts forgiven by IHS under Section108(f)(4) of IRC.
Legislation would bring the Indian Health Service in line with National Health Service Corps and the Armed Services Health Professions scholarships which are currently tax exempt.
Currently, there are over 1,550 health professional vacancies in the Indian Health Service. Making IHS loan repayment tax exempt would free up $5.71 million, funding an additional 115 health professionals.
Each Indian Health Service medical professional in the program will bring in significant added revenue through 3rd party billings.
Bipartisan support in the 114th Congress both House and Senate
Bipartisan support in the 113th Congress
Presidents FY16 budget supports this approach
American Dental Association
American Academy of Pediatrics
National Indian Health Board
National Council of Urban Indian Health
On April 14, 2015, the U.S. Senate passed a two (2) year renewal for the Special Diabetes Program for Indians (SDPI). The renewal was contained in a larger bill called: The Medicare Access and CHIP Reauthorization Act of 2015 (HR 2). CCUIH is grateful to the National Indian Health Board for the work that they continue to do to make this program sustainable and effective for the long-term.
SDPI is one of many programs in this legislation. Other provisions included a 2-year authorization of the Children Health Insurance Program (CHIP) and a permanent adjustment of the Medicare physician payment formula. You can read a summary of the legislation here.
SDPI provides critical programs that are helping our Tribal communities address complications and burdens of Type 2 diabetes. The newly-passed legislation funds SDPI at $150 million per year, which is the same as the current level. This program will now expire on September 30, 2017.
Congress established the Special Diabetes Program for Indians (SDPI) in 1997 as part of the Balanced Budget Act to address the growing epidemic of diabetes in American Indian and Alaska Native communities. SDPI currently provides grants for 404 programs in 34 states – including California.
At a rate of 2.8 times the national average, American Indians and Alaska Natives have the highest prevalence of diabetes. In some AIAN communities, over 50% of adults have been diagnosed with type 2 diabetes.
SDPI is changing troubling statistics like this, with marked improvements in average blood sugar levels, reductions in the incidence of cardiovascular disease, prevention and weight management programs for our youth, and a significant increase in the promotion of healthy lifestyle behaviors. This success is due to the nature of this grant program to allow communities to design and implement diabetes interventions that address locally identified community priorities.
SDPI in California
Nearly 9% of California’s population, or 2.5 million people (CDC, 2010), have diagnosed diabetes, many of which suffer from serious diabetes related complications or conditions. The rate of diabetes for Urban Indians is 78% higher compared to the general population of California.
SDPI funding in California totals $12,086,979. Of this total, $2,018,600 funds 7 Diabetes Prevention programs, 1,369,900 funds four Healthy Heart programs, and 8,698,479 funds 41 Community-Directed Grant programs.