Friday, December 7, 2012

Secretary Sebelius' remarks at today's White House Tribal

Secretary Sebelius' remarks at today's White House Tribal 
> Nations Conference
> 
> White House Tribal Nations Conference
> 
> December 5, 2012
> Washington, DC
> 
> Good Morning.  The Department of Health and Human Services is proud  
> to be partners with you in working to open new doors of opportunity  
> across Indian Country.
> 
> During a recent visit to Tribal communities in South Dakota, I saw  
> some great examples of our work together.
> 
> At Sinte Gleska University on the Rosebud Sioux Indian reservation,  
> I met young people served by a unique children’s mental health  
> program that blends Western and traditional Lakota cultural  
> approaches to healing.
> 
> I met students at the Red Cloud Indian School on the Pine Ridge  
> Indian reservation where the Administration is supporting a Lakota  
> Language Program which teaches the Lakota traditions through a rich  
> K-12 curriculum.
> 
> And I met community members who had begun to eat healthier and  
> increase their physical activity with support from the Special  
> Diabetes Program for Indians.
> 
> There are rich partnerships like these all across Indian Country.  
> And they are giving more First Americans reason to feel hope for  
> the future instead of despair.
> 
> To be sure, we face incredibly persistent challenges today: high  
> unemployment, energy costs, suicide, chronic disease and federal  
> resources stretched thin.
> 
> But I also know that smart investment has allowed us to make real  
> progress. Programs like those I visited in South Dakota were made  
> possible by a strong collaboration between tribes and the Obama  
> Administration.
> 
> They are also part of something bigger happening across Indian  
> Country.
> 
> When President Obama took office, he recognized that we needed more  
> than a series of individual success stories. We needed a  
> comprehensive approach. And if you look back over the last 4 years,  
> you can begin to see what that has meant for Indian Country.
> 
> Four years ago, the Indian Health Service had a budget of $3.8  
> billion. Today, it’s 29 percent larger at $4.3 billion.
> 
> Four years ago, the Contract Health Service budget was $579  
> million.  In most places, IHS could fund only life or limb  
> referrals. Today, the Contract Health Service budget is $843  
> million, a 46 percent increase that has allowed many more patients  
> to get the referrals they need.
> 
> And it’s not just the budget.
> 
> Four years ago, the reauthorization of the Indian Health Care  
> Improvement Act was hopelessly stuck in Congress. Today, after more  
> than a decade of trying, it has been permanently authorized. The  
> Indian Health Service is here to stay.  The law also means that  
> Tribes can get coverage for their employees through the Federal  
> Employees Health Benefits Program.  More than 10,000 are already  
> enrolled.
> 
> And by approving every single Tribal Facility for the National  
> Health Service Corps, we’re bringing more providers to communities  
> in need. As you know this is a program that says to doctors,  
> nurses, and dentists: “If you go practice in an underserved  
> community, we’ll give you a scholarship or help pay your loans.”  
> Four years ago, because of the complicated certification process,  
> fewer than 60 IHS and Tribal facilities were eligible for Corps  
> members. Today, there are 587.
> 
> I am also proud to say that after close consultation with Tribes,  
> the VA and IHS will announce a national agreement tomorrow for the  
> VA to reimburse IHS for the direct care it provides veterans. This  
> agreement includes the outpatient all-inclusive rate that Tribes  
> preferred. Implementation will begin soon at federal sites. This  
> agreement will make it easier for tribes to enter their own  
> agreements with VA for the health services they provide.
> 
> Now at HHS, the well-being of the American Indian and Alaska Native  
> people is a priority that extends beyond the Indian Health Service  
> to reach every operating division and program office.  We recognize  
> that giving people the opportunity to thrive requires more than  
> just access to quality care. It is also comes from investing in  
> whole families and strong communities.
> 
> Four years ago, American Indian and Alaska Natives in the foster  
> care, and child welfare system had to go through large state  
> programs and outside groups. Today, we have created a process for  
> tribes to operate their own Title IV-E programs. The Port Gamble  
> S’Klallam [ SKLAW-lam] Tribe was the first. And right now we  
> continue to process additional agreements with other tribes.
> 
> Four years ago, we were seeing a steady decline in the number of  
> children in Head Start who spoke a tribal language at home. Today,  
> we’re using Head Start’s new performance standards to begin  
> integrating tribal language and culture into their classrooms and  
> curricula.
> 
> Four years ago, tribal nations were largely on their own in the  
> ceaseless fight against alcohol and substance abuse. Today, our  
> department has a dedicated office working with tribes as they  
> develop detailed action plans and coordinate resources from across  
> the federal government.
> 
> All of this progress is built on a strong foundation of  
> consultation. And we’ve made progress here too.
> 
> Four years ago, HHS had an outdated consultation policy on its  
> books. Today with your guidance it has been updated, and 7 agencies  
> within the Department have their own new or updated consultation  
> policies. Our new Department-wide policy calls for us to regularly  
> evaluate our progress. So we recently sent each of you a letter  
> asking for your input. And I look forward to your perspective.
> 
> Four years ago, our Department’s leadership was receiving irregular  
> updates about its work in Indian Country -- often only when there  
> was a crisis to solve. Today, our senior leaders and I meet  
> regularly with the Secretary’s Tribal Advisory Committee or STAC --  
> the first cabinet level committee of its kind.  And we have charged  
> the STAC not only with addressing today’s biggest problems but also  
> with making the most of tomorrow’s opportunities.
> 
> One of the biggest of those opportunities is our ongoing work to  
> implement the Affordable Care Act. We need your help to make sure  
> people are taking advantage of the law which includes many  
> important benefits for American Indians and Alaska Natives.
> 
> It puts in place new rules prohibiting insurers from imposing  
> lifetime dollar limits on your benefits. Young adults who would  
> otherwise be uninsured, can now stay on their parents insurance  
> until they turn 26.  And key preventive services like diabetes  
> screening and mammograms, now cost nothing out of pocket for most  
> people in private plans and elders on Medicare.
> 
> In 2014, more of Indian Country’s most vulnerable may be covered by  
> Medicaid. States will receive federal funding assistance to extend  
> their programs to uninsured adults with incomes below 133 percent  
> of the Federal Poverty Level. That’s about $15,000 a year for an  
> individual and $31,000 for a family of four.
> 
> At the same time, new competitive insurance marketplaces will allow  
> hundreds of thousands of American Indians and Alaska Natives to  
> purchase quality, affordable health coverage for the first time.
> 
> But we need your partnership to educate tribal communities about  
> the law’s new benefits and protections -- and to identify everyone  
> who is eligible and help them enroll.
> 
> And together, we need to hold our partners in the states  
> accountable. Last year, I wrote a letter to Governors reiterating  
> my full commitment to strong government-to-government relationships  
> with Tribes. And I will continue to remind states that they must  
> consider Tribes full partners during the design and implementation  
> of any programs that use HHS funds.
> 
> Looking back, it’s clear that we are in a much better place today  
> than we were 4 years ago. But the time is now to look forward.
> 
> The journey ahead will not be easy. But it is possible to envision  
> an Indian Country 4 years from now where everyone has access to the  
> quality care they need to get healthy and stay well; where more  
> children have the chance to follow her dreams; and where every  
> community can protect its culture and traditions while creating new  
> opportunities for work and growth.
> 
> We can fulfill that great promise by continuing our work together.  
> We have made great progress, but we have much more work to do. And  
> this Administration is committed to working hand-in-hand with you  
> to improve lives for the better in Indian Country.

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