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Thune and Barrasso Introduce Comprehensive Bill to Reform the Indian Health Service

“My message to our tribal citizens is clear: IHS leaders must be held accountable, and this legislation would put us in a much better position to do so.” – Sen. Thune

May 19, 2016


U.S. Sens. John Thune (R-S.D.) and John Barrasso (R-Wyo.), chairman of the Senate Committee on Indian Affairs, today introduced the IHS Accountability Act of 2016, comprehensive legislation that would address the systemic failures at IHS by increasing transparency and accountability at the agency. By implementing these common-sense reforms, IHS and its leaders could refocus on their key mission, which is to provide tribal citizens with access to safe, quality health care.   

“After years of inaction at IHS, there are still more questions than answers for the tribal members who depend on the agency for their health care needs,” said Thune. “IHS has failed – both in its treaty obligation and moral duty – to provide the quality care that Native Americans across the Great Plains area, including South Dakota, deserve. Sen. Barrasso and I have spent months working together on a comprehensive approach to address the IHS crisis, and I’m grateful for his commitment to tackling this important issue. My message to our tribal citizens is clear: IHS leaders must be held accountable, and this legislation would put us in a much better position to do so. I look forward to continuing to work with Sen. Barrasso and the delegations from our region to improve IHS.” 

“A patient-centered culture change at the Indian Health Service is long-overdue,” said Chairman Barrasso. “This bill is an important first step toward ensuring that tribal members receive proper healthcare and that there is transparency and accountability from Washington. We have heard appalling testimonies of the failures at IHS that are unacceptable and will not be tolerated. We must reform IHS to guarantee that all of Indian Country is receiving high quality medical care.” 

In February, Thune joined Chairman Barrasso in an oversight hearing and listening session on the substandard quality of care provided by IHS to the Great Plains area. Following the hearing, Thune penned an op-ed on the importance of holding IHS leaders accountable.  

The IHS Accountability Act would improve transparency and accountability at IHS by:

  • Expanding removal and discipline authorities for problem employees at the agency;
  • Providing the secretary of the U.S. Department of Health and Human Services (HHS) with direct hiring and other authorities to avoid long delays in the traditional hiring process;
  • Requiring tribal consultation prior to hiring area directors, hospital CEOs, and other key leadership positions;
  • Commissioning Government Accountability Office reports on staffing and professional housing needs;
  • Improving protections for employees who report violations of patient safety requirements;
  • Mandating that the secretary of HHS provide timely IHS spending reports to Congress; and
  • Ensuring the Inspector General of HHS investigates patient deaths in which the IHS is alleged to be involved by act or omission.

The IHS Accountability Act also addresses staff recruitment and retention shortfalls at IHS by:

  • Addressing gaps in IHS personnel by giving the secretary of HHS flexibility to create competitive pay scales and provide temporary housing assistance for medical professionals;
  • Improving patient-provider relationships and continuity of care by providing incentives to employees; and
  • Giving the secretary of HHS the ability to reward employees for good performance and finding innovative ways to improve patient care, promote patient safety, and eliminate fraud, waste, and abuse.  

The IHS Accountability Act is based primarily on feedback and information received by Thune, Barrasso, and members of the Senate Indian Affairs Committee during the February hearing and listening session. Further input from Indian Country is essential to fixing the underlying problems at IHS, which is why the senators will continue to engage with the tribes for ideas on how to improve this legislation.