Programs and funding aim to alleviate shortage of Indian healthcare providers

The Indian Health Service (IHS) has assembled bipartisan support from Congress to recruit and hire more health workers for understaffed clinics and hospitals in tribal nations.

A quarter of all positions for doctors, nurses and other care providers at IHS facilities are vacant, according to the Government Accountability Office (GAO), which means more than 1,300 positions need to be filled.

In the IHS Phoenix health services area, which includes all of Nevada and most of Utah and Colorado, 21% of physician / nurse positions are vacant, along with approximately 14% of dentist positions. .

These vacancies limit the availability of services for the 140,000 Native American and Alaskan Indians in the multi-state region who receive health and community health services from IHS, including 14 Tribal Indian Health Centers. and urban in Nevada.

This week, U.S. Democratic Senator Catherine Cortez Masto introduced legislation with Republican Senator from Alaska Lisa Murkowski to offer students preparing to work in health care fully tax-exempt scholarships and reimbursement programs. of loans in order to close these vacancies.

“As the Indian country faces a severe shortage of doctors and nurses, expanding IHS ‘ability to provide financial assistance to medical students and new health workers makes good sense,” Cortez said Masto. “This legislation will allow IHS facilities in Nevada to recruit and hire more doctors, nurses and other clinicians to help save lives and keep Native American communities healthy.”

The majority of federal health scholarships and reimbursement programs are already tax exempt. However, IHS scholarship programs are not. Cortez Masto’s bill, the IHS Health Professions Tax Fairness Act, would ensure that IHS programs enjoy the same tax exemptions that apply to Department of Defense and National Health Service Corps programs.

Cortez Masto also lobbied legislation designed to address health disparities for Native Americans in urban areas by securing provisions in the US bailout that allow programs funded under the Office of Urban Indian Health Programs to receive 100% reimbursement for Medicaid services, according to a spokesperson. .

Cortez Masto is working to make the change permanent and is looking at all avenues to do so, including the reconciliation plan Democrats are trying to work out in Congress, a spokesperson said.

American Rescue Plan funding provided $ 500 million to support health services in the Indian country. IHS hopes this investment will strengthen long-term care by investing in high-quality salaries and services for providers.

Another $ 2 billion for health infrastructure serving tribal members is included in the reconciliation program.

Resources for federally and tribally managed facilities have increased overall in recent years. However, the IHS and tribal leaders say funding is still insufficient, according to a GAO report.

In 2018, IHS estimated that federally-run and tribal-run facilities were only able to fund, on average, 49% of the health care needed by tribes.

Officials from the Phoenix area office told federal officials that the Nevada Skies Youth Wellness Center, an addiction treatment center for teenagers, had to reduce the number of available beds due to vacancies in 2018.

Part of the larger problem is that IHS cannot offer competitive salaries with other federal health agencies like the Veterans Health Administration (VHA).

In 2018, a nurse starting a career in the IHS Phoenix service area could earn around $ 63,871 at VHA, compared to $ 44,835 at IHS.

The high cost of education for health professionals makes working for less than a salary unattractive, especially when paying off student loans.

Historically, Native Americans have poorer health outcomes than the general population of the United States, including a shorter average lifespan and a higher incidence of certain medical conditions. Barriers to accessing health services only exacerbate health disparities, many of which can be alleviated, at least in part, through access to effective preventive primary care services.

“High job vacancy rates for physicians, nurses and other health care providers in our Aboriginal communities continue to be a barrier to providing adequate care. Unfortunately, the existing inequalities facing indigenous communities have been compounded by the COVID-19 pandemic, ”Murkowski said in a statement.