Opportunities for Change: Improving the Health of American Indians/Alaska Natives in Washington State docx

... areanincreasednumber of Tribalrepresentativesservingonrelevant state committeesandtaskforces.SectionVI,GoalsandObjectives,identifies the priorityissueareastargetedtobeaddressedover the nextfouryears. The goalsarethosethatAIHC,Tribes,UrbanIndian Health Organizations(UIHO),and the state willworktogetherontofurther the mission of eliminatingIndian health disparities. The firstcomponent,TribalForum for Improving AI/AN Health, focusesonstrategiestostrengthen the collectivevoice for TribesandUrbanIndian Health Programstogreaterinfluence health policyandassurefullaccessbyAI/ANsto health servicesandprograms in the state. Thisgoalalsoincludeseffortstodevelopandimplementstrongerstrategies for addressingIndian health disparitiesand the development of moreeffectivecommunicationavenuesbetweenTribesand the state soTribesareaware of emergent health news,information,and opportunities. Whileplans in the pasthaveservedwell in informingindividuals,Tribes,andorganizationson the poorstatus of Indian health andidentifyingpolicyworkbeingaccomplished,furthercollaborativeconversationsandeffortsacrosstribes,systems,organizations,andresearchinstitutionsmustbepursuedtostrategicallyaddressthesedisparities.Thiscomponentoutlineshowthatmightbegintobeaccomplishedover the nextfouryears. The four health priorityareas—Maternal‐Infant Health, Long‐TermCare,Oral Health, andMental Health services—wereidentifiedat the 2008TribalLeaders Health Summitandserveas the areas of disparitiesfromwhich the broaderworkdescribedabovecouldbeshaped.Eachpriorityareaincludes:(a)Goalstatement;(b)Problemstatement;(c)Anysupportingdata;and(d)Strategies(objectives) for addressing the problem. The strategiesarerecommendationsdeveloped in American Indian Health Commissionpositionpapersat the TribalLeaders Health Summit in November2008andsubsequentlyapprovedbycommissiondelegates in 2009.Atargetedfocus in thesefourpriorityTribal health areaswillallowustonotonlydevelopsolutionstothesespecificproblems;itwillalsoserveasawaytofurtherdefine the processbywhichadditionalIndian health disparitiescanbeaddressed in the future. The strategiesidentified in thissectionwillbepursuedbasedonresourceavailability in eacharea. The finalsection,Tribal Health Programs in Washington State, providesspecificinformationaboutexistingTribalandUrbanIndian health programsandclinics.Italsoprovidesinformationabout the types of servicethatareprovidedbyeachsite in ordertocomplete the profile of the Indian health deliverysystem in our state.  Opportunities for Change: Improving the Health of AI/ANs in WA State Page 7 2010-2013 American Indian Health Care ... 2 American IndianPolicyReviewCommission;ReportonIndian Health: TaskForceSix‐Indian Health.  Washington DC:USGovernmentPrintingOffice.1976 Opportunities for Change: Improving the Health of AI/ANs in WA State Page 10 2010-2013 American Indian Health ... andcollectionsfromthird‐partypayers(including state Medicaidprograms)toremainfinanciallyviable.Morethan36percent of AI/ANfamilies in the UnitedStatesmakinglessthan200percent of the federalpovertylevelhadno health insurance,apercentagesecondonlytoLatinos.Alongwith the community health programsassociatedwith the health carefacilities in eachcommunity,anincreasingnumber of tribesaretakinganactiverole in public health practiceandresearch in theircommunity.Theseactivitiesincludegrant‐fundedcollaborationswithacademicresearchersandfederalagencies(suchasapopulation‐basedBehavioralRiskFactorSurveillanceSurveyspecifictotribalcommunities)andactivecollaborationswith state andcounty health departments in suchareasasincreasingaccesstochildhoodimmunizations. In addition, the lastdecadehasseenamovetowardincreasingepidemiologiccapacitywithintriballyrunorganizations. In the Northwest,threetriballyoperatedepidemiologycentershavebeenfoundedwithfundingfromIHSandsustainedbygrant‐fundedactivities: the NorthwestTribalEpidemiologyCenterat the NorthwestPortlandAreaIndian Health Board,serving the 43federally‐recognizedtribes in Idaho,Oregon,and Washington (www.npaihb.org); the AlaskaNativeEpidemiologyCenterat the AlaskaNative Health Board(www.anhb.org);and the UrbanIndian Health Instituteat the SeattleIndian Health Board,whichfocusesonurbanIndiansnationally(www.uihi.org). The work of thesetribalorganizationshasmadeprogress in documenting the dramatic health problemsthatfaceNativecommunities in the Northwest.Although the health caresystemserving the AI/ANpopulationmayseemcomprehensive, the provision of adequate health caretoAI/ANsishamperedbychronicunderfunding of IHSby the USCongress. The lack of adequatefundingtobothCHSprogramsand the directservicesprovidedbyIHSandtribalfacilitiesmeansthatuniversalaccesstocare for AI/ANsisfarfromareality.Itisestimatedthat the IHSisfundedatonly50percent of itslevel of need;someprograms,suchasmental health, arefundedataslowas30percent. The relationshipbetweenchronicunderfundingandincreasing health disparitieshasbeenoutlined in tworecentreportsfrom the U.S.CommissiononCivilRights. The reportsconcludethat the state of health caredeliveryto the AI/ANpopulationis in a state of crisis.Itseemslikelythatasaccesstocarebecomesevenmorelimitedduetoinadequatefunding, health statusdisparitiesbetweenNativepeopleand the generalUSpopulationwill  Opportunities for Change:  Improving the Health of American Indians/Alaska Natives in Washington State  American Indian Health CareDeliveryPlan2010‐2013April2010...

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