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First,aState‐Tribal‐UrbanIndianHealthCollaborativehasbeenre‐institutedata
state/triballeaderpolicylevel for addressingappropriatesystemschangeandpolicy
decisionsthatneedtobemadetochangehealthoutcomes for Indianpeople.This
group—comprised of tribalgovernments,healthstaff,andstateleadersacross
multiplesystemsanddepartments—willbestrategicallyaligningstatewideIndian
healthdisparitiesworkwithGovernorGregoire’s5‐PointHealthCareInitiative.Thiswill
allow the grouptoleverageexistingresources,maximize the limitedfundscurrently
available,andcreate the infrastructurenecessarytofurtherreduceIndianhealth
disparities in the future.
Second,severalagencies,organizations,andinstitutionshaveexpressedarenewed
interest in comingtogethertodevelopamorecompleteset of AmericanIndianhealth
statusdata.Accuratedata is necessarytosupportcommunityhealthassessmentsand
policydevelopmenttoimproveservicedeliveryandhealthstatus of Indianpeople.
Withoutpaintingamorethoroughpicture of Indianhealth in Washingtontoday, the
abilitytoplanorimproveservices,monitorquality,andanalyzecosts is severely
impaired.Tribalgovernmentsmustbeintricatelyinvolved in sucheffortstoassure the
use of the data is culturally‐appropriate,acceptable,andmeaningful in improving the
health of theirpeople.Byreinstitutingeffortsthatbegan in 1997between the
AmericanIndianHealthCommissionandWashingtonStateDepartment of Health
throughanAmericanIndianDataCommittee,anupdatedframeworkcanbedeveloped
for addressingpriorityhealthissues for AI/AN.
Third,sweepingnationalhealthreformand the currentadministrationofferaunique
opportunity for change in howhealthcare is providedtoAI/ANs.AsIndianhealth
leadershipsuchas the U.S.IndianHealthServices, the NationalIndianHealthBoard,
andmoreregionally, the NorthwestPortlandAreaIndianHealthBoard,strongly
advocates for the inclusion of Indianhealthreform in nationalreformstrategies, the
state is alsorethinkinghowitprovidesquality,affordable,andcost‐effectivehealth
caretoitscitizens. The state,Tribes,and the commissionwillactivelypartner in these
effortstoaddress the need for AI/ANincreasedaccesstoexistingservices,increased
Tribalproviderreimbursementopportunitiesso
culturally‐appropriateservicescanbe
provided in Tribalcommunities,anddevelopmechanisms for evaluatingprogress for
improvedIndianhealthstatus.
SectionIII,2007‐2009Accomplishments,highlightssome of the majorachievements
made for Indianhealth in the statesince the lastplanwaspublished in 2007.Additional
partnershipshavebeendeveloped,keypolicyissueshavebeenaddressed,andthere
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impossible,toquantify. The variousentitiesthatmanagespecificAI/ANhealthdata
setsoftenemploydifferingmethods for collecting,adjusting,anddistributingdata.A
greatereffort is neededtocollaborateacrossagenciesandinstitutesthatare
conductingresearchandcollectingdata in ordertobeginaccuratelyportraying the true
extent of
Indianhealthdisparities.
Severalagencies,organizations,andinstitutionshaveexpressedarenewedinterest in
comingtogethertobeginaconversationonhowthismightbeachieved.Accuratedata
is necessarytosupportassessmentandpolicydevelopmenttoimproveservicedelivery
andhealthstatus of Indianpeople.Withoutpaintingamore
thoroughpicture of Indian
health in Washingtontoday, the abilitytoplanorimproveservices,monitorquality,
andanalyzecosts is severelyimpaired.
Tribalgovernmentsmustbeintricatelyinvolved in sucheffortstoassure the use of the
data is culturallyappropriate,acceptable,andmeaningful in improving the health of
theirpeople.Byreinstitutingeffortsthatbegan in 1997between the commissionand
the WashingtonStateDepartment of HealththroughanAmericanIndianData
Committee,anupdatedframeworkcanbedeveloped for addressingpriorityhealth
issues for AI/AN.
Thereareseveralentitiesthatconsistentlyconductresearchandcollectandinterpret
dataonAI/AN.Over the nexttwoyears, the commissionwillpartnerwith the
Department of Health, the NorthwestPortlandAreaIndianHealthBoard, the Urban
IndianInstitute,andotherepidemiology/research‐basedcenterswithagoal of
developingamorecomprehensiveunderstanding of the current‐dayhealth of the
AI/ANpopulationandprovidingTribes,Tribalorganizations,and the statemore
accurateinformationneededtoaddresspublichealthpolicyissuesimportanttoTribal
communities.
C. ... UrbanIndianHealthPrograms
The AIHChasidentifiedUrbanIndianhealthasanareathatwarrantsadditional
attentionandheightenedawareness.ManyAI/ANpeoplelive in urbanareas in the
state,andtheseAI/ANindividualsfacesignificantandoftenuniquechallenges in
accessingcareandremaininghealthy.Many of theseindividualsaremembers of
WashingtonStateTribes,othersaremembers of Tribesfromotherstates,someare
members of federallyrecognizedTribes,othersarenot. In ordertoeffectivelyaddress
healthdisparities of allAI/AN in Washington,theremustbeamoreconcertedeffortto
linkurbanIndianhealthprogramstohealthreformeffortstakingplace.Thiswillallow
for improvedcoordination in providingacomprehensivehealthcaredelivery system
for Indianpeople in Washington. In SectionIIIA,one of the prioritiesidentified for the
State‐Tribal‐UrbanIndianHealthCollaborative is tobeginthisworkbyraising
awareness of urbanIndianhealthissues.
The following is fromanissuebriefdevelopedbyRalphForquera,executivedirector,
SeattleIndianHealthBoard
5
.Thisbriefprovidesacomprehensivesummary of urban
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