Bill Overview
Title: Stronger Engagement for Indian Health Needs Act of 2022
Description: This bill elevates the current position of the Director of the Indian Health Service within the Department of Health and Human Services (HHS) to Assistant Secretary for Indian Health within HHS.
Sponsors: Rep. Stanton, Greg [D-AZ-9]
Target Audience
Population: American Indians and Alaska Natives in the U.S.
Estimated Size: 6900000
- The Indian Health Service (IHS) provides health services to American Indians and Alaska Natives.
- The restructuring aims to improve the services and possibly the reach of IHS, thus potentially impacting all service recipients.
- As of current estimates, there are approximately 6.9 million American Indians and Alaska Natives in the U.S., many of whom may benefit from improved health services.
- The impact is likely to be more pronounced for those residing on reservations or in areas receiving IHS support.
- Globally, this legislation primarily affects Indigenous people within the U.S. and not internationally, since IHS is a U.S. federal health program.
Reasoning
- I considered the budget limits to make sure the interviews reflect individuals who would naturally be impacted under the policy, focusing mainly on American Indians and Alaska Natives (AI/AN) due to the nature of the Indian Health Service (IHS) targeted improvements.
- Included individuals with varying degrees of connection to the IHS, e.g., living on a reservation, being in urban centers with IHS services, and those who rely less on IHS.
- I also included some individuals who identify as AI/AN but live in areas or have socioeconomic conditions that might limit their direct interaction with the IHS to gauge non-impact scenarios.
Simulated Interviews
Community Health Educator (Navajo Nation, AZ)
Age: 42 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- The restructuring might bring more focus and funding, allowing us to run more educational campaigns.
- I'm hopeful that the elevation of the position will mean more attention to cultural aspects of healthcare.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
Urban Clinic Nurse (Minneapolis, MN)
Age: 52 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 8.0 years
Commonness: 8/20
Statement of Opinion:
- I expect an increased budget might allow improvement of our urban clinic facilities, leading to better services for patients.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 9 | 7 |
Software Developer (Phoenix, AZ)
Age: 34 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 12/20
Statement of Opinion:
- While I don't use IHS often, it's comforting to know improvements are being made for those who do rely on it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Student (Anchorage, AK)
Age: 28 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 7/20
Statement of Opinion:
- The policy is a long overdue change that could enhance healthcare services in our underserved communities.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 7 |
Retired (Sioux Falls, SD)
Age: 60 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 11/20
Statement of Opinion:
- I hope the raised profile of IHS will mean shorter wait times and better healthcare access.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Construction Worker (New York, NY)
Age: 45 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 0.0 years
Commonness: 15/20
Statement of Opinion:
- I don't use IHS, but it's good that it might help friends and family who do.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Teacher (Tulsa, OK)
Age: 50 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 8.0 years
Commonness: 9/20
Statement of Opinion:
- Better healthcare for students means a healthier school environment and better learning experiences.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Environmental Scientist (Fairbanks, AK)
Age: 36 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- I would like to see more outreach and mobile healthcare units for remote regions.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Freelance Artist (Los Angeles, CA)
Age: 26 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 13/20
Statement of Opinion:
- I'm optimistic, though I'm not sure how much this policy affects city dwellers right away.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Retired Elder (Pine Ridge, SD)
Age: 70 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 6/20
Statement of Opinion:
- We've been waiting for change. Hopefully, this means better services and recognition of our needs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
Cost Estimates
Year 1: $10000000 (Low: $8000000, High: $12000000)
Year 2: $9500000 (Low: $7500000, High: $11500000)
Year 3: $9000000 (Low: $7000000, High: $11000000)
Year 5: $8500000 (Low: $6500000, High: $10500000)
Year 10: $8000000 (Low: $6000000, High: $10000000)
Year 100: $800000 (Low: $600000, High: $1000000)
Key Considerations
- The bill mainly aims at improving service delivery within the Indian Health Service by elevating its role.
- Any cost fluctuations depend heavily on the operational changes and staffing decisions following the role elevation.
- Long-term improvements in health outcomes may yield benefits, but they don't translate into immediate fiscal savings.