Bill Overview
Title: Restoring Accountability in the Indian Health Service Act of 2022
Description: 2022 This bill establishes a series of programs and requirements relating to recruitment and retention in the Indian Health Service, including provisions regarding pay, credentialing, and housing needs of workforce personnel.
Sponsors: Rep. Johnson, Dusty [R-SD-At Large]
Target Audience
Population: American Indians and Alaska Natives using Indian Health Service
Estimated Size: 2600000
- The Indian Health Service (IHS) serves federally recognized Tribes across the United States, which includes a significant portion of the Native American population.
- There are approximately 574 federally recognized Tribes within the United States, and the IHS serves around 2.6 million American Indians and Alaska Natives who belong to these tribes.
- Globally, the population identifying as Native American or Indigenous is much larger, but the IHS specifically serves those within the United States.
- The bill directly affects the IHS, so the primary population impacted are those receiving healthcare through the IHS.
Reasoning
- The Indian Health Service (IHS) is crucial for ensuring reliable healthcare access to Native American and Alaska Native populations. Given its broad reach across diverse geographical and socioeconomic circumstances, the policy's focus on recruitment and retention addresses critical staffing shortages within these communities.
- A $500 million budget in the first year is substantial, but when spread across numerous tribal nations and healthcare facilities, its direct impact per facility may be limited. The need for long-term, sustainable increases in staffing and services must be considered.
- Many of the individuals served by the IHS live in rural or underserved areas with few healthcare options, so improvements in service quality and access can significantly impact their well-being.
- Employment and economic outcomes within these communities may also see indirect benefits as improved IHS operations could lead to better health outcomes, thus enabling more consistent workforce participation.
Simulated Interviews
Elementary School Teacher (Navajo Nation, Arizona)
Age: 34 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- I hope this policy improves wait times at our local IHS clinic.
- It could take hours to see a doctor, especially during flu season.
- Better pay for the staff might help keep more doctors around.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 9 | 5 |
Retired (Cherokee Nation, Oklahoma)
Age: 56 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- I'm optimistic this bill will help reduce the burden on IHS doctors.
- Regular check-ups are essential for managing my condition, and sometimes appointments are delayed.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 5 |
| Year 20 | 8 | 5 |
Healthcare Worker (Juneau, Alaska)
Age: 25 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 20.0 years
Commonness: 4/20
Statement of Opinion:
- The housing assistance for health workers might be a game-changer for recruitment.
- Many colleagues speak of the high cost of living and long distances traveled to work.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 6 |
| Year 3 | 9 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 5 |
| Year 20 | 10 | 5 |
Artist (Sioux Falls, South Dakota)
Age: 42 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- Mental health services need more focus and staff.
- IHS workers are doing their best, but they seem overwhelmed.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Community Organizer (Pine Ridge Reservation, South Dakota)
Age: 29 | Gender: other
Wellbeing Before Policy: 4
Duration of Impact: 3.0 years
Commonness: 7/20
Statement of Opinion:
- I worry about the implementation being slow or benefits not trickling down here.
- It’s crucial to see changes where it counts—on the ground.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 4 |
Logistics Specialist (Fairbanks, Alaska)
Age: 39 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- Better credentialing could streamline supplies and improve efficiency.
- Supply chain problems add unnecessary stress to healthcare workers and patients alike.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 4 |
Retired Farmer (Yakima Valley, Washington)
Age: 63 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- IHS improvements would be a boons given how understaffed clinics seem.
- My son's job satisfaction is directly linked to adequate staffing and support resources.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 5 |
| Year 20 | 8 | 5 |
Graduate Student (Salt Lake City, Utah)
Age: 31 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- I'm interested in seeing how the recruitment efforts unfold given current healthcare demands.
- Retaining skilled professionals in remote areas is challenging but vital.
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 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Non-profit Director (Los Angeles, California)
Age: 47 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- There's a significant urban Native population that also relies on improved IHS services.
- Budget limitations might still restrict the effectiveness of these programs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Park Ranger (Taos, New Mexico)
Age: 24 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- I regularly advocate for youth health initiatives, so IHS improvements are vital.
- Recruitment is important, but retention will show real change.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 4 |
Cost Estimates
Year 1: $500000000 (Low: $400000000, High: $600000000)
Year 2: $510000000 (Low: $410000000, High: $610000000)
Year 3: $520000000 (Low: $420000000, High: $620000000)
Year 5: $540000000 (Low: $440000000, High: $640000000)
Year 10: $0 (Low: $0, High: $0)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- This initiative could significantly improve healthcare access and quality for the affected population.
- Recruitment and retention strategies may have a delayed impact due to the time needed to see effective workforce stabilization.
- The financial burden on the federal budget necessitates careful review of cost-benefit metrics over time.