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: Sen. Barrasso, John [R-WY]
Target Audience
Population: American Indian and Alaska Native individuals using Indian Health Service
Estimated Size: 2600000
- The Indian Health Service (IHS) is a federal agency that provides health services to approximately 2.6 million American Indian and Alaska Native (AI/AN) people who belong to 574 federally recognized tribes in 37 states.
- The bill is targeted towards improving the recruitment and retention of healthcare personnel within the IHS, which directly affects the delivery of health services to these communities.
- The benefits of a more stable and well-staffed healthcare workforce could potentially impact every AI/AN individual relying on IHS for healthcare services.
- Additionally, the employed workforce within IHS, including new recruits and current staff affected by the changes in pay, credentialing, and housing, will be directly impacted.
Reasoning
- The policy targets the Indian Health Service, which directly serves around 2.6 million American Indians and Alaska Natives. These communities are often located in rural or underserved areas where access to healthcare is limited.
- To accurately reflect the population, the sample includes a mix of people who are directly affected by the policy—those reliant on IHS services—and those indirectly affected, such as healthcare workers within the IHS and the general population with no direct use of IHS but potentially secondary effects.
- The budget is a major constraint. It limits the scope of impact and the speed at which changes can be implemented, affecting how widespread and immediate the improvements will be felt among the AI/AN communities.
- Given the policy's focus on workforce improvements, direct impacts will mostly be felt by AI/AN people and IHS workers who face immediate changes in work environment and resource allocation.
Simulated Interviews
Registered Nurse (Navajo Nation, AZ)
Age: 34 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 15/20
Statement of Opinion:
- The policy sounds promising if it means better pay and housing for us. I'm worried it's just talk and won't lead to real changes.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 5 |
| Year 20 | 9 | 6 |
Primary Care Physician (Anchorage, AK)
Age: 28 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- Improved credentialing and housing could help retain more professionals like me in the long term.
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 | 8 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 7 |
IHS Administrator (Minneapolis, MN)
Age: 48 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 8.0 years
Commonness: 8/20
Statement of Opinion:
- We always need more funding and this policy could help, but I worry about the long-term commitment.
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 | 8 | 6 |
Community Health Representative (Cheyenne, WY)
Age: 54 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 13/20
Statement of Opinion:
- Better staffing and pay to match efforts would increase job satisfaction significantly.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 8 | 4 |
Medical Student (San Diego, CA)
Age: 22 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- Increased opportunities and better support may drive more students like me to consider careers in IHS.
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 |
Retired (Phoenix, AZ)
Age: 65 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 7.0 years
Commonness: 18/20
Statement of Opinion:
- If the services improve as stated, it could mean a lot for the younger ones especially. I'm skeptical though.
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 |
Dentist (Tulsa, OK)
Age: 37 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 12/20
Statement of Opinion:
- Credentialing and pay increases could help, but real change takes time.
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 | 8 | 5 |
| Year 20 | 8 | 6 |
Public Health Official (Sante Fe, NM)
Age: 42 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 9/20
Statement of Opinion:
- Ensuring these changes are allocation-transparent is key to lasting improvements.
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 | 8 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 7 |
Pharmacist (Billings, MT)
Age: 30 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- If housing assistance is real, it would make a huge difference for my family.
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 | 8 | 6 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 7 |
Software Engineer (Los Angeles, CA)
Age: 29 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 20/20
Statement of Opinion:
- This policy doesn't affect me directly, but improvements in any healthcare system can have broad benefits.
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 | 7 | 7 |
| Year 20 | 7 | 7 |
Cost Estimates
Year 1: $250000000 (Low: $200000000, High: $300000000)
Year 2: $260000000 (Low: $210000000, High: $310000000)
Year 3: $270000000 (Low: $220000000, High: $320000000)
Year 5: $290000000 (Low: $240000000, High: $340000000)
Year 10: $320000000 (Low: $270000000, High: $370000000)
Year 100: $560000000 (Low: $500000000, High: $620000000)
Key Considerations
- The bill requires substantial initial investments which could burden the federal budget in the short term, but may yield savings and improved outcomes over time.
- The integration of new credentialing and housing standards necessitates efficient implementation strategies to avoid mounting costs.
- Political and economic factors could influence the availability of funds and support for such programs.
- Potential reductions in staff turnover rates could decrease forward costs associated with staff training and orientation.