 June 22, 2004
The agency/tribal negotiation process is distinctive in approach, with a statewide agreement among all tribally-operated health programs as well as individual agreements between tribes and the IHS. The topics of negotiations include funding issues, operation of the Alaska Native Medical Center ("ANMC") Hospital, tribal health service provisions and continuing agency responsibilities. The tribal health providers group meets across the table from a team of IHS representatives, with both sides stating their views on the statewide issues through respective Lead Negotiators. "The issues that we deal with at these negotiations affect the health care services of every man woman and child among our 5500 Native beneficiaries in the Ketchikan and Saxman communities," said President Rainwater-Sande. The meeting schedules are demanding, with the weeklong sessions beginning at 8 a.m. and continuing, virtually without pause, through the late evening hours. "The 22 individual teams are all committed to being there for as long as it takes to reach agreement," said David Landis, who has attended these meetings for the past four years. Landis added, "The importance of healthy families cannot be overstated. It is the very fabric of our lives in Southeast Alaska." Although these negotiations are typically routine, this year there were unique challenges for the negotiators. The federal Indian Health Service has always provided insurance indemnity for the tribes operating Health Contracts or Compacts, but has now started to restrict this coverage. The Alaska tribal health programs were unified in their opposition to these further restrictions on local operations. "The tribes need to have more cooperation from the federal government, not less," said Rainwater-Sande. David Landis added, "These restrictions could result in increased insurance premiums, thereby limiting resources intended for our present high-quality health care delivery system." The tribal representatives demonstrated to the IHS that they were serious about their position, unanimously refusing to finalize and sign their collective or individual compact documents. "We will finish negotiating in good faith when the federal government lives up to their responsibility to protect the tribes against expensive and time-consuming lawsuits. This is the minimum threshold of what they are obligated to do," stated Rainwater-Sande. KIC officials are unsure when
the negotiations will be completed, although the funding and
service agreements will continue as presently drafted indefinitely
if there is an impasse. "We trust that the government and
the tribes will come back to the negotiating table when there
has been an opportunity for further research and understanding,"
David Landis said. KIC officials stated that they would be keeping
the community informed as to the final outcome of these proceedings.
"We'll know how things shake out by fall or early winter
at minimum," said Stephanie Rainwater-Sande.
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