(SitNews) Ketchikan, Alaska - An agreement with the U.S. Indian Health Service (IHS) to settle SouthEast Alaska Regional Health Consortium's outstanding claims against the Indian Health Service for unpaid contract support costs has been reached. Under the agreement, the U.S. Indian Health Service has agreed to pay SEARHC $39.5 million plus interest, totaling approximately $53 million, to settle the organization’s contract support costs claims for the years 1999 through 2013.

SEARHC is a tribal health organization that compacts with the IHS under the Indian Self-Determination and Education Assistance Act (ISDEAA) to carry out the federal government's obligation to provide health care services to the Alaska Native and American Indian people of Southeast Alaska. Contract support costs (CSC) consist of those reasonable program expenses as well as other administrative and overhead costs associated with carrying out the health care services SEARHC provides on behalf of the IHS. These costs are required to be paid in full under the ISDEAA, SEARHC’s compact with the IHS, and recent U.S. Supreme Court decisions. SEARHC’s CSC claims arose from the IHS’ failure to pay these costs in full, which required SEARHC to utilize program funds meant to provide direct health care services to SEARHC patients in order to meet the shortfall. This settlement resolves SEARHC’s claims for 15 years of CSC underpayments by the IHS and will now permit SEARHC to devote more resources to providing direct health care services.

“This is a very good settlement and has concluded several years of legal wrangling and political advocacy in Washington, DC. I could not be more pleased to have these issues come to resolution and look forward to focusing our efforts in a more constructive direction,” said SEARHC President and CEO, Charles Clement.

Since the passage of the Indian Self-Determination and Education Assistance Act in 1975, tribes have had the option of using federal funding to run their own education, public safety, and health care programs. Since that time, tribal management of health care services have resulted in better delivery of care and have improved health outcomes for Alaska Natives and American Indians.

The U.S. Supreme Court recognized the necessity of tribal contract support costs in the Ramah decision in 2012, ruling that contract support costs are a binding legal obligation that must be paid in full as with any other federal contract. However, according to a news release from U.S. Senator Mark Begich (D-AK), because the IHS and BIA are funded by an annual discretionary appropriation, this binding obligation ultimately undercuts funding for the same programs and services it is meant to support. This leads to a reduction in vital programs and services for tribes and tribal organizations across the country.

Since being elect, Senator Begich has been an outspoken member of Congress on this issue. He has been encouraged by the progress that has been made in the recent year, including full funding for CSC in 2014 and several historic claims settled with Alaska Native tribal health providers as an outcome of his leadership to solve the historical CSC underpayments to tribes.

Begich on Thursday introduced two bills to ensure Alaska Native and Native American tribes that administer health care and other services through tribal hospitals, clinics, and other facilities are paid promptly and in-full for the services they deliver.

“The federal government should honor the costs of all contractual obligations regardless of whether or not the contractor is a tribal organization,” said Begich. “Refusing to pay these contracts in full and in a timely manner is a slap in the face to all the tribal organizations who are on the ground, doing the work, and making sure their people get the quality care and services they need. And we shouldn’t be robbing Peter to pay Paul by raiding discretionary funds.”

“Contract support costs” are a critical component to tribal self-determination contracting because they fund the overhead costs such as legal fees, insurance, and accounting fees that are necessary to effectively manage IHS and BIA programs and services. The Begich bills would help ensure contract support costs are paid in full, on time, and not at the expense of other critical Indian Health Service (IHS) and Bureau of Indian Affairs (BIA) programs.

The Self-Determination Commitment to Tribes Act would prevent contract support costs from being funded at the expense of direct programs and services in the annual budgeting process. It would amend Section 1305 of title 31 USC, the ”Miscellaneous Permanent Appropriations” section, by adding “Indian Self-Determination Contract Support Costs.” This language change would, in effect, make payments mandatory as opposed to discretionary.

The Self-Determination Contract Reporting Commitment to Tribes Act would require the IHS and BIA to submit contract support cost shortfall reports to Congress in a timely fashion and require that the shortfall reports be made available to the public. These reports would be used to accurately assess damage claims arising from contract underpayments to ensure a quicker payment process and help to resolve past underpayments to tribes in Alaska and nationally.

Accordiing to Begich, the bills were welcomed by tribal organizations that manage IHS and BIA health care services in Alaska and across the nation.

“The successful tribal management of programs and services previously administered by the federal government has led to safer communities and improved health outcomes for our people,” said Alaska Native Health Board Chairman, Lincoln Bean, Sr. “This policy of self-governance and self-determination represented a turning point for American Indian and Alaska Native people, but I fear that until the legislation introduced by Senator Begich is passed into law, the untenable situation of funding shortfalls will continue, pitting tribe against tribe while eroding the sovereignty and self-governing ability of us all.”

SouthEast Alaska Regional Health Consortium recognized the efforts of Alaska's U.S. Senators Mark Begich and Lisa Murkowski, and Congressman Don Young in working to hold Indian Health Service accountable for full payment of contract support costs and encouraging a timely resolution of tribes’ and tribal organizations’ outstanding CSC claims.

Quoting a news release, "SEARHC is also appreciative of the commitment made by President Obama's Administration to honor Tribal contracts in the future."

Edited by Mary Kauffman

Source of News: 

SouthEast Alaska Regional Health Consortium
www.searhc.org

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