{"id":1188,"date":"2024-10-10T18:02:40","date_gmt":"2024-10-10T18:02:40","guid":{"rendered":"https:\/\/medical-article.com\/?p=1188"},"modified":"2024-10-10T18:02:40","modified_gmt":"2024-10-10T18:02:40","slug":"cash-shortages-and-complex-rules-impede-native-american-health-care-access","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=1188","title":{"rendered":"Cash Shortages and Complex Rules Impede Native American Health-Care Access"},"content":{"rendered":"

Each year, the\u00a0Indian Health Service<\/strong>\u00a0rejects tens of thousands of requests to fund outside care that it doesn\u2019t provide, forcing patients to go without treatment or pay big medical bills themselves.<\/p>\n

The IHS is supposed to\u00a0provide free care<\/a>\u00a0to Native Americans, but it does so only at scattered clinics and hospitals the agency funds and then manages or turns over to tribes to operate. Many of those are in rural areas and offer limited services. They might not provide cancer treatment or pregnancy care, for example.<\/p>\n

That\u2019s where the agency\u2019s Purchased\/Referred Care program is supposed to come in.<\/p>\n

But funding shortages, complex rules and administrative fumbles impede access to the program, my colleague\u00a0Katheryn Houghton<\/a><\/strong>\u00a0and I reported after speaking with patients, elected officials and people who work with the federal agency.<\/p>\n

Native Americans\u202fqualify for the referred-care program<\/a>\u202fif they live on tribal land \u2014\u00a0only\u00a013 percent<\/strong>\u00a0do<\/a>\u00a0\u2014 or within their tribe\u2019s \u201cdelivery area<\/a>,\u201d which usually includes surrounding counties. Those who live in another delivery area are eligible in some cases.<\/p>\n

Jonni Kroll<\/strong>, a member of the Little Shell Tribe of Chippewa Indians of Montana, doesn\u2019t qualify, because she lives in Washington state, nearly\u00a0400 miles\u00a0<\/strong>from her tribe\u2019s headquarters.<\/p>\n

Tying program eligibility to tribal lands, Kroll said, echoes old government policies meant to keep Indigenous people in one place, even if it means reduced access to jobs, education and health care.<\/p>\n

\u201cWhat do we do? Sell our homes, leave our families and our jobs?\u201d she said.<\/p>\n

What about eligible Native Americans? They aren\u2019t guaranteed funding or timely help. Some of the IHS\u2019s\u00a0170<\/strong>\u00a0units exhaust their annual pool of referred-care funding or reserve it for the most serious medical concerns.<\/p>\n

In fiscal 2022, for example, the program denied or deferred nearly\u00a0$552 million\u00a0<\/strong>in spending for about\u00a0120,000<\/strong>\u00a0requests from eligible patients.<\/p>\n

Connie Brushbreaker<\/strong>, a member of the Rosebud Sioux Tribe in South Dakota, has been denied or wait-listed for funding at least\u00a014 times<\/strong>\u00a0since 2018.\u202fIn March, she received a letter saying her referred-care program is reserved for patients at imminent risk of dying. It doesn\u2019t make sense to her that the agency refuses to pay for treatment that will be approved once a health problem becomes more serious and expensive.<\/p>\n

Another obstacle is the estimated\u00a034 percent<\/strong>\u00a0of program staffing positions that are vacant.<\/p>\n

Multiple patients told us that staff rarely pick up the phone or return messages, or that they share confusing information about eligibility and the application process.<\/p>\n

Brendan White<\/strong>, an agency spokesperson, said improving the referred-care program is a top IHS goal. He said about\u00a083 percent<\/strong>\u00a0of the health units it manages have approved all eligible funding requests this year.<\/p>\n

The agency is tackling staff shortages and recently improved\u202fhow funding is prioritized<\/a>, he said. The IHS is\u00a0also studying<\/a>\u00a0whether it can afford to create statewide eligibility in the Dakotas.<\/p>\n

But many advocates say the only way to improve the referred-care program is to fully fund it \u2014 or even better, fully fund the IHS so patients don\u2019t need as much outside care in the first place.<\/p>\n

This article is not available for syndication due to republishing restrictions. If you have questions about the availability of this or other content for republication, please contact NewsWeb@kff.org<\/a>.<\/em><\/p>\n

KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\n

USE OUR CONTENT<\/h3>\n

This story can be republished for free (details<\/a>).<\/p>","protected":false},"excerpt":{"rendered":"

Each year, the\u00a0Indian Health Service\u00a0rejects tens of thousands of requests to fund outside care that it doesn\u2019t provide, forcing patients to go without treatment or pay big medical bills themselves. The IHS is supposed to\u00a0provide free care\u00a0to Native Americans, but it does so only at scattered clinics and hospitals the agency funds and then manages…<\/p>\n","protected":false},"author":0,"featured_media":1189,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-1188","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/1188"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1188"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/1188\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/1189"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1188"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1188"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1188"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}