Rep. Kristi Noem (R-SD) – along with Reps. Rob Bishop (R-UT), Markwayne Mullin (R-OK), Cathy McMorris-Rodgers (R-WA), and Tom Cole (R-OK) – today introduced the Restoring Accountability in the IHS ActFor years, federal reports have documented shocking cases of mismanagement and poorly delivered care at Indian Health Service (IHS) facilities.  The IHS was left to make improvements on its own, but despite funding increases almost every year, the agency produced increasingly poor care.  The Restoring Accountability in the IHS Act seeks to offer better tools for recruiting competent medical staff and leadership, improve care standards, and dramatically increase accountability.
“Enough is enough,” said Noem.  “IHS has to be reformed.  People’s lives are at stake.”
Noem continued: “The Restoring Accountability in the IHS Act would fundamentally alter how the agency operates, putting patient care first at all times.  Whether it’s recruiting competent medical staff and hospital leadership, improving care standards or instilling strict accountability measures, this legislation remains focused on ensuring tribal members in South Dakota and across the country receive the care their families need.” 

“This legislation is a strong step forward to restore accountability to the Indian Health Service and improve the delivery of care in Native American communities. I commend Rep. Noem for her work to develop creative solutions that will solve the most pressing issues plaguing Indian healthcare in the Great Plains region, and I look forward to working with her to advance this bill through the House,” said Bishop, Chairman of the House Committee on Natural Resources.
“Reforms to IHS are long overdue, and the Restoring Accountability in the IHS Act provides solutions to the obvious inefficiencies plaguing IHS,” Mullin said.  “By bringing accountability and flexibility to IHS management, Native Americans and their families will see dramatic improvements in their health care system. This bill will bring quality and reliable health services reforms to the IHS delivery system.”  

“The IHS is essential to our Native American communities across the nation, and it is crucial that we deliver on our promise to provide the best care possible for Native citizens,” said Cole. “This legislation will allow for significant reforms in the IHS, in both patient care and in protocol. Our Native Communities deserve peace of mind when seeking care for their health.”
The Restoring Accountability in the IHS Act offers a series of reforms to the IHS, addressing both medical and administrative challenges.  More specifically, the legislation: 

Offers Better Tools for Recruiting Competent Medical Staff and Leadership

  • Provides incentives to health care professionals to serve in the IHS, including pay flexibility and relocation reimbursements when employees move to high-need areas, as well as a housing voucher program for rental assistance to employees.
  • Allows managers to be eligible for the IHS student loan repayment program to incentivize more competent managers to join the agency.
  • Provides flexibility for the IHS in hiring and firing.
  • Makes volunteering at IHS facilities easier by providing liability protections for medical professionals who want to volunteer at IHS hospitals or service units and centralizing the agency’s medical credentialing system.

Improves Patient Care Standards

  • Requires the IHS to develop standards to measure wait times.
  • Requires IHS employees to attend culture training annually that teaches them about the tribe(s) they serve.

Increases Accountability

  • Enhances fiscal accountability by ensuring reports and plans are completed in a timely manner. Failure to comply with the requirements will restrict the IHS' ability to provide salary increases and bonuses.
  • Increases congressional oversight by requiring reports that assess staffing needs, existing protections against whistleblowers, and the frequency and causes of patient harm events.
  • Reiterates IHS employees’ right to petition Congress and requires HHS to notify all employees of the IHS of their statutory right to speak with Members of Congress and their staffs.

The Restoring Accountability in the IHS Act was also introduced today in the Senate by Sens. John Barrasso (R-WY), John Thune (R-SD) and John Hoeven (R-ND).

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