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Indian Affairs Committee Approves Indian Health Care Improvement Act

Legislation Includes Murkowski Amendments on Reimbursing Medical Travel Costs for Families and for Sanitation Facility Construction

Dec. 3, 2009

WASHINGTON, D.C. – U.S. Sen. Lisa Murkowski, R-Alaska, a senior member of the Senate Indian Affairs Committee, today announced that the committee approved the Indian Health Care Improvement Reauthorization and Extension Act of 2009, a bill that would permanently reauthorize Indian health programs delivered by Alaska’s Native regional health care providers.


“It has been nearly 20 years since Congress last reauthorized the Indian Health Care Improvement Act. Our first Americans suffer the highest mortality rates from diabetes, tuberculosis, alcoholism and suicide,” said Murkowski. “Indian Country has waited far too long for a bill to arrive at the President’s desk.”

The bill would permanently continue the authorization of the Community Health Aid Program (CHAP) in Alaska. Community Health aides deliver basic medical care throughout Alaska’s remote and rural villages. It would also continue the authorization for the dental health aide therapy program, an expansion of the CHAP program in 2003. 


The bill would provide important new authorizations for more comprehensive behavior health services including community based care, residential treatment and intensive out-patient treatment, among other services. It would also authorize the expansion of long-term care services including hospice care, assisted living, community based care and home care for elders. It would also allow tribally operated long-term care programs to share resources with Indian Health Service (IHS) facilities.

“I am hopeful that the expansion of long-term care services will enable regional health providers to keep elders within their communities, all of whom are an integral part of families,” said Murkowski. “Elders hold the knowledge of Alaska’s native cultures and it is vitally important that they are able to remain in their communities, if they so choose, to keep our Native cultures alive.”

Murkowski also offered an amendment to enhance the construction of sanitation facilities by clarifying the authority of federal agencies to transfer funds to the IHS and the authority of the IHS to accept these funds from other agencies.


“The construction of sanitation facilities in our rural and remote Alaska Native villages remains a top priority. Roughly a quarter of Alaska Native homes in rural areas are not served by running water and sewer systems,” said Murkowski. “The lack of sanitation facilities affects the most vulnerable members of our society. The CDC has reported that without adequate sanitation facilities, infants are eleven times more likely to be hospitalized for respiratory infections and five times more likely to be hospitalized for skin infections.”

The bill also includes language requested by Murkowski that would authorize repayment of travel costs for family members who must escort patients such as elders or young children when traveling to larger medical centers for emergency medical care. Currently there is limited authority to reimburse a person traveling with a patient and most families do not have the resources to pay for such a trip. 


Along with the Indian Health Care Improvement Act, the committee also approved the Indian Suicide Prevention Act of 2009, which Sen. Murkowski cosponsored. Sen. Murkowski offered several technical amendments provided by the Alaska Native Health Board to improve the bill’s applicability in Alaska. The bill would authorize the Secretary of Health and Human Services to carry out through the IHS a demonstration project for mental health services to help prevent Indian youth suicide through the use of telemedicine. The project would award up to five grants, for four years each, to Indian Tribes and tribal health organizations.

The bill now goes to the full Senate for consideration.

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