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April 11, 2018

Barrasso Bill to Reform Indian Health Service Passes Committee

This bill will lay a sound foundation for IHS to deliver the health care that tribal members deserve.

WASHINGTON, D.C. — Today, U.S. Senator John Barrasso (R-WY) praised the Senate Committee on Indian Affairs’ passage of his legislation, S.1250, the Restoring Accountability in the Indian Health Service Act of 2017.

Persistent failures by the Indian Health Service (IHS) to provide tribal citizens access to safe, quality health care have led to multiple patient deaths and the suffering of families and whole communities. The bill, sponsored by Barrasso and cosponsored by Senators John Hoeven (R-ND), John Thune (R-SD), and Steve Daines (R-MT), would address these issues by increasing transparency and accountability at the IHS to improve patient safety and care.

“We have heard appalling stories of failures at the Indian Health Service (IHS) that are unacceptable and will not be tolerated. We must reform the IHS to guarantee that all of Indian Country is receiving high-quality medical care,” said Barrasso. “This bill is a critical first step toward reform and reversing IHS dysfunction. It will lay a sound foundation for IHS to actually deliver the health care that tribal members deserve.”

The act will improve transparency and accountability at the IHS by:

• Strengthening removal and discipline authorities for poorly performing employees at the agency.
• Commissioning Government Accountability Office reports on personnel housing and staffing, whistleblower protections, and patient care and harm occurring at the IHS, among other reports.
• Requiring the IHS to ensure delivery of a service-wide centralized credentialing system for licensed health professionals seeking to provide health care services at multiple facilities.

The act also addresses staff recruitment and retention shortfalls at IHS by:

• Providing the secretary of the U.S. Department of Health and Human Services (HHS) with direct hiring and other authorities to avoid long delays in the traditional hiring process.
• Providing authority for health professionals to volunteer their health care services – including dental services – and be provided liability protections when working at an IHS service unit.
• Addressing gaps in IHS personnel by giving the HHS secretary flexibility to create competitive pay scales and provide temporary housing assistance for medical professionals.
• Expanding the eligibility for certain IHS employees to participate in the student loan repayment program by including degrees in business administration with an emphasis in health care management, health administration, hospital administration or public health.


The legislation reflects extensive feedback and information gathered by the committee since 2010, as well as close collaboration between the House, Senate, administration, Indian tribes and tribal organizations. Barrasso, Thune and Hoeven introduced the legislation in May 2017, and a legislative hearing was held in June 2017.

The committee voted to advance the legislation, as amended, to the full Senate. The substitute amendment, offered by Barrasso, incorporates technical corrections developed in consultation with the IHS, Indian tribes and other stakeholders.