Reauthorization of the Indian Health Care Improvement Act
The federal delivery of health services and funding of tribal and urban Indian health programs to maintain and improve the health of Alaska Natives is required by the historicaland unique legal relationship with Native Americans, as reflected in the Constitution, treaties, federal statutes and the course of dealings of the United States. Because of inferior health care, the quality and length of life for Native Americans and Alaska Natives fall well below the rest of the U.S. Health care expenditures for Native Americans is less than half what this country spends on health care for federal prisoners. The Indian Health Care Improvement Act (P.L. 94-437), first enacted in 1976, provides the framework for the Indian health care system. The Act has been reauthorized four times, most recently in 1992. It is currently up for reauthorization and is badly needed to bring our outdated and inadequate system into the 21st Century. For that reason, we call upon Congress to enact S. 1057, a bill to amend and extend the Indian Health Care Improvement Act which, for the first time, adopts the policy that the objectives for health improvements must be the same for American Indians and Alaska Natives as for all other Americans.
• Dental Health Aide Program: For the residents of nearly 200 small isolated communities in rural Alaska, access to dental care services is a serious problem. Alaska Natives suffer rates of dental caries (decay) at 2.5 times the U.S. national rates. Dentists employed by the Alaska Native tribal health agencies generally visiteach community only once a year for a week at a time. Private sector dentists generally do not live in rural Alaska, nor do they travel to provide services due to high travel costs and lack of patient insurance. Beginning in 2003, Alaska Native tribal health organizations developed a new solution to addressing rural Alaska dental needs: the Alaska Dental Health Aide (DHA) program. The DHA augments the much-heralded Community Health Aide/Practitioner (CHA/P) program. The American Dental Association (ADA), while supporting the use of preventive Dental Health Aides (DHAs), has opposed the use of Dental Health AideTherapists (DHATs) anywhere in American for nearly a century. This opposition continues despite the successful deployment of DHATs in New Zealand, Canada, Great Britain and 40 other countries. The ADA is seeking to amend the Indian Health Care Improvement Act to restrict DHAT services. AFN disagrees with this ADA position, as do many public health organizations as well as American Indian and Alaska Native organizations. We urge Congress to reauthorize the Indian Health Care Improvement Act and resist the efforts of the American Dental Association to restrict DHAT services as the Dental Health Aide Program ensures much needed dental services in rural Alaska.
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