Indian Health Service candidate pledges to tackle long-standing challenges

Indianz.Com Video: Roselyn Tso – Confirmation Hearing for Indian Health Service Director – May 25, 2022

Indian Health Service candidate pledges to tackle long-standing challenges

Thursday, May 26, 2022

By Acee Agoyo



WASHINGTON, DC — The Biden administration’s nominee to head India’s health service faced a few questions during a long-awaited nomination hearing on Capitol Hill. But Roselyn Tso, a citizen of the Navajo Nation, told the Senate Indian Affairs Committee on Wednesday that she is ready for the challenges of providing services to more than 2.5 million American Indians and Indians. Alaska Natives across the country. Chronic disparities in health care and health status have only been exacerbated by the ongoing COVID-19 pandemic, the longtime IHS employee said. “As I travel across the region to different IHS facilities, it reminds me of the many health disparities that American Indians and Alaska Natives face – health disparities that, in many cases, have been made worse by COVID-19,” Tso said in his opening statement. appointment hearing before the committee. “For example, unfortunately today too many Navajo families still do not have access to running water in their homes,” Tso continued. “Access to clean and safe drinking water is essential to the health and well-being of our population. »

Indianz.Com Audio: Nomination Hearing to Consider Roselyn Tso as Indian Health Service Director
Tso, who has worked for IHS since 1984, currently directs the Navajo Zone of IHS. The region, which serves more than 240,000 people on the largest reservation in the United States, has suffered from some of the highest COVID-19 rates in the past two years. “Throughout my career at IHS, I have worked to improve the agency to better meet the needs of the people we serve,” Tso said. “This has been most evident throughout the pandemic, where I have seen and been part of a true partnership with the Navajo Nation, the San Juan Paiute Tribe and federal, state, local and private partners to collectively fight against COVID-19.”

President Jonathan Nose of the Navajo Nation witnessed first-hand his tribe’s partnership with IHS. Thanks to those efforts, he said the reservation has some of the highest COVID-19 vaccination rates in the United States — and indeed the world. “Currently, our population aged 65 and over is 90% fully immunized,” Nez told the committee in a strong statement of support for Tso’s appointment as head of IHS. “Most of the general Navajo population is vaccinated. At a time when mainstream America barely reached 50%, the Navajo Nation was at 75%. “Because of his leadership, the Navajo Nation has achieved one of the highest vaccination rates in the world,” Nez said of his tribe’s work with Tso.

Navajo Nation Chairman Jonathan Nez, left, and Roselyn Tso appear before the Senate Indian Affairs Committee for the hearing to nominate Tso as Director of the Indian Health Service on May 25, 2022. Photo: Office of the President and Vice President of the Navajo Nation
Four members of the Senate Indian Affairs Committee — — three Democrats and one Republican — participated in Tso’s hearing, which lasted about 40 minutes. Their questions largely focused on improving IHS operations, particularly when it comes to ensuring the federal government meets its trust and treaty obligations to provide services and funding. in Indian country. Sen. Brian Schatz (D-Hawaii), chairman of the committee, noted that Tso’s written statement contained no explicit reference to tribal sovereignty or the nation-to-nation relationship between the tribes and the United States. He asked for assurances that the Biden administration “Undoubtedly, there is a fiduciary responsibility to Native Americans and Alaska Natives — particularly to health care — that has been documented in law, as well as Supreme Court decisions,” Tso replied.

Roselyn Tso

Roselyn Tso appears before the Senate Committee on Indian Affairs for her nomination hearing for the position of Director of the Indian Health Service on May 25, 2022. Photo: Navajo Nation Office of President and Vice President
Sen. Maria Cantwell (D-Washington), the committee’s former chair, also sought assurances that the IHS will fulfill its obligations through self-determination and self-government agreements with the tribes. She said the agency has historically not always made payments “in a timely manner.” “Looking at the commercial component of the Indian Health Service, we can also strengthen that part, to ensure that proper payments are made in a timely manner with respect to actual funding payments when we get funding at the regional level,” said Tso said. Cantwell. “In the Navajo area, our goal — and my expectation — was to ensure payments were made within 24 hours to every tribe, especially when CARES money and infrastructure funds were dwindling,” Tso said in reference. to COVID-19 and infrastructure. bills passed by Congress in the past two years. “It was essential,” she added. “We were able to do it, and we should be able to do it across India’s health service.”

Sen. John Hoeven (R-N.D.), another former committee chairman, was the only Republican to attend the hearing. Sen. Lisa Murkowski (R-Alaska), the panel’s current vice chair, was absent for personal reasons, her GOP colleague said. Hoeven expressed concerns about the need to ensure that IHS and tribal facilities receive medical supplies in a timely manner. He cited a May 5 article in the Wall Street Journal that reported on delays in the Great Plains region, where services were routinely rated as “substandard.” “In some cases, facilities have waited over a year for equipment,” Hoeven said. “And obviously those delays have caused hospitals to seek alternative, sometimes even more expensive, ways to proceed while waiting for equipment.” If confirmed as IHS director, Tso promised she would prioritize the agency’s business operations to improve service delivery, including medical equipment. “It can be done,” she said. “We have systems in place that allow us to do that,” Tso said, though she wouldn’t go into detail. “Ensuring that our systems are used appropriately and appropriately is essential to our operation to ensure that we have appropriate medical equipment and supplies at all times.”

Indianz.Com Video: Q&A: Nomination Hearing for Indian Health Service Director Roselyn Tso
Sen. Ben Ray Lujan (D-New Mexico) also focused on operations — or lack thereof — in his home state of New Mexico. He asked why the IHS had dramatically reduced care at a hospital serving Pueblo and Navajo communities near Albuquerque, the state’s largest city. “Recently, the Acoma-Canoncito-Laguna Hospital in New Mexico was closed and turned into a clinic Monday through Friday, 9 a.m. to 5 p.m.,” Lujan said of changes to the facility over the past two months. last years. “I was troubled by the data behind this closure, which took place during a pandemic and how the change was communicated to Pueblos and the community,” Lujan added. Tso noted that the changes were primarily due to Laguna Pueblo entering into a self-determination contract with IHS to open its own health facility. The deal for the Laguna Community Health Center required the agency to redirect funds from the larger hospital, known locally as the ACL. According to Tso, the IHS should “honor the positions and decisions of tribal leaders when they decided to assume their own health care systems under self-governance or self-determination and that was part of this particular situation. “. Although Tso promised to improve how IHS communicates these types of service level changes to tribes and patients, she did not respond to Lujan’s question about whether she would take steps to ensure that the agency “stem the tide of hospital closings”. Similar reductions in care have been seen in the Great Plains region, where a hospital lost its accreditation under federal government oversight. “It’s a good balance here to make sure that … we maximize health care systems and access to care for all of our patients,” Tso told Lujan. President Joe Biden has announced Tso as his nominee to head the IHS on March 9. He had asked the former manager to step down when he took office in January 2021. Michael Weahkee, a Pueblo de Zuni citizen, had only been on the job for nine months before leaving the post. He was the last IHS director to be confirmed by the US Senate amid a leadership shortage at the agency. For six of the past seven years, in fact, the IHS has been without a permanent director. The leadership crisis began near the end of Barack Obama’s Democratic administration and continued through most of former Republican President Donald Trump’s tenure. As chairman of the Senate Indian Affairs Committee, Schatz said he would work with Murkowski, the vice chairman, to “move this nomination forward quickly” through the panel. The next step in the process would be a business meeting to approve Tso. Assuming it is approved, it could then be considered by the full Senate. “The hearing file will be open for two weeks,” Schatz said as he greeted a special guest on the committee room dais. The daughter of Jennifer Romero, personnel director and chief counsel for the committee, closed the hearing with a hammer blow. “This hearing is adjourned,” said the young guest.

Opinion of the Senate Committee on Indian Affairs

Nomination hearing to consider Roselyn Tso as Director of Indian Health Service, Department of Health and Human Services (May 25, 2022)

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