WHEREAS, WHEREAS, WHEREAS, WHEREAS, 4-STATE INTERTRIBAL ASSEMBLY Resolution 1-12-94-02 ܕܐ:embers:. The 4-State Intertribal Assembly is an intertribal The United States Government is responsible for providing a comprehensive health services delivery system for American Indians and Alaska Natives as provided by treaty obligations, including but not limited to, the Snyder Act of 1921, the Indian SelfDetermination and Education Assistance Act of 1975, and the Indian Health Care Improvement Act of 1976; and The American Indians and Alaska Natives have paid for this right through the cession of millions of acres of land to the United States, and relinqueshment of minerals and other natural resources; and The Health Security Act is currently under debate in the United States Congress (S.1757, S.1775, and H.R.3600) with consideration of the Bills during the second session of the 103rd Congress. NOW THEREFORE, BE IT RESOLVED, that the 4-State Intertribal Assembly supports the general principles of the legislation with the following qualifiers: That all sections of the Health Security Act authorizing the Indian health care delivery programs be defined as an "entitlement" by virtue of the special political relationship that exists between Indian nations and the United States and reaffirmed through numerous treaties, executive agreements, federal statutes and case law. ⭑ The current Alternative Resource Rule/Payor of Last Resort Policy be eliminated, and to clarify the role of Indian Health Service as the primary provider of health care to Indian people, direct Federal reimbursement be provided to Indian health programs for services provided to patients eligible for third party reimbursements. The plan must ensure the right of sovereign tribal governments to authorize automatic enrollment of their members into the Indian health program until such time as the member elects to enroll in a non-Indian health plan. Exemption from payment of employee premiums by all businesses located within the exterior boundaries of the areas, or Indian communities in order to promote economic development in Indian communities. ⭑ Automatic enrollment of eligible Indians as defined by individual tribal governments into the Indian health care systems without regard to residency. The Indian health programs must be authorized and funded to enable the delivery of services comparable to those provided by competing health plans. Indian Health Service needs to ensure that health programs are not adversely impacted by state health care reform efforts. The relationship between Indian health programs and regional and corporate alliances must be clarified. Authorization and funding for Indian health care providers must be included in all relevant long-term care provisions of the Act. Federal funds must be paid directly to Indian health care providers at a level equal to the amount spent by States under Medicaid on community long-term care services. * Public Health Initiatives and other federal programs must be authorized to enable participation by Indians, Indian nations, and Indian organizations. Funding must be comparable to levels provided to non-Indian recipients. * Funding for supplemental Indian health programs must not be diverted to make up for shortfalls in the Comprehensive Benefits Package or other initiatives authorized pursuant to the Act. Appropriations must be ensured for the continuation of existing and expanded supplemental benefits to meet unmet needs. ⭑ All Congressional committees having jurisdiction over any portion of the Health Security Act of 1993 should conduct hearings in Washington, D.C. and throughout Indian Country to ascertain the impact of health care reform on Indian nations and Indian people. Funding for the infrastructure necessary to enable tribes to deliver the Comprehensive Benefit Package must be guaranteed. Adequate transitional funding must be provided to the Indian health program to enable planning for implementation of the Health Security Act. Indian health programs must be funded to enable them to meet the minimum standards of accreditation set out by the Secretary. Where resources are inadequate, relief from these requirements shall be granted until such time as funds are made available. Consultation between tribes, the Administration and Congress must begin immediately and continue during the consideration of the Health Security Act. BE IT FURTHER RESOLVED, that during deliberations of the Health Security Act, Congress and the Administration must recognize the unique and special legal relationship that exists between Indian nations and the United States. CERTIFICATION We do hereby certify that the foregoing Resolution was duly presented and acted upon by a vote of 23 For, 0 Against, 7 Silent, at a meeting of the 4-State Intertribal Assembly, quorum present, held on January 12-13, 1994 at Bloomington, Minnesota. a |