On December 3, the Senate Indian Affairs Committee approved, by voice vote, the Indian Health Care Improvement Reauthorization and Extension Act (S. 1790). The House Energy and Commerce Subcommittee on Health held a hearing on its version of the legislation (H.R. 2708) on October 20 (see The Source, 10/23/09).
The bill, sponsored by Sen. Byron Dorgan (D-ND), would permanently reauthorize and expand several existing programs, including behavioral and mental health programs targeted at women and children.
The bill would authorize “such sums as are necessary” for FY2010 and annually after that “until expended” to carry out the grants and programs authorized under the bill. It would authorize and direct the secretary of Health and Human Services to develop a comprehensive behavior health prevention and treatment program to provide to federal, tribal, state, and local agencies “information, direction, and guidance” related to “mental illness, dysfunction, and self-destructive behavior,” including child abuse and family violence. The program also must include specialized residential treatment programs for high-risk populations, including pregnant and postpartum women and their children.
Services within the behavioral health prevention and treatment program must include services for children from birth to 17 years old, including preschool and school-age fetal alcohol spectrum disorder services; adult care, including gender-specific mental health and substance abuse services, treatment for women at risk of giving birth to children with fetal alcohol spectrum disorder, and gender-based treatment for sexual assault and domestic violence; family care, including treatment for sexual abuse and domestic violence, promotion of “healthy approaches to parenting, domestic violence, and other abuse issues”; and elder care, including gender-based treatment for mental health, substance abuse, sexual assault, and domestic violence.
The measure would establish Offices on Indian Women’s and Men’s Health within the Indian Health Service and would provide grants to tribes and tribal organizations for projects that prevent, control, or eliminate communicable diseases, including HIV, tuberculosis, and sexually transmitted diseases.
The bill also would provide grants to Indian tribes, tribal organizations, and urban Indian organizations to develop comprehensive behavioral health programs that “specifically address the cultural, historical, social, and child care needs of women.” The organizations could use the grants to develop and provide programs to address fetal alcohol spectrum disorder; identify psychological, counseling, and advocacy support and relapse prevention programs for women; and develop prevention and intervention models for women that include traditional health care practices, cultural values, and community and family involvement.
S. 1790 also would authorize the secretary to establish programs to address fetal alcohol spectrum disorder, child sexual abuse prevention and treatment, and domestic and sexual violence prevention and treatment.
During consideration of the bill, the committee adopted, by unanimous consent, an amendment by Sen. Al Franken (D-MN) to create a position for HIV/AIDS prevention and treatment within the Indian Health Service. The position would coordinate prevention and treatment activities, provide technical assistance to Indian health programs, and ensure interagency coordination to include Indians in research and grant opportunities.
