Federal spending bill fully funds tribal healthcare’s contract support costs

SEARHC serves from about 17,000 Alaska Natives and American Indians in Southeast Alaska. (Photo by Lisa Phu/KTOO)
SEARHC serves from about 17,000 Alaska Natives and American Indians in Southeast Alaska. (Photo by Lisa Phu/KTOO)

A spending bill advancing in the U.S. Senate includes full funding for Alaska Native health care providers’ contract support costs, an area of Native health care that’s been underfunded even though the Supreme Court has repeatedly ruled in favor of tribes. Those costs include items like legal and accounting fees, insurance and workers’ compensation. Contract support costs were fully funded for the first time in 2014.

Sen. Lisa Murkowski chairs the appropriations subcommittee that wrote the bill. She says the spending plan fences off funding for contract support to prevent the government from taking from other programs, which has happened in the past.

“They basically dipped into existing Indian programs, shortchanging them. That’s not how to do it. You don’t rob Peter to pay Paul. What we’ve done is put in a separate appropriations account that will prevent this cycle that’s occurred at the IHS,” said Murkowski.

Contract support costs have been the subject of lawsuits and recently brought multimillion dollar settlements to tribal health care groups for overdue reimbursement. Murkowski says the new bill provides clarity.

“That’s significant. It’s significant in that the assurance going forward, full support for contract support costs, is going to be there and there’s not going to be a shortage in other accounts to pay for that full coverage,” said Murkowski.

The bill would also provide the first federal funds for tribal courts in so-called PL 280 states, which includes Alaska Native villages and states in which the state government has extensive criminal and civil jurisdiction in Indian Country. The bill has $10 million for tribal law enforcement and justice pilot projects.

“That will help insofar as how we deal with these perpetrators who seemingly time and time again inflict this level of violence and basically get away with it. Because we have not been able to collect evidence, prosecute and bring to some level of justice those offenders,” said Murkowski.

The Senate Appropriations Committee approved the bill earlier this month. It still must advance though the full Senate, which is in the midst of a larger budget gridlock.

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