Indian Health Service Portland Area Director’s Update

1. Indian Health ServicePortland Area Director’s Update Dean M Seyler - Area Director October 21, 2013 Quarterly Board Meeting Silver Reef Hotel Casino

2. Renew And Strengthen Our Partnership With Tribes • Meeting With Direct Service Tribal Councils • Four Complete, One More To Go • 2005 Master Plan Discussions • Other Service Unit Related Topics • Portland Area Direct Service Tribes Meeting • November 13th & 14th • *************POSTPONE*************

3. Ensure that our work is transparent, accountable, fair, and inclusive Fund Distribution Workgroup Teleconference Occurred August 20, 2013 Charter Updated Follow Up Meeting Will Be Scheduled Existing Members Are: Angela Mendez Janice Clements Stella Washines Dan Gleason Marilyn Scott Leroy Jackson Judy Muschamp Mark Johnston Leslie Wosnig IHS FY 16 Budget Formulation October 24th

4. Ensure that our work is transparent, accountable, fair, and inclusive FY14 Continuing Resolution Funding through January 15, 2014 29.32% $258,256,195 Portland Area Recurring 29.32% = 75,720,716 80% = $60,576,572

5. Renew And Strengthen Our Partnership With Tribes • Sanitation Facilities Construction (SFC) Program–P.L. 86-121 • 32 projects approved for $6,210,328. • 9 projects for individual site sanitation facilities – potentially available to all 43 Tribes with MOAs signed and returned. • 23 community sanitation facilities projects. • Food Safety Modernization Act • DEHS reviewing the act and working with the Food and Drug Administration (FDA), states, and other bureaus to evaluate the implementation and impact of the regulations for tribes and tribal fishers

6. Ensure that our work is transparent, accountable, fair, and inclusive Facilities Combined Space Certification Request is Scheduled for November 30-day Response Period Sent to the Council Chair and Tribal Health Director Space Where IHS PFSA’s Are Administered Determines M&I and EQ Funds Eligibility/Allocation Contracting/Compacting Tribes Are Responsible For Certification Includes Adding, Removing, and Continued Use of Space

7. Improve The Quality Of And Access To Care Facilities Trends in Maintenance and Improvement (M&I) funding for Portland Area • Increasing square footage to support • M&I Allocations going down • Dollar per square meter (SM) is going down in relation to inflation (See following 3-graphs)

8. Improve The Quality Of And Access To Care • Increasing footprint increases demand for maintenance. Portland Area foot print has grown by 20% from FY2005 to FY2013

9. Improve The Quality Of And Access To Care • While space has increased by 20% Allocations from FY2005 to FY2013 has only increased by 7%

10. Improve The Quality Of And Access To Care • This chart shows combined impact of growing footprint, relatively flat funding and inflation that reduce the amount of funds available for maintenance per square meter

11. Questions or Comments Our Mission... to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level. Our Goal... to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indian and Alaska Native people. Our Foundation... to uphold the Federal Government's obligation to promote healthy American Indian and Alaska Native people, communities, and cultures and to honor and protect the inherent sovereign rights of Tribes.