On March 23, 2011, the Indian Health Service (IHS) published the attached FEDERAL REGISTER notice making amendments to the Memorandum of Agreement (MOA) between itself and the Department of Interior (DOI) regarding coordination of efforts to prevent alcohol and substance abuse in Indian Country.
The amendments to the Indian Health Care Improvement Act contained in the Patient Protection and Affordable Care Act (ACA) required that such a memorandum – or changes to an existing memorandum – be finalized within one year of enactment. In fact, the attached notice was published exactly one year after enactment of the ACA.
The attached notice provides the text of the 2009 MOA between the IHS and the DOI followed by the new amendments to that MOA. Among the changes made by the amendments are:
- The Purposes section has been broadened from addressing substance abuse issues to include “certain behavioral health issues among Indians, specifically mental illness and dysfunctional and self-destructive behavior, including substance abuse, child abuse, and family violence.”
- While the MOA of 2009 included the Bureau of Indian Education (BIE) in planning, coordination, and consultation activities, the amendments state that the BIE “will provide resources and funding for the education of the young people receiving treatment in the YRTC’s [Youth Residential Treatment Centers] (curriculum, libraries, recreational facilities, computers, funds for teachers, etc.), and will actively identify and seek funding and resources available from the states and other entities.” The IHS continues to be responsible for funding the centers, implementing treatment programs, and advocating for additional resources.
- A new paragraph (IV.A.8) concerns identification of the scope of behavioral health problems; identification of resources, including state and private, to provide services; delineation of responsibilities of the IHS and Bureau of Indian Affairs (BIA); and development of a strategy for coordination of behavioral health services by the IHS and BIA.
- A new paragraph IV.B.3 charges the IHS with responsibility for determining the scope of substance abuse problems among Indians; for assessing the resources necessary to prevent substance abuse; and estimating the amount of funding needed to adequately support substance abuse prevention and treatment programs.
Finally, the Secretaries of the Department of Health and Human Services and the Department of Interior are to conduct an annual review of the Memorandum of Agreement.
Please let us know if we may provide additional information regarding this Memorandum of Agreement.