American Medical Association Adopts Several American Indian and Alaska Native Health Focused Resolutions, Priorities Include Traditional Healing, Health Care Access, and Nutrition

The American Medical Association (AMA) held their Annual Meeting of the House of Delegates (HOD), on June 7-12, 2024. During this, various resolutions were presented that focused on American Indian and Alaska Native Communities and Indian Health Service, Tribal, and urban Indian Organization (I/T/U) Facilities. The resolutions covered key issues such as Traditional Healing, Nutrition, Healthcare Access, and Missing and Murdered Indigenous People (MMIP). The AMA has previously shown support for UIOs, during their 2023 HOD meeting, when they passed Resolution 812 (I-23), which included language on 100% FMAP for UIOs. Resolutions, once adopted, become AMA policy and are used to guide how the AMA will advocate with federal and state governments or other entities.  As the largest medical association, adoption of these resolutions by the AMA shows Congress and various agencies the importance of specific issues and initiatives to address them.

Below are the resolutions that passed, as well as the adopted language:

CMS Report 3 – Review of Payment Options for Traditional Healing Services

  • “Our AMA support monitoring of Medicaid Section 1115 waivers that recognize the value of traditional American Indian and Alaska Native healing services as a mechanism for improving patient-centered care and health equity among American Indian and Alaska Native populations when coordinated with physician-led care”
  • “Our AMA support consultation with Tribes to facilitate the development of best practices, including but not limited to culturally sensitive data collection, safety monitoring, the development of payment methodologies, healer credentialing, and tracking of traditional healing services utilization at Indian Health Service, Tribal, and Urban Indian Health Programs”

Resolution 101 – Infertility Coverage

  • “Our AMA will work with interested organizations to encourage the Indian Health Service to cover infertility diagnostics and treatment for patients seen by or referred through an Indian Health Service, Tribal, or Urban Indian Health Program”
  • “Our AMA support the review of services defined to be experimental or 49 excluded for payment by the Indian Health Service and for the appropriate bodies to make 50 evidence-based recommendations for updated health services coverage”

Resolution 206 – Indian Health Service Youth Regional Treatment Centers

  • “Our AMA support the expansion of Indian Health Service Youth Regional Treatment Centers, recognizing them as a model for culturally-rooted, evidence-based behavioral health treatment, and prompt referral of eligible AI/AN youth to Youth Regional Treatment Centers (YRTCs) for community-directed care”

Resolution 208 – Improving Supplemental Nutrition Programs

  • “Our AMA support regulatory and legal reforms to extend eligibility for USDA Food Assistance to enrolled members of federally-recognized American Indian and Alaska Native Tribes and Villages to all federal feeding programs, such as, but not limited to, Supplemental Nutrition Assistance Program (SNAP) and Food Distribution Program on Indian Reservations (FDPIR)”

Resolution 209 – Native American Voting Rights

  • “Our AMA support Indian Health Service, Tribal, and Urban Indian Health Programs becoming designated voter registration sites to promote nonpartisan civic engagement among the American Indian and Alaska Native population”

Resolution 215 – American Indian and Alaska Native Language Revitalization and Elder Care

  • “Our AMA recognize that access to language concordant services for AI/AN patients will require targeted investment as Indigenous languages in North America are threatened due to a complex history of removal and assimilation by state and federal actors”
  • “Our AMA support federal-tribal funding opportunities for American Indian and Alaska Native language revitalization efforts, especially those that increase health information resources and access to language-concordant health care services for American Indian and Alaska Native elders living on or near tribal lands”
  • “Our AMA collaborate with stakeholders, including but not limited to the National Indian Council on Aging and Association of American Indian Physicians, to identify best practices for AI/AN elder care to ensure this group is provided culturally-competent healthcare outside of the umbrella of the Indian Health Service”

Resolution 242 – Health Care Access for American Indians and Alaska Natives

  • “Our AMA actively advocate for the federal government to continue enhancing and developing alternative pathways for American Indian and Alaska Native patients to access the full spectrum of cancer care and cancer-directed therapies outside of the established Indian Health Service system”
  • “Our AMA (a) support collaborative research efforts to better understand the limitations of IHS cancer care, including barriers to access, disparities in treatment outcomes, and areas for improvement and (b) encourage cancer linkage studies between the IHS and the CDC to better evaluate regional cancer rates, outcomes, and potential treatment deficiencies among American Indian and Alaska Native populations”

Resolution 305 – Public Service Loan Forgiveness Reform

  • “Our AMA also support the removal of any requirement for competitive bidding in the Indian Health Service that compromises proper care for the American Indian population”
  • “Our AMA will advocate that the Indian Health Service (IHS) establish an Office of Academic Affiliations responsible for coordinating partnerships with LCME- and COCA-accredited medical schools and ACGME-accredited residency programs”
  • “Our AMA will encourage the development of funding streams to promote rotations and learning opportunities at Indian Health Service, Tribal, and Urban Indian Health Programs”
  • “Our AMA will call for an immediate change in the Public Service Loan Forgiveness Program to allow physicians to receive immediate loan forgiveness when they practice in an Indian Health Service, Tribal, or Urban Indian Health Program”

Resolution 407 – Racial Misclassification

  • “Our AMA supports HIPAA-compliant data linkages between Native Hawaiian and Tribal Registries, population-based and hospital-based clinical trial and disease registries, and local, state, tribal, and federal vital statistics databases aimed at minimizing racial misclassification”

Resolution 408 – Indian Water Rights

  • “Our AMA raise awareness about ongoing water rights issues for federally-recognized American Indian and Alaska Native Tribes and Villages in appropriate forums”
  • “Our AMA support improving access to water and adequate sanitation, water treatment, and environmental support and health services on American Indian and Alaska Native trust lands”

Resolution 411 – Missing and Murdered Indigenous Persons

  • “Our AMA supports emergency alert systems for American Indian and Alaska Native tribal members reported missing on reservations and in urban areas”

Resolution 420 – Equity in Dialysis Care

  • “Our American Medical Association declare kidney failure as a significant public 36 health problem with disproportionate affects and harm to under-represented communities”
  • “Our AMA vigorously pursue potential solutions and partnerships to identify economic, cultural, clinical and technological solutions that increase equitable access to all modalities of care including home dialysis”

Resolution 502 – Tribally-Directed Precision Medicine Research

  • “Our AMA support clinical funding supplements to the National Institutes of Health, the U.S. Food and Drug Administration, and the Indian Health Service to promote greater participation of the Indian Health Service, Tribal, and Urban Indian Health Programs in clinical research”

Board of Trustees Report 31 – The Morrill Act and Its Impact on the Diversity of the Physician Workforce

  • “Our AMA acknowledges the significance of the Morrill Act of 1862, the resulting land-grant university system, and the federal trust responsibility related to tribal nations”
  • “Our AMA will convene key parties, including but not limited to the Association of American Indian Physicians (AAIP) and American Indian/Alaska Native (AI/AN) tribes/entities such as Indian Health Service and National Indian Health Board, to discuss the representation of AI/AN physicians in medicine and promotion of effective practices in recruitment, matriculation, retention, and graduation of medical students”

About the AMA House of Delegates (HOD)

NCUIH has worked with the AMA previously, as they have shown support for the needs of UIOs. Last year, NCUIH submitted written testimony to the 2023 Interim Meeting in support of a proposed resolution that included language on 100% FMAP for UIOs. This resulted in adoption of the resolution and acknowledgment by the AMA of FMAP for UIOs as a priority. Having the support of the AMA is impactful and shows Congress the need to pass 100% FMAP for UIOs. By adding resolutions during their recent HOD meeting that reflect additional needs and priorities of UIOs, the AMA is continuing this support and providing another advocacy tool for UIOs to utilize.

The House of Delegates (HOD) is the legislative and policy-making body of the American Medical Association. State medical associations and national medical specialty societies are represented in the HOD along with AMA sections, national societies such as American Medical Writers Association (AMWA), American Osteopathic Association (AOA) and the National Medical Association (NMA), professional interest medical associations, and the federal services, including the Public Health Service. At HOD Meetings, resolutions are referred to the Reference Committee for open discussion and to allow recommendations for HOD action. If adopted by the HOD, the resolution can become the foundation of a new AMA program, establish or modify policy on an issue, or become a new directive for action. Policies of the AMA House of Delegates are policy statements on health topics and are one of the cornerstones of the AMA as they define what the Association stands for as an organization. They provide the information and guidance that physicians and others seek from the AMA about health care issues.