Department of Health & Human Services OIG
Indian Health Service Use of Critical Care Response Teams To Support Health Care Facilities During the COVID-19 Pandemic
The Indian Health Service (IHS) is charged with providing comprehensive health care for approximately 2.6 million American Indians and Alaska Natives (AI/ANs). It is critical to ensure safe and accessible health care for AI/ANs during the COVID-19 pandemic. Prior OIG work found that IHS facilities often lack sufficient clinical and other staff, and identified numerous problems caused by staffing shortages, including limited patient access to specialists and problems with the use of contracted staff. The COVID-19 pandemic may exacerbate staffing shortages as IHS and Tribal hospitals continue to see more COVID-19 patients. As a response, IHS contracted additional staff by forming a Critical Care Response Team pilot program, which is designed to provide urgent medical care for COVID-19 patients in facilities with insufficient staffing. The teams are also charged with preparing and training frontline health care staff on evidence-based and best practices, supporting clinical decision making, and providing consultations and advice on hospital operations and how to manage critically ill patients. As of September 29, 2020, IHS had deployed five teams to provide services at six IHS-operated facilities and three tribally operated facilities and planned to make the program a longer-term part of IHS operations. Doing so could help remedy longstanding staffing shortages at IHS facilities. However, problems identified in prior OIG work indicate that IHS may have difficulty managing this contracted resource and integrating the teams into facility practices. OIG's review will use interviews with IHS and contracted staff, as well as document reviews, to assess IHS use of the Critical Care Response Teams, including development, management, and oversight of the teams, and IHS selection criteria for determining which facilities would receive deployments.