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Illustration: Sarah Grillo/Axios

The Indian Health Service remains deeply troubled, according to two new reports released yesterday from the Department of Health and Human Services' Office of the Inspector General.

Why it matters: The IHS is responsible for more than 2 million Native Americans — a population that tends to need a lot of care, much of it specialized. Yet the IHS has been beset for years by underfunding and mismanagement.

Driving the news: IHS hospitals often do not follow protocols for dispensing opioids, and they don't use states' prescription drug monitoring programs to track opioid prescriptions, the OIG said.

  • Hospitals within the IHS system also don't have strong cybersecurity protections in place, according to the audit (although that's not unique to IHS facilities).

A separate audit details one of the highest-profile examples of the IHS' shortcomings — the staffing shortages and safety problems that prompted the government to temporarily close the emergency department in IHS' Rosebud hospital, in South Dakota, in 2015.

The other side: Some tribes seem to be able to do better on their own.

  • Kaiser Health News spotlights Cherokee Indian Hospital in North Carolina — a new, 20-bed facility practicing an integrated care model that's performing well on metrics like controlling tribal members' blood pressure and blood sugar.

Yes, but: The Eastern Band of Cherokee Indians, which operates the North Carolina hospital, was in a unique position to opt out of the IHS, thanks to a casino whose revenues largely paid for the new hospital.

  • “Not all tribal communities have access to the economic opportunities that we have,” Casey Cooper, the hospital's CEO, told KHN. “Some tribes are in these desolate, remote locations where there are no natural resources or economic development opportunities. I get that.”

Go deeper: Government shutdown hits Native Americans especially hard

Go deeper

Biden's Day 1 challenges: The immigration reset

Illustration: Aïda Amer/Axios

President-elect Biden has an aggressive Day One immigration agenda that relies heavily on executive actions to undo President Trump's crackdown.

Why it matters: It's not that easy. Trump issued more than 400 executive actions on immigration. Advocates are fired up. The Supreme Court could threaten the Deferred Action for Childhood Arrivals (DACA) program, and experts warn there could be another surge at the border.

Broncos and 49ers the latest NFL teams impacted by coronavirus crisis

From left, Denver Broncos quarterbacks Drew Lock, Brett Rypien and Jeff Driskel during an August training session at UCHealth Training Center in Englewood, Colorado. Photo: Justin Edmonds/Getty Images

The COVID-19 pandemic has thrown the NFL season into chaos, with all Denver Broncos quarterbacks sidelined, the San Francisco 49ers left without a home or practice ground and much of the Baltimore Ravens team unavailable, per AP.

Driving the news: The Broncos confirmed in a statement Saturday night that quarterbacks Drew Lock, Brett Rypien and Blake Bortles were identified as "high-risk COVID-19 close contacts" and will follow the NFL's mandatory five-day quarantine, making them ineligible for Sunday's game against New Orleans.

Updated 13 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Health: WHO: AstraZeneca vaccine must be evaluated on "more than a press release."
  2. Politics: McConnell temporarily halts in-person lunches for GOP caucus.
  3. Economy: Safety nets to disappear in DecemberAmazon hires 1,400 workers a day throughout pandemic.
  4. Education: U.S. public school enrollment drops as pandemic persists.
  5. Cities: Surge in cases forces San Francisco to impose curfew — Los Angeles County issues stay-at-home order, limits gatherings.
  6. Sports: NFL bans in-person team activities Monday, Tuesday due to COVID-19 surge — NBA announces new coronavirus protocols.
  7. World: London police arrest more than 150 during anti-lockdown protests — Thailand, Philippines sign deal with AstraZeneca for vaccine.