Indian Health Service

Indian Health Service
	IHS Logo
Operating Division overview
Formed	1955
Preceding Operating Division	Bureau of Indian Affairs;
Jurisdiction	Federal government of the United States
Headquarters	Rockville, Maryland
Annual budget	$3.8 billion
Operating Division executive	Dr. Yvette Roubideaux;
Child Operating Division	HHS agencies;
Website	www.ihs.gov

Indian Health Service (IHS) is an Operating Division (OPDIV) within the U.S. Department of Health and Human Services (HHS). IHS is responsible for providing medical and public health services to members of federally recognized Tribes and Alaska Natives. IHS is the principal federal health care provider and health advocate for Indian people, and its goal is to raise their health status to the highest possible level. IHS provides health care to American Indians and Alaska Natives at 33 hospitals, 59 health centers, and 50 health stations. Thirty-four urban Indian health projects supplement these facilities with a variety of health and referral services.

Mission of Indian Health Service

The provision of health services to members of federally recognized tribes grew out of the special government-to-government relationship between the federal government and Indian tribes. This relationship, established in 1787, is based on Article I, Section 8 of the Constitution, and has been given form and substance by numerous treaties, laws, Supreme Court decisions, and Executive Orders. The IHS currently provides health services to approximately 1.8 million of the 3.3 million American Indians and Alaska Natives who belong to more than 557 federally recognized tribes in 35 states. The agency's annual budget is about $3.6 billion (U.S. Dollars).

Formation

IHS was established in 1955 to take over health care of American Indian and Alaska Natives from the Bureau of Indian Affairs.

Employment

The IHS employs approximately 2,700 nurses, 900 physicians, 400 engineers, 500 pharmacists, and 300 dentists, as well as other health professionals totaling more than 15,000 in all.

Employment at IHS: The Indian Health Service is one of two federal agencies mandated to use Indian Preference in hiring. This law requires the agency to give preference hiring to qualified Indian applicants before considering non-Indian candidates for positions. IHS draws a large number of its professional employees from the U.S. Public Health Service Commissioned Corps. This is a non-armed service branch of the uniformed services of the United States. Professional categories of IHS Commissioned corps officers include physicians, physician assistant's, nurses, dentists, pharmacists, engineers, environmental health officers, and dietitians. Many IHS jobs are in remote areas as well as Rockville, MD Headquarters, and at Phoenix Indian Medical Center. In 2007, most IHS job openings were on the Navajo reservation. 71% of IHS employees are American Indian/Alaska Native. (http://info.ihs.gov/Profile08.asp)

Efficiency and Public Law 93-638 (Tribal Self Determination - 1975)

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ExpectMore.gov shows four rated areas of IHS: federally administered activities (moderately effective), health care facilities construction (effective), resource and patient management system (effective), and sanitation facilities construction (moderately effective). All federally recognized Native American and Alaska Natives are entitled to health care. This health care is provided by Indian Health Service, either through IHS-run hospitals and clinics, or through tribal contracts to provide health care services. IHS-run hospitals and clinics serve any registered Indian/Alaska Native, regardless of tribe or income. Tribal contract health care facilities serve only their tribal members, with other qualified Indians/Alaska Native being offered care on a space available basis. This policy makes it difficult or impossible for an Indian who leaves their tribal home for education or employment to receive the health care services to which they are legally entitled. An IHS fact sheet clarifies that Indians are also eligible to apply for any low income health care coverage provided by state and local governments, such as Medicaid. In fact, IHS 2007 Third-Party Collections were FY $767 million, and estimated to be $780 million in 2008^[1]. Most Tribally-Operated Health Care services clinics require Native Americans who would qualify for Medicaid to apply and use their benefits at their clinics, supplementing the block grant funds they received from IHS to serve their tribe's medical needs. This double-dipping can create profits in federally funded tribally-operated health clinics^{[citation needed]}.

The Indian Health Service suffers from inadequate funding and is unable to adequately serve the population it is trying to serve.^[2] Some of those who are served by this system are not satisfied with the efficiency of IHS. An opinion writer for Indianz.com, a website for Native American news, feels Native Americans are "suffering" at the hands of IHS. ^[3] She feels IHS is underfunded and necessary services unavailable. Others have concerns that restrictions of the Indian preference policy do not allow for the hiring of the most highly qualified health professionals and administration staff, so quality of care and efficiency of administration suffer.

Administration

Indian Health Service is led by Dr. Yvette Roubideaux, M.D., M.P.H., a member of the Rosebud Sioux Tribe, South Dakota. Dr. Roubideaux was confirmed by the U.S. Senate as IHS Director on May 6, 2009, and she was sworn in on May 12, 2009, replacing director, Robert McSwain. Mr. McSwain served as acting director when Rear Admiral Charles W. Grim declined an additional term of service in September 2007, then was nominated by President George Bush, confirmed and sworn in May 2008.

IHS Areas

Aberdeen Area Director, Charlene Red Thunder, M.Ed., Cheyenne River Sioux Tribe
Alaska Area Director, Christopher Mandregan, Jr., M.P.H., Aleut Community of St. Paul, Alaska
Albuquerque Area Acting Director, Leonard Thomas, M.D., the Navajo Nation
Bemidji Area Acting Director, Jenny Jenkins
Billings Area Director, Pete Conway, M.Ed., Blackfeet Tribe
California Area Director, Margo D. Kerrigan, M.P.H., White Earth (Mississippi) Band of the Minnesota Chippewa Tribe
Nashville Area Director, RADM Richie K. Grinnell, R.S., M.P.H., Sac and Fox Nation of Missouri
Navajo Area Director, John Hubbard, Jr., M.P.H., the Navajo Nation
Oklahoma Area Director, CAPT. Kevin Meeks, Chickasaw Nation
Phoenix Area Director, Don J. Davis, M.P.H., Muscogee Creek Nation
Portland Area Director, Doni Wilder, Rosebud Sioux Tribe
Tucson Area Director, Dorothy Dupree, M.B.A., Assiniboine and Sioux Tribes

Budget

The 2010 United States federal budget includes over $4 billion for the IHS to support and expand the provision of health care services and public health programs for American Indians and Alaska Natives (AI/ANs). Investments in the Indian health system will focus on improving the health outcomes of AI/ANs and promoting healthy Indian communities. The Budget builds upon resources provided in the recovery Act for IHS.^[4] This covers 2.5 million Native Americans and Alaskan Natives for an average cost per person of $1,600, far less than the average cost of health care for other United States Citizens.[1]

References

^ "U.S. Department of Health and Human Services: Indian Health Service Fact Sheets"
^ "Trahant: The double standard of government-run health care: Indian Health Service" article by Mark Trahant in Indian Country Today Jul 7, 2009, accessed September 25, 2009
^ Indianz.com: 8-20-07, Jodi Rave: Indian Health Service Inadequate
^ http://www.whitehouse.gov/omb/assets/fy2010_new_era/A_New_Era_of_Responsibility2.pdf

External links

[1] "U.S. Department of Health and Human Services: Indian Health Service Fact Sheets"

[2] "Trahant: The double standard of government-run health care: Indian Health Service" article by Mark Trahant in Indian Country Today Jul 7, 2009, accessed September 25, 2009

[3] Indianz.com: 8-20-07, Jodi Rave: Indian Health Service Inadequate

[4] ttp://www.whitehouse.gov/omb/assets/fy2010_new_era/A_New_Era_of_Responsibility2.pdf

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v t e United States Department of Health and Human Services
Headquarters: Hubert H. Humphrey Building Xavier Becerra, Secretary of Health and Human Services Andrea Palm, Deputy Secretary of Health and Human Services
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