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).
Early History of IHS
IHS was established in 1954 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 native American. (http://info.ihs.gov/Profile08.asp)
Efficiency and Public Law 93-638 (Tribal Self Determination)
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.
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. (Indianz.com: 8-20-07, Jodi Rave: Indian Health Service Inadequate) 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.
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Administration and Direction
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 acting director, Robert McSwain. Mr. McSwain served as acting director when Rear Admiral Charles W. Grim declined an additional term of service in September 2007.
IHS Areas
- Aberdeen Area Director, Charlene Red Thunder, Cheyenne River Sioux Tribe
- Alaska Area
- Albuquerque Area Director, James Lawrence Toya, Laguna Pueblo
- Bemidji Area Director, Kathleen R. Annette, M.D., White Earth Band of Chippewa
- Billings Area Director Pete Conway, M.Ed., Blackfeet Tribe
- California Area Director, Margo D. Kerrigan, White Earth (Mississippi) Band of the Minnesota Chippewa Tribe
- Nashville Area Director Richie K. Grinnell, R.S., M.P.H., Sac and Fox Nation of Missouri
- Navajo Area Director, John Hubbard, Jr., the Navajo Nation
- Oklahoma Area
- Phoenix Area Director, Don J. Davis, a Creek-Seminole Indian
- Portland Area Director, Doni Wilder, a Rosebud-Sioux Indian
- Tucson Area
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. [3]
See also
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
- ^ http://www.whitehouse.gov/omb/assets/fy2010_new_era/A_New_Era_of_Responsibility2.pdf
External links
