Indian Health Service

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 $3.8 billion (U.S. Dollars).

Early History of IHS

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 U.S. Uniformed Services. Professional categories of IHS Commissioned corps officers include physicians, nurses, dentists, pharmacists, engineers, environmental health officers, and dietitians. Many IHS jobs are in remote areas. 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 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 to for an Indian who leaves his tribal home for education or employment to receive the health care services to which he is 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 (Medi-Cal in CA). In fact, IHS 2007 Third-Party Collections were FY $767 million, and estimated to be $780 million in 2008. (http://info.ihs.gov/Profile08.asp) Most Tribally-Operated Health Care services clinics require Native Americans who would qualify for Medicaid (MediCal in CA)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.

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.Disputed|date=March 2008

Administration and Direction

Indian Health Service is led by acting director Robert G. McSwain. Rear Admiral Charles W. Grim declined an additional term of service in September 2007. McSwain has worked at the IHS since 1976. He previously served as IHS Deputy Director since February 2005. He is a member of the North Fork Rancheria of Mono Indians of California.

IHS Areas

* [http://www.ihs.gov/FacilitiesServices/AreaOffices/Aberdeen/ Aberdeen Area] Director, Charlene Red Thunder, Cheyenne River Sioux Tribe
* [http://www.ihs.gov/FacilitiesServices/AreaOffices/Alaska/index.asp/ Alaska Area]
* [http://www.ihs.gov/FacilitiesServices/AreaOffices/Albuquerque/ Albuquerque Area] Director, James Lawrence Toya, Laguna Pueblo
* [http://www.ihs.gov/FacilitiesServices/AreaOffices/Bemidji/index.asp/ Bemidji Area] Director, Kathleen R. Annette, M.D., White Earth Band of Chippewa
* [http://www.ihs.gov/FacilitiesServices/AreaOffices/billings/index.asp/ Billings Area] Director Pete Conway, M.Ed., Blackfeet Tribe
* [http://www.ihs.gov/FacilitiesServices/AreaOffices/California/Universal/PageMain.cfm?p=10/ California Area] Director, Margo D. Kerrigan, White Earth (Mississippi) Band of the Minnesota Chippewa Tribe
* [http://www.ihs.gov/FacilitiesServices/AreaOffices/Nashville/ Nashville Area] Director Richie K. Grinnell, R.S., M.P.H., Sac and Fox Nation of Missouri
* [http://www.ihs.gov/FacilitiesServices/AreaOffices/Navajo/ Navajo Area] Director,John Hubbard, Jr., the Navajo Nation
* [http://www.ihs.gov/FacilitiesServices/AreaOffices/oklahoma/index.cfm/ Oklahoma Area]
* [http://www.ihs.gov/FacilitiesServices/AreaOffices/Phoenix/Index.cfm/ Phoenix Area] Director, Don J. Davis, a Creek-Seminole Indian

* [http://www.ihs.gov/FacilitiesServices/AreaOffices/Portland/ Portland Area]
* [http://www.ihs.gov/FacilitiesServices/AreaOffices/Tucson/index.asp/ Tucson Area]

ee also

*Health insurance
*Health insurance in the United States

External links

* [http://www.ihs.gov/ Indian Health Service]
* [http://www.ihs.gov/PublicAffairs/Bios/Documents/McSwain-IHS_ActgDir_9-2007.pdf Biography of Robert McSwain]
* [http://expectmore.gov ExpectMore.gov]