Indian Health Service
Encyclopedia
Indian Health Service 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
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population 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
Urban Indian
Urban Indians are Native Americans in the United States who live in urban areas. Urban Indians represent a growing proportion of the Native population in the United States...

 health projects supplement these facilities with a variety of health and referral services.

A 2010 report by Senate Committee on Indian Affairs Chairman Byron Dorgan
Byron Dorgan
Byron Leslie Dorgan is a former United States Senator from North Dakota and is now a senior policy advisor for a Washington, DC law firm. He is a member of the North Dakota Democratic-NPL Party, the North Dakota affiliate of the Democratic Party. In the Senate, he was Chairman of the Democratic...

, D-N.D., found that the Aberdeen Area of the Indian Health Service(IHS) is in a "chronic state of crisis." "Serious management problems and a lack of oversight of this region have adversely affected the access and quality of health care provided to Native Americans in the Aberdeen Area, which serves 18 tribes in the states of North Dakota, South Dakota, Nebraska and Iowa," according to the report.

Formation and mission

IHS was established in 1955 to take over health care of American Indian and Alaska Natives from the Bureau of Indian Affairs
Bureau of Indian Affairs
The Bureau of Indian Affairs is an agency of the federal government of the United States within the US Department of the Interior. It is responsible for the administration and management of of land held in trust by the United States for Native Americans in the United States, Native American...

.
The provision of health services to members of federally recognized tribe
Tribe
A tribe, viewed historically or developmentally, consists of a social group existing before the development of, or outside of, states.Many anthropologists use the term tribal society to refer to societies organized largely on the basis of kinship, especially corporate descent groups .Some theorists...

s 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.

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. 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
Uniformed services of the United States
The United States has seven federal uniformed services that commission officers as defined by Title 10, and subsequently structured and organized by Title 10, Title 14, Title 33 and Title 42 of the United States Code.-Uniformed services:...

. 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.

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

ExpectMore.gov lists four rated areas of IHS: federally-administered activities (moderately effective), healthcare-facilities construction (effective), resource- and patient-management systems (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 the Indian Health Service, either through IHS-run hospitals and clinics or tribal contracts to provide healthcare 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 Natives being offered care on a space-available basis. This policy makes it difficult for an Indian who leaves their tribal home for education or employment to receive health care services to which they are legally entitled. An IHS fact sheet clarifies that Indians are also eligible to apply for low-income health care coverage provided by state and local governments, such as Medicaid
Medicaid
Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...

. IHS 2007 third-party collections were $767 million, and estimated to be $780 million in 2008. Most tribally-operated health services clinics require Native Americans who qualify for Medicaid to use their benefits at their clinics, supplementing the block-grant funds they receive from IHS to serve their tribe's medical needs. This has the potential to 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. Some of those who are served by the system are not satisfied with the efficiency of IHS. A contributor to Indianz.com, a website for Native American news, feels that Native Americans are "suffering" at the hands of IHS. She feels IHS is underfunded, and necessary services are unavailable. Others have concerns that the 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.

IHS also hires Native/non-Native American interns, who are referred to as "externs"; one position available every summer at area offices is the Engineering Externship. Participants are paid according to the GS pay-grade system, which is beneficial for college students. Their GS level is determined according to credit-hours acquired from an accredited college. Engineering Extern participants generally practice field work as needed and office work.

Administration

The Indian Health Service is headed by Dr. Yvette Roubideaux, M.D., M.P.H., a member of the Rosebud Sioux in 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. McSwain served as Acting Director when Rear Admiral Charles W. Grim declined an additional term of service in September 2007; he was nominated by President George W. Bush, confirmed and appointed in May 2008.

IHS Areas

  • Aberdeen
    Aberdeen, South Dakota
    Aberdeen is a city in and the county seat of Brown County, South Dakota, United States, about 125 mi northeast of Pierre. Settled in 1880, it was incorporated in 1882. The city population was 26,091 at the 2010 census. The American News is the local newspaper...

     Area: Director, Charlene Red Thunder, M.Ed., Cheyenne River Sioux Tribe
  • Alaska
    Alaska
    Alaska is the largest state in the United States by area. It is situated in the northwest extremity of the North American continent, with Canada to the east, the Arctic Ocean to the north, and the Pacific Ocean to the west and south, with Russia further west across the Bering Strait...

     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
    Bemidji, Minnesota
    Bemidji is a city in Beltrami County, Minnesota, United States. Its population was at 13,431 at the 2010 census. It is the county seat of Beltrami County. Bemidji is the most major city in North Central Minnesota and the largest commercial center between Grand Forks, North Dakota and Duluth,...

     Area: Acting Director, Jenny Jenkins
  • Billings
    Billings, Montana
    Billings is the largest city in the U.S. state of Montana, and is the principal city of the Billings Metropolitan Area, the largest metropolitan area in over...

     Area: Director, Pete Conway, M.Ed., Blackfeet
    Blackfeet
    The Piegan Blackfeet are a tribe of Native Americans of the Algonquian language family based in Montana, having lived in this area since around 6,500 BC. Many members of the tribe live as part of the Blackfeet Nation in northwestern Montana, with population centered in Browning...

     Tribe
  • California
    California
    California is a state located on the West Coast of the United States. It is by far the most populous U.S. state, and the third-largest by land area...

     Area: Director, Margo D. Kerrigan, M.P.H., White Earth (Mississippi) Band of the Minnesota Chippewa Tribe
    Minnesota Chippewa Tribe
    The Minnesota Chippewa Tribe is a centralized government for six Chippewa bands in the U.S. state of Minnesota. It was created on June 18, 1934, and the organization and its constitution were recognized by the Secretary of the Interior two years later on July 24, 1936...

  • Nashville
    Nashville, Tennessee
    Nashville is the capital of the U.S. state of Tennessee and the county seat of Davidson County. It is located on the Cumberland River in Davidson County, in the north-central part of the state. The city is a center for the health care, publishing, banking and transportation industries, and is home...

     Area: Director, RADM Richie K. Grinnell, R.S., M.P.H., Sac and Fox Nation
    Sac and Fox Nation
    The Sac and Fox Nation is the largest of three federally recognized tribes of Sac and Meskwaki Native Americans. They are located in Oklahoma and are predominantly Sac....

     of Missouri
  • Navajo
    Navajo Nation
    The Navajo Nation is a semi-autonomous Native American-governed territory covering , occupying all of northeastern Arizona, the southeastern portion of Utah, and northwestern New Mexico...

     Area: Director, John Hubbard, Jr., M.P.H., the Navajo Nation
  • Oklahoma
    Oklahoma
    Oklahoma is a state located in the South Central region of the United States of America. With an estimated 3,751,351 residents as of the 2010 census and a land area of 68,667 square miles , Oklahoma is the 28th most populous and 20th-largest state...

     Area: Director, Capt. Kevin Meeks, Chickasaw Nation
    Chickasaw Nation
    The Chickasaw Nation is a federally recognized Native American nation, located in Oklahoma. They are one of the members of the Five Civilized Tribes. The Five Civilized Tribes were differentiated from other Indian reservations in that they had semi-autonomous constitutional governments and...

  • Phoenix
    Phoenix, Arizona
    Phoenix is the capital, and largest city, of the U.S. state of Arizona, as well as the sixth most populated city in the United States. Phoenix is home to 1,445,632 people according to the official 2010 U.S. Census Bureau data...

     Area: Director, Don J. Davis], M.P.H., Muscogee (Creek) Nation
    Muscogee (Creek) Nation
    The Muscogee Nation is a federally recognized tribe of Muscogee people, also known as the Creek, based in the U.S. state of Oklahoma. They are regarded as one of the historical Five Civilized Tribes and call themselves Este Mvskokvlke...

  • Portland
    Portland, Oregon
    Portland is a city located in the Pacific Northwest, near the confluence of the Willamette and Columbia rivers in the U.S. state of Oregon. As of the 2010 Census, it had a population of 583,776, making it the 29th most populous city in the United States...

     Area: Acting Director, Dean Seyler
  • Tucson
    Tucson, Arizona
    Tucson is a city in and the county seat of Pima County, Arizona, United States. The city is located 118 miles southeast of Phoenix and 60 miles north of the U.S.-Mexico border. The 2010 United States Census puts the city's population at 520,116 with a metropolitan area population at 1,020,200...

     Area: Director, Dorothy Dupree], M.B.A., Assiniboine and Sioux
    Sioux
    The Sioux are Native American and First Nations people in North America. The term can refer to any ethnic group within the Great Sioux Nation or any of the nation's many language dialects...

     Tribes

Budget

The 2010 United States federal budget
2010 United States federal budget
The United States Federal Budget for Fiscal Year 2010, titled A New Era of Responsibility: Renewing America's Promise, is a spending request by President Barack Obama to fund government operations for October 2009–September 2010...

 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.
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.

See also

  • Health insurance
    Health insurance
    Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...

  • Health insurance in the United States
    Health insurance in the United States
    The term health insurance is commonly used in the United States to describe any program that helps pay for medical expenses, whether through privately purchased insurance, social insurance or a non-insurance social welfare program funded by the government...

  • Luana Reyes
    Luana Reyes
    Luana Reyes ) was an American Indian health care administrator. As executive director of the Seattle Indian Health Board 1972–1982, she grew that institution from a staff of five to nearly 200 and made it a model for urban Indian institutions; subsequently, she worked for the federal Indian Health...


External links

The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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