Indian Health Service

Mission of Indian Health Service

Indian Health Service (IHS) is an Operating Division (OPDIV) within the U.S. Department of Health and Human Services (HHS) that is charged with the responsibility to provide medical and other related 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.

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 nonIndian 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.

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).

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.

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

External links

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
Secretariat staff offices	Office of the Secretary of Health and Human Services Office of the Deputy Secretary of Health and Human Services Office of Inspector General Office of the National Coordinator for Health Information Technology
Public Health Service	Office of the Assistant Secretary for Health Office of the Surgeon General Public Health Service Commissioned Corps Agency for Healthcare Research and Quality Centers for Disease Control and Prevention Agency for Toxic Substances and Disease Registry National Center for Injury Prevention and Control National Institute for Occupational Safety and Health Food and Drug Administration Health Resources and Services Administration Indian Health Service National Institutes of Health Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality
Human services agencies	Administration for Children and Families (Administration for Native Americans, Office of Refugee Resettlement) Administration for Community Living Administration on Aging Centers for Medicare & Medicaid Services
Programs	Child Welfare Information Gateway National Toxicology Program