The 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 Indianhealth projects supplement these facilities with a variety of health
and referral services.
Contents
[hide]

1Formation and mission

2Employment

3Efficiency and Public Law 93-638 (Tribal Self Determination - 1975)

4Administration

5Current issues

6IHS Areas

7Budget

8See also

9References

10External links

Formation and mission[edit]

IHS was established in 1956 to take over health care of American Indian and Alaska Natives from the Bureau of
Indian Affairs (BIA) to the Public Health Service (PHS) in hopes of improving the healthcare of Native
Americans living on Reservations. 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
theConstitution, 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 $4.3 billion (as of December 2011).

Employment[edit]
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. [1]
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 assistants, nurses, dentists,
pharmacists, engineers, environmental health officers, and dietitians. [2]

Many IHS jobs are in remote areas as well as its headquarters in Rockville, Maryland, 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.[3]

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

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. [4]
IHS-run hospitals and clinics serve any registered Indian/Alaska Native, regardless of tribe or income. Tribalcontract 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. IHS 2007 third-party collections were $767 million, and estimated to be
$780 million in 2008.[5]
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.[6] 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.[citation needed]
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 paygrade 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[edit]
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.

Current issues[edit]
A 2010 report by Senate Committee on Indian Affairs Chairman Byron Dorgan, D-N.D., found that
the Aberdeen Area of the Indian Health Service(IHS) is in a "chronic state of crisis." [7] "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.
In 2013 the Indian Health Service was hit hard by sequestration funding cuts of $800 million, representing a
substantial percentage of its budget.[8][9]

IHS Areas[edit]

Aberdeen Area:[10] Acting Director, Ron Cornelius, B.S., Oneida Tribe of

Indians of Wisconsin. The name of this area was changed in 2014 to the
"Great Plains" area.

Alaska Area:[11] Director, Christopher Mandregan, Jr.,

M.P.H., Aleut Community of St. Paul, Alaska

Albuquerque Area:[12] Director, RADM Richie K. Grinnell, R.S., M.P.H., Sac

and Fox Nation of Missouri

Bemidji Area: Acting Director, Jenny Jenkins, White Earth Band of

Chippewa Indians

Billings Area: Director, Pete Conway, M.Ed., Blackfeet Tribe

California Area:[13] Director, Margo D. Kerrigan, M.P.H., White Earth

(Mississippi) Band of the Minnesota Chippewa Tribe

Nashville Area:[14] Director, Martha A. Ketcher, M.B.A, Cherokee Nation[15]

Navajo Area:[16] Director, John Hubbard, Jr., M.P.H., The Navajo Nation

Oklahoma Area:[17] Director, RADM Kevin Meeks, Chickasaw Nation

Phoenix Area:[18] Director, Dorothy A. Dupree, B. Ed., M.B.A., Assiniboine

and Sioux Tribes

Portland Area:[19] Director, Dean Seyler, B.S., Confederated Tribes of Warm

Springs Reservation of Oregon

Tucson Area: Acting Director, George W. Bearpaw, B.S., Cherokee Nation

of Oklahoma

Budget[edit]
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. [20] 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. [21]

See also[edit]
Wikimedia Commons has
media related to Indian
Health Service.

Title 25 of the Code of Federal Regulations

Health insurance

Health insurance in the United States

Luana Reyes

References[edit]
1.

Jump up^ IHS fact sheet. Retrieved 2011-04-07.

2.

Jump up^ IHS fact sheet. Retrieved 2011-04-07.

3.

Jump up^ IHS fact sheet. Retrieved 2011-04-07.

4.

Jump up^ "U.S. Department of Health and Human Services: Indian Health
Service Fact Sheets"

5.

Jump up^ "U.S. Department of Health and Human Services: Indian Health
Service Fact Sheets"

6.

Jump up^ Indianz.com: 8-20-07, Jodi Rave: Indian Health Service Inadequate

7.

Jump up^ Senate Committee on Indian Affairs. Retrieved 2011-04-07.

8.

Jump up^ Gale Courey Toensing (March 27, 2013). "Sequestration Grounds
Assistant Secretary for Indian Affairs". Indian Country Today. Retrieved March
28, 2013.

9.

Jump up^ Editorial Board (March 20, 2013). "The Sequester Hits the
Reservation" (Editorial). The New York Times. Retrieved March 28,2013.

10. Jump up^ Aberdeen area Retrieved 2011-04-08.

11. Jump up^ Alaska area Retrieved 2011-04-08.
12. Jump up^ Albuquerque area Retrieved 2011-04-08.
13. Jump up^ California area Retrieved 2011-04-08.
14. Jump up^ Nashville area Retrieved 2011-04-08.
15. Jump up^ "Biography - Martha Ketcher" (PDF). Indian Health Service.
Retrieved 29 March 2013.
16. Jump up^ Navajo area Retrieved 2011-04-08.
17. Jump up^ Oklahoma area Retrieved 2011-04-08.
18. Jump up^ Phoenix area Retrieved 2011-04-08.
19. Jump up^ Portland area Retrieved 2011-04-08.
20. Jump
up^ http://www.whitehouse.gov/omb/assets/fy2010_new_era/A_New_Era_of_
Responsibility2.pdf
21. Jump up^ IHS fact sheet. Retrieved 2011-04-08.

External links[edit]

Indian Health Service

Indian Health Service in the Federal Register

Biography of Dr. Yvette Roubideaux

United States Department of Health and Human Services

ExpectMore.gov

Emery A. Johnson Papers - National Library of Medicine finding aid

[hide]

Agencies of the United States Department of Health and Human Services

Headquarters: Hubert H. Humphrey Building

Sylvia Mathews Burwell, Secretary of Health and Human Services

Bill Corr, Deputy Secretary of Health and Human Services

Office of the Secretary of Health and Human Services

Secretariate staff offices

Office of the Deputy Secretary of Health and Human Services

Office of Inspector General

Organizations under the

Assistant Secretary for Health

Office of the Assistant Secretary for Health

Public Health Service
Public Health Service Commissioned Corps
Surgeon General
Office of Public Health and Science
Administration for Children and Families
Administration on Aging
Agency for Healthcare Research and Quality
Agency for Toxic Substances and Disease Registry
Centers for Disease Control and Prevention
Centers for Medicare and Medicaid Services
Food and Drug Administration
Health Resources and Services Administration

Indian Health Service

National Institutes of Health
Substance Abuse and Mental Health Services Administration
Child Welfare Information Gateway
Programs

National Toxicology Program

Categories:

United States Department of Health and Human Services agencies

United States Public Health Service

Government agencies established in 1955

Native American organizations

Native American health

Hospital networks in the United States

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