Organization Analysis: Indian Health Service

Organization Analysis: Indian Health Service

This work will provide a comprehensive overview of the Indian Health Service which will describe the service, explain the agency functions and responsibilities and identify key stakeholders that are impacted by it. The Indian Health Service is a federally governed service under the jurisdiction of the U.S. Department of Health and Human Services that is responsible for the healthcare provision of American Indians and Alaska Natives. The service is comprehensive, in that it generally pays one hundred percent of health care costs for its target population and provides many of those services itself. The service has a network of clinics, health offices, dental centers, pharmacies and even small hospitals and other full service centers but also offers natives signed up for the program to utilize outside services, when necessary with direct payment from IHS to the provider. Some full service functions are limited in scope and therefore require such private contract service payment, examples would be overnight hospitalization for procedures, outpatient surgery, and pharmacy care.

Health program offices are generally located on reservations but may also have offices or non-profit entities (partly funded by the USDHHS) in some cities, where concentration of natives is high and where reservation services are not available. The IHS also directs prevention and tracking programs specific to similar programs run by the Centers for Disease Control and Prevention such as high risk chronic disease information and prevention, and also includes programs that are specific to environmental health. (IHS homepage, (http://www.ihs.gov/index.asp) the mission, goal and foundation of the service are as follows:

Our Mission... To raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level.

Our Goal... To assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indian and Alaska Native people.

Our Foundation... To uphold the Federal Government's obligation to promote healthy American Indian and Alaska Native people, communities, and cultures and to honor and protect the inherent sovereign rights of Tribes. (About IHS, (http://www.ihs.gov/PublicInfo/PublicAffairs/Welcome_Info/IHSintro.asp)

In many ways the Indian Health Service mirrors the U.S. Department of Health and Human Services, but offers treatment and/or payment for a greater number of services for those who qualify for such care. Designation as a member of one of many Indian nations, through genealogy and tribal history is generally the only qualifying determiner and if such designation is available, given the particular of tribal designations then IHS services are available to the individual at no cost. According to the About IHS website the IHS:

is responsible for providing federal health services to American Indians and Alaska Natives. 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 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. The IHS currently provides health services to approximately 1.5 million American Indians and Alaska Natives who belong to more than 557 federally recognized tribes in 35 states. (About IHS, (http://www.ihs.gov/PublicInfo/PublicAffairs/Welcome_Info/IHSintro.asp)

Though the agency functions, mainly in an independent fashion its jurisdiction under the U.S. Department of Health and Human Services is a helpmate, providing back up care in instances where there is too much distance between the individual and an IHS care provider and also collaborating on various projects and programs, often associated with prevention and immunization or finding alternative services for those in need. The IHS program also supports the development of Indian awareness and utilization of federal health care programs, such as Medicaid, Medicare and CHIP (Children's Health Insurance Program) all with specific qualification criteria that Natives served must meet, broadening the availability of health care to people who are elderly, young, disabled or who are not able to provide insurance care for themselves as their income is prohibitive. These individuals will then be able to seek some aspects of care and reimbursement through these qualifying federal services, and allow the IHS to bill federal programs to offset its own billing costs and to ensure the elimination of redundancy. These programs supplement the provision of care for American Indians and Alaska Natives and reduce the funding burden on limited funds directed to the IHS. These federal programs, also assist those who qualify in receiving care in areas where IHS services are not traditionally located, off reservation and possibly even in urban and/or rural areas without IHS services and programs.