Background. The Indian Health Service (IHS) is an agency of the US Department of Health and Human Services (HHS), therefore, it is a governmental organization. It prides itself for contributing to efforts at carrying out Emergency Support Functions, Public Health and Medical Care, especially for members of tribes recognized by the federal government (Indian Health Service).
Such support is based on the relationship established since 1787 between government-to-government involving the federal government and the Indian tribes (USA.gov, 2006). As far back as 1787 the Constitution of the United States of America provided in its Article I, Section 8 provided for this kind of relationship to continue.
This constitutional mandate had been continuously given effect through various laws, treaties, executive orders, and Supreme Court rulings (USA. gov, 2006; Bergman, Grossman, Erdrich, Todd, & Forquera, 1999).
These laws include, among others, the United States Constitution, the Snyder Act of 1921, the Transfer Act of 1954, the Indian Sanitation Facilities & Services Act of 1959, the Indian Self-Determination and Education Assistance Act of 1975, the Indian Health Care Improvement Act of 1976, the Indian Alcohol and Substance Abuse prevention and Treatment Act 0f 1986, and the Indian Child Protection and Family Violence Prevention Act of 1990 (Indian Health Service). Function and Responsibilities.
Until the present time, the IHS remains as “the principal federal health care provider and health advocate for Indian people (Indian Health Service). ” Pursuant to this role, the IHS provides a comprehensive health services delivery system for American Indians and Alaska Natives with opportunity for maximum tribal involvement in developing and managing programs to meet their health needs. Furthermore, the IHS works hard to achieve its goal of raising the health status of American Indians and Alaska natives to the highest possible level (USA. gov, 2006).
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 (Indian Health Service). Being a government agency, the IHS receives its budget through proper appropriations from the United States Congress. Since the Snyder Act of 1921, federal funds had been continually provided for the IHS in order to help with the provision of health services to Native American tribes. In 1976, this mandate was reaffirmed, through the passing of the Indian Health Care Improvement Act of 1976.
Thus, the nation consistently provides for about 60% of the health care needs of eligible Alaska Native and American Indian people (Indian Health Service). To help the IHS accomplish its goals, the IHS needed facilities, particularly hospitals (National Library of Medicine, 1998).. Thus, over the years, the IHS was able to establish over 600 IHS and tribal health care facilities that are to be found scattered in thirty-five states, which could be found usually in rural and isolated areas.
These facilities reach about 1.6 million sq. meters, with 62% of them owned by the government, while 38% is owned by the Tribes. Furthermore, IHS operates over 2000 quarters units to support health care services in remote locations (USA. gov, 2006). However, despite the expansive amount of existing facilities of the IHS, it still faces concerns on this aspect. This concern affects all stakeholders. Since the Indian user population increases annually, there is an ever-increasing need for additional staff to provide professional health services.
This leads to the overcrowding of existing facilities and the need to expand in order to accommodate additional staff. Moreover, the continuous failure to the needs related to ongoing operational and maintenance needs leads to yearly backlog in the IHS. Indeed, this backlog is now approaching $410 million. Further aggravating the situation are problems involving the low reliability and short useful life remaining on the medical and laboratory equipment available to the IHS, due to the fact that most of its equipment are already outdated (USA. gov, 2006).