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Bush seeks $3 billion for Indian Health Service
Tuesday, February 3, 2004

The director of the Indian Health Service (IHS) on Monday said his agency's new $3 billion budget will help tribes and the federal government meet Indian Country's needs.

Dr. Charles Grim, a Bush administration appointee, said IHS fared well within the Department of Health and Human Services. The agency is seeing a 1.6 percent increase above current levels and, with the exception of one account, there were no cuts for health care programs.

But Grim said the benefits for American Indians and Alaska Natives extend beyond IHS. With a large portion of the $580 billion request at HHS going to Medicare reforms and a new prescription drug benefit for seniors, he said new funds will flow into Indian Country from a number of sources.

"It makes the increase that we got expand by a lot of the things that we will be able to tap into," he said in an interview yesterday. "Just because there is an IHS program and an IHS budget doesn't mean there isn't inclusion by other programs."

For IHS specifically, there are a number of program boosts. A $36 million increase will fund pay raises at tribally- and federally-managed health care facilities. "There's a strong emphasis on both tribal and federal programs in this budget," Grim said.

There is an extra $23 million to staff five new outpatient facilities. Clinics serving the Navajo Nation, the Tohono O'odham Nation in Arizona, the Jicarilla Apache Nation in New Mexico, the Choctaw Nation in Oklahoma and the Metlakatla Tribe in Alaska will open in fiscal year 2005.

The contract health service (CHS) account will also be seeing an increase of $18 million, for a total of $496 million. CHS funds are used to purchase specialty care, including most types of surgery, and are used for tribes that don't have IHS facilities nearby. "That's the dollars we use to support the care we can't provide in our facilities," Grim said.

The Bush administration is again seeking a request in sanitation construction. At $103 million, the amount is $10 million, or 11 percent, above current levels.

"In America, about 8 percent of Indian homes still lack safe indoor water supplies, compared to just 1 percent of all U.S. homes," Grim said. "We think that's a huge initiative in the way of prevention."

But one area that won't be seeing any new money is construction of hospitals and clinics -- in fiscal year 2005, this account is being cut by $52 million. The $42 million that remains will be used to finish facilities on the Navajo Reservation in Arizona and the Sisseton-Wahpeton Reservation in South Dakota; and staff housing at Zuni Pueblo in New Mexico and the Yankton Sioux Reservation in South Dakota.

"These are sorely needed out in Indian Country," said Michael Lincoln, deputy director of the IHS.

Another area of concern for tribes is homeland security. Although the HHS budget calls for $1.1 billion for bioterror-related activities, tribal governments can't tap into the pot directly. Grim said Secretary Tommy Thompson has urged states to make sure to include tribes in their planning.

Grim also said tribal leaders are excited about preventive health initiatives underway at IHS. In fiscal year 2005, there is an additional $3 million to add three or four tribal epidemiology centers and increase support for existing seven centers.

"We have several regions that are needing them or wanting them," he said.

There is an increase of $2 million for the community health aides program in Alaska Native villages. Grim said the money will enable tribes to provide care locally instead of transporting people long distances by air.

Grim will get his first tribal reaction to the budget when he speaks to the annual "impact week" meeting of the United South and Eastern Tribes (USET) on Wednesday. An area of priority for USET member tribes is contract health services. because most tribes in the East lack local IHS facilities.

Budget Documents:
HHS Budget in Brief | HHS Performance Plan | Secretary Thompson's Remarks

Relevant Links:
Indian Health Service - http://www.ihs.gov
Department of Health and Human Services - http://www.hhs.gov