Public Health AdministrationHCAD 630November 27, 2016

Chandra PersaudMandy Perez EleazarModupe SarrattRaven Howell

Indian Health Service Agency(Established 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.)

Mission: Raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level.

Goal: To assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American

Indian and Alaska Native people.

Indian Health Services Agency Priorities:• Ensure their members have access to care• Improve the delivery of healthcare services• Address behavioral health issues• Introduce healthcare quality expertise • Engage local resources

Indian Health Service Agency History:Treaties between the United States Government and Indian Tribes frequently called for the provision of medical

services, the services of physicians, or the provision of hospitals for the care of Indian people. 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. The Snyder Act of 1921 and the permanent reauthorization of the Indian Health Care Improvement Act provide specific legislative authority for Congress to appropriate funds

specifically for the health care of Indian people. In addition, numerous other laws, court cases, and Executive Orders reaffirm the unique relationship between tribal governments and the federal government.

Indian Health Service Agency Funding:• Fiscal Year (FY) 2016 budget proposes $20.9 billion• $1.5 billion (8%) increase over the 2015 enacted level

• Increases are focused on reducing health disparities in Indian Country by targeting areas where funding will have long-term impacts, such as direct health care services, construction projects, and tribal partnerships.• The Budget provides additional investments through the Substance Abuse

and Mental Health Administration and the Administration for Children and Families to support Native American and Alaska Native youth and families.

• IHS receives grants from the Federal Government: Department of Health and Human Services• IHS and other Federal agencies provide grants, benefit programs for individuals

and families, loans, and contracting opportunities

Organization of HIS: 4 Key leaders oversee Indian Health Service

Principal Deputy DirectorMary L. Smith Deputy Director for

Management Operations

Elizabeth A. Fowler

Acting Deputy Director of Field Operations

Rear Admiral Kevin Meeks

Chief Medical Officer

RADM Sarah Linde, M.D.

Indian Health Service (IHS) Organizational Structure

To enlarge,click the chart.

Competencies of Leadership:

• The leaders of the Indian Health Service need: • High ethical and moral standards• Ability to clearly communicate• To be committed to ongoing training• To be open with new ideas and approaches • To understand and relate to the Native American Indian culture

Scope: IHS• Indian Health Service Agency (IHS) provides

Federal & National health services.• Population: American Indians and Alaska

Natives.• Indian Health Service is apart of the

Department of Health and Human Services.• United States Department of Health &

Human Services/Number of employees: 79,540 - a mixture of Civil Service, federal employees, and United States Public Health Services (USPHS) Commissioned Officers.

• Indian Health Service Number of Employees: Approx. 15,000.

Indian Health Service Agency

and Public Health

• Indian Health Service promotes an interdisciplinary approach to promote and provide for community health. Behavioral, Environmental, Health Communications, Health Promotion, Injury Prevention, School Health, & Environmental Sustainability are among their focus.

Indian Health Service Agency and

Services• Two types of services are provided by the IHS• (1) Direct health care services, which are provided by an IHS facility, or• (2) Purchased/Referred Care (PRC), which are provided by a non-IHS facility or provider

through contracts with the IHS. PRC are provided principally for members of federally recognized tribes who reside on or near the reservation established for the local tribe(s) in geographic areas called contract health service delivery areas (CHSDAs).

IHS Headquarters:5600 Fishers Lane

Rockville, Maryland 20857

Achievements of HIS:• The IHS strives for maximum tribal involvement in meeting the health needs of its service

population, who live mainly on or near reservations and in rural communities, mostly in the western United States and Alaska.

• In addition to providing safe sanitation facilities to existing homes, the IHS also provides sanitation facilities to new homes.

• The IHS conducted a variety of consultation activities with tribal leaders and representatives of tribal governments.

• Tribal leaders and representatives play an important role in the IHS budget formulation and setting health priorities at the national and regional levels.

Improving their Target Population:The Indian Health Service Agency has signed and implemented many laws and acts into congress such as:

• Indian Healthcare Improvement Act • Snyder Act

• Indian Health Care Improvement Act • Transfer Act

• Indian Health Facilities Act• Indian Sanitation Facilities Act

• Self Determination Act• Special Diabetes Program for Indians

Act• Alaska Native and American Indian

Direct Reimbursement Act• Tribal Law and Order Act

• Violence Against Women Act

IHS Goals for the Future:• Create mental and physical activities

for healthy lifestyle.• Continue to be proactive in adolescent

health.• Improve communication for

management.• Bring health care expertise in health

related fields in support of the health of the communities.

• Teach work ethics for support• Remove disparity.

IHS Goals:IHS proposed to meet their goals with input from staff, patients, tribes, and the community; to develop strategic framework to focus on the agencies priorities for changing and improving its guidelines, the goals of IHS according to their website are:

• Assess health care• Improving how services are delivered• Addressing Behavior Health Issues • Providing resources for supportive measures• Including other healthcare expertise in their services• Engaging local resources• Strengthening management • Providing training and education to employee’s and patient

Indian Health Service Agency and Future Healthcare:

• Will provide comprehensive health services including nutrition and dietetics to American Indians and Alaska Natives

• Will play a vital role in eliminating disparity with health service advancement for equal access to care

• Level the field for health equality in a community. IHS is making the necessary improvements to access health care to collect quality data on patients

IHS is important to our public health community for the targeted assistance it brings to our Native American Indians, as well as our Alaska Natives. Providing special programs and access to care for

this targeted population is Indian Health Service’s top priority. The Federal government has made it an obligation to promote healthy

American Indian and Alaska Native people, communities, and cultures, to honor and protect the inherent sovereign rights of

Tribes.

References:

• Castor, M. L., Smyser, M. S., Taualii, M. M., Park, A. N., Lawson, S. A., & Forquera, R. A. (2006). A nationwide population-based study identifying health disparities between American Indians/Alaska Natives and the general populations living in select urban counties. American Journal of Public Health, 96(8), 1478- 1484.

• Fagot-Campagna, A., Pettitt, D. J., Engelgau, M. M., Burrows, N. R., Geiss, L. S., Valdez, R., ... & Narayan, K. V. (2000). Type 2 diabetes among North adolescents: An epidemiologic health perspective. The Journal of Pediatrics,136(5), 664-672.

• Giles, S. (2016, March 15). The Most Important Leadership Competencies, According to Leaders Around the World. Retrieved from Harvard Business Review: https://hbr.org/2016/03/the-most-important-leadership-competencies-according-to-leaders-around-the-world?

• Health and Human Services.gov. (2016, November). About HHS. Retrieved from Health and Human Services: http://www.hhs.gov/about/• IHS.(2016). Indian Health Service Fact Sheet. https://www.ihs.gov/newsroom/factsheets/uihp/• Indian Health Service. (2016, March). Disparities. Retrieved from Indian Health Service: https://www.ihs.gov/newsroom/factsheets/disparities/• Indian Health Service. (2016, November). HHS Tribal FY 2016 Budget. Retrieved from Indian Health Service:

https://www.ihs.gov/redesign/includes/themes/newihstheme/display_objects/documents/HHSTribalFY2016Budget.pdf• Indian Health Service. (2016, November). Legislation. Retrieved from Indian Health Service: https://www.ihs.gov/aboutihs/legislation/• Indian Health Service. (2016, November). Our Employees. Retrieved from Indian Health Service: https://www.ihs.gov/aboutihs/ouremployees/• Indian Health Services. (2015, January). IHS Partnership. Retrieved from Indian Health Service: https://www.ihs.gov/newsroom/factsheets/ihspartnerships/• Jackson, M. Y. (1986). Nutrition in American Indian health: the past, present, and future. Journal of the American Dietetic Association, 86(11), 1561-1565.• Katzman, J.G., Fore, C., Bhatt, S., Greenberg, N., Salvador, J.G., Comerci, G.C., Camarata, C., Marr, L., Monette, R., Arora, S., Bradford, A., Taylor, D., Dillow, J.,

& Karol, S. (2016). Evaluation of American Indian Health Service Training in Pain Management and Opioid Substance Use Disorder American Journal of Public Health. Vol. 106 Issue 8, p1427-1429. 3p. DOI: 10.2105/AJPH.2016.303193

• US Department of Health and Human Services. (1998). Indian health service. Trends in Indian health, 99.• US Department of Health and Human Services. Indian Health Services. IHS Fact Sheets: Workforce. Englewood: Indian Health Service, US Department of

Health and Human Services, 2009.