U.S. Department of Health and Human Services
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INDIAN HEALTH SERVICE FY 2010 BUDGETISSUEThe enacted budget authority for the Indian Health Service (IHS) for fiscal year (FY) 2010 is $4.05 billion. This is a $471.3 million, or approximately 13 percent, increase over the IHS FY 2009 budget appropriation. Funds will go primarily to Clinical Services (operation of hospitals and clinics and purchase of medical care), and also to other IHS programs that are providing additional services and support functions. SERVING A GROWING POPULATIONThe challenge for the IHS is to continue providing access to quality health care for an increasing population. The FY 2010 enacted budget includes funds necessary to maintain the current level of services provided as well as funds to expand, within current program authority, access to care and address tribal contract support costs and essential health information technology activities. The budget includes an increase of $167 million to cover increased costs associated with pay raises, population growth, inflation, and staffing and operating costs for new/expanded facilities. BEHAVIORAL HEALTHThe FY 2010 budget includes $267 million for the Mental Health and Alcohol/Substance Abuse budgets. These funds will assist in addressing urgent behavioral health issues in Indian communities. Alcohol related deaths are over six times more frequent among American Indian and Alaska Native people than in the general population, and suicide rates are nearly twice the general population rate. The FY 2010 budget also includes an increase of $2.5 million for domestic violence and sexual assault prevention and treatment. CONTRACT SUPPORT COSTSTribes continue to increase the number of IHS programs they operate under the authority of the Indian Self-Determination and Education Assistance Act (Public Law 93-638, as amended). Tribes currently manage over half of the total IHS budget. To enable Tribes to develop the administrative infrastructure necessary to successfully manage these programs, the FY 2010 budget includes a total of $398.5 million for contract support costs. This is an increase of $113.4 million over the FY 2009 appropriation. HEALTH INFORMATION TECHNOLOGYAlso included in the enacted budget is an additional $16.3 million to help expand the IHS Health Information Technology (HIT) system to meet additional federal reporting requirements and provide essential HIT services to patients, providers, and communities. Increasing clinical needs have led to increased spending on HIT to ensure compliance with federal mandates, increase security, improve infrastructure, and continue development and deployment of the electronic health record in over 200 sites. CONTRACT HEALTH SERVICESThe enacted budget also includes a total of $779.3 million, an increase of $117 million, for contract health service (CHS) funds, which are used to purchase health care that IHS is unable to provide through its own network. The IHS uses CHS funds to supplement the care provided in its own facilities by purchasing medical care from hospitals and health providers. These CHS funds pay for specialty care, including most types of surgery, and are used to purchase medical care for tribes that do not have an IHS facility nearby. DENTAL HEALTH PROGRAMThe FY 2010 budget includes an additional $1.25 million, for a total of $152.6 million, to provide much needed dental health care services to American Indians and Alaska Natives. Compared to the general U.S. population, American Indian and Alaska Native dental patients experience more oral disease, including both tooth decay and periodontal disease. Studies have shown that almost 32 percent of adults have advanced periodontal disease, compared to only 12 percent of adults in the general U.S. population;that over 66 percent of Indian adolescents have untreated tooth decay, compared to 24 percent of similar aged children in the general U.S. population; and 46 percent of Indian children had permanent teeth with untreated decay, compared to only 11 percent of the children in the general U.S. population. SPECIAL DIABETES PROGRAM FOR INDIANSIncluded in the budget is $150 million to address diabetes prevention and treatment through the Special Diabetes Program for Indians. The IHS has awarded more than $1 billion over the past ten years to over 330 tribes, urban Indian health programs, and IHS facilities to support diabetes prevention and disease management at the local level. This program has substantially increased the availability of services such as basic clinical exams, newer treatment medications and therapies, laboratory tests to assess diabetes control and complications, screening for diabetes and pre-diabetes, nutrition education, and physical fitness activities. URBAN INDIAN HEALTH PROGRAMThe FY 2010 budget includes $43 million in funding for the Urban Indian Health Program, an increase of $5 million. The 2000 census indicated that more than 4 million Americans were of American Indian and Alaska Native heritage. Of those, approximately 60 percent lived in urban areas, with 25 percent (approximately 605,000) of them residing in counties served by urban Indian health programs authorized and funded through Public Law 94-437, Title V. The IHS supports 34 urban programs, which provide services ranging from community health to comprehensive primary health care services. ADDITIONAL INFORMATIONFor referral to the appropriate spokesperson, contact the IHS Public Affairs Staff at 301-443-3593. January 2010 |
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