U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Fact Sheets

BUDGET PLANNING WITH TRIBES

ISSUE

Graphic depicting U.S. Capitol Dome with images of a calculator key board, calculator tape readout, and a photo of vast Indian landsThe annual budget request of the Indian Health Service (IHS), an agency in the Department of Health and Human Services (HHS), is the result of a budget formulation and consultation process that involves IHS and Indian health program representatives and providers from the local to the national level. This process ensures that the budget is relevant to the health needs and priorities of American Indian and Alaska Native (AI/AN) people.

BACKGROUND

The IHS budget request is improved and strengthened with the participation of tribal leaders and health program representatives in its development. The process begins at the local level, where budget priorities are established based on the health priorities of the local community. The tribal leadership and program staff of the 12 IHS Areas (regions) develop and submit budget recommendations for an agency budget request for a given fiscal year, which are consolidated into a national set of budget and health priorities by representatives from each of the 12 IHS Areas. These priorities are presented to HHS by representatives of the tribal budget workgroup. The tribal priorities are instrumental in informing senior officials of other HHS agencies of the health needs of the AI/AN population so that they have the opportunity to include those priorities in their individual budget requests to HHS.

STATUS

The IHS and Tribes evaluate the budget formulation process to ensure it remains relevant and effective. As a result, the process is steadily improving and is responsive to changes in leadership and the emerging and shifting tribal health priorities. The IHS and Tribes have identified two items for focused attention:

  • The tribal partners in the development of the budget request are not directly involved in the budget process once the request is submitted to HHS and the Office of Management and Budget. Because of the government-to-government relationship with Tribes and the established consultation policies of the IHS and HHS, it would be a reasonable business practice to have tribal leadership involved throughout the budget formulation decision-making process.
  • 2. Tribes are requesting funding for the IHS health care facility construction (HCFC) program. The HCFC funds allow IHS to replace its priority health care facilities with modern facilities and to significantly expand capacity at its most overcrowded sites. The current average age of an IHS facility is 33 years. Facility construction provides access to a modern health care delivery system and services necessary to maintain and improve the health status and overall quality of life for communities that surround the new health care facility.

OPTIONS/PLANS

The IHS will continue to refine the budget formulation process.

ADDITIONAL INFORMATION

For referral to the appropriate spokesperson, contact the IHS Public Affairs Staff at 301-443-3593.

January 2013

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