The IHS Areas
Alaska's practice locations provide easy access to the natural wonders of this vast, unspoiled state, from tiny Annette Island at the southern tip of the panhandle to urban Fairbanks to rural Kotzebue, 260 miles north of the Arctic Circle. The Alaska Area Native Health Service provides comprehensive health services to Alaska Native people, Eskimos, Aleuts, Indians, and non-natives in remote locales through fee-for-service care. Health professionals working in Alaska experience first-hand the various cultures and traditions of Native Alaskans. Members of several tribes have historically lived in well-defined regions with little mixing of ethnic groups. As a result, each group retains many of its original customs and beliefs. The Alaska Area Service Units include hospitals, ambulatory health care centers, and community health aide clinics.
The terrain of the Albuquerque area ranges from high altitude mountain ranges to sprawling deserts to spectacular canyons. The opportunities for outdoor sports and recreation are as varied as they are abundant. The Albuquerque Area provides health services to American Indians in numerous tribal groups on reservations in New Mexico and Colorado. Each tribe has its own history, language and culture. In addition, IHS facilities serve numerous Indians who live, work, or attend school in the urban centers of the Albuquerque Area. The Albuquerque Area is divided into service units that provide an array of in-patient and out-patient services through hospitals, health care centers, field clinics and health stations. These health care facilities offer a broad range of curative, preventive, environmental and educational services to the tribes in the area.
This northern IHS lake area covers the lush, fertile states of Michigan, Minnesota, and Wisconsin, all named and celebrated for their predominant life giving resource: water. The abundance of lakes and unspoiled acres of land provide many opportunities for recreation. The Bemidji Area administers several Service Units which provide care through IHS practitioners. It also administers federally recognized tribal and urban programs which deliver services through health care providers hired directly by the tribes. Many tribal members are geographically isolated from the urban facilities and community health centers and must rely on a team approach of IHS, tribal, and contract providers for their health care needs. Facilities range from community health stations and walk-in first-aid centers to fully staffed hospitals and clinics. Preventive education and health screening are stressed in an effort to control some of the Area's chronic health problems.
The Billings Area embodies the scenic open space and big sky country of Montana and Wyoming. It serves members of Plains tribes on reservations and in surrounding communities. Many of the tribes' traditional activities and language remain intact. This area is famous for their fresh air and outdoor activities. Montana and Wyoming contain more than 17 million acres of national forest, over 3 million acres of wilderness, and many national and state parks. The Billings Area provides comprehensive health care services to Indian people through service units which include hospitals and clinics, preventive health and outreach services, alcohol treatment centers, dental and eye care facilities, and air and ground emergency transportation. Outdoor activities and fresh air complement the health promotion and disease prevention activities which have been initiated through reservation-based Community Fitness Centers.
While Indian tribes in most parts of the country are still gradually acquiring authority from the IHS to operate health facilities, California tribes already exercise responsibility for the development and operation of health care facilities. Many of the facilities are operated by tribal consortiums which provide comprehensive health care services to members and are supported by State and Federal funding, as well as private and public grants. All California Indian health facilities are managed by the Indian people themselves. Thus, IHS provides no staffing to support the California clinics, even though they serve the largest population of Native Americans of all the reservation states. Employment is arranged directly through each facility and requires that the health care provider hold a California license. The area has both rural tribal health programs and urban Indian health programs serving American Indian patients.
Great Plains Area
The Great Plains Area is a rolling prairie divided in the western portion of the Dakotas by awe-inspiring mountains including the Badlands, the Black Hills, and Mt. Rushmore National Memorial. Residents of this unspoiled region enjoy numerous opportunities to hunt, fish, ice skate, ski, and hike. Agriculture provides a steady economic base, and hydroelectric developments on the Missouri River have spurred growth. Through its Service Units, the Great Plains Area provides health care to American Indians on reservations located in North Dakota, South Dakota, Nebraska and Iowa. The two largest reservations, Pine Ridge and Rosebud, are in southwestern South Dakota. Great Plains Area facilities include hospitals, health centers, health stations and satellite clinics. The area features a comprehensive health care delivery system, including inpatient and outpatient care, preventive clinics, research, and community-based projects.
Although the Nashville Area is the largest of the twelve IHS regions geographically, it does not service the largest populate of Indian people. Many of the beneficiaries utilize the services of tribally run clinics. The Nashville Area serves members of tribes scattered across states mostly east of the Mississippi River. The Area covers the greatest number of square miles in the IHS in the "Lower-48", extending from Maine to Texas. The Area is richly endowed with the traditional cultures of many tribes. The beautiful crafts made by the tribes are highly prized by collectors. Participants at celebrations and pow-wows enjoy the chance to sample delightful traditional foods. Health care facilities are located near beautiful settings such as the Atlantic Ocean, the Great Smoky Mountains, and the Great Lakes. Most professionals in the area's facilities are employed by the tribes, but may also belong to one of the government's personnel systems, the civil service or the Commissioned Corps.
The Navajo Area serves the largest Indian tribe in the United States, the Navajo Nation. Comprehensive health care is provided to Navajo people throughout this vast reservation. Inpatient, outpatient, contract and community health programs are centered around the Navajo Area's hospitals, health centers, health stations, school clinics and Navajo tribal health programs. The vast range of facilities offers health care professionals a choice in the scale and style of health care they wish to practice. Health care professionals are also drawn to this area by the special connections made with the Navajo people and their traditions, by the appreciation of the natural beauty, and by the opportunity to see the results of the essential health care they provide to American Indians in Utah, Arizona, New Mexico, and Colorado.
Oklahoma City Area
A clean environment, lakes, small mountain ranges, and prairies characterize this area. Health professionals live and work in rural areas, small college towns, or large cities in Oklahoma and Kansas. For them, the lifestyle is quiet, unhurried, sociable, inexpensive, and focused upon the basics: good school systems, outdoor recreation, and cultural events. Service Units of the Oklahoma City Area provide care to the largest IHS service population in the U.S. with the majority of patients residing in urban settings. Hospitals and outpatient health centers and clinics provide inpatient and outpatient care. Many of the facilities are quite large with a diverse staff. State-of-the-art equipment is used in modern facilities staffed by IHS and tribally hired professionals and paraprofessionals.
Spilling across the state lines of Arizona, Nevada, and Utah, the Phoenix Area serves American Indians from many culturally diverse tribes. The Area's terrain and climate vary from desert to mesa country to alpine meadows to rugged national parks. Recreational opportunities include hiking, camping, backpacking, skiing, and water sports. Outdoor activities are popular among the Phoenix Area staff, whether stationed in desert areas, mountainous terrain, or along the Colorado River. The area's Service Units include IHS hospitals, clinics, health centers and health stations. The IHS facilities combine modern technology, western medicine, and traditional healing. Medical Center facilities provide multi-service and specialty care to patients and conduct research under the auspices of the National Institutes of Health.
The terrain of the Pacific Northwest is a varied as it is beautiful. The Northwest is famous for its varied recreational opportunities, and most Indian reservations are located among its prime recreational areas. The Portland Area oversees the delivery of health care to Indian people who reside on reservations in the States of Idaho, Oregon and Washington. The IHS operates both health centers and health stations in this area. An increasing number of health care facilities throughout the Portland Area are being operated by tribes. Facility locations vary from remote rural and coastal reservations to large metropolitan areas. Local practitioners enjoy a great deal of autonomy in their practices, whether in the clinic, lab, or pharmacy.
Dramatic scenery characterizes the Tucson Area, where elevations range from 1,400 feet in the Santa Rosa Valley to nearly 8,000 feet on Baboquivari Mountain. Popular recreational activities include camping and backpacking in nearby desert and national forests and wintertime skiing in the White Mountains or on Mount Lemmon. The Tucson Area is the smallest in the IHS, serving the Tohono O'odham Nation and the Pascua Yaqui Tribe. Health service for the Tohono O'odham is centered in Sells, Arizona, capital of the Tohono O'odham Reservation and hub of reservation life. Health care in the Sells Service Unit is a joint effort between IHS and the Tohono O'odham Health Department. The Yaqui Service Unit is jointly managed by IHS and the Pascua Yaqui Tribe. Services are rendered directly and indirectly through a non-traditional, innovative system of subcontracts.