The Alaska Area Indian Health Service (IHS) works in conjunction with Alaska Native Tribes and Tribal Organizations (T/TO) to provide comprehensive health services to 163,835 Alaska Natives. Approximately 99% of the Alaska Area budget is allocated to T/TOs who operate under the authority of Indian Self-Determination and Education Assistance Act, Public Law 93-638, as amended. The Alaska Area maintains 11 Title I contracts with Alaska tribes and tribal organizations, and negotiates one Title V compact with 25 separate tribal funding agreements each year. The Alaska Tribal Health Compact is a comprehensive system of health care that serves all 228 federally recognized tribes in Alaska. IHS-funded, tribally-managed hospitals are located in Anchorage, Barrow, Bethel, Dillingham, Kotzebue, Nome, Sitka and Wrangell. There are 72 tribal health centers, 148 tribal community health aide clinics and five residential substance abuse treatment centers. The Alaska Native Medical Center in Anchorage is the state-wide referral center and gatekeeper for specialty care. Other health promotion/disease prevention programs that are state-wide in scope are operated by the Alaska Native Tribal Health Consortium (ANTHC), which is managed by representatives of all Alaska tribes.
There are 36 residual, transitional residual and buy-back positions in the Alaska Area IHS performing inherently federal functions that cannot be contracted to T/TOs. The Alaska Area supports USPHS Commissioned Corps officers and civil service employees to T/TOs to aide them in the provision of health services. Other federal agencies such as the Arctic Investigations Laboratory of the Centers for Disease Control (CDC), work closely with the Alaska Area IHS and the tribes to improve the health status of Alaska Natives.
The Indian Health Service still holds title to six tribally operated hospitals and three tribally operated health centers in Alaska, and is responsible for their maintenance.