Indian Health Service (IHS) Director's Corner Blog updates on important issues affecting the Indian Health Service.en-usEnvironmental health officer recognized with IHS Safety and Health Award, May 25, 2017 ]]>Congratulations to Lt. Cmdr. Matthew Ellis, REHS, MPH, who received the 2016 Gary J. Gefroh Safety and Health Award for his significant contribution to healthcare safety and infection control.

Ellis leads the Portland Area IHS institutional environmental health program, providing services to 6 federal service units and 27 tribes in 3 states. During 2016, Ellis also served as emergency management coordinator and Acting Portland Area Division of Environmental Health Services Director.

In these roles, Ellis:

  • coordinated with federal, state, local, and tribal agencies to protect public health and IHS operations during wildland fires in the Wellpinit Service Unit (Spokane and Kalispel Tribes);
  • managed the deployment of equipment to produce safe indoor air-quality and maintain continuity of healthcare facilities operations to vulnerable populations during wildland fires;
  • lead response to an infection control breach potentially affecting 175 tribal clinic patients and coordinated with legal and regulatory authorities mitigating risk and liability to tribal clinic;
  • developed and disseminated new policies and procedures to prevent similar infection control issues from recurring; and
  • tailored and deployed a standardized ambulatory clinic environment of care reporting dashboard and served as co-lead for the Area healthcare Accreditation Service Unit Readiness Team.
Lt. Cmdr. Matthew Ellis receives the 2016 Gary J. Gefroh Safety and Health Award from Dean Seyler, IHS Portland Area director. Ellis was recognized for his significant contribution to healthcare safety and infection control.
Lt. Cmdr. Matthew Ellis receives the 2016 Gary J. Gefroh Safety and Health Award from Dean Seyler, IHS Portland Area director. Ellis was recognized for his significant contribution to healthcare safety and infection control.

This award recognizes significant contributions by an individual or group resulting in improved healthcare safety and/or infection control conditions at an IHS or tribal healthcare program. It is named after Capt. Gary J. Gefroh, to honor his decades of distinguished service as an environmental health officer during which he advanced health and safety of IHS patients and employees in immeasurable ways.

Lt. Cmdr. Ellis demonstrated tireless commitment and outstanding service in meeting the objectives and mission of the IHS. His efforts have improved healthcare infection control and patient care conditions at both IHS and Tribal healthcare clinics across the Portland Area.

Related Content:

Coeur d'Alene Tribe recognized with IHS Portland Area Leadership Award for "qhest life"

IHS Environmental Health and Engineering Leaders Recognized

IHS Engineers Recognized at Public Health Service Awards Ceremony

Tribal Management Grants Available for Tribes and Tribal Organizations, May 23, 2017 ]]>The Indian Health Service is now accepting applications for the Tribal Management Grant Program Exit Disclaimer: You Are Leaving, a competitive grant for federally recognized Tribes and Tribal organizations. The program is administered by the Office of Direct Service and Contracting Tribes.

The intent of the grant program is to prepare tribes and tribal organizations for assuming all or part of exiting IHS operated programs through the Indian Self Determination and Education Assistance Act; and to further develop and improve health management capabilities.

Approximately 16-18 awards will be issued to assist tribes and tribal organizations to establish goals and performance measures; assess current management capacity; analyze programs to determine if management is practicable; and develop infrastructure systems to manage or organize the programs, function, services and activities of the current health programs.

The Tribal Management Grant Program consists of four project types with funding amounts and project periods.

  • Feasibility Study: $70,000 (maximum funding) for 12 months
  • Planning: $50,000 (maximum funding) for 12 months
  • Evaluation Study: $50,000 (maximum funding) for 12 months
  • Health Management Structure: $100,000 (average funding) for 12 months; $300,000 (maximum funding) for 36 months

Important deadlines to remember:

  • Applications due: June 4, 2017
  • Review dates: June 23-30, 2017
  • Earliest anticipated start date: September 1, 2017

Read more about the Tribal Management Grant Program.

Hepatitis C Virus in Indian Country, May 19, 2017 ]]>Hepatitis C (HCV) is a contagious viral infection that causes inflammation of the liver. Early on, most people with HCV infection have no symptoms or only mild fatigue and are unaware of their infection.  However, HCV infection is a leading cause of liver cancer and liver transplants. The most recent data Exit Disclaimer: You Are Leaving shows the American Indian and Alaska Native (AI/AN) population had the highest rate of new HCV infections of all ethnic groups. Nationwide, HCV causes more deaths each year than all other reportable infectious diseases combined.


HCV is carried in the blood, and is transmitted when the blood of a person with HCV enters the body of someone who is not infected. Transmission of HCV can occur through sharing needles, syringes, or other drug-injection equipment, and very rarely through sexual intercourse. Many people, especially people born between 1945 and 1965may have been exposed to HCV through blood transfusions and non-sterile injections. The Centers for Disease Control and Prevention (CDC) recommends that these “baby boomers” be tested at least once for HCV. The recent opioid epidemic in the U.S. has resulted in many HCV infections in younger persons, so screening of young persons with risky behaviors, such as illicit drug use is important.


Recently approved HCV drug treatments are shorter and have milder side effects than previous treatments, and reportedly cure over 90 percent of patients with HCV. These new treatments can prevent most of the devastating effects of HCV. People with HCV, even those who had unsuccessful treatments in the past, should seek care as soon as possible.

IHS Partnerships that Work

In October 2016, the IHS distributed updated guidelines on HCV prevention, testing and treatment to IHS facilities. IHS adopted the goals of the National Viral Hepatitis Action Plan Exit Disclaimer: You Are Leaving and recommendations from other authorities such as the United States Preventive Services Task Force Exit Disclaimer: You Are Leaving (USPSTF), the CDC Exit Disclaimer: You Are Leaving and the American Association for the Study of Liver Diseases Exit Disclaimer: You Are Leaving for HCV screening, and clinical follow up for patients with chronic HCV infection.  

Tribal Strength

Some of our strongest partners are tribal programs such as the Alaska Native Tribal Health Consortium Exit Disclaimer: You Are Leaving (ANTHC) which leads a HCV and Liver Health Program. ANTHC has led statewide viral hepatitis efforts for decades. In 2015, the Cherokee Nation, with assistance from the CDC, became the first tribe in the U.S. to launch a HCV Elimination Project. Exit Disclaimer: You Are Leaving The tribe’s goal is to screen 80,000 patients between the ages of 20 and 65 for HCV C over the next three years. Last year the Cherokee Nation screened 23,000 patients. 

Project ECHO and Telehealth

Providers at numerous IHS hospitals and clinics are working with external specialists like Project ECHO Exit Disclaimer: You Are Leaving (Extension for Community Health Outcomes) and telehealth programs. The “Liver Connect” educational telemedicine conference serves all of Alaska from its hub in Anchorage. Other programs at the University of New Mexico, the University of California at San Francisco, and the University of Washington provide telehealth and teleconsultation services to treat our Indian Health Service/Tribal and urban (I/T/U) patients on-site, rather than referring them to facilities far away from their support systems and their communities.


The Fort Peck Service Unit (FPSU) in Northeast Montana is hours away from HCV specialists.  Pharmacists at FPSU are keystones in the HCV response. HCV patients on the Fort Peck reservation are being successfully treated by a Pharmacist-led HCV treatment program, in conjunction with a local physician and the ECHO telehealth program. This program has successfully cured over 10 patients. Ft Peck pharmacists and many other pharmacists in I/T/U facilities are helping to lead medical teams in the follow up, treatment, and cure of HCV patients.

Hope for the Future

IHS will continue to utilize the National Viral Hepatitis Plan for 2017-2020 Exit Disclaimer: You Are Leaving, and is committed to: 1) improving clinicians’ capacity to treat HCV, 2) preventing new infections, and 3) improving the lives of AI/AN people living with HCV. With an estimate of 20,000 to 40,000 patients in need of HCV treatment, IHS will continue to examine how to best allocate its clinical and financial resources to raise the physical, mental, spiritual and social health of AI/ANs to the highest level.

IHS Navajo Area Launches Prediabetes Awareness Campaign, May 16, 2017 ]]>The Indian Health Service launched a new prevention campaign by the Shiprock Health Promotion Program, at the Northern Navajo Medical Center, that is aimed at IHS patients, local community members and organizations to increase the awareness and knowledge of prediabetes by educating people about the seriousness of prediabetes, and that it can be reversed.

The Shiprock Health Promotion Program is building on the groundwork created by a 2016 CDC national prediabetes awareness campaign. The Shiprock program is promoting a prediabetes awareness campaign for the Navajo population that will continue through early 2018. The campaign materials will include posters Exit Disclaimer: You Are Leaving at IHS clinics and hospitals, roadside billboard signs Exit Disclaimer: You Are Leaving and a video available for patients to watch while in waiting rooms at an IHS facility. You can help spread the word about prediabetes through social media by using the campaign's hashtag #PrediabetesCanBeReversed.

Do I Have Prediabetes - campaign infographic to find out if you are at risk for prediabetes
"Do I Have Prediabetes" campaign infographic to find out if you are at risk for prediabetes

This campaign allows people to assess their own risk and take action to reverse a prediabetes diagnosis before their blood sugar level is high enough to be type 2 diabetes. Without lifestyle changes, those with prediabetes are likely to progress to type 2 diabetes. The campaign hopes to encourage more patients to talk to their doctors about prediabetes and order a blood sugar test.

According to the CDC, 29 million people have diabetes, that's nearly 1 out of 11, and 86 million are estimated to be prediabetic. As a population, American Indians and Alaska Natives have the highest rates of diabetes. In the Navajo Area, 1 in 5 have diabetes and it is estimated that 75,000 have prediabetes. The CDC claims that 9 out of 10 people who have prediabetes do not know they have it.

Watch an interview Exit Disclaimer: You Are Leaving on prediabetes awareness with Navajo diabetes educator, Nora Benally, on the Four Directions of Wellness show.

The work that the IHS Navajo Area is doing to promote the prediabetes awareness campaign is important, because we recognize that some patients will develop Type 2 diabetes. The IHS Division of Diabetes manages the Special Diabetes Program for Indians (SDPI) The SDPI program has made it possible for Native American communities to sustain quality diabetes programs and care practices. For instance, the program has successfully implemented innovative interventions in American Indian and Alaska Native communities across the nation to address the epidemic of diabetes. Guided by both the scientific literature and community-driven priorities, the SDPI has helped the grantees, Tribal leaders and IHS collectively build one of the most strategic and comprehensive diabetes treatment and prevention programs in the United States. One of the recent successes includes research that shows kidney failure from diabetes among Native American adults decreased 54 percent between 1996 and 2013. Kidney failure from diabetes in Native Americans was the highest of any race, but now has declined the fastest. The progress made by the Indian Health Service (IHS) in reducing kidney failure from diabetes in the Native American population is the subject of January's Vital Signs Exit Disclaimer: You Are Leaving

Related Content:

Coeur d'Alene Tribe recognized with IHS Portland Area Leadership Award for "qhest life", May 12, 2017 ]]>The Coeur d’Alene Tribe of Indians was recognized today with the Indian Health Service Portland Area Leadership Award for their extraordinary efforts to improve the health and wellbeing of American Indians and Alaska Natives through the hnqhesnet program Exit Disclaimer: You Are Leaving Hnqhesnet is a Coeur d'Alene word that means “it is our well-being.” The project received a three-year, $1.9 million grant from the Centers for Disease Control and Prevention’s Racial and Ethnic Approaches to Community Health Exit Disclaimer: You Are Leaving (REACH) program. The program seeks to improve health in the community by promoting access to healthy, traditional foods and access to physical activity, with a cultural emphasis.

The program promotes the “qhest life,” meaning a good, healthy and traditional way of life. “The qhest life is the best life, because it’s life based on long-held traditions of health and wellness,” according to the tribal program.

Pow Wow Sweat is a series of workout videos that promote fitness through traditional dance as exercise.
Pow Wow Sweat is a series of workout videos that promote fitness through traditional dance as exercise.

The program encourages traditional foods as part of a diet rich in fruits, vegetables, and lean proteins. The program also invokes native traditions in increasing physical activity. Hunting, gathering, and migration were daily physical activities for Coeur d'Alene ancestors. The program encourages tribal members to honor their ancestry and echo those movements by getting 30 minutes of daily physical activity through walking, running, swimming, gym workouts, and traditional games and other activities.

Finally, the hnqhesnet program seeks to further honor traditions by encouraging respect of elders, preserving language, educating and empowering youth, and engaging in traditional community activities such as gardening, ceremonies, storytelling, and more.

The Portland Area is proud to recognize this innovative, culturally-relevant approach to improving community health through healthy eating and active lifestyles and honors the tribe in its support of the IHS mission to raise the physical, mental, social, and spiritual health of American Indians to the highest level.

Related Content:

First Steps into Fitness

Diabetes Prevention Program teaches healthy lifestyle changes

IHS Health Promotion/Disease Prevention

Healthy Vision Month: IHS is a Leader in Using Technology to Prevent Vision Loss, May 9, 2017 ]]>During Healthy Vision Month Exit Disclaimer: You Are Leaving, I want to remind patients that annual eye exams are important to maintaining healthy vision. Many eye diseases, including diabetic retinopathy Exit Disclaimer: You Are Leaving, don’t show symptoms in their early stages.

Diabetic retinopathy is the leading cause of new blindness among working age adults, even though it can be easily treated with timely diagnosis. Unfortunately, about half of all patients with diabetes don’t get an annual retinal examination that could prevent needless vision loss.

IHS uses an innovative telemedicine program that provides high-quality retinal exams in primary care clinics, without requiring a trip to see a specialist. The IHS teleophthalmology program uses special equipment to quickly obtain retinal photographs, which are electronically sent to a central reading center where they are interpreted by specially trained and certified IHS eye doctors. Since dilation drops are not needed, this can be done during a regular office visit without disrupting the rest of the patient’s day.

Through the use of this technology, IHS has increased the number of American Indians and Alaska Natives receiving an annual retina exam by 20% from 2007 to 2015, substantially reducing the number of patients subject to vision loss. This innovative and effective program increases quality and access of care, while also reduced the overall cost of care by avoiding complications resulting from delayed or missed care.

These telemedicine examinations have been carefully tested for quality, and the IHS teleophthalmology program has been validated to American Telemedicine Association (ATA) Category 3, which means that its clinical outcome is equal or better than a conventional eye examination for diabetic retinopathy. As one of the few, and largest, programs validated and operating at this level, the IHS teleophthalmology program has brought high quality point of care specialty service to over 150,000 American Indian and Alaska Native patients.

As a leader in this telemedicine domain, the IHS teleophthalmology program is active in the development of the standards for diabetic telemedicine care, and the advancement of the technology used to provide this care. The program is deployed at approximately 100 sites in 25 states and continues to expand and update the program to improve compliance with standards of care and reduce avoidable vision loss due to DR among AI/AN.

Related Content:

Indian Health Service launches telehealth program to expand health care access for native veterans

Indian Health Service and Children’s Hospital of Philadelphia Partner on Pediatric Telehealth

Indian Health Service awards $6.8 million telemedicine services contract to Avera Health

Building Early Childhood Caries Prevention Into IHS Activities, April 26, 2017 ]]>Tooth decay is a significant problem for American Indian and Alaska Native preschool children. Half of all American Indian and Alaska Native preschool children have experienced tooth decay.

IHS focuses intensely on this issue by

  • Visiting homes and calling new parents to educate them about tooth care for their children, and by funding tribally operated health programs to do the same.
  • Presenting to community groups, teachers and daycare providers in Indian communities, so they are aware of the dental health needs of children and what they can do with nutrition and brushing to make a difference.
  • Educating the public during National Children’s Dental Health Month.
  • And, by using special health care initiatives to identify and share best practices in early childhood caries, or cavities, prevention, so that all IHS providers are working together to prevent dental decay in young children.
Programs participating in the IHS Early Childhood Caries Collaborative developed innovative, culturally appropriate materials to promote dental health with patients, staff and community partners.
Programs participating in the IHS Early Childhood Caries Collaborative developed innovative, culturally appropriate materials to promote dental health with patients, staff and community partners.

The Early Childhood Caries Collaborative

One important project now drawing to a conclusion is the Early Childhood Caries Collaborative, which started in 2010. The project focused on reducing the proportion of children experiencing dental decay among American Indian and Alaska Native children under the age of 71 months. Having benefited thousands of patients and many Indian health system dental clinics over the past seven years, the effort is now documenting best practices and ensuring those are thoroughly incorporated into our systems of care. I shared our results at a meeting of IHS dental health leaders in Albuquerque this week.

For example, in the IHS Portland Area, dental health providers at federal-government-operated clinics and tribally operated clinics adopted the slogan “Baby Teeth Matter.” Indian health care providers met face-to-face several times a year to review data from their programs and receive training and technical assistance, building a community for children’s dental health. They set a policy making dental visits the first step of every well-child visit. With this focused effort, they were able to nearly triple the number of kids being seen for dental care, over a 3-year period.

Because almost half of American Indian and Alaska Native preschool children have tooth decay by age 2, another key message has been to take children to the dentist as soon as the first tooth erupts. Previously, many pediatricians recommended that children first visit the dentist at age 2, but another key message of the collaborative is that “2 is too late.” Kids need dental care before 2 years of age.

This key message advised parents to:

  • Lift the lip and look for chalky white or brown spots. Go to the dentist if you see these signs of cavities.
  • Brush baby’s teeth twice daily with a thin layer of fluoride toothpaste beginning when the first tooth comes in.
  • Put baby to bed on his or her back without a bottle and wean from the bottle around 12 months of age.
  • Feed your baby a healthy diet and limit sweets and sodas.
  • Ask about fluoride varnish treatments to protect your baby’s teeth from cavities.

The Early Childhood Caries Collaborative national leadership team would like to congratulate those facilities and programs that participated in the project, particularly recognizing the 54 programs that participated in our virtual learning community. These programs were instrumental in identifying, testing and sharing best practices. IHS patients and providers benefit from the best practices that the virtual learning community identified, tested and shared. We encourage IHS, tribally operated clinics, and urban dental programs to continue to prioritize the oral health of children in future years.

Related Content:

Access IHS data briefs on dental health disparities through the IHS Dental Portal.

Current job openings in Indian health dentistry

Follow IHS Dental Careers on Facebook

IHS provides high quality children's dental health care

April is STD Awareness Month, April 25, 2017 ]]>April is recognized as Sexually Transmitted Disease (STD) Awareness Month and brings attention to the nearly 20 million new STDs that occur in the United States each year. While STDs affect all racial and ethnic groups, American Indian/Alaska Native (AI/AN) populations are affected at a higher rate.

In November 2016, the Centers for Disease Control and Prevention (CDC) released its latest Sexually Transmitted Diseases Surveillance Report Exit Disclaimer: You Are Leaving, showing the highest rates of STDs in 20 years. The report identifies that in 2015, AI/ANs had the second highest rates for both chlamydia and gonorrhea infections, and AI/AN women had the second highest primary and secondary syphilis rates among all race groups. Reports of congenital syphilis (CS), a disease that occurs when a mother with syphilis passes the infection on to her baby during pregnancy, is particularly concerning among AI/ANs.

Raising Awareness

The IHS National STD program is committed to continue raising awareness of STDs as a high priority health issue and supporting partnerships, collaborations, policies and education that help reduce the impact of sexually transmitted diseases in Indian Country. The consistent use of clinical reminders in the Electronic Health Record (EHR), and patient and provider education are important and proven interventions for improving STD screening rates and disease prevention. In an effort to stem the rising rates of STDs in Indian Country, the IHS National STD Program, in collaboration with CDC, has developed additional STD educational and technical assistance resources that can be used as-is or adapted by individuals and clinicians to guide local STD screening and treatment efforts. These resources include sample policies and protocols that are available to sites to adopt or adapt based on sites’ needs and local epidemiology. National EHR reminders prompting STD screenings for targeted patient groups are available for deployment at local sites to improve chlamydia and other STD screening rates.

What you can do

STDs, like chlamydia and gonorrhea, can be asymptomatic. Untreated STDs can lead to pelvic inflammatory disease (PID) and infertility. STD infections also increase the likelihood of contracting and transmitting human immunodeficiency virus (HIV).  Although readily preventable when detected during early pregnancy, unrecognized and untreated CS can cause severe illness, miscarriage, stillbirth and early infant death.

STD screening is important for early detection and treatment. National recommendations advise for an annual chlamydia screening for all women between 16-24 years of age. In addition, other high risk groups such as pregnant women and Men who have Sex with Men (MSM) should be also be screened. All pregnant women should be screened at their first prenatal visit and women at high risk should be rescreened early in their third trimester and again at delivery.

Knowing your STD status is a critical step to stopping STD transmission. If you know you are infected you can take steps to protect yourself and your partner. Be sure to ask your healthcare provider to test you for STDs. Many STDs can be diagnosed and treated.

Related Content:

IHS Opens New Youth Regional Treatment Center in California

IHS Awards $7.6 Million for the 4-in-1 Grant Opportunity for Urban Indian Programs

April is National Child Abuse Prevention Month, April 24, 2017 ]]>As we observe National Child Abuse Prevention Month, the Indian Health Service has an important role in improving the lives of Native youth.

When I reflect on my Tribe's past, and similar stories across many tribal nations, I know that my ancestors raised their children through strengths-based parenting and strong communities. Bernard Romans, a renowned Dutch cartographer who surveyed Choctaw lands in the 1770s, wrote that children "are never beaten or otherwise rudely chastised and very seldom chided."

H. B. Cushman, the son of missionaries working at Mayhew, a Choctaw Indian station in Mississippi in the mid-19th century, wrote that "one would naturally infer that youth would arrive at manhood, a set of desperadoes, indulging in every vice and committing every crime. But this was not so. No race of young people ever grew up to manhood who were of a more quiet nature and peaceful disposition than the youths of the Mississippi Choctaws." These historical accounts are a testament to traditions that carry on to this day.

IHS recently hosted training provided by the Johns Hopkins University in Albuquerque, New Mexico, where 26 community health representatives were trained in an early intervention home visiting program called Family Spirit. Family Spirit Exit Disclaimer: You Are Leaving focuses on young children up to three years of age and their families. It is evidence-based, culturally tailored, and shown to improve outcomes for children with the help of front line community health representatives.

In March, IHS announced ten pilot sites in our Pediatric Integrated Care Collaborative Exit Disclaimer: You Are Leaving, or PICC, to improve the capacity of primary care to serve children and families experiencing trauma and chronic stress. The project is a result of a partnership between IHS and the Johns Hopkins University Center for Mental Health Services in Pediatric Primary Care. Under the guidance of Johns Hopkins faculty, pilot sites will work toward increasing the quality of child trauma services by integrating behavioral and physical health services for families with young children.

In February, IHS announced a new service of the Indian Children’s Program which offers pediatric neuropsychology consultations to provide expert opinion, clarify diagnoses, and provides behavioral health treatment recommendations. The Indian Children’s Program also offers training for healthcare providers on important clinical topics, such as autism.

The IHS also provides child sexual abuse examiner and clinical skills training for health care providers through a partnership with the International Association of Forensic Nurses called the Tribal Forensic Healthcare Training Project. The training allows medical professionals to acquire and maintain the knowledge, skills, and competency to provide clinical services in response to child sexual abuse. The next web-based course on pediatric sexual assault examiner opened on April 19. It is a self-paced course and runs through June 30. For more information, please visit Exit Disclaimer: You Are Leaving

In honor of National Child Abuse Prevention Month, I encourage you to join us in our efforts of early intervention, screening, assessment, training, and community-based programming to build resiliency among children and youth and promoting family engagement.

Related Content:

IHS Announces Pilot Program for Child Trauma-Informed Integrated Care

Family Spirit Program is Aimed at Assisting New Parents

National Social Work Month

Earth Day: Healthy Planet, Healthy Populations, April 21, 2017 ]]>Last year on Earth Day I encouraged everyone to make every day Earth Day. What did we do at IHS during the past year to accomplish that?

We have increased employee participation of telework to reduce greenhouse gas emissions from 26,832 telework days to 29,198 telework days annually. The construction of a new Fort Yuma Health Center is well under way and is expected to receive the Leadership in Energy and Environmental Design (LEED), Gold Certification. LEED is the most widely used green building certification and rating system internationally.

The IHS Desert Sage Youth Wellness Center in Hemet, Calif., include xeriscaping to minimize water use by planting indigenous species that are compatible with the local climate to reduce or eliminate the need for irrigation. This is one of many IHS efforts to reduce our impact on the environment.
The IHS Desert Sage Youth Wellness Center in Hemet, Calif., include xeriscaping to minimize water use by planting indigenous species that are compatible with the local climate to reduce or eliminate the need for irrigation. This is one of many IHS efforts to reduce our impact on the environment.

Funding has been approved to implement energy conservation measures such as lighting replacements at Northern Valley Indian Health Exit Disclaimer: You Are Leaving in Chico, CA; the Healing Lodge of the Seven Nations Exit Disclaimer: You Are Leaving in Spokane, WA; and Fort Belknap Service Unit facilities in Montana.

IHS efforts also include xeriscaping Exit Disclaimer: You Are Leaving projects, which minimize water use by planting indigenous species that are compatible with the local climate to reduce or eliminate the need for irrigation. This is being implemented at three health care centers in Montana, at the Riverside/San Bernardino County Indian Health Center Exit Disclaimer: You Are Leaving in Banning, CA, and Fort Washakie Health Center in Wyoming.  These are only a few examples of our efforts.

We are proud of these improvements and will continue to work hard on reducing our resource use and our impact on the environment.

The focus of this year’s Earth Day campaign is Environmental and Climate Literacy.  Environmental and climate literacy Exit Disclaimer: You Are Leaving is the engine not only for advancing environmental and climate laws and policies but also for accelerating green technologies and jobs. A healthy planet is the basis for healthy populations, which contributes to the IHS Mission: to raise the physical, mental, social and spiritual health of American Indians and Alaska Natives to the highest level.

Related Content:

IHS Environmental Sustainability Program

Let's make every day Earth Day