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IHS Provides an Update on Advance Appropriations Implementation

by Jillian Curtis, Chief Financial Officer and Office of Finance and Accounting Director

In Fiscal Year 2023, the Indian Health Service received the first ever advance appropriation for the agency, which protects our patients from the harmful impacts of potential continuing resolutions or lapses in appropriations in Fiscal Year 2024. Advance appropriations provide long overdue funding stability and predictability for the Indian health system. The IHS is already reaping the benefits of the advance appropriations, as hospitals and health clinics have reported this change has improved planning for health care services and increased job security for health care providers.

The FY 2024 advance appropriation includes a total of $5.1 billion for the IHS, with nearly all programs receiving the same amount of funding that was appropriated in FY 2023 enacted. The full prior-year funding level will be available for these programs on Oct. 1, 2023, regardless of Congressional action on appropriations legislation for FY 2024.

To ensure the successful implementation of advance appropriations, the IHS has identified three strategic goals:

Goal 1: Distribute FY 2024 advance appropriations for IHS, tribal, and urban Indian health programs as close as possible to Oct. 1, 2023.

The IHS’s first goal in implementing advance appropriations is to distribute the funds as soon as possible after Oct. 1, 2023. To achieve this goal, the IHS has taken numerous steps, including updating existing budget execution systems and internal timelines, to allow for funds to be distributed as quickly as possible.

Goal 2: Engage regularly with tribal leaders, urban Indian organization leaders, and Congress.

The IHS’s second goal in implementing advance appropriations is to ensure regular engagement with our stakeholders. As part of that effort, the IHS posted a Dear Tribal and Urban Indian Organization Leader Letter today that includes additional information on our overall implementation plan.

Goal 3: Demonstrate the impact of advance appropriations.

IHS’s third goal in implementing advance appropriations is to demonstrate the positive impacts of advance appropriations. To achieve this, we are developing a plan to seek input from IHS, tribal, and urban Indian organizations on their experience with advance appropriations. Stay tuned for more information.

Jillian Curtis, Chief Financial Officer and Office of Finance and Accounting Director

Jillian Curtis is the Indian Health Service chief financial officer and the director for the Office of Finance and Accounting. As director, she is responsible for agency budget formulation, execution, and associated systems and policies, and advises the IHS principal deputy director and senior management staff on the agency's financial activities.