Indian Health Service’s urban programs in funding squeeze
AS THE PARTIAL GOVERNMENT SHUTDOWN drags into its fourth week, Native American healthcare advocates are warning lawmakers that funding for the Indian Health Service is already drying up for some key programs.
The National Council of Urban Indian Health last week warned lawmakers that one of its Urban Indian Health Program facilities was slated to close Jan. 12. That facility took care of three patients who overdosed on opioids the week the shutdown started. Two of those patients died.
Three more clinics may have to close before the end of the month if Congress and the White House can’t find a resolution, the council warned, and another will need to cut back on operations two weeks after that. Thousands of patients would get shortchanged on treatment, according to the council’s estimate. One-third of the 13 facilities surveyed have started to prepare for closure.
The Urban Indian Health Program has 41 different programs across the country and is funded by grants to cover addiction and behavioral health treatment, primary care, dental care, immunizations, HIV treatment and more. Nearly 80% of American Indians and Alaska Na- tives live in urban areas, but funding for those patients is less than 1% of the IHS budget so these programs serve as a supplement to other funding sources.
For broader tribal healthcare operations, individual tribes have to decide how to maintain and manage their programs through the shutdown, accord- ing to the National Indian Health Board, an advocacy group. Despite the funding losses, IHS will keep up its direct clinical treatments “because they involve the safety of human life,” the board said in a statement. But other programs “not directly related to the safety of the human life” won’t necessarily continue.
Not all tribes have the funding to operate fully now, even with the promise of reimbursement from IHS when the shutdown ends. And in a separate issue, if a tribal hospital or clinic needs to refer patients to a hospital, they need ready money to pay for the care.
As congressional spending talks fell apart before Christmas, Rep. Markwayne Mullin (R-Okla.), GOP co-chair of the House Indian Health Service Task Force, introduced a bill to fund the agency through September, or the end of the current fiscal year. He had to reintroduce the measure at the start of the new Congress, but it isn’t likely to go anywhere.
Mullin argued that the agency, which is perennially plagued with funding shortages but whose budget doesn’t count as mandatory spending from Congress, needs a financial buffer from the politics of the current spending fight.
“Native Americans deserve quality, reliable healthcare services as promised in treaties with the federal government,” Mullin said. “My bill, which would provide a stable source of funding for IHS through fiscal year 2019, is a good start.”
Mullin’s Democratic co-chair on the task force, Rep. Raul Ruiz of California, said he supports “any legislation that recognizes this unique relationship and the need to fund the IHS during govern