The Cheyenne River Health Center in Eagle Butte, South Dakota, an Indian Health Service facility. Photo: Apnewcombwei / Wikimedia Commons, CC BY-SA 4.0.
U.S. Health and Human Services Secretary Robert F. Kennedy Jr. has notified Congress that the department plans to invest $1.86 billion in Indian Health Service infrastructure, Native News Online reported.
In an Oct. 5 letter to Rep. Rosa DeLauro, D-Conn., ranking member of the House Appropriations subcommittee that oversees HHS, Kennedy outlined plans to draw on the department’s Nonrecurring Expenses Fund.
According to the National Indian Health Board, the plan allocates about $1.4 billion to the IHS health care facility construction backlog, which dates to a priority list established in 1993, and about $410 million to modernize electronic health records.
A long backlog
The proposed investment exceeds the $1 billion HHS had previously announced for the construction backlog. NIHB credited the advocacy of tribal nations and called the commitment historic as the federal government works to meet its trust and treaty obligations.
The IHS provides health care to American Indian and Alaska Native people as part of the federal government’s trust responsibility, directly and through tribes and tribal organizations that run their own health systems under self-determination contracts and compacts. Many facilities are decades old, and the agency’s aging records system has long been a target for replacement.
The legal foundation
Federal responsibility for Indian health care rests on treaties and on laws such as the Snyder Act of 1921 and the Indian Health Care Improvement Act, which Congress made permanent in 2010. The agency serves about 2.8 million American Indians and Alaska Natives, according to the IHS.
In recent years, Congress has begun providing advance appropriations for much of the IHS budget, so that tribal and federal clinics are less exposed to government shutdowns. Facility construction and information technology, however, have remained dependent on annual decisions.
Caveats
The funding plan remains subject to the federal appropriations process, and the amounts may change as implementation proceeds, Native News Online reported.
That caveat matters. Tribal leaders have long argued that IHS funding should be protected from year-to-year budget fights, and the plan arrives months after a separate Brookings analysis documented how canceled federal grants cost tribes and Native organizations nearly $470 million.
Source: Native News Online.
