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Health
Bush's IHS budget sees increases all around


The Indian Health Service (IHS) survived the Bush administration's funding ax on Monday, emerging with $3.0 billion in budget authority for fiscal year 2006.

Increases were proposed for nearly every program at the agency, a primary source of health care for America Indians and Alaska Natives throughout the country. With an additional $64 million, IHS was one of the few entities within the Department of Health and Human Services to see a boost in resources.

"With these funds, the IHS will provide high quality health care through 49 hospitals, more than 240 outpatient centers, and more than 300 health stations and Alaska village clinics, helping 1.8 million people," said new Health and Human Services Secretary Mike Leavitt at a press briefing yesterday.

The only exception, again, was an $86 million cut for construction of new facilities. This is the fourth year in a row that the Bush administration has reduced funding in this area, citing completion of hospitals, clinics and staff quarters.

The reduction came despite an "effective" rating for the program from the White House Office of Management and Budget. Since 2001, IHS programs have consistently received some of the best scores under the administration's rating system. This year, IHS was one of just two HHS agencies to demonstrate "effective" success.

Nevertheless, there were a host of other increases in the IHS request. The clinical services account is growing by $128 million to nearly $2.9 billion. This money goes for the operation of hospitals and clinics, purchase of medical care and other health programs.

Contract health services, a component of clinical services, will be increased by $27 million to $525 million next year. CHS funds are used to purchase specialty care, including most types of surgery, and are used by tribes that don't have IHS facilities nearby.

In the area of self-determination, tribes are operating more and more IHS programs. Officials estimate that tribes will control $1.8 billion, or 55 percent, of the agency's budget in 2006.

To continue that trend, the budget seeks $269 million for contract support costs, an increase of $5 million. Officials hope this will provide for 20 to 25 more tribal contracts.

This time around, funding was restored to the urban health program and the Indian Health Professions program, both of which had been flatlined in the 2005 request. The urban health funds will support 34 Indian organizations that provide service in cities with large numbers of Indian people

In another shift, the Bush administration is only seeking $94 million for sanitation construction to bring safe water supplies to reservations and Alaska Native villages. In prior years, the administration sought in excess of $100 million but the amount kept getting pared down by Congress.

Elsewhere, IHS is authorized to distribute $150 million under the special diabetes program created by Congress. Along with collections from Medicare, Medicaid and private insurance, the agency's spending tops $3.8 billion.

Budget Documents:
HHS Budget in Brief | HHS [from White House]

Relevant Links:
Indian Health Service - http://www.ihs.gov