IHS budget 'targeted' to meet specific needs

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Diabetes treatment, contract health services and sanitation improvement were the highlights of the Indian Health Service (IHS) budget released on Monday.

With a budget authority of $2.89 billion, the agency charged with improving providing care to 1.6 million American Indians and Alaska Natives won't be seeing major increases across the board. The request is $73 million above the 2003 level, the majority coming from a special Congressional program aimed at fighting rampant rates of diabetes.

But the IHS interim director said Indian Country should be pleased nonetheless. Dr. Charles Grim called President Bush's budget an example of "targeted" increases.

"They are targeted to very specific programs, but they're very important programs," he said in an interview. "They are targeted to areas that I think most tribal leaders would agree with."

Within the budget, a record $150 million, an increase of $50 million, will be used for diabetes prevention and treatment grants. Tribes are building new facilities, buying new medication and teaching their members how to combat a disease that can lead to to high blood pressure, heart disease, blindness, kidney failure and amputations.

The IHS request puts $25 million more dollars into contract health services. The $493 million, a 5 percent increase from the 2003 level, is used to purchase medical care, often specialized, from non-IHS providers. According to budget documents, this money will fund 511,000 outpatient visits, an increase of 18,000.

The other targeted area is sanitation construction. Grim said a disproportionate number of Native Americans lack proper safe water and waste disposal systems. The budget seeks $114 million, a $20 million increase, to improve 22,000 homes.

"We still have about 8 percent of our Indian homes that don't have adequate water sanitation facilities, compared to 1 percent of the nation," he said.

As for the cuts, health facility construction is seeing another decrease for the second year in a row, mostly due to the completion of new hospitals and clinics. Two facilities on the Navajo Nation, one on the Metlakatla Reservation in Alaska and another on the Sisseton-Wahpeton Reservation in South Dakota are to be completed in 2004.

Grim acknowledged a backlog in repair and construction. He said the IHS is currently updating its "master" list in order to determine where updated facilities are needed.

Tribes are controlling more and more federal dollars through contracting. In 2004, 53 percent of the IHS budget will be managed directly by tribes.

"When you take a look at the federal versus the tribally managed programs, they have been increasing over the years," he said. "I think we have seen a lot of positive benefit."

Relevant Documents:
HHS Budget | HHS Secretary Tommy Thompson | HHS Budget [from OMB]

Relevant Links:
Indian Health Service -

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