IHS budget cuts construction funds
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The new budget for the Indian Health Service (IHS) released last week proposes to cut funds for the construction of new facilities even as the agency acknowledges a $484.8 million backlog in maintenance and repairs.

Although the amount of the slash, $14.3 million, is one of the few cuts within IHS, tribal leaders point out the request comes after years of increased, and sustained, funding. The construction budget saw historic increases during the Clinton administration, jumping from just $41.4 million in 1998 to $86.3 million last year.

But the cut doesn't necessarily mean Indian Country will see an across-the-board slowdown in high priority projects. The replacement hospital on the Winnebago Reservation in Nebraska to serve the Winnebago and Omaha tribes, for example, is seeing a decrease because the IHS will have fully funded the $47.9 million project by fiscal year 2003.

The same goes for the new hospital on the Navajo Nation in Fort Defiance, Arizona, to serve the country's largest tribe. Funds are being reduced by $7.4 million in anticipation of the facility opening next summer.

Other projects aren't so lucky. No funds are being requested for a clinic on the Metlakatla Reservation in Alaska, even though the project needs $13.8 million, or one on the Sisseton-Wahpeton Reservation in South Dakota, where $27.0 million is needed.

A $19.8 million clinic to serve tribes in western Oklahoma won't receive startup funds either. Hospital staff buildings in Bethel, Alaska; Zuni Pueblo in New Mexico; the Fort Belknap Reservation in Montana; the Yankton Sioux Reservation in South Dakota and on the Navajo Nation in Kayenta, Arizona, won't see funds although nearly $40 million is needed.

Also being cut are $22.5 million in ambulance grants and $8.5 million for the dental program. These are offset, however, by increases in funds to help complete four clinics in Arizona and Oklahoma.

Overall, the IHS budget is $2.9 billion, an increase of $60 million over the current fiscal year. But while many programs are seeing a boost, many are due to "accrued" costs and not actual program increases.

More than 1 million urban American Indians and Alaska Natives, for example, won't be seeing any additional medical, dental and other services even though accrued costs show the this area of the budget is growing. Some members of Congress, including Sen. Pete Domenici and Rep. Heather Wilson, Republicans of New Mexico, have been trying to increase money for urban programs, which grew $5 million during the Clinton years.

Alaska Native sanitation projects get a special highlight by the White House in a "Which Of These Projects Would You Fund?" section of President Bush's budget. The Office of Management and Budget acknowledges a $1.8 billion backlog here but there are no actual program increases.

And as part of a government-wide performance improvement initiative, OMB also rates the IHS as "moderately effective at providing health care services to Native Americans, reducing health disparity, constructing new and replacement hospitals, and managing self-governance activities." The entire Department of Health and Human Services got negative marks in five benchmark areas.

The IHS serves more than 1.5 million American Indians and Alaska Natives. Based in Rockville, Maryland, with 12 area offices, it is headed by director Michael Trujillo.

Get Budget Documents:
IHS Budget Justification [HHS] | IHS Budget Authority Chart [HHS] | IHS Profile [HHS] | HHS Budget [HHS] | HHS Budget [OMB]

Relevant Links:
The Web Source for IHS Budget Documents -
Indian Health Service -
Department of Health and Human Services -

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