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House subcommittee hears tribal calls for predictability, staffing and EHR fixes as IHS proposes realignment
Summary
Tribal leaders and IHS officials told the House Natural Resources Subcommittee that modernizing implementation of PL 93-638 requires predictable timelines, stronger area-office capacity, EHR modernization and stable funding; witnesses warned that rushed consultation or centralizing negotiations could slow services.
The House Natural Resources Subcommittee on Indian and Insular Affairs held an oversight hearing on implementation of Public Law 93-638 (the Indian Self-Determination and Education Assistance Act), examining how the Indian Health Service (IHS) can support the growing number of tribes and tribal organizations that now manage a majority of the agency’s budget under title I contracts and title V compacts.
Deputy Director Benjamin Smith of the Indian Health Service told the subcommittee that IHS now works through a network of “more than 600 federal and tribal health facilities, as well as 41 urban Indian organizations across 37 states,” serving roughly “2,800,000 American Indians and Alaska Natives each year.” He said the agency has “12 area offices that oversee 170 service units” and noted that about “62% of the Indian Health Service budget” is transferred to tribes today. Smith identified workforce shortages, aging facilities (an average facility…
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