IHS From the Beginning ...

The establishment of Indian Health Services date back to the date of discovery. It is through the organization of hundreds of treaties into law which form the basis of the federal governments’ health care provisions to Native Americans.

Treaty health care terms represented part of the government’s payment to Indian tribes for giving up their ancestral homelands to the United States. These treaties were, and still are, contracts by and between the federal and tribal governments. The 1921 Snyder Act provides for continued federal program authority and identifies “the relief of distress and conservation of Indian health” as a federal function.

During the 1950’s the creation of basic health services progressed under the jurisdiction of the newly formed Indian Health Service. Moving into the 1960’s the emphasis shifted toward health program management, health planning, health professional and health occupational training for Native Americans, and health management training for Indian Health Service administrators. The Community Health Representative training initiative was established in 1965. The intent of this particular program was to bridge the existing gap between community member patients needing health care and the clinics and hospitals providing such care.

The 1970’s were revolutionary for Indian Health Services. President Richard Nixon had introduced the concept of “Tribal Self-Determination.” This concept proposed tribal governments taking over the management of federal programs provided to them. Congress took formal action on this concept in 1975 by enacting the Indian Self-Determination and Education Act.

Emerging in the 1980’s were vast increases in funding for Indian Health programs with special emphasis on professional excellence, construction of modern health facilities, and movement toward greater tribal involvement. Throughout the 1990’s a continual unfolding growth of the “self-determination” process was portrayed. Congress passed legislation extending tribal self-governance, allowing tribes to contract for the programs, services, functions, and activities within Indian Health Service and the Bureau of Indian Affairs.

Today the Indian health care system administers services through 48 hospitals, 238 health centers, 167 health stations, 180 Alaska village clinics, and 34 urban projects. Here on the Flathead Reservation the Confederated Salish and Kootenai Tribal Health department provides a wide range of services to a significant user population totaling over 10,000 Native Americans. Funding for this effort is increasingly constrained as the cost of health care continues to climb parallel to the escalating health care needs in our area.

The provision of quality, competent, and timely health care is of the highest priority. Our continuing efforts are geared toward efficient and effective service delivery, while exploring additional avenues to enhance funding levels and expand our health care systems.