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
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
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.