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HHS Federal Program Inventory

Indian Health Service (IHS)

Budget Authority (in millions of dollars)

 FY 2012FY 2013FY 2014


3.1    Clinical Services

IHS partners with Tribes to provide primary care, and behavioral and community health for a growing population of more than 2.2 million eligible American Indians and Alaska Natives (AI/AN). By partnering with Tribes, IHS ensures maximum tribal participation in administering programs that impact Tribal communities directly. IHS and Tribes deliver comprehensive health services to members of more than 566 federally recognized Tribes through direct services in over 620 hospitals, clinics, and health stations on or near Indian reservations.

The Clinical Services program provides funding for five key areas:

  • Hospitals and Health Clinics, which supports access to quality health care in IHS and Tribal hospitals, clinics and health stations and helps address health conditions such as diabetes, cardiovascular disease, obesity, maternal and child health, physical trauma, and behavioral health issues.
  • Dental Health, which provides primarily preventive and basic care, with about 90 percent of services in the basic dental services category.
  • Mental Health, which provides a community-oriented clinical and preventive mental health service program that provides outpatient mental health and related services, crisis triage, case management, prevention programming, and outreach services.
  • Alcohol and Substance Abuse, which works to reduce the incidence of alcoholism and other drug dependencies in AI/AN communities.
  • Contract Health Services (proposed to be renamed Purchased/Referred Care), which purchases essential health care services not available in IHS and Tribal health care facilities or when the facilities cannot provide the services needed including inpatient and outpatient care, routine emergency ambulatory care, transportation, and medical support services including laboratory, pharmacy, nutrition, diagnostic imaging, physical therapy, etc.


  • Supported Strategic Goal:  Strengthen health care
  • Supported Strategic Objective:  Ensure access to quality, culturally competent care for vulnerable populations

3.2    Preventive Health

The Preventive Health program provides funding for four key areas:

  • Public Health Nursing, which supports prevention-focused nursing care interventions for individuals, families, and community groups as well as improving health status by early detection through screening and disease case management. The program home visiting service provides primary, secondary, and tertiary prevention focused health interventions.
  • Health Education, which supports the provision of community health, school health, worksite health promotion, and patient education, and standardizes, coordinates, and integrates education initiatives within IHS, including health literacy for AI/AN individuals and communities, provision of professional education and training, and developing educational materials for staff, patients, families, and communities.
  • Community Health Representatives, which help to bridge the gap between AI/AN individuals and health care resources through outreach by specially trained indigenous community members. CHRs use local community knowledge to help integrate and disseminate basic information about health promotion/ disease prevention and self-management support to patients.


  • Supported Strategic Goal:  Advance the health, safety, and well-being of the American people
  • Supported Strategic Objective:  Promote prevention and wellness

3.3    Operations, Support, and Other Services

Working in partnership with Tribes to accomplish agency goals and objectives of comprehensive health care services provided to AI/AN, the Direct Operations, Support, and Other Services program provides,  a variety of support service programs, including agency level oversight as a critical aspect of the IHS mission. Oversight of programs at the executive level of Headquarters and Area Offices is directly linked to program quality and accountability. Support services include program activities in Urban Health, Indian Health Professions, Self-Governance, and Tribal Management Grants. These support services enable Tribes to be actively engaged, and to have maximum participation in the direct operations of IHS programs.

  • Supported Strategic Goal:  Strengthen health care
  • Supported Strategic Objective:   Increase Efficiency, Transparency and Accountability of HHS Programs

3.4    Indian Health Facilities

The Indian Health Facilities programs include project activities, program support, medical equipment, and quarters return activities. Project activities include Maintenance and Improvement, Sanitation Facilities Construction, and Health Care Facilities Construction. The goals of the Indian Health Facilities programs are to provide optimum availability of functional, well maintained health care facilities and staff housing; provide technical and financial assistance to Indian Tribes and Alaska Native communities to promote a healthy environment through the cooperative development and continuing operation of safe water, wastewater, and solid waste systems and related support facilities; and assist each American Indian Tribe and Alaska Native community to achieve its unique goals for obtaining health care facilities and establishing and maintaining a healthy environment.

  • Supported Strategic Goal:  Strengthen health care
  • Supported Strategic Objective:  Ensure access to quality, culturally competent care for vulnerable populations

3.5    Special Diabetes Program for Indians

The Special Diabetes Program for Indians (SDPI) grant program provides mandatory funding for diabetes treatment and prevention through 404 IHS, tribal and urban Indian health grant programs.

The mission of the IHS Division of Diabetes Treatment and Prevention is to develop, document, and sustain a public health effort to prevent and control diabetes in AI/AN. This mission is accomplished by promoting collaborative strategies for the prevention of diabetes and its complications to AI/AN through its extensive diabetes network. The diabetes network consists of a national program office, Area Diabetes Consultants in each of the 12 IHS Areas, 19 Model Diabetes programs in 23 different IHS and Tribal sites, and 336 local SDPI Community-directed grants and sub-grants, and 68 Diabetes Prevention and Healthy Heart Initiatives in IHS, Tribal and Urban Indian sites.

This extensive diabetes network supports the SDPI grant programs by providing comprehensive diabetes surveillance, research translation, promotion of quality assurance and improvement activities, technical support, resource and best practices information, and develops and distributes American Indian specific diabetes education materials and training.  The IHS combines both clinical and public health approaches to address the problem of diabetes and its complications.

  • Supported Strategic Goal:  Advance the health, safety, and well-being of the American people
  • Supported Strategic Objective:  Promote prevention and wellness.

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