Summary of Activities that Continue
The Indian Health Service (IHS) facilities that provide patient care will remain open in the event of a lapse of appropriation, and staff required to support these activities will continue to serve. IHS Commissioned Corps officers will continue to serve. Third party collections and carryover balances, including from supplemental COVID-19 appropriations, will help to fund the provision of care by the Indian Health Service. Facilities construction projects supported with previously appropriated funds will also continue. Tribal Health Program operations could continue under a CR, depending on the availability of funding.
Summary of Contingency Staffing Plan
In the event of a lapse of appropriation, 14,564 (96%) of IHS staff will be retained, including 12,114 (80%) who are exempt (their activities or position are already funded or otherwise exempted) and 2,450 (16%) who are excepted (their activities are deemed necessary by implication or for the safety of human life or protection of property).
A total of 12,114 (80%) IHS staff will be exempt. This includes 11,895 staff that will have funding available during a lapse in appropriations, paid for through reimbursements from Medicare, Medicaid, Private Insurance or transfers from the Veterans Health Administration for Dual Eligible patients for health care services, and 219 staff paid for through carryover or other available funds.
A total of 2,450 (16%) IHS staff are considered excepted and can legally continue their activities in the absence of appropriations. These staff fall into three categories; 1) those whose work is necessary for the safety of human life, 2) those whose work is necessary for the protection of property, and 3) those whose work is "necessarily implied" from the authorized continuation of other activities.
Excepted IHS staff will continue to perform vital tasks related to imminent threats to human health or life including those providing or supporting direct patient care not paid for by third party collections.
Excepted staff will also continue activities ensuring the protection of IHS facilities and properties and maintaining computer equipment and systems.
Additionally, a limited number of IHS staff will serve to provide the necessary operational support of activities at Health Clinics and Hospitals and ensure they can continue authorized and funded activities, direct staff call backs, and coordinate administration of exempt activity. IHS has 1,601 Public Health Service Commissioned Corps Officers who will continue working under this exception.