Running Head: INDIAN HEALTH SERVICE: CREATING A CLIMATE FOR CHANGE 1
Indian Health Service:
Creating a Climate for Change
HSM692/Strategic Management of
Health Services Organization
Running Head: INDIAN HEALTH SERVICE: CREATING A CLIMATE FOR CHANGE 2
Dr. Michael Trujillo was appointed as a Director of the Indian Health Service. Dr. Trujillo was ...view middle of the document...
The majority of the Indian people are very poor, 32% of AI/AN are below poverty level the highest among races and are working with very scarce resources. American Indians or Alaskan Natives are only 2nd among median household incomes at around $20,000. There is a generally young population possibly caused by early deaths. In 1955, there was a 33 deaths per 1,000 difference between AI/AN in comparison to the average of all races. In 1992, after 1988 formation of AI/AN federal agency, AI/AN infancy mortality rate has dropped to coincide with average rate of all races.
The population had no adequate third-party billing system. It was difficult to recruit different staff to serve a large population with health indicators lagging behind the rest of the United States.
The different tribes have non-traditional healthcare views, and it was difficult to accommodate this in the government agency. Due to the limited resources there was inclination to centralize decision making.
“IHS created the impression that it could fulfill all the needs
Running Head: INDIAN HEALTH SERVICE: CREATING A CLIMATE FOR CHANGE 4
of local communities, it would contribute to false expectations and disappointment”. (1)Historical Perspective
IHS was elevated to agency status within the USPHS in 1988. “This would reflected on improving reputation of IHS as an institution, as well as the growth, and support for Indian self-determination, and the process by which the Indian people may
choose to some degree of the administration and operation of their health services and the IHS mission.” (1)
In January 1994, Dr. Trujillo told the same Committee that the local tribes and communities needed to be more involved in the decision-making process for Indian self-determination. (1)
During this 1995, there were 34 Indian-operated urban programs. This interrelation between the federal government, tribal governments, and urban Indian groups was a key component of Indian health care management. (1)
An ongoing personnel problem concerned the recruitment and retention of dedicated, qualified professionals. The Indian Self-Determination and Education Assistance Act would recognized the various options that are involving all the staff. “Congress passed the Indian Health Care Amendments of 1988, which authorized
Running Head: INDIAN HEALTH SERVICE: CREATING A CLIMATE FOR CHANGE 5
different third parties billing such as Medicaid and Medicare.” (1)
The IHS was considered a discretionary program within the confines of the federal budget...