WASHINGTON — A $100 million boost to the IHS budget next year will help
maintain the agency’s health initiatives for American Indian and Alaska
Native people, but will fall short of addressing all of the health problems
in Indian country, a health service spokesman said.

IHS’s budget of approximately $3.9 billion for fiscal year 2006 represents
an increase of $100 million, or 2.7 percent, over this year’s spending.

About $3.1 million comes from an appropriation signed recently by President
Bush. The remaining funding includes $6 million from rentals of staff
quarters, $648 million from private health insurance and Medicare/Medicaid
collections, and $150 million from a congressional appropriation for the
Special Diabetes Program for Indians.

“It’s more than a lot of other agencies got, so in this tight budget year
we’re doing OK. We didn’t have any cuts. Obviously, it doesn’t meet the all
of the needs. As everybody knows, medical costs are increasing
dramatically. We could use a lot more, but then it’s good that we have the
increase,” said Dianne Dawson, a public affairs spokesman.

IHS, an agency within the Department of Health and Human Services, is the
primary federal agency responsible for carrying out the treaty obligations
of the U.S. government regarding health care to Indians in consultation
with the tribes.

The IHS provides health services directly, through tribal contracted and
operated health programs, and through services purchased from private
providers.

In fiscal year 2006, the tribes will administer $1.6 billion, or 53 percent
of the total budget.

Most users of the Indian health system are members of the more than 560
federally recognized tribes. About 1.8 million American Indians and Alaska
Natives will be eligible for health services next year, an increase of 1.6
percent. The agency anticipates an additional 29,000 people will seek
services next year.

Last year, approximately 1.4 million people used the programs, Dawson said.
“People really use our services. We have what we consider the best rural
health care program in the world and we have people from other countries
who look at us as a model.”

While most services are provided to people living on or near reservations,
1 percent of the IHS budget goes into its Urban Indian Health Program. Next
year, around $33 million will provide services to 600,000 urban Indians and
Alaska Natives at 34 urban Indian health organizations around the country.

Among other expenditures, the 2006 budget includes $32 million for federal
employee pay increases; $38 million for health care facility construction;
$93 million for sanitation construction to provide safe water and waste
disposal systems to an estimated 20,000 Indian homes; $523 million in
contract health service costs; $267 million for contract support costs; and
$150 million in diabetes prevention and treatment grants.

Under Dr. Charles Grim’s direction, the IHS is focusing on three
overarching and inter-related health initiatives: behavioral health, health
promotion and disease prevention, and chronic diseases, Dawson said.

“Behavioral health includes drug abuse prevention, fighting depression,
dealing with all the things that contribute to behavioral health and good
mental health. In Indian country you’re talking about a spectrum of
problems — economic deprivation, racism, cultural alienation, rural
isolation. All of those things can contribute to behavioral and mental
health problems, which in turn contribute to physical problems like chronic
diabetes, obesity, heart problems: all related to diet and exercise.

“These are all big problems in Indian country and the factors that feed
into them are all closely related, back and forth, but you have to start
somewhere and we are looking at lifestyle issues,” Dawson said.