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Policy Issues in American Indian Health Governance

Published online by Cambridge University Press:  01 January 2021

Donald Warne
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Extract

Perhaps the most significant law affecting the provision of health services to the American Indian and Alaska Native (AI/AN) population is the Indian Self-Determination and Education Assistance Act of 1975 (ISDEAA, PL 93-638). This Act allows tribes to assume the management and control of health care programs from Indian Health Service (IHS) and to increase flexibility in health care program development. Under ISDEAA, tribes have the option to contract or compact with IHS to deliver health services using pre-existing IHS resources (formula-based shares tables determine funding for various IHS sites), third party reimbursements, grants, and other sources. Typically, tribes develop their own non-profit health care corporations to provide services to their community, and as a result are eligible for grants and other types of funding not available to federal agencies like IHS.

Type
JLME Supplement
Information
Journal of Law, Medicine & Ethics , Volume 39 , Issue S1 , Spring 2011 , pp. 42 - 45
Copyright
Copyright © American Society of Law, Medicine and Ethics 2011

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References

The Indian Self-Determination and Education Assistance Act, Public Law 93–638.Google Scholar
U.S. Department of Health and Human Services, The Indian Health Program, 1980, DHHS Publication No. (HAS) 80–1003.Google Scholar
The Indian Health Care Improvement Act, Public Law 94–437.Google Scholar
1988 Amendment to ISDEAA, 102 Stat. 2285, Public Law 100–472.Google Scholar
Title 42 of the U.S. Code, Chapter 6A, Public Health Service Act, and section 254b, (the equivalent of Section 330) available at <http://www4.law.cornell.edu/uscode/42/254b.html> (last visited November 17, 2010).+(last+visited+November+17,+2010).>Google Scholar
Public Law 101–512, Title III, § 314, 104 Stat. 1915, 1959–60 (1990). In 1990, Congress enacted that “any civil action or proceeding” against “any tribe, tribal organization, Indian contractor or tribal employee” involving claims resulting from the performance of self-determination contract functions “shall be deemed to be an action against the United States” and “be afforded the full protection and coverage of the Federal Tort Claims Act.”Google Scholar
Indian Health Services, “Direct Service Tribes,” available at <http://www.ihs.gov/NonMedicalPrograms/otp/dst/index.cfm> (last visited November 17, 2010).+(last+visited+November+17,+2010).>Google Scholar