Copyright © 2000 NLThomas
All Rights Reserved

WASHINGTON, DC - Congress has appropriated $30 million for the Indian health care improvement fund, and stated that the money should be distributed according to the Indian Health Services’ level of need funded formula (LNF). Under these guidelines, Oklahoma’s Indian Health Service area would receive more than $10 million in additional funds in the coming fiscal year, more than 30 percent of the increase, because of past under funding. The additional funds will be distributed among IHS facilities in Oklahoma, including Claremore Indian Hospital, W.W. Hastings Hospital in Tahlequah and the six Cherokee Nation clinics.

Last year, the Indian Health Service distributed $9 million from the fund according to the LNF formula. This year, the House of Representatives recommended dropping the Indian health care improvement line item from the budget entirely, but after wrenching testimony and congressional visits from Native American leaders, including Cherokee Nation Principal Chief Chad Smith, the Senate and House appropriated $30 million to the fund.

"Unfortunately, this is not a recurring funding source," Smith said. "We need to make sure that in all future years this money is again distributed based on need."

According to an Indian Health Service formula, the Oklahoma area would need more than $86 million a year just to be brought up to the IHS national average. That average would still just fund 60 percent of the health care needs, according to the same formula.

"We’re pleased with the additional $10 million for one year, but we can’t be satisfied with a small, temporary correction to this ongoing inequity. Every tribe in Oklahoma supports the recommendation that all new money appropriated for Indian health be distributed according to the LNF formula."

Smith went on to say that Oklahoma tribes are not calling for a redistribution of existing funds, but rather support an adequate, equitable funding for all Indian health programs.

Currently, that is not the case. Oklahoma has approximately 22 percent of the total Indian population in the United States, but Oklahoma tribes receive health funding at the rate of $856 per patient per year, the lowest per capita funding of any area. The average IHS area is funded at $1351 per patient.

"Our care givers are providing quality services, but their pool of resources is too small," Smith said. "They can’t do everything that is needed."

Congress also agreed to increase spending on contract health by more than $40 million across the Indian Health Service, but that money will not be distributed according to the LNF formula, and Oklahoma will get a disproportionately small share of the increase. Contract health funds are used to pay for specialized treatments that Indian health facilities can’t provide.

"For contract health services last year, we got a little more than $7 million for 100,000 people," said Mim Dixon, executive director of Cherokee Nation’s health division. "We don’t have any money at all for cancer treatment."

Still, the Cherokee Nation of Oklahoma is pleased with the new appropriations.

"Congress is beginning to understand the critical unmet health care needs of Native Americans," Smith said. "For the first time in the history of Indian health care, there is logic behind the way appropriations are distributed. They are taking a step in the right direction by finding a way to get more health care to the people who have been provided the least."

For example, Chief Smith compares the Oklahoma and Nashville areas of the Indian Health Service. The two areas are very similar but Oklahoma receives the lowest per capita funding rate, while Nashville receives the highest funding rate. "No one can explain why these two similar areas have such a funding disparity. I’m glad that Congress is beginning to take small steps towards correcting the inequity that plagues Native Americans in Oklahoma."