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IHS budget sees cut in final year of Bush era
Wednesday, February 6, 2008
Filed Under: Health | Politics

The Indian Health Service saw a slight cut in its budget this week after benefiting from years of steady growth.

President Bush is proposing to spend $4.3 billion on services and facilities in fiscal year 2009. The budget includes a $21 million cut for construction of new clinics and hospitals.

The 2009 request also zeroes out the $35 million urban Indian health program. Bush has tried to cut the program for three years in a row, only to see it restored by Congress.

The budget does include some increases. Clinical services will see a $42 million boost, to be used for a $9 million increase in contract health services and to staff two new health facilities.

There's also an increase of $4 million for preventive health programs and a $4 million increase for contract support costs. But when the cuts are taken into account, the services portion of the IHS budget remains the same as the 2008 level -- around $3.9 billion.

The facilities portion of the IHS budget includes the $21 million cut to health care facilities construction. Spending on sanitation facilities construction, maintenance and improvement and medical equipment remains the same as 2008.

"The IHS budget is developed in consultation with American Indian and Alaska Native tribal leaders and representatives, who play an important role in the annual formulation and prioritization of the IHS budget and health priority focus," said IHS acting director Robert McSwain, who goes before the Senate Indian Affairs Committee tomorrow for his confirmation hearing.

"This budget reflects the impact of the department's tribal budget consultations and a continuing federal government commitment to provide for the health of members of federally recognized tribes," said McSwain, a member of the North Fork Rancheria of Mono Indians from California.

With the American Indian and Alaska Native population growing at high rates, the IHS budget has steadily increased under the Bush administration. Just last year, the White House sought an additional $246 million for clinical services, which included a $49 million increase for contract health services.

The 2009 budget, however, stops the growth. The few programs that saw increases were increased by much smaller amounts than in prior years while programs that appeared to be priorities in the past -- such as Indian Health Professions, which provides scholarships and loans to students -- saw major cuts.

Yet IHS has always been rated favorably by the White House Office of Management and Budget. Of six IHS programs assessed under the Program Assessment Rating Tool, or PART, four received "effective" or "moderately effective" ratings and two were deemed "adequate." None fell into the "ineffective" category.

IHS has consistently met more than 80 percent of its targets under the Government Performance and Results Act. That's one of the best records of all agencies within the Department of Health and Human Services.

FY2009 Budget Documents:
HHS In Brief | GPRA Performance | More IHS Documents

Hearing Notice:
HEARING on the nomination of Robert G. McSwain, to be Director of the Indian Health Service. (February 7, 2008)

Relevant Links:
Indian Health Service -
National Council of Urban Indian Health -
National Indian Health Board -

Related Stories:
Senate confirmation hearing for IHS director (2/4)
Bush nominates McSwain as director of IHS (12/19)
Charles Grim withdraws nomination for IHS (9/6)
White House blocked testimony on trust responsibility (7/27)
IHS slow to resolve audit recommendations under Grim (7/26)

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