Indian Health Service. Funding Based on Historical Patterns, Not Need
GENERAL ACCOUNTING OFFICE WASHINGTON DC HUMAN RESOURCES DIV
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IHS distributes funding among its 12 service delivery areas based primarily on the level of funding each area received in previous years. This approach takes little account of the number of Indians eligible for or using IHS services in an area, their health status, or the areas particular service needs. Since 1980, IHS has attempted to redistribute a portion of its funding by formulas that incorporate measures of service needs. These efforts have had limited sucess, however, due to objections from Indian tribes adversely affected by the changes. Further, in 1988, the Congress prohibited the reduction of 5 percent or more of the funding for any program, project, or activity of an IHS service unit without prior submission of a report to the Congress.
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