Urban Indian Health
Authors: Kauffman JA, Kauffman J
Publication Year: 1990
Last Updated: 2010-01-21 08:14:08
Journal: Indian Health Service, Office of Planning, Evaluation, and Legislation
Keywords: Community Health Planning; Community Health Services; Delivery of Health Services/Legislation and Jurisprudence; Health Services Needs and Demand; Health Policy; Health Resources; Health Services Administration; Urban Health; Urban Population
Short Abstract:
The purpose of this 1990 Indian Health Service (IHS), Urban Roundtable was to discuss and develop a consensus statement for each of the issues prepared for their review. The group elected to add the need to examine and foster state involvement in urban health care. The following issues were discussed by the participants: 1) expanding the database for Urban Health; 2) delivering services to non-Indians; 3) medical malpractice costs; 4) the New Federalism or contracting federal Indian funds to tribal governments; 5) patient billing systems; 6) state health care and assistance resources; and 7) unserved urban sites.
Abstract: The purpose of this 1990 Indian Health Service (IHS), Urban Roundtable Table was to discuss and develop a consensus statement for each of the issues prepared for their review. The group elected to add the need to examine and foster state involvement in urban health care. The following issues were discussed by the participants: 1) expanding the database for Urban Health; 2) delivering services to non-Indians; 3) medical malpractice costs; 4) the New Federalism or contracting federal Indian funds to tribal governments; 5) patient billing systems; 6) state health care and assistance resources; and 7) unserved urban sites. The following items summarize the participants' consensus statements. 1) The acknowledgement base for urban Indian health status and health care resources is lacking, although some urban health programs have conducted excellent need assessment and health planning documents. 2) IHS needs to address the unique service delivery model that has evolved through its urban program. When urban health programs supplement their IHS investment, they should not be penalized, for this resourcefulness. 3) The medical malpractice crisis is affecting urban health programs. Some insurance premiums have increased up to 500%. Many programs have had to discontinue services, and in some instances provide care without insurance. 4) Future assessments should focus on the growing trend toward tribal contracting of federal Indian dollars and the movement toward a "New Federalism" in the tribal-federal relationship. 5) Additional revenues are generated for urban health programs through the implementation of billing systems. Many of the resources utilized by urban programs require that they implement a sliding fee billing system. 6) States have a responsibility to provide assistance to communities in need of health and social services, including Indian populations within that state. 7) While the Indian Health Care Amendments Act of 1988 provided the IHS with the authority to fund "new starts" in unserved urban communities, no unserved communities have developed programs under this mechanism. The roundtable participants recommended: 1) a central gathering point for all studies done by or about Urban Indian Health Programs be made available at the IHS Headquarters; 2) roundtable participants should be reconvened to assess and evaluate the impact of the urban round table process, findings, and recommendations. 3) other issues including the Fetal Alcohol Syndrome and Fetal Alcohol Effect in urban populations needs to be assessed and support systems developed; 4) Acquired Immune Deficiency Syndrome poses a serious threat to urban Indians; 5) develop and disseminate material which describes the urban health program and answers basic questions about urban Indian health and the urban program; and 6) increase the number of headquarters staff and amount of IHS resources focused on the issue to urban Indian health.
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Code: 3111
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