Interim Report on FY 2011 Indian Health Service Budget

In this Memorandum we provide an interim report on the final funding levels for the FY 2011 Indian Health Service (IHS) budget. The IHS budget is included in the Department of Defense and Full-Year Continuing Appropriations (CR) Act (HR 1473, PL 112-10) which was signed into law April 15, 2010. PL 112-10 funds federal agencies through the end of the fiscal year, September 30, 2011. Federal agencies were instructed to file operating plans with Congress within 30 days of enactment the allocation of FY 2011 funds.

The IHS has provided the attached one-page chart regarding its final FY 2011 funding figures; there is no accompanying narrative. The funding chart leaves unanswered questions relating to staffing of new facilities, construction projects, and the nature of the $8.2 million increase to the Hospitals and Health Clinics account. We will update this Memorandum when more detailed budget information becomes available. We expect detailed Bureau of Indian Affairs budget information within a few days.

As earlier reported, PL 112-10 reduced total funding for all federal Departments and Agencies by nearly $40 billion below the FY 2010 enacted level. The IHS budget was not reduced, but it contains no increases to address built-in costs or shortfalls and was subject to the 0.2 percent across-the board reduction applied to all discretionary accounts (except Defense).

The FY 2011 funding increases requested by the Obama Administration were not realized. The requested increase for Contract Support Costs (CSC) was $46 million, but FY 2011 funding for CSC is $797,000 below the FY 2010 level. The requested increase for Contract Health Services was $84 million but that also was not realized. The Administration proposed $60 million for inflation, $52 million for population growth and $24 million for pay costs for civilian employees and Commissioned Corps officers. The only portion of these requested increases in the final FY 2011 IHS budget is a 1.4 percent pay increase for Commissioned Corps officers. We do not yet have information on how much funding may be in the budget for staffing and operations of new facilities (the Administration’s request was $38.8 million).

The total increase for the IHS budget over FY 2010 is minimal, $16.8 million, consisting of $7.6 million in the Services account and $9.2 million in the Facilities account.

PL 112-10 (Section 1101(a)) provides that funding, unless otherwise specified, is “under the authority and conditions provided in the applicable appropriations acts for fiscal year 2010…” As PL 112-10 did not specifically change the legislative provisions from those in the FY 2010 IHS appropriations act, they remain in effect in FY 2011 (a cap on contract support costs; Individual with Disabilities Act data collection in BIE schools; prohibition on implementing eligibility regulations; authorization for services to non-Indians, subject to charges; and Indian Self-Determination Act agreements exemption from the limitation on no-bid contracts). The restriction on the use of IHS funds in Alaska to regional Native organizations (with some exceptions) was enacted in the FY 2010 appropriations act for two years, so that still is in effect through
September 30, 2011.

PL 112-10 also provides (Section 1111) that earmarks contained in the FY 2010 appropriations Act/s, committee reports or joint explanatory statement have no legal effect with respect to the FY 2011 appropriations act.

Because FY 2011 funding is so tied to the provisions in the FY 2010 appropriations act, you may want to have available the FY 2010 Interior, Environment, and Related Agencies appropriations acts and reports and our memo on FY 2010 IHS appropriations for reference:

HSDW General Memorandum 09-138 dated October 30, 2009

And on (Congress’s website):

House Report – H. Rpt. 111-180
Senate Report – S. Rpt. 111-38
Conference Report – H. Rpt. 111-316 (Division A)
Public Law 111-88

Again, we will report in more detail on the FY 2011 IHS budget and its allocation process as information becomes available.