On December 16, 2014, President Obama signed HR 83, the Consolidated and Further Continuing Appropriations Act, 2015 (Act) providing FY 2015 funding for 11 of the 12 appropriations bills. The House approved the bill on December 11 by a vote of 219-206 and the Senate followed suit on December 13, approving it by a vote of 56-40. This Memorandum is specific to Indian Health Service (IHS) appropriations which is included in Division F of the Act. All federal agencies had been funded under a Continuing Resolution (CR) at FY 2014 levels for the first two and half months of FY 2015.
For the IHS, the enactment of an appropriations bill that had been considered by Appropriations Committees rather than a flat funded CR resulted in the better outcome. It allowed, for instance, for increased appropriations for Contract Support Costs (which are not capped); Purchased/Referred Care; Urban Indian Health; and Indian Health Professions that a straight CR would not have provided. Had Congress not approved HR 83, it is likely that the IHS would have operated under a CR for the entire fiscal year.
The Managers’ Explanatory Statement accompanying the Act notes that the House Report language is to be complied with unless specifically contradicted. The Senate Interior Appropriations Chair and Ranking Member released a draft bill and report, but they were not considered in Committee and not officially filed and thus the Explanatory Statement does not reference them. The Managers’ Explanatory Statement instructs:
Language contained in House Report 113-551 providing specific guidance to agencies regarding the administration of appropriated funds and any corresponding reporting requirements carries the same emphasis as the language included in this explanatory statement and should be complied with unless specifically addressed to the contrary herein.
FUNDING OVERVIEW
For the IHS Services Account the Act contains $199 million over the FY 2014 enacted level and $9.9 million over the Administration’s request. For the IHS Facilities Account the funding is $8.5 million over FY 2014 enacted but $1.76 million below the requested amount.
The difference between the Act and the requested amount includes the net of increases over the requested amount of $45 million for Contract Support Costs (CSC), $25 million to restore programs whose funding was reduced in FY 2014 in order to meet full CSC needs (the Administration requested $10 million for this purpose); $9.8 million for Indian Health Professions (the Administration proposed a $5 million increase); and $2.2 million for Urban Indian Health. Decreases in the Act below the Administration’s request are $15 million for Purchased/Referred Care (still resulting in a $35 million increase over FY 2014) and $63 million for medical inflation which would have been spread throughout the budget.
While the Administration originally requested $617 million for CSC, they later requested an additional $45 million over that amount when funding needs became more apparent.
As expected, the Act does not include funding for the Administration’s proposed Opportunity, Growth, and Security Initiative which would have provided $56 billion equally divided between defense and nondefense spending. The Administration had proposed
$200 million of this amount for the construction of health care facilities on the IHS priority list.
Built-In Costs
–Staffing of New Facilities. Consistent with the Administration’s proposal the Act includes (in the Services and Facilities accounts combined) $70.8 million for staffing and operations costs for the following new facilities: San Carlos Health Center ($28.4 million); Southern California Youth Treatment Center ($3.2 million); Choctaw (MS) Alternative Rural Health Care Center ($10.9 million); and Kayenta Alternative Rural Healthcare Center ($28.3 million). The Managers’ Explanatory Statement instructs: “Funds are limited to facilities funded through the Health Care Facilities Construction Priority System or the Joint Venture Construction Program that are newly opened in fiscal year 2014 or that open in fiscal year 2015. None of the funds may be allocated to a facility until such facility has achieved beneficial occupancy status.”
–Inflation; Newly Recognized Tribes; Pay Increase. As mentioned above, the Act does not include the $63 million requested by the Administration for medical inflation, nor does it provide funding for non-medical inflation or population growth. The Act provides $7.9 million to partially fund five newly recognized tribes and $2.6 million to go toward a one percent pay increase, the cost of which is estimated to be $20 million.
LEGISLATIVE PROVISIONS
Contract Support Costs (CSC). The Act does not place a cap on CSC spending, but the Managers’ Explanatory Statement includes $662,970,000 for IHS, the amount estimated by IHS to fully fund CSC. The House Report states that should this amount be insufficient, the IHS is to submit a reprogramming request. Current estimates for CSC for FY 2015 are such that we are hopeful that the $662 million allocation will make a repeat of the reprogramming scenario, and its attendant headaches, unlikely in FY 2015.
The Act, as requested by the Administration, provides that no FY 2014 or FY 2015 CSC funds may be used by the IHS or the BIA to pay prior years CSC or to repay the Judgment Fund for payments for judgments or settlements related to prior years CSC claims.
Finally, the Act, consistent with the Interior appropriations acts for FYs 1999-2014, attempts to limit the ability of the IHS and BIA to fund prior years shortfalls in CSC funding from remaining unobligated balances for those fiscal years. This provision has been included in the appropriations acts for many years and has not precluded recovery on past-year CSC claims.
See the Contract Support Costs section elsewhere in this Memorandum for the text of the CSC Report and bill language.
IDEA Data Collection Language. The Act continues to authorize the BIA to collect data from the IHS and tribes regarding disabled children in order to assist with the implementation of the Individuals with Disabilities Education Act (IDEA):
Provided further, That the Bureau of Indian Affairs may collect from the Indian Health Service and tribes and tribal organizations operating health facilities pursuant to Public Law 93-638 such individually identifiable health information relating to disabled children as may be necessary for the purpose of carrying out its functions under the Individuals with Disabilities Education Act. (20 U.S.C. 1400, et. seq.)
Prohibition on Implementing Eligibility Regulations. The Act continues the prohibition on the implementation of the eligibility regulations, published September 16, 1987.
Services for Non-Indians. The Act continues the provision that allows the IHS and tribal facilities to extend health care services to non-Indians, subject to charges. The provision states:
Provided, That in accordance with the provisions of the Indian Health Care Improvement Act, non-Indian patients may be extended health care at all tribally administered or Indian Health Service facilities, subject to charges, and the proceeds along with funds recovered under the Federal Medical Care Recovery Act (42 U.S.C. 2651-2653) shall be credited to the account of the facility providing the service and shall be available without fiscal year limitation.
Assessments by DHHS. The Act continues the provision that has been in Interior appropriations acts for a number of years which provides that no IHS funds may be used for any assessments or charges by the Department of Health and Human Services “unless identified in the budget justification and provided in this Act, or approved by the House and Senate Committees on Appropriations through the reprogramming process.”
Limitation on No-Bid Contracts. The Act continues the provision regarding the use of no-bid contracts. The provision specifically exempts Indian Self-Determination agreements:
Sec. 412. None of the funds appropriated or otherwise made available by this Act to executive branch agencies may be used to enter into any Federal contract unless such contract is entered into in accordance with the requirements of Chapter 33 of title 41 United States Code or chapter 137 of title 10, United States Code, and the Federal Acquisition Regulations, unless:
(1) Federal law specifically authorizes a contract to be entered into without regard for these requirements, including formula grants for States, or federally recognized Indian tribes; or
(2) such contract is authorized by the Indian Self-Determination and Education and Assistance Act (Public Law 93-638, 25 U.S.C. 450 et seq.) or by any other Federal laws that specifically authorize a contract within an Indian tribe as defined in section 4(e) of that Act (25 U.S.C. 450b(e)); or
(3) Such contract was awarded prior to the date of enactment of this Act.
FUNDING FOR INDIAN HEALTH SERVICES
FY 2014 Enacted $3,982,842,000
FY 2015 Admin. Request $4,172,182,000
FY 2015 Enacted $4,182,147,000
Definition of Indian. The House Committee notes the problems caused by various definitions of “Indian” referenced in different sections of the Affordable Care Act and urges the Department of Health and Human Services, the IHS, and the Treasury Department to work together to establish a consistent definition of Indian with regard to health care. The House Report states:
The Committee recognizes the Federal government’s trust responsibility for providing healthcare for American Indians and Alaska Natives. The Committee is aware that the definition of who is an “Indian” is inconsistent across various Federal health programs, which has led to confusion, increased paperwork and even differing determinations of health benefits within Indian families themselves. The Committee therefore directs the Department of Health and Human Services, the Indian Health Service, and the Department of the Treasury to work together to establish a consistent definition of an “Indian” for purposes of providing health benefits. (H Rept. 113, p. 86)
We also note that the Department of Health and Human Services (Centers for Medicare and Medicaid/Departmental Management) portion of the Managers’ Explanatory Statement addresses the issue of Indian eligibility for benefits, stating:
The agreement directs CMS to work with the Internal Revenue Service to review federal regulations under their respective jurisdictions to determine who is eligible as an Indian for the benefits and protections provided to Indians. The agreement directs CMS to submit a report with the agency’s findings to the Senate and House Appropriations Committees within 180 days of enactment of this act.
SPECIAL DIABETES PROGRAM FOR INDIANS
While the entitlement funding for the Special Diabetes Program for Indians (SDPI) is not part of the IHS appropriations process, those funds are administered through the IHS. SDPI is currently funded through FY 2015 at $150 million, minus a two percent reduction ($3 million) due to the sequestration of non-exempt mandatory programs. (PL 112-240)
HOSPITALS AND CLINICS
FY 2014 Enacted $1,790,904,000
FY 2015 Admin. Request $1,862,501,000
FY 2015 Enacted $1,836,789,000
The Act provides $41.6 million for staffing of new facilities; $3.6 million for newly-recognized tribes; $2.57 million for pay costs increase; $4.7 million for epidemiology centers; $172 million for Health Information Technology; recurring funding of $8.9 million for the domestic violence prevention initiative; $3 million to restore the Director’s Emergency Fund and a transfer of $4.8 million to the loan repayment program.
The House Report directs IHS to address the need for more health care volunteers by implementing a simplified and centralized credentialing process, stating:
Because IHS faces a health care provider shortage of 1,500 professionals, the Committee directs the Service to expeditiously convene a meeting of interested Tribes and health care organizations to design a pilot program to address credentialing problems and report the results to the Committee within 180 days of the enactment of this Act.
(H. Rept. 113-551, p. 85-86)
The Managers’ Explanatory Statement encourages IHS “to work with Tribes and health care organizations to find creative ways to address the Service’s health care provider shortage, including improvements to the credentialing process.”
DENTAL SERVICES
FY 2014 Enacted $165,290,000
FY 2015 Admin. Request $175,654,000
FY 2015 Enacted $173,982,000
The Act includes $8.2 million for staffing of new facilities, $468,000 for newly-recognized tribes and $500,000 for an initiative to increase preventive dental care in Bureau of Indian Education (BIE)-funded elementary schools by bringing dentists and hygienists into the schools. The IHS and the BIE are directed to consult with tribes about the piloting of this initiative. The House Report states with regard to this BIE school issue:
Early childhood caries (i.e. cavities) is an epidemic in Indian country and among other things it impacts the ability of children to concentrate and learn. The Committee received testimony again this year about an initiative to increase preventive dental care for children by bringing dentists and hygienists into elementary schools. The Committee recommendation includes $500,000 in the Indian Health Service budget to begin the initiative and directs the BIE to work with the Service and to consult with Tribes about piloting the initiative in the BIE school system. (H. Rept. 113-551, p. 45)
In addition the Managers’ Explanatory Statement encourages the IHS to work with the BIE to establish a pilot program integrating preventive dental care at schools within the Bureau system.
The House Committee directs the IHS “to work toward completion of electronic dental records (EDR) at the remaining 80 of 230 Federal and tribal dental sites.”
MENTAL HEALTH
FY 2014 Enacted $77,980,000
FY 2015 Admin. Request $82,025,000
FY 2015 Enacted $81,145,000
The Act provides $2.8 million for staffing of new facilities and $319,000 for newly-recognized tribes.
ALCOHOL AND SUBSTANCE ABUSE
FY 2014 Enacted $186,378,000
FY 2015 Admin. Request $193,824,000
FY 2015 Enacted $190,981,000
The Act provides $4.3 million for staffing of new facilities and $289,000 for newly-recognized tribes.
.
PURCHASED/REFERRED CARE
(Formerly Contract Health Services)
FY 2014 Enacted $878,575,000
FY 2015 Admin. Request $929,041,000
FY 2015 Enacted $914,139,000
The Act provides $2.6 million for newly-recognized tribes and within the total
$51.5 million for the Catastrophic Health Emergency Fund.
The House Report, noting that the IHS and tribes must prioritize care under this program (Levels I-V), encourages them to measure the impact of funding increases at each level of care.
Medicare-Like Rates Legislation Encouraged. The Administration included in its budget justification support for a proposal that tribes, the IHS, and urban Indian organizations utilizing the Purchased/Referred Care program be charged Medicare-Like rates for non-hospital services, thus stretching the funding for Purchased/Referred Care. Medicare-Like rates are currently required for hospital services. A 2013 Government Accountability Office report concluded that IHS and tribal facilities would save millions of dollars and be able to increase care if the Medicare-Like rate cap was imposed on non-hospital providers and suppliers through the Purchased/Referred Care program. The House Committee concurred and in its Report urges the IHS to “work aggressively with the relevant committees” to enact such authorizing legislation.
On December 5, 2015, the IHS proposed a rule to expand Medicare-Like rates to non-hospital Purchased and Referred Care Services. Comments are due January 20, 2015. For additional information, see our General Memorandum 14-096 of December 12, 2014.
PUBLIC HEALTH NURSING
FY 2014 Enacted $70,909,000
FY 2015 Admin. Request $76,353,000
FY 2015 Enacted $75,640,000
The Act provides $4.5 million for staffing of new facilities and $257,000 for newly-recognized tribes.
HEALTH EDUCATION
FY 2014 Enacted $17,001,000
FY 2015 Admin. Request $18,263,000
FY 2015 Enacted $18,026,000
The Act provides $861,000 for staffing of new facilities and $164,000 for newly-recognized tribes.
COMMUNITY HEALTH REPRESENTATIVES
FY 2014 Enacted $58,345,000
FY 2015 Admin. Request $59,386,000
FY 2015 Enacted $58,469,000
The Act provides $124,000 for newly-recognized tribes.
HEPATITIS B and HAEMOPHILUS
IMMUNIZATION (Hib) PROGRAMS IN ALASKA
FY 2014 Enacted $1,826,000
FY 2015 Admin. Request $1,855,000
FY 2015 Enacted $1,826,000
The Budget Justification noted a need for data sharing agreements with tribal partners in order to access screening test results.
URBAN INDIAN HEALTH
FY 2014 Enacted $40,729,000
FY 2015 Admin. Request $41,375,000
FY 2015 Enacted $43,604,000
The Act provides $2.7 million above the FY 2014 level and $2.2 million above the requested level.
INDIAN HEALTH PROFESSIONS
FY 2014 Enacted $33,466,000
FY 2015 Admin. Request $38,466,000
FY 2015 Enacted $48,342,000
The Act provides $14 million over the FY 2014 enacted level which consists of: 1) restoration of the $5 million taken from the program in FY 2014 in order to meet CSC needs; 2) a $4.8 million transfer of loan repayment funding from the Hospitals and Clinics line item, thus consolidating loan repayment funds in one line item; and 3) a $5 million program increase.
Programs funded under Indian Health Professions are: Health Professions Preparatory and Pre-Graduate Scholarships; Health Professions Scholarships; Extern Program ; Loan Repayment Program; Quentin N. Burdick American Indians Into Nursing Program; Indians Into Medicine Program; and American Indians into Psychology.
Proposal to Exempt Scholarship and Loan Repayment Programs from Federal Taxes. The Administration proposed, as in past years, to make the IHS Health Professions Scholarship Program and Loan Repayment Program tax-exempt, thus freeing up funding now used to pay taxes on these benefits. The House Committee agreed that such legislation should be enacted, noting that 25 percent of the Loan Repayment funds go to pay federal tax liabilities and that in FY 2013 over 500 loan repayment applicants were turned away due to limited funds. The House Committee suggests that the cost of such legislation might be offset by private collections:
The Committee encourages efforts to extend fair tax treatment of Federal scholarship and loan repayment programs to IHS-funded programs so that appropriated funds can help more applicants and further reduce vacancies. To that end, the Committee notes that IHS collected $85.3 million from private insurers in fiscal year 2013, which suggests that increased costs to the government to hire more IHS professionals by fairly adjusting the tax code are at least partially offset by private collections as a result of services provided by those newly-hired professionals. The Committee encourages IHS to re-submit its legislative proposal with the fiscal year 2016 budget and to include defensible estimate of offsets via third party collections. (H. Rept. 113-551, p. 87)
Use of Defaulted Funds. The Act continues the provision that allows funds collected on defaults from the Loan Repayment and Health Professions Scholarship programs to be used to recruit health professionals for Indian communities:
Provided further, That the amounts collected by the Federal Government as authorized by sections 104 and 108 of the Indian Health Care Improvement Act (25 U.S.C. 1613a and 1616a) during the preceding fiscal year for breach of contracts shall be deposited to the Fund authorized by section 108A of the Act (25 U.S.C. 1616a-1) and shall remain available until expended and, notwithstanding section 108A(c) of the Act (25 U.S.C. 1616a-1(c)), funds shall be available to make new awards under the loan repayment and scholarship programs under sections 104 and 108 of the Act (25 U.S.C. 1613a and 1616a).
TRIBAL MANAGEMENT
FY 2014 Enacted $1,442,000
FY 2015 Admin. Request $2,442,000
FY 2015 Enacted $2,442,000
The Act restores the $1 million taken from the program in FY 2014 in order to meet CSC needs.
Funding is for new and continuation grants for the purpose of evaluating the feasibility of contracting the IHS programs, developing tribal management capabilities, and evaluating health services. Funding priorities are, in order, 1) tribes that have received federal recognition or restoration within the past five years; 2) tribes/tribal organizations that are addressing audit material weaknesses; and 3) all other tribes/tribal organizations.
DIRECT OPERATIONS
FY 2014 Enacted $67,894,000
FY 2015 Admin. Request $68,065,000
FY 2015 Enacted $68,065,000
The Act provides $171,000 for newly-recognized tribes.
The IHS states in its budget submission that 56.5 percent of the Direct Operations budget would go to Headquarters and 43.5 percent to the 12 Area Offices. Tribal Shares funding for Title I contracts and Title V compacts are also included.
SELF-GOVERNANCE
FY 2014 Enacted $4,727,000
FY 2015 Admin. Request $5,727,000
FY 2015 Enacted $5,727,000
The Act restores the $1 million taken from the program in FY 2014 in order to meet CSC needs.
The Self-Governance budget supports implementation of the IHS Tribal Self-Governance Program including funding required for Tribal Shares; oversight of the IHS Director’s Agency Lead negotiators; technical assistance on tribal consultation activities; analysis of Indian Health Care Improvement Act new authorities; and funding to support the activities of the IHS Director’s Tribal Self-Governance Advisory Committee.
The IHS estimated in its budget justification that in FY 2015, $1.6 billion will be transferred to tribes to support 89 ISDEAA Title V compacts and 114 funding agreements.
CONTRACT SUPPORT COSTS
FY 2014 Enacted $587,376,000
FY 2015 Admin. Request $617,205,000
FY 2015 Enacted $662,970,000
The Act does not place a cap on CSC spending. The House and Senate Committees recommend $617,205,000 for IHS and $246,000,000 for BIA, the amounts requested by the Administration. However, as the situation became clearer regarding the amount that would be needed to fully fund CSC in FY 2015, the IHS notified Congress that $45 million more would be needed. Congress in the FY 2015 Consolidated Funding Act included the additional $45 million for CSC. The House Report states that should those amounts be insufficient, the agencies are to submit a reprogramming request. The House Report reads as follows:
The Committee recommendation includes $617,205,000 as requested for full funding of the estimated contract support costs. The Committee expects IHS to submit a reprogramming request to the Committee if the final calculated contract support costs exceed this amount, in order to ensure that contract support costs are fully paid. The Committee recognizes that inconsistencies exist between Indian Affairs and IHS in the ways that contract support costs are estimated and managed, and encourages both the agencies and the Tribes to recommend ways that the Committee can be helpful in promoting consistency. Tribes that exercise their self-determination rights and enter into contracts with multiple Federal agencies shouldn’t have to navigate inconsistent rules across different agencies. (H. Rept. 113-551, p. 87)
The BIA report language is substantively the same except for the recommended amount.
The Act, as requested by the Administration, provides that the only amounts available for CSC are the sums appropriated under the Services account, and, on the Interior side, the Operation of Indian Programs account. It also states that no FY 2014 or FY 2015 CSC funds may be used by the IHS or the BIA to pay prior year CSC or to repay the Judgment Fund for payment of judgments or settlements related to past-year CSC claims. For contract support costs, FY 2015, the bills provide (Section 406 regarding FY 2014 is comparable):
Sec. 407. Amounts provided by this Act for fiscal year 2015 under the headings “Department of Health and Human Services, Indian Health Service, Indian Health Services” and “Department of the Interior, Bureau of Indian Affairs and Bureau of Indian Education, Operation of Indian Programs” are the only amounts available for contract support costs arising out of self-determination or self-governance contracts, grants, compacts, or annual funding agreements for fiscal year 2015 with the Bureau of Indian Affairs or the Indian Health Service: Provided, That such amounts provided by this Act are not available for payment of claims for contract support costs for prior years, or for repayments of payments for settlements or judgments awarding contract support costs for prior years.
The Act, consistent with the Interior appropriations acts for FYs 1999-2014, attempts to limit the ability of the IHS and BIA to fund past-year shortfalls in CSC funding from remaining unobligated balances for those fiscal years. This provision has been included in the appropriations acts for many years and has not precluded recovery on past-year CSC claims.
Sec. 405. Notwithstanding any other provision of law, amounts appropriated to or otherwise designated in committee reports for the Bureau of Indian Affairs and the Indian Health Service by Public Laws 103-138, 103-332, 104-134, 104-208, 105-83, 105-277, 106-113, 106-291, 107-63, 108-7, 108-108, 108-447, 109-54, 109-289, division B and Continuing Appropriations Resolution, 2007 (division B of Public Law 109-289, as amended by Public Law 110-5 and 110-28), Public Laws 110-92, 110-116, 110-137, 110-149, 110-161, 110-329, 111-6, 111-8 and 111-88, 112-10, 112-74 and 113-6 for payments for contract support costs associated with self-determination or self-governance contracts, grants, compacts, or annual funding agreements with the Bureau of Indian Affairs or the Indian Health Service as funded by such Acts, are the total amounts available for fiscal years 1994 through 2013 for such purposes, except that for the Bureau of Indian Affairs, tribes and tribal organizations may use their tribal priority allocations for unmet contract support costs of ongoing contracts, grants, self-governance compacts or annual funding agreements.
FUNDING FOR INDIAN HEALTH FACILITIES
FY 2014 Enacted $451,673,000
FY 2015 Admin. Request $461,995,000
FY 2015 Enacted $460,234,000
MAINTENANCE AND IMPROVEMENT
FY 2014 Enacted $53,614,000
FY 2015 Admin. Request $53,614,000
FY 2015 Enacted $53,614,000
Maintenance and Improvement (M&I) funds are provided to Area Offices for distribution to projects in their regions. Funding is for the following purposes: 1) routine maintenance;
2) M&I Projects to reduce the backlog of maintenance; 3) environmental compliance; and
4) demolition of vacant or obsolete health care facilities. Of the funding requested, $50.1 million would be allocated to sustain the condition of federal and tribal healthcare facilities buildings;
$3 million for environmental compliance projects; and $500,000 for demolition projects.
FACILITIES AND ENVIRONMENTAL HEALTH SUPPORT
FY 2014 Enacted $211,051,000
FY 2015 Admin. Request $220,585,000
FY 2015 Enacted $219,612,000
The Act includes $8.5 million for staffing of new facilities and $67,000 for newly-recognized tribes.
MEDICAL EQUIPMENT
FY 2014 Enacted $22,537,000
FY 2015 Admin. Request $23,325,000
FY 2015 Enacted $22,537,000
The Administration’s request was to to distribute the FY 2015 funds as follows: $17.3 million for new and routine replacement medical equipment at over 1,500 federally- and tribally-operated health care facilities; $5 million for new medical equipment in tribally-constructed health care facilities; and $500,000 each for the TRANSAM and ambulance programs.
CONSTRUCTION
Construction of Sanitation Facilities
FY 2014 Enacted $79,423,000
FY 2015 Admin. Request $79,423,000
FY 2015 Enacted $79,423,000
Four types of sanitation facilities projects are funded by the IHS: 1) projects to serve new or like-new housing; 2) projects to serve existing homes; 3) special projects such as studies, training, or other needs related to sanitation facilities construction; and 4) emergency projects. The IHS sanitation facilities construction funds cannot be used to provide sanitation facilities in HUD-built homes.
The IHS proposed in its budget justification to distribute up to $48 million to the Area Offices for prioritized projects to serve existing homes; up to $5 million for projects to clean up and replace open dumps on Indian lands; and $2 million would be reserved at IHS Headquarters ($1 million for special projects and emergency needs; $500,000 to collect homeowner data and demographic information in three of the IHS Areas; and $500,000 for improving data collection systems to help fund a Water Resource Center to develop teaching materials and techniques for homeowners and communities to support usage in a way that promotes health). The Water Resource Center is in partnership with the Alaska Native Tribal Health Consortium whose funding stream began in FY 2012 with $250,000 and is expected to be funded for five years through FY 2016.
Remaining funding will be for new and like-new homes, including sanitation facilities for homes of the disabled or sick with a physician referral, with priority for BIA Housing Improvement Projects.
Construction of Health Care Facilities
FY 2014 Enacted $85,048,000
FY 2015 Admin. Request $85,048,000
FY 2015 Enacted $85,048,000
The FY 2015 IHS health facility construction is as follows:
• Kayenta Health Center in Kayenta, AZ – $18,869,000 to complete construction of the health care facility and staff quarters
• Northern California Regional Youth Treatment Center in Davis, CA – $17,161,000 for site preparation and to begin and complete construction of the treatment center
• Fort Yuma Health Center in Winterhaven, CA – $46,292,000 to begin and complete construction of the replacement health center which received design funding in 2008
• Gila River Southeast Health Center in Chandler, AZ – $2,726,000, to continue construction of the health center which received design funding in 2008 and initial construction funds in 2009.
OTHER
TRANSAM Equipment, Ambulances, Demolition Fund. The Act continues language to provide up to $500,000 to purchase TRANSAM equipment from the Department of Defense, $500,000 to be deposited in a Demolition Fund to be used for the demolition of vacant and obsolete federal buildings, and up to $2.7 million for the purchase of ambulances.
If we may provide additional information or assistance regarding FY 2015 Indian Health Service appropriations, please contact us at the information below.
