Ninth Circuit Dismisses Quechan Tribe's Case Regarding IHS Standard of Health Care

In an unpublished memorandum opinion in Quechan Tribe of the Fort Yuma Indian Reservation v. U.S., et al., the Ninth Circuit Court of Appeals holds that the United States does not have a statutory, common law, or constitutional duty to meet a specific standard of adequate medical care at an Indian Health Service (IHS) facility, and that the Court cannot compel IHS to maintain the facility safely.

This case began when the Quechan Tribe (Tribe) filed a complaint against the IHS, alleging that it violated certain duties that it owes the Tribe when it provided inadequate medical care at the Fort Yuma Service Unit (Unit). The complaint was based on the Tribe’s allegations that the Unit’s facilities are the oldest in the IHS system, are in a condition of disrepair, and create unsafe conditions for tribal members seeking care. In the complaint, the Tribe alleges that the United States has a duty to meet a specific standard of adequate medical care based on (1) the federal-tribal trust relationship, and (2) two federal statutes, the Snyder Act and the Indian Health Care Improvement Act. The Court held that the federal-tribal trust relationship does not, in itself, create a judicially enforceable duty, because the “trust obligations of the United States to the Indian tribes are established and governed by statute rather than the common law.” Additionally, the Court held that neither the Snyder Act nor the Indian Health Care Improvement Act contains sufficient trust-creating language on which to base a judicially enforceable duty because both statutes “speak about Indian health only in general terms,” and “neither requires the United States to provide a specific standard of medical care.”

The Tribe also argued that the Court should issue an order compelling IHS to maintain and operate the Unit safely, and to allocate additional funds to the Unit. The Court noted that it cannot compel IHS to maintain the Unit because there is no specific, statutory command requiring IHS to do so, and it also cannot compel IHS to allocate greater funding to the Unit, because IHS’s allocation is committed at its discretion.

Although the Court ultimately dismissed the case, it emphasized “that we appreciate the Tribe’s commitment to ensuring adequate healthcare for its members, and we acknowledge the challenges faced by the Tribe in ensuring such care. However, the solution lies in Congress and the executive branch, not the courts.”

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