President Proposes 1.8% Increase for Indian Health Service
Fiscal Year 1999 Budget

(Washington, D.C.) -- The Fiscal Year (FY) 1999 Budget Request for the Department of Health and Human Services (HHS) is $380.8 billion, an increase of $21.7 billion, or 6 percent, over the comparable FY 1998 amount. The discretionary portion of the HHS budget totals $38 billion in budget authority, a 6.8% increase over the FY 1998 budget authority.

Indian Health Service (IHS) Summary: The President’s FY 1999 budget proposal for the IHS is $2.5 billion, representing a 1.8% increase, or $44 million, in program level spending over the FY 1998 budget. The IHS budget represents 0.6% of the HHS budget and 6.6% of the HHS discretionary budget. The increase represents $19 million in additional budget funding, an increase of 0.9% over FY 1998 levels, and a proposed increase of $25 million (for a total of $323 million) in reimbursement collections from private insurance of eligible recipients and collections from Medicare and Medicaid.

The $19 million budget authority represents a net gain of $3 million in health services and $16 million in facilities construction:

Services -- Increases and reductions in this category result in a net gain of $3 million. The treatment and prevention of cervical and breast cancer will be increased by $5 million. This will provide access to breast and cervical cancer screening services for an additional 60,000 American Indian and Alaska Native women. There will be an additional $9 million funding level for alcohol and substance abuse to expand efforts at changing communities that will complement current programs that focus on treatment and prevention of individuals. The community efforts will emphasize community development, parenting skills, and community programs primarily for women and children. To allow for the additional funding levels for the health efforts related to breast and cervical cancer and alcohol and substance abuse, there will be approximately $10 million in reductions from other clinical services accounts. The focus on breast and cervical cancer and substance abuse prevention and treatment is part of the HHS initiative to reduce racial disparities in health outcomes. In addition, within the appropriation is a redistribution of approximately $1 million from services to facilities.

Facilities Construction -- A proposed increase of $25 million for facilities construction will be used to begin replacement of the 60-year-old hospital in Fort Defiance, Arizona, and to support the second year of construction on the Hopi outpatient facility, the replacement facility for the Keams Canyon Hospital. The proposed increase is achieved with $16 million in new funding and redistributing $9 million from other facilities accounts. There will be a postponing of $5 million in sanitation construction projects and a $4 million reduction in maintenance and improvement projects and in acquisition of modular dental units.

The IHS provides a comprehensive health care program to 1.5 million American Indians and Alaska Natives who are members of more than 550 Federally recognized tribes through a workforce of approximately 14,400 and an additional tribal and urban Indian health workforce of approximately 10,000. Annually, there are about 90,000 hospital admissions, 6.5 million ambulatory medical visits, 690,000 public health nursing visits, 3.9 million community health representative client contacts, and 2.4 million dental services. Unlike other minority populations, American Indians and Alaska Natives have a special and unique government to government relationship as a result of treaties, laws, Supreme Court decisions, and Executive Orders.

NOTE TO EDITORS: A copy of this release, and additional information can be found on the IHS website (http://www.ihs.gov). A copy of Secretary Shalala’s remarks at the 2/2/98 press conference on the FY 1999 HHS Budget Proposal and a copy of the HHS Department FY 1999 Budget document is available on the HHS website (http://www.hhs.gov).