James Whittier Parker: “my amendment strikes onerous language in the bill which dramatically alters current law as it relates to Indian health…”

“my amendment strikes onerous language in the bill which dramatically alters current law as it relates to Indian health services. The Indian Health Service was established to provide direct health care to Indian tribes by providing hospitals, clinics and health professionals on reservations. Initially these health services were provided and operated directly by the Indian Health Service, which continues to do so on many reservations. However, in the early 1970s during the 93rd Congress, Congress passed legislation allowing tribes direct operation of their health services under contract with IHS if they wanted to do so and were able to comply with the terms of the statute. Public Law 93-638 provided further that those tribes exercising this contracting option would be entitled to the same compensation for contract support costs that IHS would receive were the agency providing direct service, costs which the agency would no longer incur. This all worked relatively well for a while with a number of tribes taking over direct operation of their health services and receiving funding to offset their contract support costs although most tribes never received the full funding to which they were entitled. In recent years with the growth of tribal self-governance and self-determination, more and more tribes began to contract for direct operation of their health services.”