Document Type



The extent of rural isolation and lack of mobility affects a majority of Indian families and individuals living in outlying areas such as the Blackfeet Indian Reservation. The purpose of the study is to review the patient transportation system at each Service Unit within the Indian Health Service (IHS) Billings Area and develop and present various alternatives for providing the most efficient and effective transportation system to those Indian people seeking and obtaining health care at IHS facilities or referrals to contract health service facilities.This study conducted mileage surveys to get exact information for better transportation. In addition, the interview method was used to find out exactly what type of health transportation was provided to the people on the Blackfeet Reservation. Interviews were conducted with the following programs: 1) Blackfeet Community Health Representatives; 2) Glacier County Welfare Department; 3) Bureau of Indian Affairs Social Services Department; 4) Office of Native American Programs; 5) Emergency Medical Services; 6) Blackfeet Tribal Police Department; 7) Blackfeet Family Health Services; 8) Blackfeet Alcoholism Program; 9) Blackfeet Community Services; 10) Indian Health Services; 11) Blackfeet Senior Citizens\' Center; and 12) Blackfeet Home Health Care.The findings of the study are as follows: 1) transportation problems faced by the rural elderly are particularly severe; 2) primary roads that traverse the Reservation are two-lane highways suffering from various states of disrepair, and contribute to a relative high incidence of traffic fatalities; 3) secondary roads on the Reservation create the major problems for intra-reservation traffic. They are generally unpaved, yet the sections that are paved suffer from inadequate maintenance.This study made eight recommendations. They are: 1) interconnect the rural isolated areas on the Reservation with health and welfare delivery systems, manpower training, economic development and similar programs located in Browning, the urban ""hub"" of the Reservation; 2) conduct a study of actual costs for ambulance services; 3) locate an ambulance in each community with adequate staffing; 4) insure, for the benefit of the economically disadvantaged, handicapped, and elderly people, effective utilization of a rural transportation system throughout the Reservation; 5) establish and maintain an adequate communication system; 6) increase the mobility of those persons in outlying rural communities who do not have reasonable access to alternative forms of transportation and who are often deprived of mobility where public transportation is adequate or non-existent; 7) encourage the various programs that provide transportation or social services to develop a coordinated approach to the organization and financing of public transportation; and 8) correct relevant economic information needed for future decisions regarding national programs for rural transportation.

Publication Date



Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-20).