Document Type



The primary purpose of this study was to evaluate projects and programs that will assist the Indian Health Service (IHS) and Tribes in improving communication and administration of programs provided by both groups. This includes factors such as who should provide the services, what services should be provided, and how they should be provided. The scope of this program was the Billings Area Office, which is comprised of seven Indian Health Boards. A unit by unit evaluation of the costs and services provided, was performed in a managerial manner. Input from each of the seven Tribal boards was presented in a short narrative, along with tables and line item budget entries. Graphs were also provided to show how each of the seven tribes fared in terms of funding, services provided, expressed needs, and involvement by the Tribal board. For the seven Tribes served by the Billings Area Office, there was a lack of the following: 1) psychiatric foster and/or home care; 2) burn care unit; 3) chemical dependency unit; and 4) alcoholism out-patient or in-patient services. Funding and expenditures were not controlled by the Tribal Boards. The final observation addressed the reluctance of the Montana Indian Health Board to obtain new contractors or suppliers for the Tribal boards, totally ignoring the problems reported. The most effective board would be one consisting of community and Tribal members, ensuring a fair representation of the population. There is a need for an advocate with a background in contract health services to meet with IHS on a more equal basis. IHS must be more willing to open the books for evaluation by the Tribal boards. In addition, Indians should lobby Congress for more control of the monies allocated for Indian health care.

Publication Date



Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-45).