Document Type



The Indian Health Service (IHS) was mandated by Congress in 1981 through H.R. 4035 to assess the performance of alcoholism projects and determine the effectiveness of the American Indialaska Native alcoholism programs funded under the authority of P.L. 96-537, ""The Indian Health Care Improvement Act."" The purpose of this study was to determine the effectiveness of the American Indialaska Native Alcoholism Service Programs funded under the authority of P.L. 96-537. The IHS was directed to evaluate all existing alcoholism projects in order to redirect funds to those projects of greatest merit. The evaluation was a comparative assessment of the alcoholism projects. The data presented in this study are the evaluation findings from 125 Indian alcoholism programs determined by IHS, subject to the Congressional mandate. The evaluation was implemented by sending questionnaires to each unit. The evaluation criteria had been field tested and modified on several occasions and evolved into the present evaluation instrument for alcoholism programs. The criteria was designed so that several management components, and the patient service process, can be scored individually, as well as provide a composite score for the total program; i.e.: 1) evaluation of administrative structure; 2) case management; and 3) treatment or service project. Indian alcoholism programs are valuable service providers and serve a major health need among Indian people. Approximately 95% of the programs exceeded the minimum standard of compliance to the performance criteria. As a result of the study, the following generalizations about the Indian alcoholism programs can be made: 1) programs rated in the Class A category (very high compliance) offered more than one type of service and over half provided both residential and outpatient components; 2) only two Class A programs offered all the program service components rated by the evaluation instrument; 3) Class B programs tended to principally stress residential care; 4) Class C programs generally had no residential care; and 5) residential care was not provided by any of the Class E programs. A complete description of each project, along with recognition of its common strengths and weaknesses, was also found. Sound administrative structures and high quality care provided to clients were apparent, but individualized aftercare treatment was regarded as needing improvement. This study has been the first attempt to obtain a comprehensive performance assessment of the alcoholism programs supported by IHS. Although the comparative assessment appears positive, it is not recommended that funding be cut. It is clear that IHS relies on Federal funding to continue its alcoholism services. IHS recommends a steadier balance of funds be utilized to address research, initiation of new and innovative programs, work toward prevention of alcohol abuse through educational programs, and technical assistance.

Publication Date



Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-42).