J Kauffman

Document Type



This report consists of the findings of the Rural Indian Health Roundtable (RT) held on September 27-28, 1990, in Washington, D.C. The purpose of the roundtable was to bring together experts in the fields of health care, community development, tribal governance, academia, and policy to chart pathways for enabling tribal governments to become providers of rural health services. The roundtable participants addressed the level of ownership at the community level including input and control in the governance of the programs. The report contains a section that lists the chronology of mandates that the Indian Health Service (IHS) acts under in providing health care for the American Indian and Alaska Native (AI/AN) population. The mandates include the Indian Self-Determination Act of 1975 and its 1988 amendments intended to reinstate local control and responsibility to AI/AN populations. The meeting topics ranged from inadequate health care for rural communities, the depletion of resources, lack of funding, escalating costs of services, and recommendations. The report describes how good health care has been developed through activism and persistence at the community level. Recommendations include re-examining programs and services to make them more responsive to the needs and priorities of AI/AN communities. Furthermore, Congress, the IHS, and tribes should support the process of consensus building in tribal communities and make other traditional forms of decision-making a contemporary part of the IHS and tribal government relations, including blending governance with community development.

Publication Date



Indian Health Service, Staff Office of Planning, Evaluation, and Research, Rockville, MD 20857 (RT-02).