JA Kauffman

Document Type



The purpose of this 1990 Indian Health Service (IHS), Urban Roundtable Table was to discuss and develop a consensus statement for each of the issues prepared for their review. The group elected to add the need to examine and foster state involvement in urban health care. The following issues were discussed by the participants: 1) expanding the database for Urban Health; 2) delivering services to non-Indians; 3) medical malpractice costs; 4) the New Federalism or contracting federal Indian funds to tribal governments; 5) patient billing systems; 6) state health care and assistance resources; and 7) unserved urban sites. The following items summarize the participants\' consensus statements. 1) The acknowledgement base for urban Indian health status and health care resources is lacking, although some urban health programs have conducted excellent need assessment and health planning documents. 2) IHS needs to address the unique service delivery model that has evolved through its urban program. When urban health programs supplement their IHS investment, they should not be penalized, for this resourcefulness. 3) The medical malpractice crisis is affecting urban health programs. Some insurance premiums have increased up to 500%. Many programs have had to discontinue services, and in some instances provide care without insurance. 4) Future assessments should focus on the growing trend toward tribal contracting of federal Indian dollars and the movement toward a ""New Federalism"" in the tribal-federal relationship. 5) Additional revenues are generated for urban health programs through the implementation of billing systems. Many of the resources utilized by urban programs require that they implement a sliding fee billing system. 6) States have a responsibility to provide assistance to communities in need of health and social services, including Indian populations within that state. 7) While the Indian Health Care Amendments Act of 1988 provided the IHS with the authority to fund ""new starts"" in unserved urban communities, no unserved communities have developed programs under this mechanism. The roundtable participants recommended: 1) a central gathering point for all studies done by or about Urban Indian Health Programs be made available at the IHS Headquarters; 2) roundtable participants should be reconvened to assess and evaluate the impact of the urban round table process, findings, and recommendations. 3) other issues including the Fetal Alcohol Syndrome and Fetal Alcohol Effect in urban populations needs to be assessed and support systems developed; 4) Acquired Immune Deficiency Syndrome poses a serious threat to urban Indians; 5) develop and disseminate material which describes the urban health program and answers basic questions about urban Indian health and the urban program; and 6) increase the number of headquarters staff and amount of IHS resources focused on the issue to urban Indian health. Accession # 9702161 Entry Date: 991105 Author(s): Handler A. Querec L. Title: Indian babies who die....a comparison with those who survive the first year of life. Institution Indian Health Service, Office of Planning, Evaluation, and Legislation, Rockville, Maryland 20857 Source: Indian Health Service, Staff Office of Planning, Evaluation, and Research. Rockville, Maryland 20857 Date: 1992 Document Type: Agency Publication Tribe/Alaska Native American Indian, Alaskan Native Geographic Region United States U.S. State USA Key Words Birth Weight; Cause of Death; Data Collection; Gestational Age; Infant Mortality; Infant Welfare; Maternal Age; Prenatal Care; Survival Analysis; Vital Statistics Abstract This report compares characteristics of Indian babies who die during the first year of life with those who survive that critical and highly vulnerable period. The report uses the linked birth/infant death data sets prepared by the National Center for Health Statistics (NCHS) for the years 1983 through 1986. Data from the linked file include various health and demographic characteristics of the infant and parents recorded on the birth certificate at the time of the birth of the child. The linked file is a better measure of Indian infant mortality because there is evidence that there is underreporting of Indian race on death certificates in certain geographic areas. The racial categorization in this report is based on the race of both parents as it is reported on the birth certificate. The report uses the Indian Heath Service (IHS) definition of Indian as an infant whose mother or father is reported as Indian. The term Indian as it is used here includes the American Indian and Alaskan Native population. This report is a second in a series prepared by HIS from the linked birth/infant death data set; the first was based on a 1983 file. Numerous charts and graphs showing the number and percent distribution of American Indian and Native Alaskan infant deaths are included in the report.

Publication Date



Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, Maryland 20857 (RT-01).