The Indian Health Service (IHS) serves as a federal health program for American Indians and Alaska Natives. As an agency within the U.S. Department of Health and Human Services, it provides a comprehensive health service delivery system for approximately 2.6 million people. The organization is organized into various areas and service units to manage its mission of providing access to quality health care.
Leadership within the IHS Great Plains Area is headed by an area director. In 2019, James Driving Hawk was appointed as the director for this area. Driving Hawk, an enrolled member of the Rosebud Sioux Tribe, holds a Bachelor of Science degree in Business Administration from Cardinal Stritch University. According to a 2019 press release, Driving Hawk brings expertise in business office operations, healthcare administration, financial management, tribal budget consultation, and purchased/referred care. The Great Plains Area provides services to more than 130,000 American Indian people across 17 tribes in South Dakota, Nebraska, Iowa, and North Dakota. This area encompasses 19 service units, which include 10 health centers and seven hospitals.
To support tribal sovereignty, the IHS administers cooperative agreements through the Office of Tribal Self-Governance. These annual awards assist tribes and tribal organizations with the necessary planning and preparation to assume responsibility for providing health care to their members through the Tribal Self-Governance Program. These agreements are categorized into two types: Planning Cooperative Agreements and Negotiation Cooperative Agreements. Planning agreements assist tribes with the planning phase, which includes budgetary research, internal tribal government planning, legal research, and organization preparation related to administering health care programs. Negotiation agreements assist tribes by defraying costs related to conducting and preparing for self-governance program negotiations.
Several specialized divisions support the agency's mission. The Division of Planning, Evaluation, and Research (DPER) coordinates agency strategic planning and aligns these efforts with budgeting, performance reporting, and program integrity activities. This division leads health planning efforts, including support for facilities and staff plans, and collaborates with Tribal Planning Officers. DPER also supports the use of data and evidence in management decision-making and supports national health research, including research related to the delivery of care and health problems affecting American Indian and Alaska Native people.
The Office of Environmental Health and Engineering (OEHE) works to support the IHS mission by providing technical and financial assistance to Alaska Native communities and Indian tribes. The OEHE aims to promote a healthy environment through the continuous operation of safe waste, wastewater, and water systems. This office is composed of five divisions that provide support to the 12 IHS Areas, many tribal programs, all IHS service units, and IHS Headquarters. The Division of Facilities Planning Construction (DFPC) manages the design, planning, and construction of new health care delivery space and major modernization of existing space. It also manages the construction of personnel quarters to ensure staff housing is available. The Division of Facilities Operations (DFO) maintains an inventory of space and maintenance deficiencies in health care facilities and manages existing facilities to keep them in a safe, usable condition. Additionally, the Division of Sanitation Facilities Construction (DSFC) provides environmental engineering assistance with sanitary surveys and utility master plans.
What this means for Fort Duchesne
For the people of Fort Duchesne, the Indian Health Service operates as a massive federal framework designed to support tribal self-governance. Through various divisions and cooperative agreements, the agency works to provide essential health care, manage facility construction, and maintain sanitary and environmental standards to ensure quality care for American Indians and Alaska Natives.
