The Bemidji Area Indian Health Service serves 29 tribes within the three state area (Michigan, Minnesota and Wisconsin) and there are a total of 13 service units. The Area also encompasses five urban programs (Detroit, MI, Chicago, IL, Minneapolis, MN, Green Bay and Milwaukee, WI). The largest tribe is Chippewa, but there are also Menominee, Oneida, Mohican, Winnebago, Ottawa, Potawatomi and Sioux Tribes. Tvo additional tribal groups are in the process of requesting federal recognition. The Bemidji Area has the following types of facilities: The two hospitals (Cass Lake, MN and Red Lake, MN) are essentially o short-stay recuperative nature with по obstetrical deliveries surgical services provided. The bed capacity at Cass Lake is 11 medical adult and 2 medical pediatric) while Red Lake has 23 beds medical adult, 9 medical pediatric and 4 obstetric). GOVERNANCE AND STRUCTURE Consensus Statement Indian Health Service Roundtable Health Care Reform-February 9-10, 1994 . New opportunities should be provided for inter-tribal collaborative. arrangements and American Indian/AN practitioners to work independent of Indian Health Service to meet the needs of tribal government under National Health Care Reform. A policy statement is needed to reinforce cultural appropriate health delivery in I/T/U systems of care. Governance: Based on treaty obligations, the intent of the federal government was to provide adequate and equal health care to American Indians and Alaska Natives and the right to exercise governance over the Indian Health Service and state-run programs responsible for health care programs to their American Indian and Alaska Native citizens. A National Board on Indian Health_is_recommended to establish authority over the Indian Health Service, composed of elected tribal officials overseeing finances, implementation of existing authorities, recruitment, retention, research and other federal and state Health Care Reform efforts. This Beard will seek representation on the National Health Board under the Health Security Act. The states shall not exercise jurisdiction over the delivery of Indian Health Care unless mutually agreed upon under a government-to-government relationship. Structure: Budget reductions are contradicting the intent of the Health Care Reform and violating the treaty obligations of the federal government for which there is overwhelming opposition by tribal government. Health Care Reform should not be considered in a climate of budget reductions. Rather, Health Care Reform should be developed with the resources necessary to provide for the highest quality of health care in American Indian/AN Communities. Specific Recommendations: 1. Current staffing and budget cuts slated for the IHS in Fiscal Years 1994 and 1995, severely undermines I/T/U stability, structure and ability to move into health care reform. The Roundtable participants felt strongly that the staffing and budget cuts to IHS is a violation of stated federal policy, a violation of Indian treaties and inconsistent with the stated goals of health care reform. Staffing cuts in IHS are |