Abstract
The 2018–9 partial government shutdown created a 35-day gap in federal appropriations for the Indian Health Service and tribal health programs. With ongoing challenges for American Indian and Alaska Native health systems, including clinician shortages and poor health outcomes, the funding gap engendered substantial health risks. Other federal health systems have been sheltered from this and past shutdowns through receiving their appropriations in advance. Several approaches exist to implementing advance appropriations, including instituting advance appropriations across Bureau of Indian Affairs and Indian Health Service programs; or by moving Indian Health Service funding to the same appropriation as the Department of Health and Human Services. Furthermore, building and strengthening health partnerships with non-federal institutions, such as academic medical centers, may help distribute financial risk and strengthen care systems.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 75-80 |
| Number of pages | 6 |
| Journal | Journal of health care for the poor and underserved |
| Volume | 31 |
| Issue number | 1 |
| DOIs | |
| State | Published - Feb 2020 |
| Externally published | Yes |
Keywords
- Alaska Native
- American Indian
- Indian Health Service
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health