Indian Health Service Case Study
CASE
Indian Health Service:
7
Creating a Climate for Change
“As an enrolled member of the Laguna Pueblo in New Mexico,
I am a member of the Sun Clan and have the name of my great grandfather, Osara, meaning ‘the sun’,” Dr. Michael Trujillo told the United States Senate Committee on Indian Affairs in
1994 during his confirmation hearing as Director of the Indian
Health Service (see Exhibit 7/1). He told the committee that he had known the remoteness of Neah Bay at the northwest tip of
Washington on the Makah reservation, lived in the Dakotas, and experienced the winters and geographic barriers to health care in
Eagle Butte, Rosebud, and Twin Buttes. He had come before them, he also told them, “as the President’s nominee for …show more content…
He emphatically stated that “During my tenure, there is going to be continued emphasis throughout the agency and in our interactions with other health partners for complete recognition of the Indian self-determination process.”
Dr. Trujillo knew that self-determination was far from complete. Although
IHS still had many important functions to fulfill, putting health care back into the hands of the tribes was proving to be difficult. Each tribe had different concepts of health, and it was difficult to accommodate such variety in a government agency. Moreover, in the face of scarce resources there was always an inclination to centralize rather than decentralize decision making, and Dr.
Trujillo knew that if the IHS created the impression that it could fulfill all the needs of local communities, it would contribute to false expectations and disappointment. Historical Perspective
IHS had a clear mandate: to provide high-quality health services to American
Indians and Alaska Natives (AI/ANs). The basis for this responsibility was established and confirmed by numerous treaties, statutes, and executive orders. The
Indian Health Service:
7
Creating a Climate for Change
“As an enrolled member of the Laguna Pueblo in New Mexico,
I am a member of the Sun Clan and have the name of my great grandfather, Osara, meaning ‘the sun’,” Dr. Michael Trujillo told the United States Senate Committee on Indian Affairs in
1994 during his confirmation hearing as Director of the Indian
Health Service (see Exhibit 7/1). He told the committee that he had known the remoteness of Neah Bay at the northwest tip of
Washington on the Makah reservation, lived in the Dakotas, and experienced the winters and geographic barriers to health care in
Eagle Butte, Rosebud, and Twin Buttes. He had come before them, he also told them, “as the President’s nominee for …show more content…
He emphatically stated that “During my tenure, there is going to be continued emphasis throughout the agency and in our interactions with other health partners for complete recognition of the Indian self-determination process.”
Dr. Trujillo knew that self-determination was far from complete. Although
IHS still had many important functions to fulfill, putting health care back into the hands of the tribes was proving to be difficult. Each tribe had different concepts of health, and it was difficult to accommodate such variety in a government agency. Moreover, in the face of scarce resources there was always an inclination to centralize rather than decentralize decision making, and Dr.
Trujillo knew that if the IHS created the impression that it could fulfill all the needs of local communities, it would contribute to false expectations and disappointment. Historical Perspective
IHS had a clear mandate: to provide high-quality health services to American
Indians and Alaska Natives (AI/ANs). The basis for this responsibility was established and confirmed by numerous treaties, statutes, and executive orders. The