Indian Self-Determination Contracting: Effects of Individual CommunityContracting for Health Services in Alaska

摘要

Our review encompassed all Indian Health Services (IHS) contracts currently ineffect in Alaska under the provisions of the Indian Self-Determination Act, whether these contracts are with regional health organizations (RHOS) or with communities. We analyzed programs and services covered by each contract and compared costs and service availability. We conducted work on site at the IHS Alaska area office and the Alaska Native Health Board office in Anchorage and at IHS headquarters in Rockville, Maryland. To gain a better understanding of circumstances surrounding a recent IHS award of a large individual community contract in Ketchikan, we also conducted work there. We supplemented this information through interviews with officials from RHOS and Native communities. Our work was conducted from December 1997 through April 1998 in accordance with generally accepted government auditing standards.