Skip Navigation

U.S. Flag

Print Print   Download Reader Download   Text Enlarge text size Reduce text size Normal text size

Indian Health Service 30-Day Report to Congress, General Plan for Expenditure of Recovery Act Funds

Introduction

This Report to Congress is prompted by language in the American Recovery and Reinvestment Act of 2009 (“ARRA”) in the Interior General Provisions, Title VII, Section 701, as follows:

“Sec. 701. (a) Within 30 days of enactment of this Act, each agency receiving funds under this title shall submit a general plan for the expenditure of such funds to the House and Senate Committees on Appropriations.”

The following information is presented in response to the requirement outlined in part (a), above.

Summary

A total of $500 million was provided to the Indian Health Service in ARRA for Services ($85 million) to fund health information technology activities, and for Facilities ($415 million) to fund construction and sanitation projects, as well as deferred maintenance projects and the purchase of equipment. These activities are presented in the five areas funded by the Act: Health Information Technology ($85 million), Sanitation Facilities Construction ($68 million), Health Care Facilities Construction ($227 million), Maintenance & Improvement ($100 million) and Equipment ($20 million.)

Health Information Technology ($85 million)

Activities to be Funded: The purpose of this funding, as specified in the ARRA, is for health information technology activities, including telehealth services development and infrastructure requirements, to be allocated at the discretion of the IHS Director. IHS will fund activities based upon the IHS mission to improve access, quality, safety and overall health status of American Indian/Alaska Native patients and populations.

Activities to be funded with this investment include the following:

  1. HIT (Resource and Patient Management System -RPMS) application development and enhancements
    • RPMS Electronic Health Record (EHR) Modernization
    • Personal Health Record
    • Population Health Application Enhancements
    • Practice Management System Acquisition
    • RPMS Architecture Enhancements
  2. HIT and telehealth infrastructure and development
    • Security Enhancements
    • Network upgrades

Distribution of Funds and Timeline: Approximately 95% of these activities will be carried out through commercial contracts and may also be carried out under a P.L. 93-638 contracts with a Tribe or Tribal organization. IHS will use up to 5% of the ARRA funds for administrative costs related to these activities.

Approximately 20% of the funds will be used for hardware acquisition for the purpose of infrastructure modernization relating to security, networking, communications, and health information technology. These purchases will be completed through new contracts competed among vendors offering products that meet the government’s requirements.

In addition, a number of new acquisitions are anticipated for software development and related services. These new acquisitions will also be awarded via appropriate contract vehicles, as well as through existing Tribal contracts as appropriate. The Indian Health Service has several existing GSA competitively awarded contract vehicles that will be accelerated to accommodate the immediate opportunity afforded by the ARRA funding.

IHS anticipates that it will obligate approximately 60% of the funds in FY 2009 and 40% in FY 2010.

Sanitation Facilities Construction ($68 million)

Activities to be Funded: The FY 2009 ARRA funding of $68,000,000 for Sanitation Facilities Construction Projects will be used to provide essential sanitation services to AI/AN homes and will assist in reaching the IHS objective of increasing the number of AI/AN homes with potable water. Program design and activities will follow the current program structure of funding documented sanitation projects prioritized by level of need.

Distribution of Funds and Timeline: The existing Sanitation Deficiency System (SDS), which inventories the needed sanitation facilities projects, will be used with modifications to prioritize and select projects for the ARRA funding. SDS was modified for use in choosing ARRA projects that can be started and completed expeditiously by adding scope, completion of project development or master plan, and scheduling as scoring criteria, in addition to the standard scoring criteria based on health need, Tribal priority and capital cost. The majority of all SFC projects are constructed by Tribes, Tribal organizations, or Indian-owned construction firms. Projects are funded through execution of arrangements or agreements between the Tribe and IHS. SFC projects can be managed by the IHS directly (Direct Service) or they can be managed by Tribes that elect to use Title I or Title V authorization under P.L. 93-638, the Indian Self-Determination and Education Assistance Act. IHS will use up to 5% of the ARRA funds for administrative costs related to these projects.

IHS anticipates that it will obligate approximately 75% of the ARRA funds in FY 2009, and 25% in FY 2010.

Health Care Facilities Construction ($227 million)

Activities to be Funded: The $227 million provided in ARRA funds for the IHS Health Care Facilities Construction Program will allow the completion of two facilities. The priority facilities that will be constructed with ARRA funds will have completed drawings and initiated construction to complete construction as soon as possible. The facilities will be determined by language in statute requiring that the funds be used to complete up to two facilities from the current construction priority list for which work had already been initiated. One of the facilities that will be constructed with ARRA funds is located in Nome, Alaska.

Distribution of Funds and Timeline: In accordance with Congressional direction, both projects that will be selected will be on the health facilities construction priority list and under construction. Completion of facility construction for the Nome replacement facility will be implemented by direct Federal, open competition contract with respective applicable laws. IHS will use up to 5% of the ARRA funds for administrative costs related to these projects.

IHS anticipates that it will obligate approximately 75% of the ARRA funds in FY 2009, and 25% in FY 2010.

Maintenance & Improvement ($100 million)

Activities to be Funded: The ARRA funding of $100,000,000 will be used for infrastructure projects to improve the condition, fire-life safety, and efficiency of existing healthcare facilities and enhance energy conservation. IHS will invest in infrastructure projects to provide for economic benefit, advances in health care services, and improving the condition of existing infrastructure.

Distribution of Funds and Timeline: The ARRA funds will be distributed to the IHS Areas using a modification of existing methodologies and only those projects that receive priority ranking at the Area level will be funded. Infrastructure projects using the ARRA funds will be executed using a combination of federal construction contracts and P.L. 93-638 construction project agreements. The IHS Areas will select infrastructure projects based upon need and the requirements of ARRA in partnership with tribes and tribal organizations. IHS will use up to 5% of the ARRA funds for administrative costs related to these projects.

IHS anticipates that it will obligate approximately 75% of the ARRA funds in FY 2009, and 25% in FY 2010.

Equipment ($20 million)

Activities to be Funded: The purpose of this funding, as specified in the ARRA, is for the purchase of equipment. IHS will use the funds to purchase equipment based on health care needs in all Areas. IHS is identifying these activities based upon the IHS mission to improve access, quality, safety and overall health status of American Indian/Alaska Native patients and populations.

Distribution of Funds and Timeline: IHS plans to distribute the majority of funds to IHS and Tribal health care facilities, on a priority basis, for the acquisition of medical equipment. The funds would be distributed to each IHS Area using the equipment replacement formula used for normal annual distribution of appropriated funds for equipment replacement. The distribution will be modified slightly for the ARRA by excluding locations receiving a new facility in which they will be receiving equipment funding as part of the new construction budget; in addition, IHS also anticipates spending a portion of the funds to support the ambulance needs for 84 tribal and IHS emergency medical services (EMS) programs. GSA and IHS support approximately 175 of these ambulances nationwide. The ARRA funds will be used to replace ambulances that have exceeded the GSA-mandated life span of ten years or 100,000 miles. IHS will use up to 5% of the ARRA funds for administrative costs related to these projects.

IHS anticipates that it will obligate approximately 75% of the ARRA funds in FY 2009, and 25% in FY 2010.