Today, the Subcommittee on Indian and Insular Affairs held an oversight hearing about the need to modernize federal support of 638 contracting as part of the Indian Health Service. Subcommittee Chair Jeff Hurd (R-Colo.) issued the following statement in response:

“Self-governance works when the federal government provides the support tribes need to manage their own health programs. Right now, delays and inconsistent processes are creating unnecessary barriers. Today’s hearing focused on whether IHS’ realignment will address these challenges and strengthen the agency’s ability to support tribal self-determination across all Office Areas.”

Background

Contracting authorities provided under the Indian Self-Determination and Education Assistance Act (ISDEAA), commonly known as 638 contracting, support tribal health care delivery and promote self-governance in Indian communities.

For many tribes, the most significant barriers to 638 contract implementations are bureaucratic delays: slow contract amendments, uncertain review processes, and backlogs. The need for clarity, consistent processes, and timely responses increases as more tribes pursue 638 contracts and assume management of health programs.

Under the Trump administration, IHS is pursuing substantial agency realignment to improve consistency, reduce variation across Area Offices, and strengthen technical support in an effort to streamline processes, clarify roles, and better support tribes pursuing self-governance.