Photo: Councilman Appenay provides the Tribes’ comments
By MICHAEL STEELE, Policy Analyst
July 18, 2025
MINNEAPOLIS, Minn. – Councilman Ronald T. Appenay of the Fort Hall Business Council joined other Tribal leaders on July 15 during a consultation hosted by the Indian Health Service (IHS). Benjamin Smith, Acting Director of the IHS and member of the Navajo Nation, hosted the event seeking recommendations to realign the IHS to enable the delivery of, “…high-quality, accessible health care to American Indian and Alaska Native (AI/AN) communities.”
During opening remarks, Smith explained that the IHS is not exempt from decisions at the federal level, and that an increasing number of Tribes are moving towards self-governance. However, thanks to U.S. Department of. Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.’s commitment to Indian Country, the IHS has largely been exempt from federal cuts. Smith stressed that no decisions or actions have been made that would affect patient care. He further explained that since the IHS has not undergone any restructuring efforts in over 20 years, it must make efforts now to become more scalable and flexible to better serve Indian Country.
During his comments, Appenay explained:
“IHS must identify and include in the discussion all federal agencies and programs that have a role in health care for Tribal members.”
He emphasized that the IHS must maintain sufficient capacity to address the uniqueness of each Tribe to ensure all Tribal members receive the care and support they deserve. Appenay also suggested that funding be made available to expand IHS services, which would allow Purchased/Refer Care (PRC) funds to stay on reservations to expand services.
Appenay requested an update on the “PATH Electronic Health Record,” a medical records program desperately needed to replace IHS’ antiquated health record system. He also asked that IHS provide access to funding for records management. Appenay then addressed challenges Tribes face negotiating agreements with the IHS, and noted that centralizing or consolidating services is not the answer to improving services. He concluded his remarks by requesting that IHS address deferred maintenance and outdated medical equipment in its facilities.
Comments from other Tribes included the need to recognize traditional healing methods, reduce barriers to hiring employees, improve technical assistance to Tribes, and reduce bureaucratic procurement requirements. Additionally, several leaders emphasized that the IHS needs to hear Indian voices down to the patient level before making changes, and the IHS needs to look at private sector healthcare systems’ ideas for improvement.
Acting Director Smith concluded the consultation by sharing IHS’ commitment to transparency, citing Secretary Kennedy’s directive that changes within HHS should not require those affected being forced to file Freedom of Information Act (FOIA) requests to get answers. IHS’ plan for reorganization is due this fall.
(Michael Steele photos)