Summary

Pursuant to a congressional request, GAO obtained information on: (1) Indian Health Service (IHS) funding distribution methods and the funds allocated for fiscal year (FY) 1980 through FY 1990; (2) per-capita funding for the Oklahoma IHS area; and (3) the effect of IHS funding constraints on health services delivery in Oklahoma, with special attention to the Contract Health Services (CHS) program.

GAO found that: (1) IHS distributed its funding among its 12 service delivery areas based primarily on previous-year funding and rarely used needs-based methods; (2) total IHS funding increased from approximately $517 million in FY 1980 to about $1 billion in FY 1990, and Oklahoma's funding increased from $59.9 million to $131 million during that period; (3) increased needs-based funding for Oklahoma failed to increase its overall funding share; (4) per-capita funding for Oklahoma Indians was relatively low due to limited needs-based funding and the growing number of eligible Indians in the area; and (5) IHS service delivery was strained in Oklahoma due to substantial increases in demand for outpatient services and rationing of the CHS program.