Rural Tribal Health – Resources
Selected recent or important resources focusing on Rural Tribal Health.
Tribal Water Infrastructure: Opportunities Exist to Improve Federal Assistance
Provides an overview of federal roles in tribal water infrastructure projects. Examines the extent to which the Indian Health Service (IHS) can fund water infrastructure for homes and buildings in a tribal community. Explores opportunities to streamline application processes and administrative requirements when IHS collaborates with other federal agencies. Describes the limited financial capacity some tribes have to operate and maintain their water infrastructure, and the potential effects of IHS providing financial assistance for these purposes. Presents recommendations for Congress and federal agencies, including the U.S. Department of Agriculture (USDA) and the Environmental Protection Agency (EPA).
Additional links: Full Report
Date: 09/2026
Sponsoring organization: Government Accountability Office
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Provides an overview of federal roles in tribal water infrastructure projects. Examines the extent to which the Indian Health Service (IHS) can fund water infrastructure for homes and buildings in a tribal community. Explores opportunities to streamline application processes and administrative requirements when IHS collaborates with other federal agencies. Describes the limited financial capacity some tribes have to operate and maintain their water infrastructure, and the potential effects of IHS providing financial assistance for these purposes. Presents recommendations for Congress and federal agencies, including the U.S. Department of Agriculture (USDA) and the Environmental Protection Agency (EPA).
Additional links: Full Report
Date: 09/2026
Sponsoring organization: Government Accountability Office
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The IHS Navajo Area Office's Internal Controls for Awarding, Monitoring, and Reporting Sanitation Facilities Construction Projects Could Be Improved
Examines how the Navajo Area Indian Health Service (NAIHS) administered funds it received under the Infrastructure Investment and Jobs Act for 187 IHS Sanitation Facilities Construction (SFC) Program projects between fiscal years 2022 and 2024. Describes the NAIHS internal controls for awarding, monitoring, and reporting SFC Program projects, and whether NAIHS followed these controls.
Additional links: Report Highlights
Date: 09/2026
Sponsoring organization: Office of Inspector General (HHS)
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Examines how the Navajo Area Indian Health Service (NAIHS) administered funds it received under the Infrastructure Investment and Jobs Act for 187 IHS Sanitation Facilities Construction (SFC) Program projects between fiscal years 2022 and 2024. Describes the NAIHS internal controls for awarding, monitoring, and reporting SFC Program projects, and whether NAIHS followed these controls.
Additional links: Report Highlights
Date: 09/2026
Sponsoring organization: Office of Inspector General (HHS)
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Snapshot of Indian Health Service Sanitation Facilities Construction Projects Funded Under the Infrastructure Investment and Jobs Act
Describes how the Indian Health Service (IHS) used funds it received under the Infrastructure Investment and Jobs Act for the IHS Sanitation Facilities Construction (SFC) Program between fiscal years 2022 and 2025. Identifies challenges that IHS faced to administer SFC Program projects and actions taken by IHS Area Offices and tribes to address those challenges.
Additional links: Report Highlights
Date: 09/2026
Sponsoring organization: Office of Inspector General (HHS)
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Describes how the Indian Health Service (IHS) used funds it received under the Infrastructure Investment and Jobs Act for the IHS Sanitation Facilities Construction (SFC) Program between fiscal years 2022 and 2025. Identifies challenges that IHS faced to administer SFC Program projects and actions taken by IHS Area Offices and tribes to address those challenges.
Additional links: Report Highlights
Date: 09/2026
Sponsoring organization: Office of Inspector General (HHS)
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Recovery Is Possible: Continuity of Care from Incarceration to Community, with Kelsea O'Leary
An episode of the Exploring Rural Health podcast featuring Kelsea O'Leary, Behavioral Health Program Manager for the Choctaw Nation of Oklahoma. Focuses on strategies used to facilitate continuity of care for justice-involved tribal citizens in recovery as they transition to post-incarceration life. Part 3 in a 3-part series featuring the 2026 Rural Communities Opioid Response Program (RCORP) Innovation Tank finalists, with Choctaw Nation of Oklahoma's work winning second place.
Date: 08/2026
Sponsoring organization: Rural Health Information Hub
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An episode of the Exploring Rural Health podcast featuring Kelsea O'Leary, Behavioral Health Program Manager for the Choctaw Nation of Oklahoma. Focuses on strategies used to facilitate continuity of care for justice-involved tribal citizens in recovery as they transition to post-incarceration life. Part 3 in a 3-part series featuring the 2026 Rural Communities Opioid Response Program (RCORP) Innovation Tank finalists, with Choctaw Nation of Oklahoma's work winning second place.
Date: 08/2026
Sponsoring organization: Rural Health Information Hub
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Tribal Health, Medicaid, and Child Welfare: Supporting Behavioral Health and Traditional Healing
A 3-part series that discusses the collaboration of tribal health, Medicaid, and child welfare systems and the subsequent benefits for Native American and Alaska Native children and families. Includes examples on how to integrate traditional healing practices into behavioral health services.
Author(s): Anne Smithey, Jahira Sterling, Ruby Goyal-Carkeek
Date: 05/2026
Sponsoring organization: Center for Health Care Strategies
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A 3-part series that discusses the collaboration of tribal health, Medicaid, and child welfare systems and the subsequent benefits for Native American and Alaska Native children and families. Includes examples on how to integrate traditional healing practices into behavioral health services.
Author(s): Anne Smithey, Jahira Sterling, Ruby Goyal-Carkeek
Date: 05/2026
Sponsoring organization: Center for Health Care Strategies
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Rural/Urban Differences among American Indian/Alaska Native Peoples in Health Care Access and Outcomes, 2019–2023
Compares health outcomes and healthcare utilization metrics for American Indian and Alaska Native (AI/AN) rural and urban residents using 2019-2023 National Health Interview Survey (NHIS) data. Discusses the impact of various sociodemographic factors and the Indian Health Service (IHS) on study findings.
Author(s): Katy Backes Kozhimannil, Hailey A. Baker, Julia D. Interrante, Kyle X. Hill, Melissa L. Walls
Citation: Journal of Community Health, 51, 232-239
Date: 04/2026
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Compares health outcomes and healthcare utilization metrics for American Indian and Alaska Native (AI/AN) rural and urban residents using 2019-2023 National Health Interview Survey (NHIS) data. Discusses the impact of various sociodemographic factors and the Indian Health Service (IHS) on study findings.
Author(s): Katy Backes Kozhimannil, Hailey A. Baker, Julia D. Interrante, Kyle X. Hill, Melissa L. Walls
Citation: Journal of Community Health, 51, 232-239
Date: 04/2026
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Fourteen of Thirty Selected Indian Health Service and Rural Providers Did Not Comply or May Not Have Complied With Terms and Conditions and Federal Requirements for Expending Provider Relief Fund Payments
Examines whether 30 selected Indian Health Service (IHS) and rural providers that received Provider Relief Fund (PRF) payments spent funds in accordance with Federal and program requirements. Describes unallowable and potentially unallowable expenditures and inaccurately calculated or unsupported lost revenues and their causes. Presents recommendations for the Health Resources and Services Administration (HRSA) and HRSA's response.
Additional links: Report Highlights
Date: 02/2026
Sponsoring organization: Office of Inspector General (HHS)
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Examines whether 30 selected Indian Health Service (IHS) and rural providers that received Provider Relief Fund (PRF) payments spent funds in accordance with Federal and program requirements. Describes unallowable and potentially unallowable expenditures and inaccurately calculated or unsupported lost revenues and their causes. Presents recommendations for the Health Resources and Services Administration (HRSA) and HRSA's response.
Additional links: Report Highlights
Date: 02/2026
Sponsoring organization: Office of Inspector General (HHS)
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Update to the Payment for Historically Excepted Tribal Federally Qualified Health Centers (FQHCs) for Calendar Year (CY) 2026
Provides an overview of updates to the historically excepted Tribal Federally Qualified Health Center (FQHC) Prospective Payment System (PPS) rate for calendar year 2026.
Date: 02/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides an overview of updates to the historically excepted Tribal Federally Qualified Health Center (FQHC) Prospective Payment System (PPS) rate for calendar year 2026.
Date: 02/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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2026 Heart Disease & Stroke Statistical Update Fact Sheet: American Indian/Alaska Natives & Cardiovascular Diseases
Reports statistics on cardiovascular disease, coronary heart disease, stroke, and high blood pressure among American Indians and Alaska Natives. Includes data on smoking, physical inactivity, and diabetes.
Date: 02/2026
Sponsoring organization: American Heart Association
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Reports statistics on cardiovascular disease, coronary heart disease, stroke, and high blood pressure among American Indians and Alaska Natives. Includes data on smoking, physical inactivity, and diabetes.
Date: 02/2026
Sponsoring organization: American Heart Association
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Purchased/Referred Care and Cancer: Overview and Options for Tribal Consideration
Describes the Purchased/Referred Care (PRC) program of the Indian Health Service (IHS) and discusses how it functions in the cancer care pathways for Oklahoma tribal communities. Offers recommendations to tribal leaders for working with and alongside the program to improve health outcomes while supporting self-determination. Recommendations discuss tribal governance, collaborations, service delivery models, care coordination, and engaging with federal policymakers.
Author(s): Grace Fox
Date: 01/2026
Sponsoring organization: Native Nations Center for Tribal Policy Research
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Describes the Purchased/Referred Care (PRC) program of the Indian Health Service (IHS) and discusses how it functions in the cancer care pathways for Oklahoma tribal communities. Offers recommendations to tribal leaders for working with and alongside the program to improve health outcomes while supporting self-determination. Recommendations discuss tribal governance, collaborations, service delivery models, care coordination, and engaging with federal policymakers.
Author(s): Grace Fox
Date: 01/2026
Sponsoring organization: Native Nations Center for Tribal Policy Research
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