History of Indian Health Service

4. History of Indian Health Service Agreement established in 1787 through treatise in the US Constitution A division of the US Dept Health and Human Services IHS was established in 1955 to take over health care of American Indian and Alaska natives from Bureau of Indian Affairs

5. IHS Work Force Has 15,000 Employees 2700 nurses 900 physicians 400 engineers 500 pharmacists And 300 dentists

6. Facilities 33 hospitals, 59 health centers, and 50 health stations Provide service to 1.9/2.2 millions 562 federally recognized tribes in 35 states $3.3 billion dollars budget

7. Facilities in Navajo Nation Federal: Chinle, Crownpoint, Gallup, Kayenta, Shiprock Tribal: 638 Sites: Fort Defiance, Tuba City, Winslow Hopi Health for Hopi Native Americans

10. What does FDA regulate? Drugs, biologics, medical devices, veterinary medicine, food, cosmetics Foreign assignments Vaccines

12. Health Resources and Services Administration (HRSA) It is the primary Federal agency responsible for improving access to health care service for people who are uninsured, isolated or medically vulnerable. Mission To improve health and achieve health equity through access to quality services, a skilled health workforce and innovative programs.

13. HRSA Bureaus and Offices • Bureau of Primary Health Care (BPHC) • Mission: to provide high quality, culturally competent primary health care services to underserved and vulnerable populations • Program serves as the health safety net for over 21 million people nationwide

14. The Medical Officer role within HRSA Medical Officers serve as senior public health analysts providing clinical oversight for a variety of programs within HRSA to provide program expertise and grantee assistance

15. Some Other Bureaus within HRSA HIV/ AIDs Bureau Bureau of Health Professions Bureau of Clinician Recruitment Maternal Child Health Bureau Office of Rural Health Policy

17. Central Intelligence Agency (CIA) Background: Created 1947 by President Truman via the National Security Act An independent agency responsible for providing national security intelligence to senor US policymakers Collects intelligence through human sources Correlates and evaluates intelligence related to national security Provides direction for and coordination of collection of intelligence outside the U.S.

18. CIA Mission: • Preempts threats and further US national security objectives by collecting intelligence that matters, producing objective all-source analysis, conducting effective covert action as directed by the President, and safeguarding the secrets that help keep our Nation safe. (CIA website)

19. CIA – Physician Opportunities • Provide medical care and advice to Agency employees, dependents, and assets • Positions available for overseas assignments • Requirements: • Board certified in Family medicine, Preventative Medicine, Internal Medicine, Pediatrics, Emergency Medicine, or Psychiatry

21. U.S. Department of State • Mission: • Shape and sustain a peaceful, prosperous, just, and democratic world and • Foster conditions for stability and progress for the benefit of the American people and people everywhere. • This mission is shared with the USAID, ensuring we have a common path forward in partnership as we invest in the shared security and prosperity that will ultimately better prepare us for the challenges of tomorrow. (U.S. Department of State website)

22. U.S. Department of State Physician Opportunities • Foreign Service Specialist • Provide important healthcare service at one of over 270 posts overseas, in Washington, D.C., or elsewhere in the U.S. • Access position openings from State Department website or USAJobs

24. National Institutes of Health (NIH) Headquarters in Bethesda, MD Funds medical research in universities and research institutions, domestically and internationally (extramural research) Conducts research in its own laboratories and the NIH Clinical Center, the largest hospital in the world dedicated to clinical research (intramural research)

25. National Institutes of Health (NIH) • Made up of 27 institutes and centers • Largest institutes (budget appropriations) • National Cancer Institute • National Institute of Allergy and Infectious Diseases • National Heart, Lung, and Blood Institute • National Institute of General Medical Sciences • National Institute of Diabetes and Digestive and Kidney Diseases • National Institute of Neurological Disorders and Stroke • National Institute of Mental Health • National Institute of Child Health and Human Development • National Institute on Aging

26. National Institutes of Health (NIH) • Roles of NIH Medical Officer (examples) • Administers extramural grants and contracts • Evaluates activities of funded investigators • Makes recommendations on the design, conduct, and monitoring of clinical trials and other studies • Directs clinical investigations and trials for the treatment of patients at the NIH Clinical Center

28. CDC History • Founded in Atlanta in 1946 as the “Communicable Disease Center” • Original mission: prevent malaria from spreading across the nation • CDC now = “Centers for Disease Control and Prevention” • Consists of >12 Centers, Institutes, & Offices • Address infectious disease, chronic disease, injuries, environmental health, occupational health, etc.

29. CDC Activities CDC works with partners around the country and world to: Prepare the US to respond to emergency health threats Investigate and stop deadly disease outbreaks Detect harmful germs rapidly in the US food supply Strengthen the quality, response and effectiveness of America’s laboratories Provide critical data that saves lives and protects people Put proven prevention strategies to work Provide life-saving vaccines

30. CDC Work Force • More than 15,000 employees in nearly 170 occupations • Most positions are located in Atlanta, but… • A few CIOs have positions in other areas (e.g., Washington DC area, Cincinnati) • Field staff assigned to all 50 states and more than 50 countries • Includes >900 Commissioned Corps Officers • >400 Medical Officers

31. CDC Epidemic Intelligence Service 2-year post-graduate training program of service and on-the-job learning for health professionals interested in the practice of applied epidemiology One of the main routes of entry to a career at CDC Accepts applications each year from May–August:http://www.cdc.gov/EIS/ApplyNow.html

38. What is the mission of the USPHS? To protect, promote and advance the health and safety of the nation

39. Where do USPHS officers serve? Practically every single Federal Agency Many countries around the world In practically every state of the nation

41. USPHS response to Ebola crisis 800 officers were deployed domestically and overseas in West Africa Main mission at the Monrovia Medical Unit (MMU) Training program to assist capacity building in Liberia

42. USPHS response to Ebola crisis Supporting investigation and infection control measures Sierra Leon on 19-MAR-2015 to support NIH trials Augmenting CDC staff with officers fluent in French in Guinea

43. USPHS response to Ebola crisis Quarantine Stations:  Corps is extending its mission support of Quarantine stations at the 5 entry airports at IAD, ATL, JFK, WEB, ORD.

44. CDRTang@gmail.com