A change in position by Indian Health Service (IHS), announced on Jan. 23, 2012, means that chiropractors are now included as a priority profession in the IHS Loan Repayment Program.
The mission of the Indian Health Service, an agency of U.S. Department of Health and Human Services created in 1979, is to elevate the health status of American Indian and Alaska Natives (AI/AN) to the highest possible level. Despite concerted and sustained efforts by IHS and tribal programs, substantial disparities in health persist for AI/AN compared to the overall U.S. population. Despite these health disparities, since 2004, IHS has maintained a position of "no demand, no need" for chiropractic and other complementary health professions. [See "The 'No Demand, No Need' Policy of Indian Health Service Against Doctors of Chiropractic," April 9, 2011 issue of DC, for background information.]
As reported in my original article, the student loan repayment program is managed by 15 discipline chiefs, with 22 occupations included in a list of needed professions. The article quoted Michael Berryhill, physician recruiter and professional contact at IHS, who offered this explanation for why chiropractic has not been included in the program in previous years:
"The Indian Health Service Loan Repayment Program (IHSLRP) annually consults with Indian tribes, tribal organizations, Urban Indian Health Organizations, and the various health facilities operated by the IHS to determine their staffing needs. Beginning in fiscal year (FY) 2004 and continuing through FY 2010, chiropractic medicine was not identified as one of the needed professions for which priority would be given for the IHSLRP; thus, it was eliminated from the list of eligible professions."
An annual survey is sent to more than 800 IHS facilities, tribal health centers and urban Indian health centers to identify priority ratings of the 22 health professions using high, medium or low scores. This survey pertains to the relative needs of the American Indian / Alaska Natives health profession provider loan repayment program and satisfies the requirements of Section 104(b)(1) of the Indian Health Care Improvement Act.
In the 2010 survey, chiropractic and other complementary health professions were not included. The American Indian Alaska Native Doctors of Chiropractic (AIANDC) argued that alternative and complementary health care providers are included in the Indian Health Care Improvement Act and should be included in the survey. The 2011 survey was identical to the 2010 survey with one exception: it included a cover letter that provided a list of additional professions – including chiropractors – that could be handwritten on blank spaces on the form. The 2012 survey will include chiropractic along with the other added priority disciplines.
Jacqueline Santiago, chief of the IHS loan repayment program, has indicated that FY 2012 applications will be accepted Feb. 17 – Aug. 17 or until funds are expended. With an estimated funding of $20 million last year, 701 loan repayment awards were issued; of these, 407 were for new applicants and 294 were for extensions of projects already funded.
Best funding opportunities exist for American Indian / Alaska Native doctors of chiropractic who are contracted full time in a clinical tribal health care facility, urban Indian health center or IHS facility. Applications are available on the IHS Loan Repayment Program Web page: www.ihs.gov/JobsCareerDevelop/DHPS/LRP/
To see the Federal Register announcement in its entirety, click here.
Dr. Gary Auerbach, founding president of the World Federation of Chiropractic, holds a graduate certificate in public health from the University of Arizona, Zuckerman College of Public Health. He is the administrator of the American Indian / Alaska Native Doctors of Chiropractic Ad-Hoc Committee. If you are an American Indian / Alaska Native DC in the U.S., visit www.aiandc.org to learn more.