Proposal for Replacement of Indian Health Service Hospital

The Indian Health Service (IHS) and the Cherokee Tribe jointly proposed to replace the W.W. Hastings Hospital operated by IHS with a new facility adjacent to the city hospital at Tahlequah, Oklahoma. The IHS program document for the replacement of the W.W. Hastings Hospital was deficient in several respects. It did not: (1) contain sufficient planning for the integration of Indian and non-Indian health needs provided at the Tahlequah Community Hospital; (2) calculate the number of acute care hospital beds and amount of square footage in accordance with planning methods approved by the Department of Health, Education, and Welfare; or (3) develop the justification for and facility requirements of the training and educational programs which the tribe had planned. A review of the IHS hospital construction program identified weaknesses in program planning. The IHS method of planning for acute care hospital beds does not recognize the downward trend in IHS hospital usage; if IHS proceeds as planned, its hospitals will contain too many beds. Appropriations for IHS hospital planning and construction should not be made until IHS adjusts its method for planning hospital capacity and size to recognize the downward trend in hospital use and the availability of existing community facilities.