The Crow Service Unit, the Indian Health Service hospital in Crow Agency, is in a budget crunch, but steps are being taken to deal with the problem.
Some services are being scaled back and efforts are under way to boost revenues to make sure the year ends in the black, an IHS spokeswoman said.
Charlene Johnson, supervisory program management officer, couldn't name the exact amount the deficit, but said its cause is multifaceted.
"The Indian Health Service is currently funded at a little over half the need," Johnson said.
Although the IHS has gotten regular budget increases, she said, those increases have not kept up with medical inflation or with the needs of the growing population.
"For example, we may have received a 1 percent increase in the budget, but the medical inflation has been 10 percent," Johnson said. "The ability to purchase the same service (as) the year before has decreased significantly."
The result of that is money often runs low months before the Oct. 1 start of the new budget year, and the situation has worsened over the years, Johnson said.
One piece of good news could be President Obama's decision to recommend a 13 percent increase in the IHS budget for the new budget year, but it's up to Congress to approve that amount.
"This is the largest increase in the budget in approximately 20 years," Johnson said. "This will certainly help in alleviating the financial situation."
To deal with the current budget shortfall, some of the contract care services, in which outside specialists come to Crow Agency to meet with patients, has been cut. There has also been a push to collect more third-party payments, from Medicare, Medicaid and private insurance companies.
When the Crow Service Agency isn't able to treat a particular medical problem, patients are able to go out of system to get the care and the IHS hospital will pick up the tab through its Contract Health Services program. But that funding is limited, and participants must meet strict tribal and geographical criteria to qualify.
To cut costs, criteria for the services people can seek outside the hospital have tightened even more, to include only emergencies "resulting in the loss of life, limb or eye," Johnson said.
If those people who qualify for the Contract Health Services program also have private insurance, Medicaid or Medicare, that insurance must kick in before the CHS insurance does.
No employees have been laid off and no part of the Crow Agency hospital has been closed, she said. And contrary to one rumor, janitorial services have not been cut back.