Nurse advice line coverage in the Billings Area.
The Billings Area covers Montana and Wyoming. TULQ provides 24/7 telephone nurse triage for the IHS service units, 638 tribal health programs, and Urban Indian Organizations that serve it.
The Billings Area serves the Crow, Northern Cheyenne, Blackfeet, Assiniboine, Gros Ventre, Sioux, Chippewa-Cree, Eastern Shoshone, and Northern Arapaho nations. Service populations are spread across some of the largest and least densely populated reservations in the country, where the nearest emergency department is frequently an hour or more away.
Facilities and programs in this Area
The Billings Area includes IHS-operated service units alongside tribally operated 638 programs and compacts. Illustrative facilities:
- Crow and Northern Cheyenne service units
- Blackfeet Community Hospital
- Fort Belknap and Fort Peck service units
- Wind River service unit
This is not a complete list. The Indian Health Service maintains the authoritative directory of Area facilities and service units, and tribally operated programs change hands between IHS and tribal operation over time.
What coverage looks like here
The service is the same everywhere: one number, answered any hour by a U.S. state-licensed registered nurse working Schmitt-Thompson telephone triage protocols, with the encounter documented and returned to the facility. What changes by Area is the context around it, how far the nearest emergency department is, what the winter looks like, whether the caller has reliable cellular service, and how the program is funded.
For IHS-operated service units, after-hours coverage is typically procured through the Area office and appears publicly on SAM.gov. For 638 programs and compacts, it is procured directly by the tribe or tribal organization, with no IHS solicitation required. Both paths are covered on our tribal health page.
Elsewhere in the system
All twelve IHS Areas
The full map: which states each Area covers and where nurse advice line procurement has been active.
Read →Built for Indian Country
Why a tribal health program's after-hours problem is not the same problem the mainstream vendors solve.
Read →Protecting the PRC budget
How avoidable emergency department use draws against a finite Purchased/Referred Care allocation.
Read →Sources
- Indian Health Service Area office and facility directories.
- SAM.gov contract opportunities, Indian Health Service notices.
- Indian Self-Determination and Education Assistance Act of 1975, P.L. 93-638 (25 U.S.C. § 5301).
Facility lists are illustrative, drawn from public IHS materials, and change over time as programs move between IHS and tribal operation. TULQ is launching in 2026; this page describes intended coverage, not past contract performance.
Coverage for the Billings Area.
Tell us which facility or program you are scoping and we will walk through what after-hours coverage would look like for that service population.