Nurse advice line coverage in the Portland Area.
The Portland Area covers Washington, Oregon, and Idaho. TULQ provides 24/7 telephone nurse triage for the IHS service units, 638 tribal health programs, and Urban Indian Organizations that serve it.
The Portland Area serves more than forty federally recognized tribes across the Pacific Northwest, most of them operating their own health programs under 638 contracts or compacts. It is also where TULQ's own name comes from, tultxʷ, the Lushootseed word for the confluence of the Tolt and Snoqualmie rivers, in western Washington.
Facilities and programs in this Area
The Portland Area includes IHS-operated service units alongside tribally operated 638 programs and compacts. Illustrative facilities:
- Yakama Indian Health Center, Toppenish WA
- Warm Springs Health & Wellness Center, Oregon
- Colville and Nez Perce tribal health programs
- Puget Sound and coastal tribal clinics
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.
Recent procurement activity
The Yakama Indian Health Center in Toppenish, Washington solicited a “24 Hour Nurse Advice Line” under RFQ 75H71325Q00030, structured as a base year plus four option years.
Notably, that requirement was set aside for Women-Owned Small Business rather than under the Buy Indian Act, under NAICS 621111: a useful reminder that the Buy Indian preference is applied acquisition by acquisition, not automatically across an Area.
These notices are matters of public record and are summarized here as context. A Sources Sought notice is market research, not a commitment to solicit or award, and notices are routinely amended or superseded. Work from the current posting. More for contracting officers.
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 Portland 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.