Things worth writing down.
Explainers on the parts of tribal health contracting and after-hours care that are badly documented elsewhere. Written from public sources, cited, and reviewed by our clinical director where the content is clinical.
Purchased/Referred Care
How a nurse line protects your PRC budget
PRC is appropriated annually and it runs out. What avoidable ER visits actually cost you, and how to size diversion honestly.
Read →What is Purchased/Referred Care?
Eligibility, payer of last resort, notification deadlines, and medical priority: the four conditions outsiders miss.
Read →Reducing avoidable ER visits in Indian Country
What the evidence supports, what vendor marketing overstates, and how to model it defensibly.
Read →Federal contracting
ISBEE vs IEE: which applies?
One test apart: whether you also meet the SBA size standard for the solicitation's NAICS code.
Read →The Buy Indian Act in plain language
25 U.S.C. § 47, the 2022 IHS final rule, and how a requirement actually reaches the market.
Read →For contracting officers
Capability summary, NAICS codes, and recent nurse advice line procurement by IHS Area.
Read →Clinical practice
What culturally competent means on a triage call
Household structure, understated pain, distance as a clinical variable, and how to evaluate a vendor's claim.
Read →After-hours coverage for UIOs
Urban Indian Organizations serve most of the AI/AN population and have no PRC backstop. What that changes.
Read →Nurse advice line by IHS Area
All twelve Areas, the states each covers, and where procurement has been active.
Read →Something we should write about?
If there is a question your program keeps having to answer from scratch, tell us. The useful pieces here started as somebody's question.