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The California Rural Indian Health Board, Inc. (CRIHB) was founded and incorporated in 1969 by a consortium of nine California Indian Tribes to advocate for the return of federal health care services to the American Indian population of California. Those services had been withdrawn in the 1950's as part of the federal policy of termination that resulted in the loss of federal tribal status to numerous small tribes. Through the efforts of this organization two decades of shameful neglect of Indian health problems was brought to an end.

As stated in the corporate bylaws "This corporation is formed to provide a central focal point in the Indian health field in California for planning, advocacy, funding, training, technical assistance, coordination, fund-raising, education, development and for the purpose of promoting unity and formulating common policy on Indian health care issues."

CRIHB is currently sanctioned by 31 tribes to operate under the Indian Self-Determination Act (P.L. 93-638 seq.) as a Tribal Organization for the purpose of contracting with the Indian Health Service for the provision of Headquarters and Area Office Functions. Twenty tribes authorize the CRIHB/IHS to contract for comprehensive health care services.

CRIHB began with nine reservation projects that were funded in 1968 by the State of California's Department of Health, Education and Welfare (DHEW), Bureau of Maternal and Child Health as a Demonstration Project. The original funding was $245,000.

In 1970 CRIHB was incorporated as the California Rural Indian Health Board, Inc.

The original founding reservation projects were:

1. Hoopa Reservation Health Project
2. Modoc County Indian Health Project
3. Round Valley Reservation Health Project

4. Lake County Indian Health Project

5. Tuolumne Rancheria Health Project

6. Tule River Reservation Health Project

7. Owens Valley Health Project

8. Morongo/Soboba Health Project

9. Pala Reservation Health Project

From those nine projects CRIHB expanded its membership to seventeen tribal organizations by 1977.

1. Central Valley Indian Health Project
2. Hoopa Reservation Health Project
3. Indian Health Council
4. Clearlake Indian Health Project

5. Mendocino County Indian Health Project
6. Modoc County Indian Health Project
7. Northern Sierra Indian Health Project
8. Pi Ma Pa Indian Health Project

9. Riverside San Bernardino County Indian Health Project
10. Round Valley Reservation Health Project

11. Shasta-Siskiyou-Trinity Rural Indian Health Project

12. Sonoma County Indian Health Project

13. Tri-County Indian Health Project
14. Tule River Indian Health Center

15. Tuolumne Indian Health Project
16. Northern Valley Indian Health Project
17. United Indian Health Services

The DHEW grant with California's State Dept. of Health lasted for one and a half years. The CRIHB grant was converted to a contract which was administered by the Public Health Service from 1971 to 1978. In 1978 the program was transferred to the Indian Health Service due to Public Law 93-638.

Public Law 93-638
93rd Congress, S.1017
January 4, 1975


An Act
To provide maximum Indian participation in the government and education of the Indian people; to provide for the full participation of Indian tribes in programs and services conducted by the Federal government for Indians and to encourage the development of human resources of the Indian people; to establish a program of assistance to upgrade Indian education; to support the right of Indian citizens to control their own educational activities; and for other purposes.
(Signed into law by President Nixon)

CRIHB desired to contract under P.L. 93-638 in order to benefit from the contracting provisions that were much more advantageous than contracting under the Buy Indian Act.

Therefore, CRIHB initiated a planning process facilitated by Urban and Rural Systems Associates (URSA) of San Francisco. The Plan was completed and adopted by the Board in 1978. At that time, the CRIHB Board of Directors chose to pursue the option that would one day result in CRIHB becoming the Area Office in California. At the time this vote was taken, all tribal health programs operating in California were members of CRIHB.

Soon after the plan called for CRIHB to adopt two kinds of membership, funded and non-funded, in order to continue a relationship with those tribal programs that were considering withdrawing from CRIHB in order to contract directly with the IHS under P.L. 93-638.

CRIHB's initial proposal to contract under P.L. 93-638 was denied by the IHS. CRIHB sued the IHS and finally was deemed eligible to contract as a tribal organization.

One of the stipulations that CRIHB was required to implement prior to approval of the P.L. 93-638 contract was a reconfiguration of the Board of Directors. All CRIHB board members were required to be members of federally recognized tribes (not necessarily from California). There were several "Indians of California" on the Board at the time that resigned their positions so that a federally recognized Indian person from their local program could take their place and make CRIHB eligible.

The 80's brought a tremendous amount of change to CRIHB and to the IHS in California.

  • As a direct result of the Rincon Law Suit the Area Office grew from a small program office to a full-blown Area Office.
  • Tribal health programs expanded - no longer limited to only the "Hospitals & Clinics" line item.
  • Amendments to the Indian Health Care Improvement Act were favorable to California and allowed increased growth in programs and funding.
  • The 1988 amendments to P.L. 93-638 included references to tribes contracting for all of the programs established for the benefit of Indians including administrative functions.
  • The 1992 amendments further strengthened the rights of tribes to self-determination through the contracting process, and included provisions for the tribal self-governance program.
  • The technical amendments of 1994 further clarified the tribes' rights to contract/compact and to participate in the rulemaking process.
  • The increased level of contracting between 1992 - 1995 caused IHS to begin to seriously plan for the restructuring and downsizing of the IHS at the Headquarters, Area Office and Service Unit levels.
  • In 1995 CRIHB entered into its first Contract and Annual Funding Agreement (AFA) for area office functions. The three-year contract expired in September 1998 and was renewed for another three years.
  • In 1998 CRIHB contracted for certain Headquarters shares.

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