California Area Office

The Indian Health Service California Area Office provides the healthcare delivery system to the State of California, the home of the largest population of American Indians/Alaska Natives (AI/AN) in the country. According to the 2020 United States Census, California's Indian population was 631,016. The California Area IHS supports 104 of the 109 federally recognized tribes.

There are presently 34 California tribal health programs operating 102 ambulatory clinics and 62 dental clinics under the authority of the Indian Self Determination Act. IHS funds nine (9) urban health programs that operate under the authority of the Indian Health Care Improvement Act. In FY 2024 California tribal health programs had 199,589 registered users and 86,244 active users. Registered users are a cumulative total for all Indian patients ever seen at tribal facilities, and active users are those that have accessed care during the past three years.

None of the tribal facilities and programs currently operating in California originated as facilities previously operated by the IHS, as is the case in other IHS areas. Population sizes and dispersion of tribal groups in the California Area makes it unlikely that a traditional hospital with an emergency room and maternity care would be viable and accessible for California's Native population. However, other opportunities for expanding care for the Native people are being explored in a joint effort between California Area IHS and the 104 federally-recognized Tribes we serve.

Tribal programs will continue to rely on private and public hospitals to meet inpatient and emergency needs. Some tribal health program physicians have privileges at local hospitals and follow their patients through the local hospital system. Otherwise, the patients are referred to private physicians using Purchased/Referred Care (PRC) funding, as well as other alternate resources. Most programs have not developed laboratory, pharmacy or x-ray specialties, so these services are purchased from the private sector through PRC funding or other tribal resources.