This relationship, established in 1787, is based on Article I, Section 8 of the Constitution, and has been given form and substance by numerous treaties, laws, Supreme Court decisions, and Executive Orders. The provision of health services to members of federally recognized tribes grew out of the special government-to-government relationship between the federal government and Indian tribes. It also provides support to students pursuing medical education to staff Indian health programs. Many tribes also operate their health systems independent of IHS. Several tribes are actively involved in IHS program implementation. Thirty-three urban Indian health projects supplement these facilities with various health and referral services. As of April 2017, the IHS consisted of 26 hospitals, 59 health centers, and 32 health stations.

The IHS provides health care in 37 states to approximately 2.2 million out of 3.7 million American Indians and Alaska Natives (AI/AN). IHS is the principal federal health care provider and health advocate for Indian people. IHS is responsible for providing direct medical and public health services to members of federally recognized Native American Tribes and Alaska Native people.

Department of Health and Human Services (HHS). The Indian Health Service ( IHS) is an operating division (OPDIV) within the U.S.

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