Valuable Indian Health Service Resources

Jeremy Parmley, MPH, MPAS, AE-C, PA-C

We recently spoke with U.S. Public Health Service Commissioned Corps Commander and Indian Health Service (IHS) Chief Clinical Consultant for PAs, Jeremy Parmley, MPH, MPAS, AE-C, PA-C, about IHS PA opportunities, loan repayment resources, and more. Check out our conversation to learn how your students can get involved.

Tell us about your work with Indian Health Service.

As a United States Public Health Service Commissioned Officer, I’ve worked at three different Indian Health Service sites over the last 16 years. All three of my IHS sites were in New Mexico, so I’ve had the opportunity to work with several different tribes. I’ve seen different cultures and customs, and I’ve seen firsthand the health disparities facing rural and Native communities. It has shaped my worldview.

For many people in rural communities, by the time they come in for care, their need has progressed past when someone might usually come in because they didn’t have access to the care they needed. Geographical disparity is very real. A lot of times, the roads are not paved. When it snows or rains, roads can be impassable for days. No electricity can cause medical problems for people who need to keep their insulin and other medications cold.

As the chief clinical consultant for PAs, I serve as a resource and advocate for all IHS PAs. At last count, 102 PAs were working for IHS. Right now, I’m working on addressing pay disparities and working to ensure all IHS PAs have the autonomy they need working in remote locations with a limited number of providers. We want it to be as rewarding as possible for PAs to come and work with us.

What are some of the critical services IHS provides?

IHS has 26 full-size hospitals, 53 health centers, 150 Alaska Village clinics, and 30 health stations to serve 574 federally recognized tribes in 37 states, for a total of 2.56 million beneficiaries. In 2018, there were 41,000 inpatient visits and 13.8 million outpatient visits. From what I’ve seen in my 16 years of IHS service, they do an excellent job with the resources they have.

Tell us about the need for high-quality health care in Native communities.

When thinking about the health needs of Native communities, it’s essential to understand the disparities facing Native peoples. The life expectancy for Native Americans is 73.7 years old, and for the general population, it’s 78.1. The injury mortality rate is 2.4 times higher than the national average. Access to adequate sanitation facilities is a big part of public health, and currently, 38,000 Native Americans, or 9.5%, don’t have access to adequate sanitation facilities. And 7,100, or 1.8% of Native Americans, don’t have access to safe drinking water, almost double the general population. IHS also has environmental health employees implementing initiatives that monitor and investigate injuries and diseases to identify and correct the hazards that may have led to them. Native communities need top-quality care – they deserve that care.

What are some of the opportunities available to PAs working at IHS?

Many PAs serve as clinical directors or chief of staff at their medical facilities. Anything you could think of as a medical professional, you can do as a PA in the IHS. PAs really have opportunities to serve as leaders here.

How can PA programs build relationships with clinics and encourage students toward working with IHS?

The US Public Health Service has a JR and SR Commissioned Officer Student Training and Extern (COSTEP) program. In these programs, you are commissioned officers that are paid and accruing years of service while in school. These programs help many providers get hands-on exposure that are interested in public health service. Beyond that, so many facilities around the country have student rotations. We encourage any student to contact any facility they’re interested in doing a rotation at. They can find the numbers and email addresses on the website.

Learn more about loan repayment opportunities available below:

  1. National Health Service Corps loan repayment: $30,000 or 50,000 per 2-year commitment – 
  2. IHS loan repayment: $20,000/year (w/taxes paid) for initial 2-year commitment w/option for 1 year renewals – 
  3. Some states have loan repayment: ex: New Mexico: $50-70,000 (w/taxes paid) per 2 year commitment –

Find other IHS and US Public Health Service resource links below:

Commissioned Corps of the U.S. Public Health Service: