Indian Health · Research · Teaching · Professional Work
This site is a curated research archive of selected work from my career in Indian health. It focuses on how Indian health programs are financed, organized, measured, and understood—drawing on more than 25 years as a Tribal health director, policy analyst, and researcher with Tribes and Tribal organizations.
The core of the site is the Indian Health Financing series and related materials on Tribal health program management, data systems, and policy pathways. Teaching resources and practical tools are also included.
The Indian Health Financing Series is complete. Related analysis, teaching materials, and practical tools are added from time to time; the most recent are listed below. The site is offered as an open-access resource in service of Tribal Nations, primarily for Tribal leaders, health directors, program administrators, and specialized researchers.
Start here
Research Map: how the papers fit together, with reading paths.
Papers The Indian Health Financing Series, related papers, and the compiled bibliography.
Research Map A visual and thematic guide showing how the papers connect — by layer, by theme, and by recommended reading path.
Graphics Downloadable graphics from the research, organized by topic.
Managing Tribal Health Programs Practical materials drawn from experience managing Indian health programs, developing grant proposals, and working with health policy and administration.
Course A graduate-level course on Indian Health Finance, including lecture notes and instructional materials.
AI Sandbox Papers written mainly by AI on Indian health finance questions, each marked with an IHF-AI badge, with my occasional analysis.
This site is an archive of work developed over many years. Some materials are historical; others are intended to provide a framework for understanding current issues. All papers and technical reports are open-access for citation and academic research within Indian health.
Recent Updates
Hank Adams and the Policy Process (October 2026) Hank Adams’s work, traced through six stages of the policy cycle, from setting the agenda to implementation and evaluation. It is a study of how research, argument, and the trust of partners turn Tribal goals into policy. Go to the page →
Word Versions of the IHF Series (October 2026) All 19 papers in the Indian Health Financing Series can now be downloaded as Word documents as well as PDFs, for readers who want to quote, adapt, or excerpt them. Go to the Papers Index →
Data Tables (October 2026) American Community Survey (PUMS) tabulations on AI/AN health coverage, with key figures and downloadable spreadsheets. View the tables →
How the Papers Fit the Research Map
The papers in this archive represent different parts of a continuing examination of how Indian health care is financed, delivered, measured, and improved. The Indian Health Finance Research Map provides a framework for understanding the major areas of this research, while the Indian Health Finance Research Timeline shows how the work developed over four decades.
No claim is made that the author participated in the 1970s — his career in health began in the 1980s, and in Indian health in 1995.
This timeline shows the development of the research across more than four decades. The work evolved from participation in national policy and technical advisory efforts into a broader body of research examining Indian health financing, data, coverage, and health system performance.
The early work established a foundation in federal and Tribal health policy. Later research increasingly focused on Medicaid, Medicare, enrollment, data, and financing relationships — bringing together the policy experience and data work that inform the research presented on this site.
Is This Site for You?
This site is built primarily for Tribal leaders, health directors, program administrators, and Tribal health researchers and policy analysts working within Indian health systems; it is an academic and historical resource, not a source of current news, regulatory updates, clinical guidance, or active advocacy. See what this site does and does not cover →
Ask Dr. Fox
Have a question about this research? Ask Dr. Fox — the AI assistant in the bottom right corner of each page — for answers grounded in the papers themselves. It searches this site and the papers posted here, not the internet, and it updates daily as new material is added.
About the Author
I worked in Indian health as a Tribal health program administrator, a Tribal health director for the Port Gamble S’Klallam, Skokomish, and Squaxin Island Tribes. I worked for two leading Indian health organizations: in executive leadership and policy at the Northwest Portland Area Indian Health Board and from 2019 to 2023 as the Director of National Indian Health Board’s Data Project. The need to respond, with data, to the Covid crisis interrupted some of the work you see here. More about me →
