"The Indian Health Service (Indian Health Services) does not use blood quantum to determine eligibility for its services. Instead, its regulations state that services will be made available to persons of Indian descent belonging to the Indian community served by the local facilities and program. However, individual tribes may use blood quantum to determine who belongs to the Indian community, and the Indian Health Services respects their determinations. Thus, a tribal determination to change blood quantum requirements would have an effect on the Indian Health Services program.

The Inter-Tribal Council of the Five Civilized Tribes has passed a resolution lowering the blood quantum requirements for health care services. However, it is the Indian Health Service's position that tribes determine their membership according to their respective constitution and laws, and that a resolution by the Inter-Tribal Council is effective only if permitted by the five tribes involved. In addition, the Indian Health Services believes that any change in tribal blood quantum requirements should be of general applicability, and not just for health services"