Understanding the Eastern Shoshone Tribe’s Joint Venture

September 1, 2026

In October of 2009, the Shoshone and Arapaho Joint Business Council applied to participate in the FY 2010 Indian Health Services Joint Venture. The Joint Venture construction program was awarded in 2014. In 2022, an agreement between both tribes was approved to split the Joint Venture to build two different facilities. Each tribe will proceed with its own facility project without having to obtain permission from the other.

Here are some planned project details:

  • Current staffing personnel: 129.8 vs Projected Staffing personnel: 260.5
  • Current funding from IHS: $8.5 million vs. projected staffing funding: $31 million annually for at least 20 years.
  • Current operation hours: Monday- Friday, 8- 5 (excluding most holidays) vs. projected operation hours: every day of the year from 7 am to 7 pm.
  • Existing Clinic size: 23,903 square feet vs. new clinic size: 93,614 square feet
  • The planned project is estimated to cost $116.4 million
  • Planned services: Primary Care, Adult Medicine, Pediatrics, OB/GYN, Alternative Medicine, Acupuncture, Chiropractic, Massage, Traditional Medicine, Telemedicine, Dental, Visiting Specialty Dental, Optometry, Visiting Podiatry, Visiting Other Medical and Surgical Care, Mental Health, Alcohol and Substance Abuse, Social Services, Case Management, Psychiatry/Tele-Psychiatry, Laboratory Services, Pharmacy, Diagnostic Imaging Radiography, Physical Therapy, Administration, Human Resources, Information Technology, Health Information Management, Business Office, Purchased/Referred Care (PRC), Security, Facility Management, Property and Supply, Education and Group Consultation, Public Facilities, Housekeeping and Linen, Employee Facilities, Health Education, Public Health Nursing/CHR, Public Health Nutrition, OEHE (Environmental Health), and Wellness Center​.
    • Additional services planned: Diabetes Program, Elder Services, Emergency Preparedness, Suicide Prevention, Tobacco and Cancer Program, and Tribal Transportation​

Why is this project so important? The Wind River Reservation has always been underfunded by IHS, and the Federal Government rarely increases funding for IHS. The only way to increase annual recurring funding for the Eastern Shoshone Tribe is through a Joint Venture Project. Currently, Warm Valley Health Care receives $8.5 million annually from IHS. $3.5 million is solely for Purchased Referred Care, and $5 million is used for clinic operations. Our current annual budget for operations is $26 million. We rely heavily on Medicaid and other third-party revenue to make up the other $21 million to keep the clinic operational. The Joint Venture protects against any national changes in Medicaid. Additionally, entering into an IHS Joint Venture Construction Program (JVCP) project does not, by itself, reduce the Tribe’s Program, Functions, Services, and Activities (PFSAs) funding or tribal shares. In fact, the structure of the IHS JVCP is intended to add capacity to the IHS health care delivery system, with IHS seeking additional funding for the facility’s staffing and operations. The Joint Venture staff funding offered alone would make us less reliant on 3rd party funding, help us to increase services, and assist us in paying off a loan for the clinic quickly. 

As mentioned earlier, the space would more than triple our current size. Right now, we are almost at maximum capacity, and we just finished an addition. There is no other way to keep adding onto this building. The proposed site is the current rodeo grounds because the project needs at least 15.2 acres. This site would give us 20 acres to build on, with potential to grow. Currently, there is no more time or funds to evaluate another site without the possibility of potentially losing this project altogether.

Healthcare access can improve health, but economic development has a larger impact on the overall health of a community. This has been well studied and verified in medical literature.  More jobs for tribal members allow families to have stable housing, nutrition, healthcare, and education, which all contribute to lower rates of addiction and chronic disease. Therefore, this Joint Venture Project with IHS is the single most generationally impactful opportunity to improve the health of Eastern Shoshone Tribal members. This is an extraordinary opportunity—one that many Tribal communities would go to great lengths to have. Please do not let it pass us by. 

-Shoshone Business Council