Truck-hauled decentralized water and wastewater systems are a common service type for First Nations in Saskatchewan and Canada, because of their low life cycle cost (LCC) through the scope of Indigenous Services Canada (ISC). This regular hauling by heavy trucks increases the degradation of a community’s gravel road network, thereby requiring an increased budget for repairs. This study analyzes the cost of this increased degradation in the context of current operations and maintenance (O&M) funding and typical O&M budgets to determine if there is justification for increased funding or different levels of service (LOS). A hypothetical road network was examined, and it was found that historic levels of funding were significantly inadequate to meet basic maintenance needs with the expected deterioration of road networks. Recently increased funding levels (2021) are closer, but still less, than other values taken from local municipal budgets in the literature. An LCC forecast showed that the funding gap does not allow for scheduled major surface renewal, which leaves First Nations in a cycle of reactive and emergency maintenance. Further, with the expectation of deteriorated road surfaces comes impacts to health and safety. Accounting for these non-monetized impacts is important in decision evaluation for alternate LOS. Considering a broader scope of costs and impacts associated with decentralized systems demonstrates the need for flexibility in funding and decision-making in consideration of First Nations infrastructure management.