Indian Self-Determination

To enable Indian tribes to assume the management and operation of programs, functions, services, and activities (PFSA) for the delivery of health care to Indian people.

To enter into a self- determination contract or contracts with Indian tribes or tribal organizations (T/TO) interested in transferring
the responsibility for the administration and provision of health services from the government to tribal leadership.
Examples of Funded Projects

Hospitals and Health Clinics, Dental Health, Mental Health, Alcohol and Substance Abuse, Contract Health Service, HIV/AIDS, Public Health Nursing, Health Education, Community Health Representatives, Immunization AK, Indian Health Professionals, Director Operations, Contract Support Costs, Diabetes, Catastrophic Health Emergency Fund, Facilities Maintenance and Improvement, Sanitation Facilities Construction, Health Care Facilities Construction, Facilities and Environmental Health Support, Equipment, and Personnel Quarters.


Agency - Department of Health and Human Services

The Department of Health and Human Services is the Federal government's principal agency for protecting the health of all Americans and providing essential human services, especially to those who are least able to help themselves.

Office - Aberdeen Area IHS, Alaska Area IHS, Albuquerque Area IHS, Bemidji Area IHS, Billings Area IHS, California Area IHS, Nashville Area IHS, Navajo Area IHS, Oklahoma City Area IHS, Phoenix Area IHS, Portland Area IHS, and Tucson Area IHS.
Website Address

http://www.ihs.gov



Program Accomplishments

The transfer of responsibility for the delivery of health care from the IHS to the tribes for the delivery of their own health care has been successful. Forty-two percent of the IHS budget has been transferred to contracting and compacting tribes to deliver IHS funded services to their own communities. The remaining 58 percent of the IHS budget funds IHS managed health care delivery systems. There are Indian self-determination contracts covering tribally operated facilities that include three hospitals, 97 health centers, one school health center, and 65 health stations. Similar support is expected in fiscal year 2005 and fiscal year 2006.

Uses and Use Restrictions

Funds are for the tribes to provide the PFSAs transferred from the Indian Health Service (IHS).

The funds are not available for construction unless specifically authorized by Congress.

Tribes can reallocate funds within their budget from one line item to another without contract modifications.

Tribes also receive administrative funds for the contracted programs.

Eligibility Requirements

Applicant Eligibility

Any federally-recognized tribe that formally requests, through a governing body action, a resolution, to enter into a self-determination contract or contracts for the purpose of planning, conducting, and administering programs, or portions thereof, including construction programs, provided that the T/TO submits a contract proposal that conforms to the requirements contained in 25 CFR 900.8 may apply.

Beneficiary Eligibility

Indian tribes will benefit.

Credentials/Documentation

None.

Aplication and Award Process

Preapplication Coordination

The Agency shall, within 30 days of receipt of a notice of intent to contract, provide the tribe pre- proposal technical assistance, if requested to do so.

The Agency will also notify the tribe of the amount of funds available to contract, under 106(a) of the ISDA, and begin planning for the transfer of responsibilities and funding to the tribe.

This program is excluded from coverage under E.O.

12372.

Application Procedures

A tribe or tribal organization may submit a proposal for a self-determination contract or a proposal to amend or renew an existing contract. Unless there is a declination issue the Secretary shall within 90 days after receiving the proposal, approve the proposal and award a contract to the tribe. Declination issues are: (A) The service to be rendered to the Indian beneficiaries of the particular program or function to be contracted will not be satisfactory; (B) adequate protection of trust resources is not assured; (C) the proposed project or function to be contracted for cannot be properly completed or maintained by the proposed contract; (D) the amount of funds proposed under the contract is in excess of the applicable funding level for the contract as determined under Section 106(a); or (E) the program, function, service, or activity (or portion thereof) that is the subject of the proposal is beyond the scope of programs, functions, services, or activities covered under paragraph (1) because the proposal includes activities that cannot lawfully be carried out by the contractor.

Award Procedures

The agency negotiation learn and the representatives of the tribe shall develop the agenda for the contract negotiation session(s). The agency negotiation team should assure that any issues identified during the proposal review stage, together with any agency recommendations for overcoming these issues, are raised at the negotiations. Title I contracts are generally awarded at the area office level. They are awarded for a definite period of time (1 to 3 years) or may be designated as "mature" and awarded for a definite or indefinite period of time.

Deadlines

(1) The tribe must be notified within 2 days of the receipt of a proposal that the agency has received their proposal; (2) within 7 days of the receipt of a proposal the agency will assemble a proposal review team; (3) within 15 days of the receipt of a proposal the tribe will be notified of any missing information; (4) if a tribe requests technical assistance it will be provided within 30 days of the date of the request from the tribe; (5) final negotiations should be completed within 60 days of the receipt of a proposal; and (6) the agency has 90 days from the date of the receipt of a proposal to review and award or decline a contract proposal.

Authorization

Indian Self-Determination and Education Assistance Act, Title I, Public Law 93-638, as amended, Section 102; Contract Disputes Act of 1978; 31 U.S.C. 75.

Range of Approval/Disapproval Time

Provisions of the Contract Disputes Act of 1978 (CDA) describe the procedures the agency will follow for claims in excess of $100,000 and claims for less than $100,000.

Appeals

Section 102 of the ISDA and Subpart L of the regulations are the basic sections covering the appeal procedures. Section 900.150 of 25 CFR lists the decisions a T/TO can appeal under Subpart L (25 CFR 900.150-169). The procedures here apply to those appeals. Also, 25 CFR Section 900.151 of the regulations describes appeals that are covered under Subpart N of the regulations and other appeals. The T/TO has three options in appealing a decision under 25 CFR 900-150. The T/TO can request an informal conference and/or can file a formal appeal. The T/TO also has the option of going directly to the Federal court at any time.

Renewals

Annual funding agreements are renegotiated and renewed annually. Title I contracts may be designated as "mature" and awarded for a definite or indefinite period of time.

Assistance Considerations

Formula and Matching Requirements

A T/TO may use funds provided under a Title I contract to meet matching or close participation requirements under other Federal and nonfederal programs.

Length and Time Phasing of Assistance

Not applicable.

Post Assistance Requirements

Reports

Unless required by statute, there are no mandatory reporting requirements for Title I contracts.

Each T/TO shall negotiate with the agency the type and frequency of program narrative and program data report(s), that respond to the needs of the contracting parties and that are appropriate for the purposes of the contract.

Audits

Section 5(f) of the ISDA requires a T/TO to submit an annual "Single Audit Act" as required by Chapter 75 of Title 31 USC. OMB Circular No. A-133, Audits of States, Local Governments and Nonprofit Organizations, revised June 24, 1997, rescinded circular No. A-128 and superseded the Prior version of A-133. Revised circular No. A-133 now applies to T/TO. In accordance with the provisions of OMB Circular No. A-133, (Revised, June 27, 2003), "Audits of States, Local Governments, and Nonprofit Organizations," nonfederal entities that expend financial assistance of $500,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for the year, except as noted in Circular No. A-133.

Records

Department of Health and Human Services (DHHS) and the Comptroller General of the United States or any of their authorized representatives, shall have the right to access any books, documents, papers, or other records of a grantee, subgrantee, contractor, or subcontractor, which are pertinent to the HHS award, in order to make audits, examinations, excerpts, and transcripts. Grantees are required to maintain accounting records 3 years after the end of the budget period of the award. If any litigation, claim, negotiation, audit or other action involving the records shall be retained until completion of the action and resolution of all issues arising from it, or until the end of the regular 3-year period, whichever is later.

Financial Information

Account Identification

75-0390-0-1-551; 75-0391-0-1-551.

Obigations

(Direct Payments) FY 07 $509,600,000; FY 08 $509,600,000; and FY 09 est not available.

Range and Average of Financial Assistance

$31,963 to $25,950,652; $1,722,872.

Regulations, Guidelines, and Literature

Public Law 93-638, as amended, Internal Agency Procedures Manual for Contracting Under Title I of the Indian Self-Determination and Education Assistance Act; Indian Health Circular No. 2000-01, "Contract Support Costs apply."

Information Contacts

Regional or Local Office

Aberdeen Area IHS, Alaska Area IHS, Albuquerque Area IHS, Bemidji Area IHS, Billings Area IHS, California Area IHS, Nashville Area IHS, Navajo Area IHS, Oklahoma City Area IHS, Phoenix Area IHS, Portland Area IHS, and Tucson Area IHS.

Headquarters Office

Mr. Douglas Black, Director, Office of Tribal Programs, Indian Health Service, 801 Thompson Avenue, Suite 220, Rockville, MD 20852. Telephone: (301) 443-1104. Grants Management Contact: Ms. Kimberly Pendleton, Senior Grants Management Officer, Division of Grants Operations, Indian Health Service, 801 Thompson Avenue, TMP, Suite 360, Rockville, MD 20852. Telephone: (301) 443-5204.

Criteria for Selecting Proposals

Applicants who meet the requirements of Section 102 of Public Law 93-638, as amended, and provide a proposal in accordance with 25 CFR 900 will be funded.



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Edited by: Michael Saunders

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