Self-Governance 101 Training - PowerPoint Presentation

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Self-Governance 101 TrainingIndian Health ServiceOffice of Tribal Self-Governance

May 10, 2016Dakota Event CenterAberdeen, South DakotaSlide2

Overview of the Legislative History of the Indian Self-Determination and Education Assistance Act (ISDEAA)Tammy Clay Policy Analyst, OTSG

Tamara.Clay@ihs.govSlide3

Tribal Self-Determination, Sovereignty, and Self-GovernanceAmerican Indians and Alaska Natives (AI/ANs) exercised their inherent rights to self-determination and self-governance long before the arrival of non-Indigenous peoples to the Americas. Slide4

Tribal Self-Determination, Sovereignty, and Self-GovernanceAfter centuries of Federal policies ranging from extermination and removal to assimilation and neglect, Tribal self-determination has become the hallmark of United States Indian policy. It is also a human right. (

Strommer and Osborne, 2010)Slide5

The legal basis for Tribal sovereignty is found in the United States (U.S.) Constitution, treaties, Federal laws or statutes, court cases, executive orders, and administrative policies. Slide6

Through these Authorities, the U.S. Government:Recognized Tribes as distinct political entities;Reaffirmed Indian nations retain their inherent right to govern themselves and their territories subject only to limitations imposed by Federal law;

Engages in nation-to-nation relationships with Tribal governments; and Requires all Federal agencies to interact with Tribes as governments.Slide7

Tribal Self-Governance“Self-Governance is a Tribally driven initiative fundamentally designed to incorporate the government to government relationship into a meaningful partnership process between the U.S. and Indian Tribes, founded on our political relationship with the U.S. by treaties and agreements.”

-Dale Risling, Dr., Chairman Hoopa Valley Tribe of California, October 20, 1993Slide8

Indian Health Service (IHS)Authorities – Prior to 1975 Snyder Act of 1921, Public Law (Pub. L. 67-85) – Authorized appropriations and expenditures for health services and other purposes for AI/

ANs.Transfer Act of 1955, (Pub. L. 83-568) – Indian health care moved form the Department of Interior to the Public Health Service, IHS.Slide9
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Indian Self-Determination and Education Assistance Act (ISDEAA) (Pub. L. 93-638)Signed into Law in 1975, and reaffirmed Congressional support of the Nation-to-Nation relationship between the United States and each Tribal Nation.Enacted to ensure “effective and meaningful participation by Indian People in the planning, conduct, and administration” of Federal services and programs provided to the Tribes and their members [25 U.S.C. 450a(b)].Slide11

ISDEAA (Pub. L. 93-638)Provided Tribes with the option to exercise their sovereignty by: (1) Assuming the administration and operation of Programs, Services, Functions and Activities (PSFAs) from the Indian Health Service (IHS), via contracting and/or compacting; and/or

(2) Continuing to receive health care through the IHS- administered, direct-care health system. Slide12

The Indian Health Care Improvement Act (IHCIA) of 1976 (Pub. L. 94-437)Implemented Federal trust responsibility for the care and education of Indian People.

Serves as the main legal authority for IHS.The Patient Protection and Affordable Care Act (ACA) of 2010 (Pub. L. 111-148) amended IHCIA, and permanently reauthorized and expanded the IHCIA authorities, including new authorities for Tribes participating in Self-Governance. Slide13

1988 ISDEAA Amendments (Pub. L. 100-472) Revisions substantially removed many of the administrative and practical barriers that persisted under ISDEAA.Authorized the Tribal Self-Governance Demonstration Project within the Bureau of Indian Affairs (BIA), Department of Interior (DOI), by adding Title III to ISDEAA.

Authorized BIA to negotiate compacts with Tribes; and gave Tribes more flexibility in operation of programs.Slide14

Tribal Self-Governance Extended to IHSIn 1991, IHS received funding to perform a feasibility study to explore extending Tribal Self-Governance to IHS (Pub. L. 102-184).Following the success of the DOI Self-Governance Demonstration Project, Congress extended the same authority to IHS through the Indian Health Amendments of 1992 (Pub. L. 102-573). Slide15

IHS Tribal Self-GovernanceIn 1994, an amendment to Title III [Pub. L. 103-435, §§ 301 and 302(a)] extended the Tribal Self-Governance Demonstration Project to 18 years; 30 Tribes per fiscal year to participate.In 1996, Tribal leaders participated with Agency representatives in a negotiated rule making process to implement the Title I Self-Determination Contracting Program, now referred to as the IHS Office of Direct Service and Contracting Tribes program. (See 61 FR 32482) Slide16

In 1996, the Tribal Self-Governance Advisory Committee (TSGAC) was established, to:Advise the Director, IHS, and provide assistance on issues of concern, regarding Tribal Self-Governance and its implementation. The IHS Tribal Self-Governance Advisory Committee (TSGAC) membership consists of a Primary and an Alternate representative from each of the IHS Areas that have Self-Governance Tribes.

http://tribalselfgov.org/resources/documents/Slide17

ISDEAA AmendmentsIn 2000, Title V (Pub. L. 106-260) was passed, and created a permanent Tribal Self-Governance program for IHS.In 2002, Title V [42 Code of Federal Regulations (C.F.R.) Part 137] Tribal Self Governance Regulations were promulgated via a rule-making process, with Tribal and Agency representatives to implement Title V.

https://www.gpo.gov/fdsys/pkg/CFR-2007-title25-vol1/pdf/CFR-2007-title25-vol1-part900.pdfSlide18

Take AwaysThe Secretary is prohibited from waiving, modifying, or diminishing in any way the trust responsibility of the U.S. with respect to Indian Tribes and individual Indians that exists under treaties, Executive orders, other laws, or court decisions

. (25 U.S.C. 458aaa-6(g))Tribes are in the best position to administer their own health programs as they are most familiar with their Tribe’s health

, social, economic, political, and

cultural determinants

, as well as their particular tribal history (i.e. historical trauma).Slide19

Take AwaysThrough participation in the IHS Tribal Self-Governance program, Tribes have the flexibility to shape their health programs to incorporate evidence-based practices with traditional health practices to meet Tribal member’s needs most effectively.Slide20

Overview of the Tribal Self-Governance Program and Office of Tribal Self-GovernanceSlide21

Options for Tribes TodayBased on the needs of their communities, Tribes may choose one or a combination of the following options:Receive health care services directly from the Indian Health Service (IHS);Use the authority of the Indian Self-Determination and Education Assistance Act (ISDEAA) and either

Contract with the IHS to administer individual programs and services the IHS would otherwise provide (referred to as Title I Self-Determination Contracts); orCompact with the IHS to assume full control over

programs, services, functions or activities (PSFAs), or portions thereof, that the IHS would otherwise provided

(referred to as

Title V Self-Governance Compacts).  Slide22

Participation in Title I and Title VTitle I:227 contracts and annual funding agreements$900 million transferred through Title I contracts

Title V:352 Tribes participating directly or through tribal organizations and intertribal consortia in the Tribal Self-Governance Program (TSGP)88 Compacts and 113 Funding Agreements

Title V agreements transfer $1.8 billion, approximately 1/3 of the IHS appropriation.

Combined, these agreements transfer

approximately $2.5 billion, over half the IHS appropriation.Slide23

Benefits of Title V CompactingParticipation in the TSGP affords Tribes the most flexibility to set its own health care priorities and tailor heath care services to the needs of their communities when assuming IHS PSFAs.

A Tribe or Tribal Organization may redesign or consolidate PSFAs and reallocate or redirect funding without IHS approval in accordance with the ISDEAA.Strong Federal-Tribal partnerships have been critical to the continued success of Title V and the TSGP.

No routine monitoring is required.Tribally-Driven NegotiationsSlide24

Areas participating in the Tribal Self-Governance ProgramSlide25

Self-Governance ImplementationReviews eligibility requirements for Tribes to participate in the Tribal Self-Governance Program (TSGP) and applications for TSGP Planning and Negotiation Cooperative Agreements.Participates in nation-to-nation negotiations

of ISDEAA Title V Compacts and Funding Agreements and provide oversight and support of the Agency Lead Negotiators (ALNs).Oversees funding to Self Governance Tribes Agency Advisor on TSGP

Special Project OversightNation-wide Self-Governance Education and Outreach

Tribal Consultation

Office of

Tribal

Self-Governance (OTSG) Slide26

Who negotiates for the Government?IHS negotiation teams are lead by an Agency Lead Negotiator (ALN). The only

person with authority to negotiate Compacts and Funding Agreements on behalf of the IHS Director.Supported by:OTSG Program Analyst and Financial Analyst Member of the Office of the General Counsel

IHS subject matter experts at Area and HQ OfficesSlide27

Great Plains Area ISDEAA Title V Team Area Point of Contact: Sandy NelsonOTSG: Program Analyst: Aaron LaneFinancial Analyst: Carla MayoSlide28
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Program and Management AnalystsAdminister and Facilitate Self-Governance Negotiation process

Analyzes and evaluates the PSFAs being considered for Self-Governance.Process completed Compacts and Funding Agreements

Provides support and technical assistance on Self-Governance issues

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Financial AnalystsMakes the payments to the Self-Governance Tribes at the beginning of the funding cycle (Fiscal, Calendar).

Makes payments based on amendments to funding tables throughout the year.Audit Review for Self-Governance Eligibility

OTSG Budget Activities

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Policy Analysts

Works on a wide range of national issuesAdminister OTSG Cooperative Agreements

Maintains and updates OTSG Policy ManualsReview HHS Agency policy and regulations

Composes responses to Congressional inquires

Prepares briefing materials for OTSG and the IHS Director

Conducts research and analysis

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Overview of Eligibility Requirements Slide33

Eligibility Overview: 3 RequirementsTo be eligible for the IHS Tribal Self-Governance Program, a Tribe must:

Successfully complete a planning phase;

Request participation in self-governance by resolution or other official action by the governing body of each Tribe to be served; and

Demonstrate, for 3 fiscal years, financial

stability and financial management capability.

(25 USC 458aaa-2(c)); 42 C.F.R. PART 137, Subpart C; 42 C.F.R. 137.15–26) Slide34

1. Planning Phase The planning phase shall be conducted to the satisfaction of the TribeUsually, this stage is the longest and most work.

It must include:Legal and budgetary research Internal Tribal government planning and organizational preparationWhen complete, a “planning statement” is submitted to OTSG. Slide35

2. Request Participation

Request participation in self-governance by resolution or other official action by the governing body of each Tribe to be served;

(25 USC 458aaa-2(c)); 42 C.F.R. PART 137, Subpart C; 42 C.F.R. 137.15–26) Slide36

For the purposes of eligibility, “evidence that, during the 3-year period … an Indian tribe had no uncorrected significant and material audit exceptions in the required annual audit of the tribe’s self-determination contracts or self-governance funding agreements with any federal agency shall be conclusive evidence of the required stability and capability.” 25 USC 458aaa-2(c)(2)

The IHS Office of Tribal Self-Governance (OTSG) reviews the Tribe’s audits to determine whether this requirement has been met.

3. Financial RequirementSlide37

3-year period: The most recent 3 yearsUncorrected: Title V does not include terms “clean audit” or “mature contract”Audit exceptions

: Usually from the Tribe’s auditor in the auditSelf-determination contracts or self-governance funding agreements with any federal agency:The review only looks at the BIA and the IHS contracts/compacts findings, except for cross-cutting centralized functions (e.g. personnel, payroll, property management, etc.). (42 CFR 137.22)

It does not include casino, HUD, or DHHS/Child Care grant findings.

3. Financial Requirement: Key FeaturesSlide38

Sample Eligibility Determination Memo

Final step

in the eligibility process:

The IHS Office of Tribal Self-Governance produces an eligibility determination memo, which is sent to the Tribe

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FY 2016 ResourcesOffice of Tribal Self-Governance and Office of Direct Service & Contracting Tribes

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Presentation OverviewOTSG Planning and Negotiation Cooperative AgreementsOverview of Pre-award ResourcesODSCT Tribal Management GrantsSlide41

Types of Funding Opportunities PLANNING

NEGOTIATION

Gather information on available

PSFAs

and related funding

Improve and enhance the healthcare delivery system to better meet the needs of the Tribal community

Identify PSFAs to be negotiated and included in Compact and Funding Agreement (FA)

Identify Tribal funding shares to be included in the FA

Develop terms and conditions of the FA

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Planning Cooperative Agreements(available, not required)

Planning Cooperative Agreements provide resources to Tribes interested in entering Self-Governance and to existing Tribes interested in expanding their PSFAs.

Who can apply?Tribes that have not received a Cooperative Agreement;Tribes that received a Cooperative Agreement but chose not to enter into the Tribal Self-Governance Program;

Existing Self-Governance Tribes that are planning to assume and/or expand current Programs, Services, Functions and Activities (PSFAs). This includes Tribes that have already received a Cooperative Agreement.

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Planning Activities ExamplesLegal and Budgetary ResearchAttend meetings Hire consultants to conduct research and gather informationConduct internal reviews by evaluating policies & procedures

Train and educate staff, Tribal Council, Board of DirectorsResearch & evaluate PSFAs at all organizational levelsCompleted to the satisfaction of the Tribe.

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Negotiation Cooperative Agreements(available, not required)

Negotiation Cooperative Agreements provide resources to Tribes to help defray costs related to preparing for and conducting Tribal Self-Governance Program negotiations.

Who can apply?Tribes that plan to negotiate a Compact and Funding Agreement with the IHS, which includes:

Preparation and discussion each Program, Service, Function, and Activity (PSFA) in comparison to the current level of services so the Tribe can make an informed decision on new or expanded program assumption.

Identification of Tribal shares associated with PSFAs that will be included in the funding agreement.

Development of the terms and conditions that will be set forth in the Compact and Funding Agreement. Slide45

Negotiation Activities ExamplesAttend or conduct trainings and meetingsTravelHire consultants to develop Compact and Funding Agreement

Review funding tables45Slide46

Award Amounts and ProcessFive FY16 Planning Cooperative Agreement awards in the amount of

$120,000 each will be issued, subject to the availability of appropriations and budgetary priorities of the IHS.

Five FY16 Negotiation Cooperative Agreement awards in the amount of

$48,000 each

will be issued.Slide47

Key DatesApplication Deadline Date: June 3, 2016Signed Tribal Resolution Due Date: June 3, 2016Start of Objective Review Date: June 17, 2016Earliest Anticipated Start Date: July 1, 2016Slide48

Announcements are made through a Federal Register Notice, the Grants.gov website (www.grants.gov) and the OTSG website (www.ihs.gov/selfgovernance). The announcement contains information on the number of agreements available, how to apply, deadlines, requirements and scoring criteria

.Slide49

OTSG Cooperative AgreementsPlanning Cooperative Agreement: http://www.grants.gov/web/grants/search-grants.htmlNegotiation Cooperative Agreement: http://www.grants.gov/web/grants/search-grants.htmlSlide50

Point of ContactAnna Johnson, Program Analyst, OTSG Email: Anna.Johnson2@ihs.govOffice: (301) 443-7821Slide51

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ODSCT Resources

Feasibility – up to $70,000 and 1 year

Planning – up to $50,000 and 1 year

Evaluation – up to $50,000 and 1 year

Health Management Structure – average $100,000/year (not to exceed $300,000 for 3 years)

Tribal Management GrantsSlide52

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Eligibility Information

Eligibility:

Any federally recognized Indian Tribe or Tribally sanctioned Tribal organization

Tribal organizations that operate mature contracts that are designated by a Tribe to provide technical assistance and/or training.

Cost Sharing or Matching: No requirement

Documentation Required:

Tribal Resolution – Draft may be submitted initially but a final

ratified resolution is

required

Priority I: FRN or letter from BIA verifying establishment of

Tribe within last 5 years

Priority II: NEAR letter and attachment A

or

Financial Statement

Audit Definitions

Consortium Participation: Identify member Tribes

Tribal Management GrantsSlide53

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Key Dates

June 8, 2016 – Final Application Deadline

(All applications

must

be received by this date.)

June 20-24 – Objective Review

September 1 – Earliest Anticipated Project Start Date

Tribal Management GrantsSlide54

ODSCT Point of ContactOffice of Direct Service and Contracting Tribes 301-443-1104Slide55

Pre-Award and Startup InformationBoth are a one-time cost incurred reimbursement.Pre-award costs are incurred prior to the award date of the contract/compactStartup costs are incurred after the award date but during the initial year of operationSlide56

Pre-award and Startup ProcessYou must send a letter to the Area Director informing their office of your intent to start incurring Pre-award costs. You must include an approximate amount of your costs you will incur for your planningCheck with Area regarding the reasonableness of your costs and availability of funds

Costs are negotiated before awardSlide57

Thank You! Any Questions?