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Indian Health Service The Federal Health Program for American Indians and Alaska Natives


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Part 3, Chapter 18:  Manual Attachment II

Memorandum of Agreement Between Indian Health Service and the
Bureau of Indian Affairs published in the Federal Register on March 6, 1987


52 CFR 9709 dated March 26, 1987 is not available on this site, please contact your Area Directives, Delegation's and Control Officer (DDCO) for a hard copy.  This is an exact replica of the Memorandum of Agreement between DHHS and DOI, however, is not the official publication.
52 CFR 9709 Dated March 26, 1987


Please contact your Area DDCO for a hard copy of this CFR

MEMORANDUM OF AGREEMENT
BETWEEN
DEPARTMENT OF HEALTH AND HUMAN SERVICES
AND
DEPARTMENT OF THE INTERIOR


  1. POLICY

  2. It is the policy of the Department of Health and Human Services (DHHS) and the Department of the Interior (DOI) that all coordination of ongoing activities or new activities undertaken pursuant to the Indian Alcohol and Substance Abuse Prevention and Treatment Act of 1986, Title IV, Sub Title C of Pub. L. 99-570, will be done in a manner that is least disruptive to tribal control, in accordance with the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450, et. seq.), and local control in accordance with Section 1130 of the Education Amendments of 1978 (25 U.S.C. 2010).  To accomplish this policy of coordination, the Indian Health Service (IHS), DHHS, and the Bureau of Indian Affairs (BIA), DOI, shall outline both long-term and short-term goals.  Furthermore, the BIA and IHS shall coordinate alcohol and substance abuse programs existing on the date of the enactment to Pub. L. 99-570 with all new activities undertaken pursuant of Pub. L. 99-570.  The Secretary of the Interior, acting through the Assistant Secretary for Indian Affairs, BIA, and the Secretary of Health and Human Services (DHHS), acting through the Director, IHS, shall bear equal responsibility for the implementation of Pub. L. 99-570 in cooperation with Indian tribes, who have the primary responsibility for protecting and ensuring the well-being of their members and the coordination of resources made available under this Memorandum of Agreement (MOA) through implementation of Tribal Action Plans (TAP).

  3. PURPOSE

  4. The purpose of this agreement is to establish a management framework for implementation of the Indian Alcohol and Substance Abuse Prevention and Treatment Act of 1986 that results in the coordination of resources and programs of the BIA and the IHS to assist Indian tribes and Alaskan Natives to achieve their goals in the prevention, intervention, treatment, and follow-up of alcohol and substance abuse.

  5. AUTHORITY

  6. Snyder Act (25 U.S.C. 13), the Indian Self-Determination and Education Assistance Act (Pub. L. 93-638), and the Indian Alcohol and Substance Abuse Prevention and Treatment Act of 1986 (Pub. L. 99-570).

  7. BACKGROUND

  8. The IHS and the BIA recognize alcohol and substance abuse as a disease which is both preventable and treatable.  The IHS and the BIA recognize chemical dependency as a major serious health and social problem affecting the individual, family, and tribe,

    The BIA and the IHS have multiple programs which already respond to the consequences of alcohol and substance abuse (i.e., education, social services, judicial services, law enforcement, mental health, acute and chronic medical care services, etc.), and prevention and treatment programs for alcohol and substance abuse.  However, there is a need to provide a national focus on alcohol and substance abuse at all BIA and IHS Central, Area, Agency/Service Unit offices and schools to promote the efficient and effective use of resources and programs within the organizations as well as between organizations.

  9. ORGANIZATION RESPONSIBILITIES

    1. Central Office

    2. The Central Office of IHS, as represented by the Associate Director, Office of Health Programs, and BIA, as represented by the Deputies to the Assistant Secretary for Education and Tribal Services, are responsible for ensuring compliance, monitoring of performance, subsequent evaluation and follow-up activities for this MOA.  The Central Offices within 90 days of signature of this MOA will devise an Organizational Master Action Plan (OMAP) which will direct the cooperative efforts to accomplish the intent of Pub. L. 99-570.  The OMAP will provide for long-term and short-term plans that include integration of data systems, identification of specific objectives and goals, capability to maintain progress toward these goals, development of standards, and review and evaluation of existing BIA/IHS regulations and manuals to identify potential changes to support the intent of Pub. L. 99-570 and this MOA.

      Short-term immediate requirements include:

      1.  Newsletter:  The IHS and the BIA will jointly fund the newsletter on an equal basis.  The BIA will take the lead role in publishing the newsletter.

      2.  Community training:  The IHS and the BIA will jointly fund community training.  The IHS will take the lead role in providing the training with the BIA participating in the development of the minimum standards.

      3.  Judicial Services and Law Enforcement Training:  The BIA will take the lead role in development and implementation of the training, but agrees to coordinate this training with the IHS training in Item 2.

      4.  Identification of Programs:  The IHS and the BIA agree to compile a listing of programs and resources on an Area basis through the use of Area teams consisting of designated IHS and BIA personnel.

      5.  Emergency Medical Assessment:  The IHS and the BIA will jointly develop and implement procedures for emergency medical assessments by April 30, 1987, unless amended.

      6.  Minimum Standards:  The IHS and the BIA will develop and establish minimum standards as appropriate for new alcohol and substance abuse program responsibilities in consultation with Indian tribes, in the absence of Federal or State standards.

      7.  Scope of Problem:  The IHS, in cooperation with the BIA and tribes, will determine the scope of the problem of alcohol and substance abuse among Indian people, including the number of Indians within the jurisdiction of the IHS who are directly or indirectly affected by alcohol and substance abuse and the financial and human costs, by September 1987, unless amended.

      8.  Assessment of Resources:  The IHS, in cooperation with the BIA and tribes, will conduct an assessment of the existing and needed resources and provide an estimate of funding necessary for a program of prevention of alcohol and substance abuse and the treatment of Indians affected by alcohol and substance abuse, by September 1987, unless amended.

      9.  Emergency Shelters:  The BIA in cooperation with the IHS will promulgate standards by which the emergency shelters under Pub. L. 99-570, section 4213, subsection (a) shall be established and operating, by September 1987, unless amended.

      10.  Tribal Comprehensive Report:  The IHS in cooperation with BIA will provide tribes with an annual tribal comprehensive report of BIA and IHS alcohol and substance abuse data.

      11.  Child Abuse and Neglect:  The BIA in cooperation with the IHS will compile data relating to the number and types of child abuse and neglect cases and the type of assistance provided, reflecting those that involve, or appear to involve, alcohol and substance abuse, those which are recurring and those that involve other minor siblings.

      12.  Curriculum:  The BIA in cooperation with the IHS will provide technical assistance as necessary to develop and implement curricula in kindergarten and grades 1 through 12 relating to alcohol and substance abuse prevention and treatment.

      13.  Crisis Intervention:  The BIA in cooperation with the IHS will provide for individual student crisis intervention in schools funded by BIA and a reporting of all incidents relating to alcohol and substance abuse by August 1987, unless amended.

      14.  Model Juvenile Code:  The BIA, in cooperation with the IHS and in consultation with the Indian tribes, will develop a model juvenile code in September 1987, unless amended.

    3. Area Office

    4. Area Directors for the IHS and the BIA and appropriate Education line officials are responsible for the implementation of this MOA through coordination of resources and programs and for providing requested and needed technical assistance to Agency Superintendents, principals, Service Unit Directors, tribes, and school boards.

      IHS/BIA Area Directors and appropriate Education line official(s) shall develop a joint Area level workplan, within 60 days of the approval of the Central Office OMAP, which will identify specific organizational problems, resources, and programs within that jurisdiction.

    5. Agency/Service Units

    6. The BIA Agency and Education Superintendents and IHS Service Unit Directors are directed to cooperate fully with tribal requests pursuant to Pub. L. 99-570, Section 4206, in the development of a Tribal Action Plan (TAP) and shall enter into an agreement with the tribe for the implementation of the TAP within funding constraints and program regulations.

      If the tribal government does not initiate a tribal resolution to write a TAP within 90 days after publication of this MOA, the BIA/IHS shall develop a Local Action Plan (LAP).  The IHS will take the lead in the development of the LAP unless the Service Unit is contracted, in which cases the BIA will become the lead Agency.  Details are to be defined in the Area workplan.

  10. PERIOD OF AGREEMENT

  11. This MOA shall remain in effect as long as is necessary to carry out the intent of the Congress.

  12. MODIFICATION/PROVISIONS AMENDMENT

  13. This MOA, or any of its specific provisions, may be revised by written approval of both signatory parties or their designees, provided that a copy of the amended MOA shall be distributed to each Indian tribe.

  14. MEETINGS AND REPORTS

  15. IHS/BIA Meetings

    In order to assure that these cooperative efforts are pursued in a continuing and timely fashion, IHS and BIA representatives will meet on a regular basis, not less than semi-annually, to review the activities supported by this agreement and will share information, report on progress and explore new areas for cooperation.  In addition, other meetings may be arranged to discuss specific projects.

    Reports

    Accomplishments reports and action plans shall be submitted by field offices through their respective organizations to BIA and IHS Central Offices.  An annual progress report and a summary of meetings and activities conducted under this agreement will be prepared and submitted to the Director, Indian Health Service, and the Assistant Secretary for Indian Affairs at the completion of each fiscal year.  This report will be shared with tribes.  It shall also identify for Congress the progress or lack thereof in each of the specified areas of cooperation.

  16. PRIVACY ACT

  17. The confidentiality of information which identifies individual persons and is exchanged pursuant to this agreement between the Indian Health Service and the Bureau of Indian Affairs is to be safeguarded in accordance with requirements contained in the Privacy Act of 1974 (Pub. L. 93-579).  In addition, regulations of the Department of Health and Human Services which implement the Privacy Act of 1974 within DHHS, contained at 45 CFR Part 5b, are followed.

    Information exchanged between the IHS and the BIA which indicates a diagnosis, prognosis, referral or treatment of alcohol or drug abuse is to be protected in accordance with requirements contained in the "Confidentiality of Alcohol and Drug Abuse Patient Records" regulations issued by DHHS at 42 CFR Part 2.

  18. REVIEW OF THE MOA

  19. The Assistant Secretary of Indian Affairs and the Director, IHS, shall review this MOA annually within a month of the anniversary of the signing of this MOA.  Upon completion of this review, the OMAP shall be revised and/or updated and Area/Agency workplans revised accordingly.

    For:  Department of Health and Human Services
    Signed by Secretary, HHS March 16, 1987

    For:  Department of the Interior
    Signed by Secretary, DOI February 24, 1987



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