PURPOSE.  The purpose of this section is to establish the Indian Health Service (IHS) Policy and Procedures for the offer, acceptance, acknowledgement, and administration of gifts (including bequests, legacies, and donations from living donors) to support any IHS component or activity.  This section applies to the receipt of all monetary and non-monetary gifts, except for gifts of real property.
 

AUTHORITY.  The authority for Gift Administration is derived from 41 Code of Federal Regulations (CFR), Part 101-49; Sections 231 and 405(b)(1)(H) of the Public Health Service Act (PHS), as amended; 42 United States Code (U.S.C.), 238, 284(b)(i)(H) (gift acceptance statutes); 42 CFR Volume 1, 1-399; 41 CFR 102-36; United States Treasury Department Deposit Regulations; Treasury Fiscal Requirements Manual, Part 5, Section 4020; PHS Agency Heads for "Delegation of Authority to Accept Gifts," Title XXI of the PHS Act; Standards of Ethical Conduct for Employees of the Executive Branch, 5 CFR, Part 2635, and all amendments and supplements; Title 42, Chapter 1, Part 34, Subpart E, Section 36.61-66, "Contributions of the Benefits of Patients"; 5 U.S.C. 7353 (noncriminal prohibitions on gifts; Executive Order 12674; 18 U.S.C.201(b), [Anti-Bribery Statute]; 18 U.S.C. 209 [Salary Supplementation Prohibition]; and the Office of General Counsel (OGC), Department of Health and Human Services (HHS), opinion dated January 13, 2004, Re: Gift Acceptance Authority."  These gift regulations/rules implement fundamental principles of public service, namely that Federal officials and employees should not use their public office for their own personal gain or give appearance that they are not carrying out their official duties with complete impartiality.
 

POLICY  It is the policy of the IHS to (1) use statutory and delegated authorities to accept gifts that support the mission and goals of the IHS in order to enable IHS management to efficiently control the acquisition, accountability, and use of these resources; and (2) to ensure that IHS employees avoid conflicts of interest and violations of laws regarding unauthorized augmentation of appropriations, expenditures in excess of appropriations, handling of miscellaneous receipts, and the "Standards of Ethical Conduct for Employees of the Executive Branch."
 

DEFINITIONS.
 

Authorizing Official. The "Authorizing Official" is the IHS official with the delegated authority to accept the gift, i.e., the Director, IHS; Area Director; Director of Headquarters Operations (DHO); and (possibly) Service Unit Director.
 

Gifts. Gifts are defined as "gratuitous conveyances or transfers of ownership in property without any consideration." (25 CG 637, 639 1946.) A gift, therefore, is something bestowed voluntarily and without consideration or compensation. For purposes of the HHS statutes authorizing acceptance of gifts, a grant to IHS usually qualifies as a conditional gift. In ordinary usage, "grant" means "gift," usually for a particular purpose.
 

Conditional Gift. A conditional gift is a gift in which the donor imposes a condition or restriction on the use of the gift or a condition to be met to obtain the gift. The IHS is only authorized to expend conditional gift funds to support functions stated within the terms or the conditions of the gift.
 

Unconditional Gift. An unconditional gift is a gift in which the donor does not impose a condition or restriction on the use of the gift or a condition to be met to obtain the gift. The IHS is authorized to expend unconditional gift funds to support any of its authorized functions, within the scope of the intended use designated by the donor, including research on a specific disease or illness. When a donor requests that a gift be used for research on a specific disease or activity without further specification as to its purpose or manner of use, the gift is considered unconditional and may be used to carry out the mission of the recipient IHS Area/program/activity relating to research into that specific disease or activity.
 

Personal Property. Personal property is a tangible item that is not real property, including but not limited to American Indian and Alaska Native (AI/AN) artwork/crafts, furniture, equipment, office machines, medical equipment, vehicles, materials, and supplies. This definition excludes monetary gifts, such as, money, stocks, and bonds.
 

Real Property. Real property is a tangible item that may be land or buildings, utility systems, fixtures, or other property, which are installed and become an integral part of the real property.
 

Recommending Official. The “Recommending Official” can be any IHS staff who has received a gift offer or is possibly a subject-matter expert.
 

RESPONSIBILITIES. Officials of the IHS are authorized by law and delegation of authority to accept gifts, excluding gifts of real property, on behalf of the IHS.  In making decisions on the acceptance of each gift, IHS Authorizing Officials must consider the information provided in Manual Exhibit 5-22.3-A, “IHS Pre-Acceptance Check List,” and Manual Exhibit 5-22.3-B, “Conflict of Interest Analysis - Gift Acceptance.” Completion of both forms is required before an Authorizing Official can accept such a gift.
 

Director, IHS. The Director, IHS, has the authority to accept gifts, excluding gifts of real property, insofar as the gift applies to the mission of the IHS.

 

Deputy Ethics Counselor. The Deputy Ethics Counselor (DEC) is responsible for administering and managing the Gift Administration Program for all IHS gift activities.
 

Area Ethics Contacts. The Area Ethics Contacts are available to provide guidance and advice to Area personnel.
 

Program Integrity and Ethics Staff.  The Program Integrity and Ethics Staff (PIES) will:
 

receive and maintain the Annual Gift Reports;
 

prepare and maintain the IHS Gift Report to the Director, IHS; and
 

coordinate/maintain a database regarding gifts received by the IHS.
 

Director of Headquarters Operations. The DHO is responsible for:
 

accepting gifts within his/her delegated authority,
 

approving expenditures from gift funds,
 

approving the amount of funds and type of investments, and
 

meeting all reporting requirements.
 

Area Directors. Area Directors responsible for:
 

forwarding all gift offers in excess of $1 million from their respective Area to the PIES, for review and recommendation for submission to the Director, IHS, for approval or disapproval;
 

accepting gifts within his/her delegated authority;
 

approving expenditures from gift funds;
 

approving the amount of funds and type of investments; and
 

meeting all reporting requirements.
 

Office of the General Counsel. The OGC, HHS, including regional attorneys, provides guidance on legal issues in the administration of gifts, including gift conditions, use of gift funds, and statutory authorities; negotiates with attorneys representing potential donors or donors' estates; and coordinates with the Director, PIES, and/or the Assistant Special Counsel for Ethics, OGC, on the interface of general legal issues and issues of ethics.
 

GIFT SOLICITATION IS PROHIBITED.  Employees are prohibited, either directly or through another party, from requesting or suggesting donations to the IHS or any of its components of funds or other resources intended to support activities, except grant funds as authorized by the Comptroller General.

When an outside organization or individual expresses an unsolicited interest in supporting IHS activities, an employee may provide information on the authority of IHS to accept gifts and the procedures for the offering and acceptance of gifts. Where there is not a clear distinction between activities that acquaint potential donors with the existence of a gift fund (permissible) and activities that are active solicitations (not permissible), employees should seek case-by-case guidance from their Area Ethics Contact and/or the PIES.

This prohibition on solicitation of gifts does not preclude the opportunity for the IHS to seek outside collaboration for specific IHS activities, such as a particular project, study or conference, as long as these activities constitute permissible co-sponsorship between the IHS and the outside entity, an application for grants available to Federal agencies, or a collaborative agreement.
 

GIFT CATEGORIES. If there is a question in determining whether a gift is conditional or unconditional, contact your local Area Ethics Contact, OGC, or PIES for assistance.
 

Gifts to Support Individual Employees. A gift to support the activities of an individual employee may be accepted only if the principal benefit of the gift is to the IHS rather than to the employee.
 

Contributions for the Benefit of Patients.  A gift for the benefit of patients may be accepted only if the gift is intended for the benefit of all patients in a ward or unit of a particular hospital or station.  Contributions of personal property which may be accepted include, but are not limited to, recreational equipment, furniture, radios, and television sets.  Monetary contributions may be expended for materials, services, or activities which contribute to the well-being or morale of patients, including, but not limited to, the provision of reading and entertainment materials, and recreation activities, and, in appropriate cases, the necessary financial support (including travel expenses, meals, and lodging) of relatives, guardians, or friends of patients to enable such persons to be available for the patient's comfort and support.
 

Conditional Monetary Gifts. For a conditional monetary gift, the potential donor must agree in writing that, upon completion of the stipulated conditions, any remaining funds will be transferred to the unconditional gift account for the support of any other objectives of the recipient IHS Area/program.  A letter of acceptance of the gift from the Authorizing Official must acknowledge the donor's agreement to this condition.  (See Manual Exhibit 5-22.3-C, "IHS Sample Letter Acceptance of Gift.")
 

Monetary Gifts.  The IHS will accept a monetary gift subject to any limitations imposed by law or by HHS or IHS policies.  Where a bequest or legacy, in full or in part, of the general estate (for example, a bequest of one-third of the rest, residue, and remainder of the estate), the IHS will request the Executor of the estate to liquidate the assets and make a distribution in cash, as authorized under the applicable probate or other laws.
 

Gifts Not Accepted. A gift may not be accepted if the conditions imposed by the donor are illegal, contrary to HHS or IHS policy, unreasonable to administer, contrary to generally accepted public standards; the total costs associated with acceptance are expected to exceed the cost of purchasing a similar item plus the cost of normal care and maintenance; or the gift would create a conflict of interest or the appearance of a conflict of interest to a reasonable person.
 

Grants.  The IHS may also accept a "grant" as a conditional gift as proper augmentation to its appropriations and it may use its appropriated funds to cover any cost incurred in applying for the grant. The PHS gift acceptance statutes provide IHS the specific authority to supplement or "augment" its appropriations with gifts, so long as the following conditions are met:
 

The statutory requirements imposed on the acceptance of conditional gifts are otherwise met.
 

The grant funds are used in the furtherance of the IHS's mission.
 

There are no objections to the IHS's acceptance of these grants.
 

When applying for grants, the IHS specifically indicates that the IHS and/or IHS site is a Federal agency under the HHS.  In all cases, the IHS must be eligible to apply for and accept grants, both private and Federal.
 

In situations where solicited grants or other types of awards are made to IHS employees for medical or other professional purposes, it is necessary to determine whether the funds are intended for the IHS or for the employee
 in that person's individual capacity.

PROHIBITED AND NON-PROHIBITED SOURCES. 
 

Prohibited Source. A prohibited source is an entity that has or is seeking to obtain contractual, financial, or another business relations interest in the performance or non-performance of an IHS function. In all cases, a recommending IHS official will perform a conflict-of-interest analysis (see Manual Exhibit 5-22.3-B) to determine if the potential donor is a prohibited or a non-prohibited source. In all cases of a gift offer, the Authorizing Official must be aware of the increased probability that an actual or appearance of a conflict of interest may exist. If the donor expresses, directly or indirectly, any expectation of receiving a future benefit, such as a contract award, an endorsement, etc., the gift shall not be accepted.
 

Non-Prohibited Source. If an employee receives monetary awards from outside organizations that support the costs of IHS activities, then IHS would accept the funds as gifts to the IHS and, by law, deposit them to the appropriate IHS gift fund. Employees and managers should seek guidance as necessary from their local Area Ethics Contact, OGC, or PIES to avoid the potential for conflict of interest or other potential impropriety in the acceptance of funds from outside sources.
 

PROCEDURES. 
 

Gift Offer. All gift offers must be made in writing to the IHS. The offer should include any specific conditions to be met to obtain the gift or restrictions on the use of the gift.
 

Monetary Gifts. In the case of conditional monetary gifts, the potential donor will be asked to agree in writing to the IHS requirement that, upon the completion of the stipulated conditions, any remaining unobligated conditional funds will be transferred to the component's unconditional gift fund account for the support of any other IHS objectives. Gift funds are "no year" monies and are available until expended. Generally, funds should be obligated within the fiscal year (FY) in which they are received.
 

Acceptance Letters. Within 10 workdays after the initial receipt of a monetary gift, the recipient IHS component's Authorizing Official must determine whether to accept the gift or not and must notify the donor in writing. This timeframe may be extended in cases where negotiation with the donor is required. If the gift is accepted, it will be deposited into the component's appropriate gift fund account. The letter of acceptance must say that the gift is being deposited to the "component's gift fund account" and state the purpose for which the funds will be used. (Acceptances must be in writing and signed by the Authorizing Official. Copies of the acceptance letters must be attached to the annual report.) If the gift is not accepted or the donor refuses to accept the IHS's terms, a letter to the donor will state why the IHS cannot accept the offer. The Area Ethics Contacts and PIES are available to assist in preparing acceptance letters. (See Manual Exhibit 5-22.3-C.)
 

Investment of Gift Fund Monies.  The authorizing Official will determine annually if excess funds will not be used within a 12-month period, usually the FY.  If it is determined that there are excess funds and the amount of these funds is more than $50,000, the Authorizing Official will request in writing to the Director, IHS, the approval to invest the excess funds in an interest-bearing account of the United States as authorized by law.  The Authorizing Official's memorandum must
 include the amount of funds to be invested, the source of the funds, and any recommendations regarding the Treasury bills, notes, or bonds to be purchased.

Contributions for the General Benefit of All Patients Within the Hospital or Station.  The officer in charge of a hospital or station or his delegate may accept contributions of money or personal property that are donated for the general benefit of all patients within the hospital or station (or a ward or unit thereof) without further specification or conditions as to use. Contributions tendered subject to conditions by the donor, such as expenditure or use only on behalf of certain patients or for specific purposes, shall not be accepted. Contributions of money or property shall he accepted in writing: Contributions of money accepted will be treated consistently with Federal deposit rules and as supplemented with appropriate procedures for the facility. Contributions of property accepted will be recorded and accounted for in the same manner as other Government-owned property.
 

Annual Plan and Annual Report. Each Authorizing Official will prepare an annual plan and an annual report (See Manual Exhibits 5-22.3-E, “IHS Annual Gift Administration Plan” and Manual Exhibits 5-22.3-F, “IHS Annual Gift Administration Report.”) for all gifts accepted. The annual report and the annual plan will include the disposition of the gift. If monetary gifts are received, the annual plan will include the amount of funds on hand, expenditures during the past year, and the anticipated use of the funds in the coming year. Both the annual plan and the annual report will be forwarded to the Director, PIES, by November 30 of each year for the previous FY.
 

Official Travel. Gift funds may be used to pay for necessary travel expenses under the same regulations and procedures as for travel supported by appropriated funds for attendance at award ceremonies, conferences, and similar events. It is acceptable to pay travel expenses for spouses or any other appropriate individual, related by blood or affinity, to attend award ceremonies for honorees, because the expenditures are in support of the employee and of morale, which benefits the IHS in accomplishing its mission.
 

Disposition of Prohibited Gifts. The IHS may authorize the disposition or return of prohibited gifts at Government expense. Written notification should accompany all gift returns. Use of penalty mail for the limited purpose of forwarding reimbursements to donors is authorized. If a gift cannot be accepted, the following are some possible alternatives:
 

Return tangible items to the donor.
 

Pay the donor the market value of the gift (retail cost of an item or service of like quality through the acquisitions process.)
 

Destroy, share within the Area, or donate to charity perishable items only, subject to the approval of the Authorizing Official.
 

Accountability. In all instances of gift acceptance, pertinent Federal, HHS, and lHS financial and personal property requirements must be met.
 

LIMITATIONS.
 

Gifts That May Not Be Accepted. Offers of property shall not be accepted if the total costs associated with acceptance are expected to exceed the cost of purchasing a similar item plus the cost of normal care and maintenance.
 

Conditional Gifts. Gifts may not be accepted if conditions imposed by the donor are illegal; contrary to Federal, HHS, or IHS policy; unreasonable to administer; contrary to generally accepted public standards; would create a conflict of interest or the appearance of a conflict of interest to a reasonable person; or create a conflict of interest that cannot be resolved satisfactorily by an ethics official (IHS or HHS).
 

Endorsement. Gifts shall not be accepted when offered for the purpose of securing an endorsement or the appearance of an endorsement. Donors that are commercial organizations will be advised that the acceptance of a gift does not constitute an endorsement. Gifts may not he accepted when the donor expresses, directly or indirectly, an expectation of receiving a future benefit or condition, such as a contract award, an endorsement, etc., from the IHS.
 

Real Property. The Secretary of Health retains the authority to accept gifts of real property. Procedures associated with accepting gifts of real property are not within the scope of this section.
 

WAIVERS/EXCEPTIONS. The granting of requests for exceptions to the policy will be administered and recommended by the DEC. The “IHS Gift Pre-Acceptance Checklist,” (Manual Exhibit 5-22.3-A) should be used as a guide when preparing the request. Letters requesting a waiver or exception to policy for gift acceptance should include a complete description of the  item(s) requested to be waived, a justification or reason for the request, any cost(s), other alternatives considered, timeframe(s) as applicable, what will happen if an exception is not granted, and the recommendation of the Area Director. (See Manual Exhibit 5-22.3-D, “IHS Sample Memorandum Waiver/Exception to Policy.”) The waiver request must be submitted through the PIES for review and recommendation to the DEC, IHS.
 

WILLS AND TRUSTS. Copies of wills and trusts naming the IHS as beneficiary and letters of transmittal will be forwarded to the OGC. The receiving IHS component is responsible for acknowledging receipt of the will or trust promptly and notifying their finance officer when the estate has been settled. Since any interest the IHS might receive may be contingent or subject to prior interests, or could be revoked during the life of the person making the bequest, no entry will be made in the accounts.
 

RECORDS. An individual case file must be established for each gift offered The file must include the following:
 

Copy of the original written gift offer.
 

Signed Pre-Acceptance Checklist.
 

Signed Conflict if Interest Analysis.
 

Copy of all correspondence, including letters of acceptance, etc.
 

Purpose. This Section establishes policy and procedural guidelines for the operation of the personnel suitability and security program of the Indian Health Service (IHS).
 

Policy.  The provisions of this chapter apply to all IHS employment applicants, appointees, employees, members of the Public Health Service Commissioned Corps, and contractors who work in IHS-controlled facilities, information technology, or on sensitive IHS projects. Exception: Employees on temporary appointment of 120 days or less that occupy a position not covered by Public Law (P.L.) 101-630, “Indian Child Protection and Family Violence Prevention,” are not covered by this policy.
 

Suitability Issues. Suitability issues result from pre-employment or post-employment misconduct. Suitability issues may arise from several sources, including:
 

United States Office of Personnel Management (USOPM) pre-employment or post-employment investigations;
 

a review of the employment application, investigation questionnaires, or other employment checks such as inquiries to current and prior employers, and personal references; and
 

other information from any source, that raises questions about an individual’s suitability for employment or retention.
 

MS-wide executive administration and direction of the personnel suitability and security program.
 

Designating a Security Officer and alternate.
 

Ensuring full management commitment to the goals and objectives of the program.