Manual Exhibit 8-4-B

INFORMATION TECHNOLOGY PROJECT PROPOSAL SCREENING INFORMATION FORM
1. Proposed Project Name:
2. Primary Point of Contact (Name):	Telephone: E-mail:
3. Does the proposal support a mission/function that needs to be performed by the Federal Government? Answer with explanation:
4. Please indicate the Indian Health Service (IHS) mission area(s) supported by this proposal (see directions for a list list of valid missions from the IHS Strategic Plan). A. B. C.
5. Should this proposal be undertaken because no alternative private sector or governmental source can support the functions? Answer with explanation:
6. Does the proposal support work processes that have been simplified or otherwise redesigned to reduce costs or improve effectiveness? Answer with explanation:
7. Is this project of strategic value to the IHS? Answer with explanation:
8. Does the project cut across two or more IHS organizations? (i.e., does it affect service units as well as administrative offices) Answer with explanation:
9. Is the proposal compatible with the current IHS Information Technology Architecture? Answer with explanation:
10. What is the estimated life-cycle cost over 5 years? $
11. Reviewer's recommendation and discussion: A. This proposal: ٱ satisfies the initial acceptance requirements. ٱ does not satisfy the initial acceptance requirements. If the proposal satisfies the initial acceptance requirements, answer number 12.
12. The proposal is a: ٱ major proposal. ٱ minor proposal. ٱ incomplete proposal. Reason: If the proposal is a minor proposal, answer number 13.
13. I recommend this minor proposal: ٱ be funded. ٱ not be funded. ٱ be reviewed by the ITIRB. Reason:

Information Technology Project Proposal
Screening Information Form
Instructions

The following numbered directions correspond to the numbered blocks on the form. Please do not limit the information you provide because of the size of the blocks on the form. You can enlarge the blocks with your computer. The information contained in this form represents the Chief Information Officer (CIO) Office's conclusions reached during Phase II --Proposal Screening. During this phase, an initial assessment is made as to whether the proposal is a major or minor proposal and also if it is appropriate for the Indian Health Service (IHS), based on Federal guidelines, to fund. For minor proposals, the CIOs office can determine if the project should be funded.

1.	Proposed Project Name: Insert proposed project name from the IHS Information Technology (IT) Project Proposal Form.
2.	Primary Point of Contact: Insert the name and telephone number of the primary point of contact (Project Sponsor) from the IHS IT Project Proposal Form.
3.	Inherent Federal Function. Does the proposal support a mission/function that needs to he performed by the Federal Government? Answer the question based on the information contained in the proposal.
4.	Mission Related. Please indicate the IHS mission areas supported by this proposal. Base your answer on information contained in all of the relevant blocks on the IHS IT Project Proposal Form, primarily focusing on Core IHS Mission/Business Area Affected (Block 9) and Suggested Performance Measures (Block 11). The "Missions" (Block 1-5) should be taken from the four strategic objectives in the IHS Strategic Plan.
5.	No Other Source Available. Should this proposal he undertaken because no alternative private sector or governmental source can support the function? Information to answer this question should he contained in the IHS IT Project Proposal Form (Block 13).
6.	Cost Effectiveness: Does the proposal support work processes that have been simplified or otherwise redesigned to reduce costs or improve effectiveness? Information to answer this question should be contained in the IHS IT Project Proposal Form (Block IO). In general, a Business Process Re-engineering (BPR) requirement should be underway or planned for a proposed project to receive funding. An explanation may be provided to show why a BPR is not needed or not relevant in particular cases.
7.	Strategic Value. Is this project of strategic value to the IHS? Have the answers to the IHS IT Project Proposal Form, Blocks 4, 9, and 11 demonstrated a link to any of the strategic objectives listed in the IHS Strategic Plan?
8.	Cross-cutting. Does the project cut across two or more IHS organizations? In making this determination, consider all the IHS components that are expected to be affected. Where will the benefits be realized? Which components will use the proposed project?
9.	Compatibility. Is the proposal compatible with the current IHS Information Technology Architecture Plan? Base this answer on information provided in the IHS IT Project Proposal Form, Block 10 (BPR Requirements) and Block 12 (High Level IT Architecture Description).
10.	Life-cycle Cost. What is the estimated life-cycle cost over 5 years? Transfer the information from the IHS IT Proiect Proposal Form (Block 6).
11.	Reviewer's Recommendation and Discussion

Proposal. Based on your answers to the questions on this form, determine if this project proposal has sufficient information for you to make a recommendation or if more information needs to be supplied. If the information is sufficient, determine if the project meets the initial acceptance requirements below) and if it is a major or minor proposal. Support your recommendation in the block using as much space as you need.

Initial Acceptance Requirements. The initial acceptance requirements are based on the Office of Management and Budget (OMB) Memorandum 97-02 (Raines' Rules) and Department of Health and Human Services (HHS) guidance. In general, proposed projects need to satisfy the following requirements to be accepted into the IHS ITIRB process:

1.	It should support a mission or function that needs to be performed by the Federal Government.
2.	It should provide a service that must be done by IHS because no alternative private-sector or Government source can do it better or more efficiently.
3.	It should support work processes that have been simplified or otherwise redesigned to reduce costs, improve effectiveness, and make maximum use of commercial, off-the-shelf technology.
4.	It should clearly support the mission and strategic objectives of IHS.

Major or a Minor Project Proposal. In determining if the project is a major or a minor project proposal, consider answering the criteria questions using a scale with "yes" at one end and "no" at the other end. Answers toward the "yes" end of the continuum suggest that the project proposal is a major proposal, while answers toward the "no" end of the continuum suggest that the project is a minor proposal. Major/minor criteria:

1.	Do the benefits associated with this project extend throughout the IHS system?
2.	Are the expected costs significantly above $1 million?
3.	Will the proposed project require a significant change to the IHS ITA plan?