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About DFO

The Division of Facilities Operations (DFO) develops, implements, manages and evaluates the Indian Health Service (IHS) healthcare facilities engineering program. The program provides technical and management assistance/support for the IHS healthcare facilities, staff quarters and engineering activities, including routine operations, preventative and corrective maintenance and repair and improvement of physical plants, resource utilization, and planning for the continued growth of existing healthcare facilities. The facilities consist of not only the main clinic or hospital, but supply buildings, garages, and other facilities necessary for a safe and efficient operation. Included with many of the healthcare facilities are personnel quarters utilized by the employees of the Service Units.

Typical duties for health facilities personnel include the operation of heating, cooling, and ventilation systems, maintenance of building fixtures, operation of standby power systems, landscape and parking maintenance, and equipment repair. Staff quarters activities include the maintenance of the physical structure, heating and cooling systems as well as fixtures and appliances provided by the Government. The program also reports any changes in asset value of real property. Also included within the Facilities Management Program is providing support, funding and expertise for Clinical Engineering and medical equipment management.

Land leases and rental agreements are negotiated with the appropriate entities and executed through formal documentation. The Quarters Program, which involves rental rates and occupant management, is the responsibility of the Area Real Property Officer.

Since 1975, when Congress enacted the Indian Self-Determination and Education Assistance Act, tribes have been able to assume management of their healthcare services by negotiating contracts with the IHS. The Indian Self-Governance Demonstration Project (SGDP), initially authorized in 1992, greatly expanded this partnership effort by simplifying the self-determination contracting processes and facilitating the assumption of IHS programs by tribal governments and organizations. Finally, in 2000, the President signed the Self-Governance Amendments of 2000, which established a permanent authority for the IHS to enter into self-governance agreements with tribes.

Areas of Responsibility

  • Develop, implement, and manage programs affecting healthcare facilities operations, including routine maintenance and improvement, real property asset management, quarters, and clinical engineering
  • Develop, implement, monitor and evaluate agency program activities, objectives, policies, plans, guidelines, and standardized data systems for healthcare facilities operations
  • Serve as principal resource for coordination of facilities operations and provide consultation to IHS and the Tribes on healthcare facilities operations
  • Facilitates real property asset and quarters management processes
  • Formulates financial resource allocation methodologies
  • Maintain information on Federal and Tribal facilities for program budget justification
  • Develop and evaluate technical standards and guidelines for healthcare facilities operations