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


     Indian Health Manual
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Part 4 - Staff Services/Special Programs

Chapter 5 - Office Of Tribal Affairs


Title Section
Purpose 4-5-1
Basic Concepts 4-5.2
Goal 4-5.3
Objectives 4-5.4
Program 4-5.5
    Consultation 4-5.5A
    Liaison 4-5.5B
    Orientation 4-5.5C
    Coordination 4-5.5D
Organizational Relationships & Responsibilities 4-5.6
    Organizational position 4-5.6A
    Functional relationships 4-5.6B
    Responsibility defined 4-5.6C
    Delegation of functions, responsibilities, & authorities 4-5.6D
     Headquarters 4-5.6D(1)
       Director, Office of Tribal Affairs 4-5.6D(1)a
       Assistants to the Director, Office of Tribal Affairs 4-5.6D(1)b
     Area and Field Offices 4-5.6D(2)
       Indian Health Area Director 4-5.6D(2)a
       Area Tribal and Native Affairs Officers 4-5.6D(2)b
     Service Units 4-5.6D(3)
Reporting and Review 4-5.7
    Routine Reports 4-5.7A
    Special Reports 4-5.7B
    Review 4-5.7C

Appendices Description
4-5.6D(1)(a)iv Extra Indian Health Service Relationships
Part I:  Liaison
Part II:  Indian Health Service Replies to Congressional and other Specified Correspondence

4-5.1  PURPOSE

This chapter sets forth the basic concepts and objectives; the program; and the organizational relationships and responsibilities of the Office of Tribal Affairs.

4-5.2  BASIC CONCEPTS

The Indian Health program is administered in a setting unlike that of other Public Health Service programs.  It consists of an intricate maze of related components of the American Indians and Alaska Natives; administration policies on Indian affairs; activities of State governments and their sub-divisions; other organizations and individuals actively interested in Indian affairs; the conflicting cultures of the traditional and modern American Indians and Alaska Natives, and the various levels of advancement and understanding of the many tribal groups.  These components are forces having considerable bearing on the manner in which all services are extended to the American Indian and Alaska Natives.

Consistent with the changing health role, and the increasing involvement and participation of American Indians and Alaska Natives there are :

  1. Problems of major policy or program changes relating to services provided by the Indian Health Service.

  2. Problems related to the day-to-day operations which are often of a critical nature due to the availability of new and expanded social and economic benefits.

  3. Problems related to factors beyond the control of the Indian Health Service such as Congressional action, administration’s Indian policy and intervention of Indian interest groups.

4-5.3  GOAL

The goal of the Office of Tribal Affairs is to contribute to accelerating achievement of the Indian Health Service goal of elevating the health status of American Indians and Alaska Natives to the highest possible levels.

4-5.4  OBJECTIVES

The goal of the Office of Tribal Affairs can be achieved through attaining the following objectives:

  1. To prevent or reduce problems of ongoing program operations stemming from relationships between the Indian Health Service and its consumers.

  2. To contribute to effective program development, implementation, evaluation and long-range planning functions of the Indian Health Service.

  3. To strengthen mutual understanding and develop positive and organized support of the Indian Health Service policies and programs by Indian and related interest groups.

  4. To develop the broadest possible sensitivity, empathy and responsibility of the Indian Health Service staff toward the American Indians and Alaska Natives.

  5. To encourage maximum utilization of all available public and private health resources by the American Indians and Alaska Natives .

  6. To develop with the concurrence of tribal groups, a continuing desire for greater involvement and participation in the operation of their health programs.

4-5.5  PROGRAM

The objectives of the Office of Tribal Affairs will be achieved through a program consisting of four major activities.

  1. Consultation

    1. Provide consultation and guidance to Indian Health Service staff, tribal groups and tribal members, and all other agencies relevant to Indian Health Service programs.

    2. Search out and identify alternatives and make recommendations for inclusion in short and long range planning of Indian Health Service operations.

  2. Liaison

    Assist in developing, maintaining and be involved in liaison activities among Indian Health Services, tribal groups and individuals and other agencies.

  3. Orientation

    1. Participate in the orientation of new Indian Health Service staff and in an ongoing in-service orientation program for all permanent Indian Health Service personnel.

    2. Encourage consumer participation in orientation regarding new and ongoing programs throughout the Indian Health Service program.

    3. Evaluate and relate information regarding American Indians and Alaska Natives to Indian Health Service staff.

  4. Coordination

    1. Serve as principal contact and coordinator for the Indian Health Service in relation to the National Indian Health Board, Area and Service Unit Health Boards.

    2. Serve as a primary focal point for Indian Health Service activities dealing with Indian tribal governments and organizations.

4-5.6  ORGANIZATIONAL RELATIONSHIPS AND RESPONSIBILITIES

  1. Organizational position

    The Office of Tribal Affairs is an Office within the Indian Health Service headquarters as a staff position under the Office of the Indian Health Service Director.

  2. Functional relationships

    The Director, Office of Tribal Affairs at headquarters provides technical guidance to the Area Tribal Affairs Officers and, therefore, will deal in day-to-day technical matters with the Area Tribal Affairs Officers, and the latter with the Service Unit Director.  Their inter-relationships are within the framework of policy set by the Director, Indian Health Service, and the Indian Health Area Director.

  3. Responsibility defined

    Actions of all Indian Health Service employees ultimately affect total relations with American Indians and Alaska Natives.  Responsibility as defined below, however, relates to planning, developing, maintaining and coordinating Tribal Affairs activities -- consultation; liaison; orientation and coordination -- aimed principally at prevention or reduction of unnecessary problems emerging from relationships between the Indian Health Service and the American Indians and Alaska Natives.

  4. Delegation of functions, responsibilities, and authorities

    Responsibility for implementation of Tribal Affairs activities is designated as follows:

    1. Headquarters.  The Director, Office of Tribal Affairs, is responsible to the Director, Indian Health Service, for organizing and maintaining an organized Indian Health Service Tribal Affairs program

      1. The Director, Office of Tribal Affairs

        1. Coordinates development of Tribal Affairs plans and required resources for submission to the Director, Indian Health Service; exercising final authority for recommendation on Tribal Affairs matters.

        2. Serves as Tribal Affairs advisor to the Indian Health Service Director, participating in all major Indian Health Service decisions, including policy development. Exercises recommending authority to the Indian Health Service Director, on the development of policy and plans.

        3. Provides technical guidance to Areas, reviews and recommends Tribal Affairs program adjustments to be made in the Area based on review and appraisal of the Indian Health Service program and progress in terms of resources and needs.  Exercises recommending authority for program modifications, and recommending authority for placement of counterpart Area Personnel.  Submits periodic reports of Indian Health Service-wide status of Tribal Affairs activities, taking independent action within the guidelines set by the Indian Health Service Director.

        4. Represents the Service in extra-Service relationships, as delegated by the Indian Health Service Director, promoting understanding of the Service program (Appendixes 4-5.6D(1)(a)(iv), Parts I and II)

      2. Assistants to the Director, Office of Tribal Affairs

        1. Deputy, Office of Tribal Affairs Management Officer, serves as office manager under the technical direction of the Director, Office of Tribal Affairs, as a Deputy Director.  In the absence of the Director assumes responsibility for the over-all functions of the office.  Provides guidance and direction to the OTA staff in the Community Relations Branch and Correspondence Control Branch in the coordination, planning and implementation of their programs.

        2. Assistant to the Director, Office of Tribal Affairs, for all aspects of consumer and community relations.

          Serves as coordinator for the National Indian Health Board and consultant to the Area and local Indian Health Boards as requested by tribal groups, and performs day-to-day activities of the Office of Tribal Affairs, headquarters.

        3. Assistant to the Director, Office of Tribal Affairs for congressional and controlled correspondence.  (See objectives and responsibilities outlined in appendix 4-5.6D( 1) (a) (iv) , Part II) .

    2. Area and Field Offices.  Full Tribal Affairs functions, responsibilities and authorities exist in all Indian Health Service Areas.  The scope of Area functions, responsibilities, and authorities parallels those at the headquarters level and consists of achieving the Tribal Affairs objectives by providing consultation on a continuing basis regarding the impact of total Indian Affairs on Indian Health Service operations through developing, maintaining, and coordinating sound relationship between the Indian Health Area Service staff organizations, and individuals involved in Indian Affairs by obtaining field data required for program planning and improving operations; and by providing orientation to Area and Service Unit personnel in matters related to Indian Affairs and its impact on Indian Health Programs.

      1. Indian Health Area Director.  Functions, responsibilities, and authorities for conducting a Tribal Affairs Program in each Area are delegated by the Director, Indian Health Service to the Indian Health Area Directors, who, in areas employing Tribal Affairs Officers, may redelegate them to these officers.

        The Indian Health Area Director, in the absence of an Area Tribal Affairs Officer, may assign Tribal Affairs responsibilities to others at the Area level temporarily until an Area Tribal Affairs Officer is selected or appointed.  At that time, the Indian Health Area Director will recall Tribal Affairs responsibilities and, as rapidly as possible and feasible, delegate them to the newly appointed Tribal Affairs Officer.

      2. Area Tribal and Native Affairs Officers

        As the Office Director of the Area Tribal and Native Affairs:

        1. Coordinates establishment of policy and plans for Tribal Affairs activities, using independent action within guidelines set by the Indian Health Area Director.

        2. Serves as advisor to the Indian Health Area Director on Tribal Affairs matters, participating in all major Area decisions, including policy development, exercising recommending authority for development of policy and operational plans, including Indian community development, contractual activities and extra-mural training.

        3. Supervises Tribal Affairs employees, providing for their development, advancement, and exercising authority for their selection with concurrence of the Indian Health Area Director.

        4. Provides Tribal Affairs consultation to Service Units, recommending specific Tribal Affairs program adjustments to be made in the Service Units on the basis of review and appraisal of Area Tribal Affairs program and progress in terms of resources and needs, and submitting periodic reports on Area-wide status of Tribal Affairs activities.

        5. Represents the Area and Headquarters in extra-Service relationships, as delegated by the Indian Health Area Director, promoting understanding of the Indian Health Service program.

    3. Service Units

      Under the jurisdiction of the Areas.

4-5.7  REPORTING AND REVIEW

  1. Routine Reports.  Reporting will be accomplished consistent with Area policy.

  2. Special Reports.  Events which could alter the course of Indian Health Service-Indian relationships should be promptly reported by the Area Tribal Affairs Officer through the Indian Health Area Director in accordance with Indian Health Service Manual Part I, Chapter VI.

  3. Review.  Area Tribal Affairs programs as set forth in written plans are subject to review by the Director, Office of Tribal Affairs.


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