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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 5, Chapter 15:  Manual Appendix 5-15-D

Records management Program Questionnaire


SECTION I.  POLICY AND PROCEDURE YES NO N/A
1. Have copies of Part 5, Chapter 15, "Records Management Program," Indian Health Manual, been distributed throughout the records management network and are guidelines being implemented?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
2. Has a copy of the "Guide to Developing an Indian Health Service (IHS) Files Maintenance and Disposition Plan" been distributed throughout the records management network?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
3. Are National Archives and Records Administration (NARA) guidelines related to electronic recordkeeping, micrographics, and filing equipment implemented in offices throughout the records management network?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
4. Do records maintenance, storage, and use practices comply with provisions of the Privacy Act and Freedom of Information Act?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
SECTION II.  RECORDS MANAGEMENT NETWORK

YES NO N/A
5. Is a Records Management Officer (RMO) or a Records Management Liaison (RML) designated for your organization as the primary coordinator of records management activities?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
6. Has an organization-wide memorandum or directive been issued to identify the RMO/RML and their related roles and responsibilities?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
7. Has an organization-wide records management management network been identified to assure flow of program information throughout the organization?  If so, is there a current listing of network participants available?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
8. Have staff members identified as records management network participants been provided information on the responsibilities and roles via training or briefing sessions?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
9. Do you have a plan to periodically provide managers with information on the records management program activities and requirements?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
10. Does Area management support activities to promote an active records management program within your organization?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
11. Do you have a network strategy for disseminating information on records management activities and requirements?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
12. Has the IHS Records Management Program's communique, "For The Record," served as an effective information sharing and promotional tool for records management activities in your Area?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
SECTION III.  FILES IMPROVEMENT AND RECORDS DISPOSITION TRAINING

YES NO N/A
13. Have the records management network participants and file managers been provided training in files maintenance and records disposition through NARA workshops or other formal training?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
14. Do you have a plan to provide periodic, refresher courses in files maintenance and records disposition for records management network participants and file managers?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
SECTION IV.  FILE SYSTEM DEVELOPMENT AND MAINTENANCE YES NO N/A
15. Are official file stations identified throughout the organization?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
16. Are "record" and "nonrecord" material filed in separate filing areas?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
17. Are staff members in this organization familiar with the difference between "Program Records," "Personal Papers," "Administrative Records," and "Reference Materials?"

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
18. Are "Program Record" files maintained separately from "Administrative Record" files?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
19. Are "Reference Materials" and "Personal Papers" maintained separately from files containing "Program Records" and "Administrative Records?"

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
20. Are "Reference Materials" periodically (at least annually) reviewed and purged of all superseded/obsolete items?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
21. Are staff members in this organization aware that the following materials should not be filed:  envelopes, routing slips, duplicate copies of reports, or informational copies of memorandums?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
22. Are there procedures in each office to determine whether each document being created or received must be filed?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
23. If an office maintains case files, does the office have guidelines to identify the standard set of documents that must be maintained in the case file?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
24. Have file plans been developed for official file stations throughout the organization, reviewed annually, and updated as necessary?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
SECTION V.  RECORDS DISPOSITION ACTIVITY

YES NO N/A
25. Have you identified and reported any 'unscheduled records" to the IHS RMO?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
26. Are files cutoff periodically to identify "inactive records?"

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
27. Are "inactive records" destroyed according to NARA and IHS guidelines?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
28. Are "Program Records" routinely transferred to the Federal Records Center according to instructions provided in the IHS Records Disposition Schedule (RDS)?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
29. Are "Program Records" and "Administrative Records" disposed of according to guidelines provided in the IHS RDS and the NARA General Record Schedule?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
30. Do all file stations in this organization submit an "Annual Records Report?"

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
SECTION VI.  ELECTRONIC RECORDS

YES NO N/A
31. Are staff members in this organization aware of the record status of data/information placed on, stored, and accessed from electronic information systems?

Comments________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
32. Are e-mail messages that contain record information printed out and filed with related program records?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
33. Are the instructions regarding the prompt disposition process, followed for non-record e-mail messages?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______
34. Does your organization have restrictions on the use of e-mail?

Comments:________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

______ ______ ______


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