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

Tribal Consultation

ISSUE

The involvement of tribal governments in activities of the Indian Health Service (IHS) is mandated by law.

BACKGROUND

The United States has a government-to-government relationship with American Indian and Alaska Native Tribes that is based on treaties, law, Presidential Executive orders, and numerous court decisions. An integral part of this relationship is the requirement that agencies of the federal government consult with and involve tribal leaders in decisions and activities that affect tribal governments and members of their sovereign nations. In 1997, the IHS Director promulgated the first comprehensive Tribal Consultation and Participation Policy in the federal government. The policy established a minimum set of expectations for IHS staff with respect to consulting and working with tribal leaders.

STATUS

The IHS conducts a variety of consultation activities with tribal leaders and representatives of tribal governments, including national meetings, regional inter-tribal consultation sessions, meetings with delegations of leaders from individual Tribes, Area consultation sessions, and tribal advisory workgroups. In recent years, tribal leaders and representatives have come to play an important role in the IHS budget formulation and setting health priorities at the national and regional levels.

The increased involvement of Tribes in advising and participating in the decision-making process of the Agency has resulted in stronger collaborations between the federal government and tribal governments; innovations in the management of programs; and important issues being brought forward for consideration by IHS, the Administration, and Congress in a timely fashion.

OPTIONS/PLANS

Consultation practices within the IHS are reviewed continuously to ensure that they meet the requirements of the Agency consultation policy. The IHS adopted a revised Tribal Consultation Policy in 2001. Continuing discussions with tribal leaders resulted in the adoption of the third IHS Tribal Consultation Policy in January 2006. In 2008, the IHS Director's Advisory Workgroup on Tribal Consultation was established. The Workgroup now consists of 24 elected tribal officials (two from each of the 12 IHS Areas). In partnership with the IHS Director, the Workgroup strives to make the tribal consultation process more meaningful, effective, and accountable.

The result of these efforts has been significant. For instance, the IHS improved its process for tribal delegation meetings by producing more complete briefing documents and responding to Tribes in a timely manner to address follow-up items from the meeting. Tribes now receive an acknowledgment response for comments submitted to the Agency. The IHS also issued a Tribal Consultation Activities Summary by Topic that summarizes all consultations since 2009 and provides the status on the outcomes of each consultation. In addition, the IHS has held multiple Tribal Consultation Summits, which serve as a "one-stop shops" to learn about consultation and workgroup activities and to make recommendations.

ADDITIONAL INFORMATION

For referral to the appropriate spokesperson, contact the IHS Public Affairs Staff at 301-443-3593.

January 2013

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