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     Indian Health Manual

Circular 05-04

Indian Health Service
Rockville, Maryland

Refer to: OD/PFCG


Effective Date:  08/04/2005


  1. PURPOSE.  The Director's Executive Council (DEC) serves as a policy advisory group to the Director, Indian Health Service (IHS).  As such, it focuses on issues related to strategic direction, recommended policy, and organizational adjustments called for by changes in the health systems environment.

  2. AUTHORITY.  The DEC is established by Agency authority to facilitate the accomplishment of the Agency's mission.  The DEC is composed wholly of full-time officers or employees of the IHS (Federal Government employees) and is not governed by provisions of Public Law 92-463, as amended (5 United States Code, Appendix 2), the Federal Advisory Committee Act, Section 3(2)(C)(i), which sets forth standards for the formation and use of advisory committees.

    The DEC has no direct line authority; the group will recommend actions, establish workgroups, and recommend policy.  The DEC will carry out the responsibilities identified in this circular and those assigned by the Director, IHS, with commensurate authorities assigned by the Director.  The DEC will request staff support through Headquarters senior staff, as necessary.


    1. Liaison.  Establish and maintain continuous position as liaison among the Office of the Director, Headquarters senior staff, and Area Directors on systems issues involving strategic direction and policy.

    2. Recommendations.  Develop recommendations for Agency-wide policy in matters that directly affect the mission of the IHS, as requested by the Director.

    3. Work Groups.  Monitor and facilitate workgroups formed to address strategic issues and policies for the Agency.

    4. Operational Issues.  Identify and refer operational issues to the Area Directors and Headquarters staff responsible for such issues.

    5. Communicate.  Provide regular communication on DEC work and activities to the Director, Headquarters senior staff, and Area Directors.


    1. The governing criteria for a DEC assignment is that the assignment is:

      1. assigned by the Director, and

      2. determined by the Director's priorities.

    2. The governing criteria for DEC involvement with issues is that the issue has:

      1. a high impact on the Agency's mission,

      2. significant impact on three or more Areas, and

      3. holds potential benefits that are significant, measurable, achievable, and consistent with the strategic direction of the Agency.

  5. MEMBERSHIP.  Individual members of the DEC shall be appointed by the Director, IHS, from the following groups:

    1. Area Directors.  Three Area Directors, one of whom will serve as the chairperson and one as co-chairperson, will be appointed by the Director, IHS, to serve on the DEC.  Each Area Director will serve a 3-year term, except for the initial appointments, which shall be for a 3-year term, a 2-year term, and a 1-year term.

      The DEC chairperson, the Area Director serving the last year of his/her 3-year term, will direct the work of the DEC.  The DEC co-chairperson, the Area Director serving the second year of his/her 3-year term, will assist the chairperson in guiding the work of the DEC and will direct the group in the absence of the chairperson.

    2. Office Directors at Headquarters.  Three Headquarters Office Directors will be appointed by the Director, IHS, to serve on the DEC.  Each Office Director will serve a 3-year term, except for the initial appointments, which shall be for a 3-year term, a 2-year term, and a I-year term.  The three Headquarters Office Directors will be recommended by the:

      1. Deputy Director for Indian Health Policy,

      2. Deputy Director for Management Operations, and

      3. Chief Medical Officer.

    3. National Professional Councils.  The chairperson (or designee from the IHS in the event the chairperson represents a Tribal organization) of the following professional councils will be members of the DEC:

      1. National Council of Chief Medical Officers,

      2. National Council of Chief Executive Officers,

      3. National Council of Clinical Directors, and

      4. National Nursing Leadership Council.

    All national professional councils members will be appointed by the Director, IHS, to serve a I-year term.  The four members who represent the above-named national professional councils will consist of the chairperson of each professional council or a designee who is an IHS employee (Federal Government employee) in a situation where the chairperson of the national professional council represents a Tribal organization.

  6. MEETINGS.  The DEC will schedule its meetings as necessary and in consultation with the Director.  Between scheduled meetings, business will be conducted through e-mail, telephone conference calls, or video conference calls.

  7. DECISIONMAKING.  The DEC will make decisions using the Agency’s consensual decisionmaking processes.  The decision shall be final at the point “a sense of the council” (defined as the point at which no member continues to object to the action proposed) is achieved.

  8. REPORTS.  The DEC chairperson will assign and coordinate the drafting of reports, position statements, and recommendations and will present the reports to the Director, IHS.

  9. SUPERSEDURE.  This circular supersedes IHS Circular No. 97-03, “Charter,Indian Health Leadership Council of the Indian Health Service," dated June 12, 1997, and IHS Circular No. 97-04, "Charter, Executive Leadership Group of the Indian Health Leadership Council," dated June 24, 1997, in their entirety.

  10. EFFECTIVE DATE.  This circular becomes effective on the date of signature.

/Charles W. Grim. D.D.S./
Charles W. Grim, D.D.S., M.H.S.A.
Assistant Surgeon General
Acting Director, Indian Health Service

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