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Indian Health Manual

The Indian Health Manual (IHM) is the reference for IHS employees regarding IHS-specific policy and procedural instructions. The IHM consists of the following:

  • Parts and Chapters - permanent policies, procedures, and operating standards specific and unique to IHS administrative and program operations are maintained in the nine Parts of the IHM.
  • IHS Circulars - the IHS Circular format is used to issue temporary IHS operating policy and establish workgroup charters.
  • Special General Memorandums (SGM) - SGM are used to interpret or reiterate existing IHS policy that requires special attention by IHS employees. The SGM format may also be used to announce new IHS policy that must be implemented immediately.
  • IHS General Administration Manual (GAM) - the IHS GAM Chapters cover administrative subject-matter areas not covered by the IHS Parts and Chapters, IHS Circulars, and SGMs. Plans are underway to eliminate the IHS GAM Chapters by incorporating its subject matter into an appropriate IHM Part or rescission of the GAM Chapter if the subject matter is outdated and no longer required.
  • IHS Delegations of Authority (DOA) - the IHS DOAs are vital to the operation of the IHS and allow the Director, IHS, to delegate to IHS officials the authority necessary to carry out the activities of the Agency. The DOAs are indexed as:
  • Transmittal Notices (TNs) - A TN is a single-page document that covers each approved IHM chapter and subsequent revisions to IHM chapters. The TN includes background information on the new or revised chapter, the Director's signature, information on materials that are superseded by the issuance, and filing and disposition instructions. It is also used to cover approved IHS Delegations of Authority.
  • Organizational Charts - The organizational chart indicates each organizational component denoted in boxes according to standard nomenclature and reporting relationships. The Organizational Charts are posted to this site for reference and information purposes, IHS Headquarters Organizational Charts.

Learn more about the Indian Health Manual.