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The Division of Facilities Planning and Construction has many programs that are authorized to construct health care facilities and staff quarters, renovate/construct Youth Regional Treatment Centers for substance abuse, Joint Venture Construction Projects, provide construction funding for Tribal small ambulatory care facilities projects, replace/provide new dental units, and to assist non-IHS funded renovation projects.

Joint Venture Construction Program

Section 818 of the Indian Health Care Improvement Act, P.L. 94-437, authorizes the IHS to establish joint venture projects under which Tribes or Tribal organizations would acquire, construct, or renovate a health care facility and lease it to the IHS, at no cost, for a period of 20 years. Participants in this competitive program are selected from among eligible applicants who agree to provide an appropriate facility to IHS. The facility may be an inpatient or outpatient facility. The Tribe must use Tribal, private or other available (non-IHS) funds to design and construct the facility. In return the IHS will submit requests to Congress for funding for the staff, operations, and maintenance of the facility per the Joint Venture Agreement.

Proposals considered under this program are evaluated against the following criteria:

  • The need for space at the location is verifiable when evaluated by using the criteria in the
  • IHS planning methodologies;
  • The Tribe is able to fund and manage the proposed project using its own (non-IHS)
  • funds;
  • The project is consistent with the IHS Health Systems Planning program; and
  • The project is consistent with the IHS Area Health Facilities Master Plan.

Additional consideration is given to Tribes that elect to fully fund the equipment for the facility.

Post Occupancy Evaluations Program

The Indian Health Service conducts Post Occupancy Evaluations (POE) of recently completed health care facilities to gain knowledge for improvement of the planning and design process for new health care facilities as well as to encourage overall improvement in the health delivery process by providing the best health care facilities possible. The major purposes of a POE include:

  1. To avoid repetitious design or construction deficiencies.
  2. To document noteworthy construction features or practices for inclusion in future projects.
  3. To evaluate the entire plan-design-construction-operation process. After the evaluation, feedback will be provided to those offices which were responsible for the planning, designing, constructing and operating processes.
  4. To save future construction and operating costs by contributing to an efficient facilities design and construction program.
  5. To evaluate staffing patterns and determining the adequacy of the space provided compared to the approved Program of Requirements.
  6. To verify that the functional requirements of the Program of Requirements are met, and that they are met at reasonable costs. The operating program and technical survey team jointly evaluate this item. Generally a POE is conducted after the initial construction and start-up defects are corrected and the facility is in full operation, 2 to 4 years after initial occupancy. This time period also allows the staff an opportunity to become familiar with the facility and to implement procedures for utilizing their department spaces.

For additional information, contact Peter Nachod, Manager of the Post Occupancy Evaluations Program.

Small Ambulatory Program (SAP)

Section 306 of the IHCIA, P.L. 94-437, authorizes the IHS to award funds to Tribes and/or Tribal organizations for construction, expansion, or modernization of ambulatory health care facilities. Where non-Indians will be served in a facility, the funds awarded under this authority may be used only to support construction proportionate to services provided to eligible American Indian and Alaska Native (AI/AN) people. In fiscal year 2021 the program received $24 million in funding. Participants in this program are selected competitively from eligible applicants.

Participants in this program are selected competitively from eligible applicants who meet the following criteria

  • Only federally recognized Tribes that operate non-IHS outpatient facilities under P.L. 93-638 contracts are eligible to apply for this program.
  • Facilities for which construction is funded under Section 301 or Section 307 of P.L. 94- 437 are not eligible for this type of program.
  • Priority will be given to Tribes that can demonstrate a need for increased ambulatory health care services and insufficient capacity to deliver such services.
  • The completed facility will be available to eligible Indians without regard to ability to pay or source of payment.
  • The applicant can demonstrate the ability to financially support services at the completed facility.
  • The completed facility will:
    • Have sufficient capacity to provide the required services.
    • Serve at least 500 eligible AI/AN people annually.
    • Provide care for a service area with a population of at least 2,000 eligible person

Application criteria to note

  • Funding is split between two categories, large and small. The category is tied to the Maximum Supportable Space (MSS) of the Service Unit the application resides in with the threshold for small is not to exceed 100,000 square feet. Large Projects will compete for $5 million in funding and small projects for $19 million.
  • All applications will require use of the Health Systems Planning (HSP) software for user population projections and suggested required building area. To sign up for HSP access please navigate to HSP Software Site and click the login button and click the hyperlink requesting access.

Instructions to complete your application online

  1. Request access to the application portal. Exit Disclaimer: You Are Leaving 
  2. Enter your first name, last name, and email address and click submit.
  3. Access will be granted within one business day. Please check both your inbox and spam/junk mail folder for the access link.
  4. Complete Sections A and B of the FY2021 SAP Application kit.
  5. The information entered can be saved and accessed again using your email address.
  6. Once you hit final submit you are no longer able to make changes to your application.
  • Section C shall be submitted to the email address
  • This year’s Application Kit is a Fillable PDF form. Applications can be submitted using this and signed with a digital signature. This method is not preferred but accepted.
  • Applications are due to your IHS Area of jurisdiction by May 15, 2022
  • Final applications are due to IHS DFPC by July 1, 2022

HSP Informal Training to complete Application

Application Kit Links

For questions and additional information, contact CDR Omobogie Amadasu, (office: 301-443-4751) Manager of the Small Ambulatory Program.

Youth Regional Treatment Centers Program

The following Youth Regional Treatment Centers were constructed or are scheduled to be completed in:

Pyramid Lake, NV - 2007
Spokane, WA (Healing Lodge of the Seven Nations) - 2005
Sacaton, AZ - 2009
Fairbanks, AK - 2004
Sitka, AK - 2004
Warm Springs - 1992
Northern California - 2016
Southern California - 2015

Green Infrastructure Funds Program

The Indian Health Service (IHS) receives annual appropriations of Green Infrastructure Funds to address sustainability in existing health care facilities. The appropriation directs the IHS Office of Environmental Health and Engineering to incorporate planning, design, and operations of buildings to reduce costs, minimize environmental impacts, use renewable energy, and incorporate green infrastructure and the most current energy efficiency codes and standards to the maximum extent practicable.

Call for proposals are typically sent to the Area Offices at the beginning of the fiscal year and are due the following January. The Division of Facility Planning and Construction (DFPC) reviews and prioritizes funding requests for activities that meet the requirements for Green Infrastructure Funds.

Criteria to distribute Green Infrastructure Funds are based on:

  1. Return on Investment
  2. Requirements Compliance (Law and EOs)
  3. Reduction in energy use
  4. Reduction in water use
  5. Enhance Indoor Environmental Quality

Requests for funding are made by submission of an IHS Area-approved; three-to-five page Request for Funding (RFF) to the DFPC. The submission should include supporting documentation, summaries of studies, and cost estimates. This document is not approval to construct the project, but rather a funding request to support the project. A Project Summary Document (PSD) or Program Justification Document (PJD) may be needed for approval to implement the project, depending of the estimated cost of the planned project.

Proposal Process

DFPC is requesting that all interested Areas submit project specific proposals. All proposals must be submitted through the appropriate IHS Area Office. This includes proposals from service units and tribal entities. For tribally owned or operated facilities, tribes are encouraged to consult in advance with their respective Area Office to assure consistency with other submissions.

All projects will be assessed, ranked and awarded until funds are exhausted. Any funds not awarded, will be added to the next year’s allocation.

Final proposals are due to IHS DFPC by January 18, 2023.

FY 2023 Call for Proposal Links

For additional information, contact CDR Mark Hench, Manager of the Green Infrastructure Funds Program.

Nonrecurring Expenses Fund (NEF Funds)

As cited in the 42 U.S. Code § 3514, unobligated balances of expired discretionary funds appropriated in the current or any succeeding fiscal year from the General Fund of the Treasury to the Department to the Department of Health and Human Services (HHS) by this or any other Act may be transferred into the NEF pool fund.

Amounts deposited in the Fund shall be available until expended, and in addition to such other funds as may be available for such purposes, for capital acquisition necessary for the operation of the Department, including facilities infrastructure and information technology infrastructure, subject to approval by the Office of Management and Budget (OMB). NEF Funds may be obligated only after the Committees on Appropriations of the House of Representatives and the Senate are notified at least 15 days in advance of the planned use of funds.

Timeline of the NEF Funds

  1. The Department estimates what their carryover will be for the year. This is done at the end of the 3rd quarter of the current fiscal year.
  2. HHS determines what funds will expire in the coming year and asks the agencies to propose projects matching that amount. Typically a request for projects is sent out in May.
  3. IHS prioritizes projects that meet the NEF-specific criteria.
  4. The HHS budget is passed by Congress. Typically from October to March
  5. HHS notifies IHS of what projects are approved.

The Fund Project-specific Criteria

Shovel Ready Projects 
Indian Health Service owned and operated facilities in need of infrastructure improvements


  • Purchase of Land for IHS facilities;
  • Quarters;
  • Planning and Design for any of the above;
  • Facilities Engineering Deficiency System (FEDS) projects;
  • Green Infrastructure facility improvements;
  • Medical Equipment for a new facility;
  • Any additional projects that meet the above criteria.

For additional information, contact Jim White, PE for additional information. 

Space Validation

Health facilities space that supports IHS programs is eligible for funding support through the annual Facilities Appropriations. The criteria for space validation is space used by IHS-approved health programs under PL 93-638. For tribal facilities, only the portion of space that conforms to the IHS health planning methodology is eligible for funding support.

Why validate space?

Validated space allows access to the allocation of funding from two different programs, maintenance and improvement (M&I) and equipment funds, which are both funded through the annual Facilities Appropriation. Once the space for a new/expanded health facility has been validated, the Division of Facilities Operations (DFO) updates the facility in Healthcare Facilities Data System (HFDS) for allocation of these funds.

How do you validate space for health facilities?

Space is validated by completing Appendix A from the “Technical Handbook for Environmental Health and Engineering Vol VI Part 77-1 Facilities Supportable Space,” and submitting it to DFPC verifying the actual use of the facility. Once the document is reviewed, it is recommended and forwarded to DFO (CAPT Robert Hemberger) for final approval and updating to HFDS. 

Appendix A must include the IHS approved services provided by the facility, the floor plan denoting the location of the services, and the size stated in gross square meters (or square feet). The most current version of the HSP contains the health program disciplines that qualify as IHS approved health service programs.

For newly constructed and/or renovated health facilities, once the facility is opened and actively seeing patients for two weeks, email the signed Appendix A along with the supporting documents to CDR Mark Hench.