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Circular Exhibit 2002-02-A

  1. Introduction.  A site-specific Continuity of Operations Plan (COOP) is being developed for the (Name of Building) located at (Address).  This COOP will ensure that the capability exists to continue the essential functions and operations of the Indian Health Service (IHS) located in the (Name of Building) in the event of a natural or man-made disaster that renders all or part of the building non-usable.
  2. Purpose.  The purpose of the Impact Analysis Questionnaire is to gather information on the mission capabilities and functions, technical responsibilities, and the space and equipment requirements necessary for operation of the IHS component located in the building.
  3. Planning.  The Impact Analysis is a technique to help managers determine what functions are essential core functions and what functions can be postponed or suspended temporarily.

    Core or essential functions are those functions that must be performed or the consequences would:

    1. Have adverse affects to the health, safety, or livelihood of workers, the public, and the environment.
    2. Have negative impact on national security.
    3. Prevent the IHS from meeting its statutory and/or regulatory obligations.
  4. Descriptions of Critical Functions and Applications.  An Impact Analysis defines the essential functions and operations of each IHS component located in the (Name of the Building).  Under normal operating conditions, the IHS is performing an essential job authorized by Congress and needed to service the public.  However, when an emergency situation occurs, some functions can be suspended temporarily, other functions can be performed at a maintenance or lower than usual level, while some limited functions must continue without interruption.  In short, during an emergency situation, fewer functions will be carried out and they will be carried out at a lower or maintenance level when they occur.

    To help managers decide which functions to continue and at what level, we assume as a premise that there are three levels of operational capability the IHS might need during any emergency situation, namely:

    1. Full Capability:
      1. This is the capability you now have.
      2. Include in the ?Full Capability? section all of the functions and operations that are in your mission/function statement.
    2. Limited Capability:
      1. These are the capabilities you need to fulfill your core or essential functions on an emergency basis for 30 days.  These core functions include those that meet your statutory or regulatory obligations, are needed to avoid negative national security impacts, and are needed to provide for the health and safety of workers and the public.  These core functions are less than those functions and operations in your normal mission.  They are the core functions that cannot be postponed or suspended for 30 days without severe negative impacts.
      2. Not included are those functions that can be temporarily shifted to other parts of the IHS; those that could be carried out using alternative means or techniques; and the functions that can be postponed and begun again after 30 days.
    3. Core Capability:
      1. This is the smallest list of core functions and operations you can provide for the 1-2 weeks.
      2. This is the core of essential activities that absolutely cannot be postponed or delayed even for a week.
      3. These functions must be carried out no matter what the emergency and must continue without interruption.
      4. They are the essential core functions.


    The Impact Analysis Questionnaire is an information gathering tool to aid in the assessment of the critical functions and capabilities of the IHS components located in the (Name of the Building).  Information collected through this questionnaire will be used to develop the (Name of the Building).  Continuity of Operations Plan (COOP) recovery plans and procedures.

    1. Instructions for Completing the Questionnaire.
      1. The forms and questions in the Impact Analysis will lead you through the Impact Analysis process using the three capability levels-full, limited and core.
      2. Specific instructions are included for each item of information requested.
    2. The Impact Analysis Questionnaire is divided into the following sections:

      Part A.  Critical Functions--Capability Levels

      Part B.  Critical Support System Requirements

      1. Vital Records
      2. Voice and Data Systems Requirements

      Part C.  Office Equipment Inventory.

      Prepared by:

      NAME: DATE:
      TITLE: E-MAIL:

      GENERAL.  This section contains questions pertaining to Indian Health Service (IHS) capabilities at three levels-full, limited, and core---that were defined above.  All IHS offices in the (Name of the Building) are requested to complete this form.  The main objective of this form is to identify physical resources, resource vulnerabilities, and critical functions related to IHS operations.

      1. Full Capability:  Please attach your mission/function statement.
        1. What are the capabilities that support the functions and operations in your mission/function statement?
        2. Please list these mission capabilities in the same order as they are listed in the mission/function statement.  Provide Mission Capability, Office Responsible, Person Responsible/Job Title, Phone, and Size of Staff.

        Mission Capability Office Responsible Person Responsible/ Job Title Phone Size of Staff
      2. Limited Capability:  List the mission capabilities that would support core essential functions at an alternative site for 30 days.  These capabilities cannot be suspended or postponed for 30 days without severe impacts.  Of the missions listed on the full capability list, indicate by number and a short descriptive statement those mission capabilities that would be part of your limited capability:  Include the minimum staff required to carry out this reduced capability.

        Mission Capability # Minimum Staff Position(s) Name(s)
      3. Core Capability:  List the mission capabilities that support the core essential functions that cannot be even for 1-2 weeks.  These are the core capabilities that must be carried out no matter what the emergency situation.  This is the shortest list of missions or capabilities that must be continuously performed or severe impacts on the health and safety of workers and the public will occur; or serious national security impacts will occur or the IHS will fail to meet statutory or regulatory obligations.

        Refer again to the full capability listing and limited listing you prepared.  Indicate by number and with a short descriptive statement those mission capabilities that are your core essential functions.  Indicate the minimum staff required to carry out these activities.

        Mission Capability Minimum Staff Position(s) Name(s)
      4. Additional Questions About Your Missions/Functions
        1. What other offices or services does your office rely on for normal operations?
        2. What offices or services rely on your office for their normal operations?
        3. What office has the primary responsibility for coordinating the reestablishment of your critical functions in a new location as a result of an emergency?
        4. Who is your Point of Contact (POC)?

          Computer Support:_______________POC:___________________Phone:_____________
          Communications Support:__________POC:___________________Phone:_____________
          Furnishings and Equipment:_________POC:___________________Phone:_____________
        5. Identify primary and alternate supervisory POCs for your office area.

          Primary Contact:_____________ Office:___________ Phone:_______

          Alternate Contact:___________ Office:___________ Phone:_______

        6. Identify any unique equipment, special fabrication requirements, physical security, equipment funding, or procurement actions that may be associated with the reestablishment or replication of this function at a remote relocation site.
        7. Identify any Emergency Standard Operating Procedures, Crisis Action Team, or Emergency Support Team that your office has or participates with.

        1. <>Vital Records.
          1. What key reference materials or operating procedures are used in the IHS (e.g., U.S. code, rule, and regulations)?
          2. In reference to Question 1, should any of the documents be stored in an off-site location (because of difficulty to replace)?  If yes, please identify.  Are they available on the Internet?
          3. Identify any electronic media, disks, hard drives, or zip files that must be stored or prepared to be available for transport to the relocation site.
        2. Voice and Data System Requirements.
          1. What are your office telephone, teleconferencing, and voice communication requirements during an emergency to support the core capabilities?  To support the limited capabilities?

              Limited Capability Core Capability
          2. What are your office print media and facsimile (fax) requirements during an emergency?  To support core capabilities?  To support limited capabilities?

              Limited Capability Core Capability
          3. Identify off-site e-mail messaging, storage requirements, and Internet connectivity required from a COOP relocation site.

              Limited Capability Core Capability
          4. What are your office's data requirements?  To support limited capability?  To support core capability?  How would you continue operations without data processing?

              Limited Capability Core Capability
            Data Requirements    
            Alternative Means    
        3. What are your backup procedures for all standalone computer systems located within the IHS' location?  Do any of these critical backups need to be stored off site?
        4. Who supplies data network and Internet connectivity to your office?
        5. Does your office share specialized data information with other offices outside of your own office?


        NOTE:  These space and equipment estimates should be linked to the staff size identified in PART A, ?Critical Functions? Section.

        In each of the following columns please record:

        Full Capability:  The Current quantity of the items listed for total office reconstitution.

        Limited Capability:  The minimum quantity your office needs to meet its 30-day limited capability requirement.

        Core Capability:  The minimum quantity your office needs to meet its 1-2 week core capability requirement.

        Replacement Resources:  The office that provides service or replacement of each resource.

        1. Physical Office Inventory:

          Description Full Capability Limited Capability Quantity Core Capability Quantity Replacement Resources
          Area in square feet
          (Office Estimated)
          Computer Workstations


          No. of Telephone lines

          FAX Machines

          Photocopy-FAX Machines




          File Cabinets


          Television Cable Leads


          Please provide copies of any memoranda that establishes an order of succession in the event of an emergency or when leaders are out of the area or overseas temporarily, within the IHS.


          If the IHS has an authorizing law or executive order separate from or in addition to that establishing the Department of Health and Human Services, please include a copy of that law or order.

          Please provide copies of any memoranda that delegate authority within the IHS during emergencies.  Include delegations to Area or field locations.

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