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Information Systems Advisory Committee – Charter - Superseded by Circular 19-06 dated 09/27/2019

Indian Health Service
Rockville, Maryland 20857

Refer to: OIT



  1. Purpose. This circular updates the Information Systems Advisory Committee (ISAC) Charter and will supersede the previous version in the Indian Health Manual, Part, 8, Chapter 2, dated July 28, 2006. The ISAC is established to guide the development and management of information technologies and health information technologies used in the delivery of care within the Indian health system. The ISAC will assist in ensuring that information technology (IT) and health IT systems, projects, and initiatives result in:
    1. Improving the patient experience of care (including quality and satisfaction),
    2. Improving the health of population,
    3. Reducing the per capita cost of health care,
    4. Improving IT/Health IT user experience, and
    5. Meeting regulatory, quality, and reporting requirements in a timely and effective manner.
    Recognizing that the health care delivery environment and information technologies that provide support are rapidly changing, the ISAC will be flexible in interpreting the roles and rules of this document and revise them as necessary to best meet its goal.
  2. Goal. The goal of the ISAC is to ensure that information systems and health IT systems are optimized to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level.
  3. Authority. The ISAC will report to the Director, Indian Health Service (IHS). The ISAC will carry out the responsibilities and authorities as provided in this charter and delegated in writing by the Director, IHS.
  4. Membership. Attention is given to provide for a diverse perspective in terms of geography, size of program, and mode of service and/or contracting instrument. Tribal membership must comply with the Federal Advisory Committee Act (FACA) Intergovernmental exemption requirements that are described in Section 6.
    1. Members of the ISAC.
      1. IHS Chief Information Officer,
      2. An elected Tribal Leader, representing their Tribe, who is a Board member of the National Indian Health Board,
      3. An elected Tribal Leader, representing their Tribe, who is a Direct Service Tribal Advisory Committee (DSTAC) Member,
      4. An elected Tribal Leader, representing their Tribe, who is a Tribal Self-Governance Advisory Committee (TSGAC) Member,
      5. National Council of Chief Medical Officers (NCCMO) Member,
      6. National Council of Executive Officers (NCEO) Member,
      7. National Council of Informatics Member,
      8. National Nurse Leadership Council (NNLC) Member,
      9. National Council of Chief Clinical Consultants Member,
      10. IHS Information Systems Coordinator Committee Member,
      11. IHS Area Director Representative,
      12. IHS Chief Information Security Officer,
      13. IHS Chief Health Informatics Officer,
      14. IHS Deputy Director for Quality Health Care,
      15. Office of Environmental Health and Engineering Representative, and
      16. One at-large member from each IHS Area consisting of elected Tribal Leaders (or designees) will be appointed by the respective Area Director.
    2. Membership Designations.
      1. The committees, councils, and programs represented on ISAC are responsible for selecting their ISAC representative or designee and notifying the ISAC in writing of the selected official. An email notification to the ISAC co-chairs is acceptable.
      2. All ISAC members will designate, in writing, an alternate who will serve in an official voting capacity in the event the member is absent. An email notification to the ISAC co-chairs is acceptable.
        1. All Tribal Leader ISAC members may temporarily designate an alternate from within their own Tribe/Tribal Organization authorized to act on the Tribal Leader’s behalf.
        2. IHS Program ISAC representatives may temporarily designate alternates from within their respective organizations who they have authorized to act on their behalf.
      3. If any ISAC member or alternate is from a Tribe or Tribal Organization, written documentation is required to be in place with the ISAC to indicate they are officially representing a Tribal Government.
    3. Membership Changes.
      1. Any ISAC member that is a Tribal leader may replace his/her authorized Tribal employee/technical staff on ISAC at his/her discretion.
      2. Tribal members may resign by request to their respective IHS Area Directors through submission in writing.
      3. The ISAC may recommend, to an IHS Area Director, the replacement of his/her Area’s at-large member who does not attend two consecutive committee meetings.
    4. Staff Support. Staff support will be provided by the IHS Office of Information Technology and can include personnel from IHS/Tribal/Urban (I/T/U) organizations or programs.
    5. Attendance by Members of the Public. Members of the public may observe the advisory group meetings but may not participate during the formal actions. The committee may seek advice from members of the public on an individual basis during listening sessions. Listening sessions will be held on an as needed basis.
  5. Chairs. The ISAC is co-chaired by one Tribal ISAC member and by one IHS ISAC member as follows.
    1. Tribal Chair. The Tribal Chair will serve a 2-year term, and will rotate between the following ISAC members in the order listed. Upon completion of the terms, the rotation will repeat.
      1. An elected Tribal Leader, representing their Tribe, who is a DSTAC Member,
      2. An elected Tribal Leader, representing their Tribe, who is a TSGAC Member, and
      3. One of the At-large Tribal Leader ISAC members selected by ISAC majority vote.
    2. IHS Chair. The IHS Chair will serve a 2-year term, and will rotate between the following ISAC members in the order listed. Upon completion of the terms, the rotation will repeat.
      1. NCCMO ISAC Representative,
      2. NNLC ISAC Representative, and
      3. NCEO ISAC Representative.
  6. Federal Advisory Committee Act Intergovernmental (FACA). The ISAC will ensure compliance with the exemption from FACA for intergovernmental communications where meetings are "held exclusively between Federal officials and…elected officers of…Tribal governments (or their designated employees with authority to act on their behalf), acting in their official capacities." 2 United States Code § 1534(b). All IHS advisory groups that are convened for the purpose of generating consensus recommendations must ensure that written documentation is in place to indicate that each member of the advisory group or his/her designee is officially representing a Tribal Government.
  7. Responsibilities.
    1. The ISAC is charged with the following responsibilities.
      1. Annually prioritizing key initiatives in information systems to be addressed by the IHS,
      2. Advising the Director, IHS, on direction, priorities, and budget and resource allocation for information systems,
      3. Promoting and supporting efficient and effective use of health IT which:
        1. improves the quality, safety, efficiency, and care coordination of population and public health;
        2. reduces health disparities and improves access;
        3. engages patients and their families;
        4. supports I/T/U organizations or programs in managing the business of health care delivery; and
        5. ensures adequate privacy and security protections for IHS systems, network, and data inclusive of Protected Health Information and Personally Identifiable Information;
      4. Developing a process for leveraging health IT in support of health care reform and quality improvement initiatives,
      5. Developing an inclusive, transparent, accountable, fair process and environment that supports collaboration between I/T/U programs consistent with applicable Tribal consultation policies,
      6. Developing a process for working cooperatively with Tribes/Tribal organizations, Urban Indian Health Programs, State entities, and other Federal agencies to share activities and costs to meet the information systems needs of Indian communities,
      7. Renewing and strengthening advocacy and support for I/T/U health IT collaboration and communication,
      8. Promoting the development, adoption and use of data and analytics, standard data sets, including development of analytic tools and disseminating information regarding the status of existing data sets, and marketing the need for maintaining standardized aggregate data,
      9. Promoting the development, adoption and use of revenue cycle tools to maximize the ability of organizations to provide quality care through financial stability,
      10. Establishing and appointing ad-hoc working groups to provide advice and perform activities dealing with current IT initiatives and issues,
      11. Communicating with and report to ISAC member stakeholder groups, and
      12. Identifying and advocating for resources needed for information systems.
    2. Meetings. The ISAC will meet at least twice annually to carry out its responsibilities either in person or virtually. The Director, IHS, co-chairs, or IHS Chief Information Officer may call special meetings. The ISAC members will be notified through the IHS ISAC Listserv; in addition, meeting notices will be posted to the IHS Calendar of Events. A summary of motions will be produced for ISAC members within 5 working days.
    3. Minutes. Minutes documenting action items and responsibilities will be produced within 15 working days of each meeting, distributed to ISAC. Meeting minutes will be maintained with the IHS, Office of Information Technology consistent with applicable records management requirements and will be made available upon request to the public.
  8. Decision Making.
    1. Quorum.
      1. A quorum will exist when at least half of the ISAC representatives are present. All decisions will be made by majority vote of those present at each meeting. If a quorum is not met, ISAC members present may discuss agenda items and make informal decisions, but the decisions cannot be acted upon until the next ISAC meeting where a quorum is met.
      2. In the event of a deadlock decision, opposing arguments will be summarized, submitted to the Director, IHS, for determination, and the outcome documented in the minutes.
      3. Vacant positions will not be counted for the purpose of calculating a quorum.
    2. Agenda Setting and Submission of Issues for Consideration. All ISAC members are encouraged to submit topics for potential inclusion in the agenda. The ISAC co-chairs will jointly establish meeting agendas.
      1. For complex concerns, issue papers are encouraged to be submitted in advance for consideration as an in-depth discussion of background, alternatives, financial costs, benefits, and impacts, and other considerations may be beneficial.
      2. Agendas will be distributed to ISAC members approximately 10 working days before each meeting.
    3. Charter Review.
      1. This charter will be reviewed on a biennial basis and as needed to evaluate its effectiveness and incorporate any improvements.
      2. The ISAC will recommend changes to the ISAC charter by a simple majority vote of the ISAC and submit to the Director, IHS, for approval.
  9. Supersedure. This circular supersedes IHS Circular No. 19-04, "Information Systems Advisory Committee - Charter," dated August 9, 2019, in its entirety.
  10. Effective Date. This IHS Circular is effective upon the date of signature.

/Michael D. Weahkee/
RADM Michael D. Weahkee, MBA, MHSA
Assistant Surgeon General, U.S. Public Health Service
Acting Director
Indian Health Service

Distribution:  IHS-wide
Date:  09/27/2019