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Indian Health Service The Federal Health Program for American Indians and Alaska Natives

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     Indian Health Manual

Program Delegation #17

Department of Health and Human Services USA logo
     Indian Health Service
 Rockville MD 20857

Program #17

DEC 14, 1998

TO: Director
Office of Tribal Self-Governance

FROM: Director of Headquarters Operations

SUBJECT: Delegation of Authority for Title III of the Indian Self-Determination and Education Assistance Act, Public Law 93-638, As Amended

Authority Delegated and To Whom

Pursuant to the authority delegated to the Director of Headquarters Operations by the Director, Indian Health Service (IHS), on March 14, 1996, I hereby delegate to the Director, Office of Tribal Self-Governance, for application IHS-wide (except for the Alaska Area), authority to approve amendments to Self-Governance Annual finding Agreements (AFA) under Title III of the Indian Self-Determination Act (ISDA) that do not require renegotiation.  Examples of these amendments include:

  1. Amendments to add congressional appropriation adjustments

  2. Amendments to add congressionally mandated increases

  3. Amendments to add third-party reimbursements

  4. Amendments to add Catastrophic Health Emergency Fund distributions

  5. Amendments to add distributions of year-end funds


The Director IHS, retains the authority to approve all initial compacts and initial AFAs awarded under Title III of the ISDEA.


The authority delegated herein may not be redelegated.

Effective Date

This authority is effective immediately, and will continue until superseded or rescinded.

/Luana L. Reyes/
Luana Reyes

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