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

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Tribal Consultation

President Obama signing the Tribal Law and Order Act, July 29, 2010.
President Obama signing the Tribal Law and Order Act, July 29,


The involvement of tribal governments in activities of the Indian Health Service (IHS) is mandated by law.


The United States has a government-to-government relationship with American Indian and Alaska Native Tribes that is based on treaties, law, Presidential Executive orders, and numerous court decisions. The IHS is committed to regular and meaningful consultation and collaboration with eligible tribal governments. Consultation is considered an essential element for a sound and productive relationship with Tribes. Tribal Consultation has been affirmed by Executive Order in 2000 and through Presidential Memoranda in 1994, 2004, and 2009. In 1997, the IHS Director promulgated the first comprehensive Tribal Consultation and Participation Policy in the federal government. The policy established a minimum set of expectations for IHS staff with respect to consulting and working with tribal leaders. The IHS Tribal Consultation Policy can be referenced at IHS Circular No. 2006-01.


The IHS conducts a variety of consultation activities with tribal leaders and representatives of tribal governments, including national meetings, regional inter-tribal consultation sessions, meetings with delegations of leaders from individual Tribes, Area consultation sessions, and tribal advisory workgroups. In recent years, tribal leaders and representatives have come to play an important role in the IHS budget formulation and setting health priorities at the national and regional levels.

The increased involvement of Tribes in advising and participating in the decision-making process of the Agency has resulted in stronger collaborations between the federal government and tribal governments; innovations in the management of programs; and important issues being brought forward for consideration by IHS, the Administration, and Congress in a timely fashion.


Consultation practices within the IHS are reviewed continuously to ensure that they meet the requirements of the Agency consultation policy. The IHS adopted a revised Tribal Consultation Policy in 2001. Continuing discussions with tribal leaders resulted in the adoption of the third IHS Tribal Consultation Policy in January 2006. In 2008, the IHS Director's Advisory Workgroup on Tribal Consultation was established, which consists of 24 elected tribal officials (two from each of the 12 IHS Areas). In partnership with the IHS Director, the Workgroup strives to make the tribal consultation process more meaningful, effective, and accountable.

In 2014, the IHS implemented several additional tribal recommendations to improve tribal consultation. These included the first ever virtual Tribal Consultation Summit, listening sessions at all 12 IHS Areas, reinstatement of an IHS Contract Support Costs Workgroup, and a partnership with the Department of the Interior to convene three joint Tribal Consultation Sessions.


For referral to the appropriate spokesperson, contact the IHS Public Affairs Staff at 301-443-3593.

January 2015

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