ELIGIBILITY FOR TRIBAL SELF-GOVERNANCE Planning, Requests, and - - PDF document

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ELIGIBILITY FOR TRIBAL SELF-GOVERNANCE

Planning, Requests, and Audits

Monday, September 29, 2014

Presentation Objectives

• Eligibility criteria overview
• Explaining the financial stability requirement
• What is a “planning phase”?
• Key Features
• Information Resources
• Funding and Support
• Review a sample eligibility memo

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Eligibility Overview: 3 Requirements

To be eligible for the IHS Tribal Self-Governance Program, a Tribe must:

• 1. Successfully complete a planning phase;
• 2. Request participation in self-governance by resolution
• r other official action by the governing body of each

Tribe to be served; and

• 3. Demonstrate, for 3 fiscal years, financial stability and

financial management capability.

• Defined in the statute (25 USC 458aaa-2(c)) and

regulations (Code of Federal Regulations Title 42, PART 137, Subpart C; 42 CFR 137.15–26)

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Demonstrating financial stability and financial management capability How to demonstrate financial stability and financial management capability?

• For the purposes of eligibility, “evidence that, during the

3-year period … an Indian tribe had no uncorrected significant and material audit exceptions in the required annual audit of the tribe’s self-determination contracts or self-governance funding agreements with any Federal agency shall be conclusive evidence of the required stability and capability.” 25 USC 458aaa-2(c)(2)

• The IHS Office of Tribal Self-Governance reviews the

Tribe’s audits to determine whether this requirement has been met.

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Key Features

• 3-year period: The most recent 3 years
• Uncorrected: Title V does not include terms “clean audit” or

“mature contract”

• Audit exceptions: Usually from the Tribe’s auditor in the

audit

• Self-determination contracts or self-governance funding

agreements with any Federal agency:  The review only looks at BIA and IHS contracts/compacts findings,

except for cross-cutting centralized functions (e.g. personnel, payroll, property management, etc.). (42 CFR 137.22) × It does not include casino, HUD, or DHHS/Child Care grant findings.

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What is a “planning phase”?

Key Features

• The planning phase shall be conducted to the satisfaction
• f the Tribe
• It must include:
• Legal and budgetary research
• Internal tribal government planning and organizational preparation

relating to the administration of health care programs

• Assessment of existing systems and resources
• Determination of Tribal priorities and goals
• Community engagement
• When complete, a “planning statement” is submitted to OTSG.

The planning statement is a very simple document saying that the planning phase has been completed to the Tribe’s satisfaction.

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Information Resources: Tribal Shares

• Part of the planning phase is gathering information on

what is available for assumption from the IHS.

• Each Tribe has a “tribal share”, which is the Tribe’s portion
• f all funds and resources that support secretarial

programs, services, functions, and activities (PSFAs) that are not required by the Secretary for performance of inherent federal functions. (Funds that are Congressionally restricted, i.e. earmarks, are also not available for tribal shares).

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Information Resources: Point of Contact

• During the planning phase, IHS provides Tribes with the

necessary financial and programmatic information to understand what PSFAs may be assumed by the Tribe and the funding associated with those PSFAs.

• Each IHS Area has an assigned Agency Lead Negotiator

(ALN). The ALN will be responsible for negotiating your compact and funding agreement on behalf of the IHS Director and is the primary point of contact for providing this information during the planning phase. The ALN may also work with Office of Tribal Activities or Office of Self- Determination staff at the Area level.

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What are Tribal Shares?

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Transferrable Categories of PSFAs

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No No No No

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3 Levels of Shares are Available

IHS-wide (HQ) Shares

Portion benefiting each Tribe

Area Level Shares

Portion benefiting each Tribe

Local Level Shares

Portion benefiting each Tribe

PSFAs and associated funds are available from all 3 levels of the IHS. Location and dispersion does not affect amounts available for contract.

+ +

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Transfer of Tribal Shares from IHS to Tribes

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“Transferred” v. “Retained”

Monday, September 29, 2014 A C B . . . X Z Y

PSFAs Associated Shares

Transferred Retained

Shares retained for other Tribes Tribe elects to contract A, B, C Leaves X, Y, Z for IHS to perform Funds associated with A, B, and C are transferred to the contract Associated funds are retained by IHS to perform X, Y, Z $

$

9/27/2014 6 How are Tribal shares determined?

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Direct Financial Measures: Shares are precisely

determined when financial accounts record actual spending for PSFAs for a Tribe, e.g. IHS funds at a local site serving 1 Tribe.

Program Measures: Shares may be calculated in

proportion to workloads, services, or patient counts for each

• Tribe. These formulas are most common for PSFAs associated

with the Office of Environmental Health and Engineering.

Proxy Formula: A proxy formula calculates shares in

proportion to indirect measures such as user counts, number

• f Tribes, or other general distributive factors.

Proxy Formula Example: Tribal Size Adjustment (most HQ PSFAs)

92% of TSA $ is calculated per user for all Tribes 8% if < 2,500 users

TSA Formula

+

Aggregate funds for ~ 50 HQ PSFAs

Portions for all Tribes

Most HQ PSFAs collectively benefit more than 560 Tribes. The TSA formula calculates a $ benefit for all Tribes in proportion to tribal user counts.

• 92% of the total funds associated with HQ PSFAs are calculated on a per

user basis (applies to every Tribe)

• 8% of the total $$ are identified for small Tribes of less than 2,500 users,

calculated on a sliding scale that diminishes approaching 2,500 users.

• This adjustment is intended to address economy of scale issues

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Protections for Tribal Shares

 Shares are determined when a PSFA is initially contracted.

The amount is recurring thereafter.

 Subsequent negotiations occur before annual

appropriations are known. Shares are ESTIMATED and adjusted when the appropriation is enacted.

 Recurring shares for contracted PSFAs are protected from

reductions except for limited reasons stated in ISDEEA.

 Funds maybe added to a contract for special projects or

limited time periods but are not recurring.

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9/27/2014 7 Special Circumstances

• Consortia – shares associated with individual tribes

maybe consolidated for ISDEAA agreements

• Delegation to another Tribe – a tribe may direct it’s shares

to another Tribe to carry out the PSFA for its members (some examples in Oklahoma)

• Grandfathered shares – a few unique agreements were

implemented early in the 1990’s especially in pilot projects before self-governance became permanent. Some of the arrangements were grandfathered.

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Information Resources: Tables & Manuals

• Information on PSFAs at the HQ level are contained in the

HQ PSFA Manual, which can be obtained from your ALN. Some Areas also have Area-level PSFA Manuals.

• Details of a Tribe’s “tribal share” at the HQ, Area, and

program level are described in a series of tables, which should be provided to you by the ALN.

• Table 4: Shows each Tribes HQ shares
• Self-Governance FA Table: Shows HQ, Area, & program shares
• Table 4F: Shows funds appropriated by Congress for Facilities and

managed by the IHS Office of Environmental Health and Engineering; primarily distributed by program formulas.

• Area shares tables (differs by Area)

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2) Area Level Tables

NEW APPROPRIATION HQ Budget AREA Budgets HQ PFSA & $ HQ SHARES

Breakout of HQ PSFA and funds.

Table #1 Table #3

Shows any CHANGES to entire IHS appropriation Splits Appropriation into parts managed by HQ and Areas Exists for each individual tribe and shows the portion of $ available to it.

Table #4 Area Budget Area PSFA & $ Table #2

3) National Level Tables

Local Budgets Local PSFA & $ Local Shares

1) Local Level Tables

Area Shares Format and content of Area and Local level tables will vary, but will generally cover the topics listed above. HQ Tracked $

Tribal Shares Tables

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Table #1 - Entire IHS Appropriation Table #3 – HQ Budget Breakout by PSFA Table #2 - Split into HQ and Area Tracked Budgets Table #4 - Portion Available to a Tribe Entire Appropriation Tracked by HQ

Overview of HQ Tables

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Tribe’s Portion of each PSFA Portion available in contract year 1 or 2 if applicable

Table 4: HQ Shares Available to a Tribe

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Self-Governance FA Table

9/27/2014 9 Table 4F

Includes funds for:

• M&I – Maintenance and Improvement
• Equipment Replacement
• Health Facility Planning and Construction-
• Health Facilities Operation & Maintenance (of maintenance, utilities, etc.)
• Sanitation Facilities Design and Construction
• Environmental Health Services (sanitarians, A&I prevention)

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Final Points about HQ Tables

• PSFAs relate to functional categories – HQ PSFA tables

do NOT correspond closely with the HQ organizational structure or staffing. HQ staff contribute to many different PSFAs and staffing is managed in aggregate.

• Protected Shares – although the organizational structure

has changed several times to address changing circumstances and needs, shares for every tribe are protected – regardless of HQ internal realignments.

• Office of Finance and Accounting – creates HQ tables.
• Other HQ Offices – responsible for carrying out the

PSFAs and descriptions in the PSFA manual.

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Sample Eligibility Memo

9/27/2014 10 Sample Eligibility Determination Memo

As the final step in the eligibility process, the IHS Office of Tribal Self-Governance produces an eligibility determination memo, which is sent to the Tribe.

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MEMORANDUM To: Director, Office of Tribal Self-Governance From: Financial Analyst, Office of Tribal Self-Governance Subject: Overall Eligibility Determination for SAMPLE TRIBE ISSUE The Tribal Council of the SAMPLE TRIBE authorized SAMPLE TRIBE to apply to participate in the Self-Governance program. This decision memorandum is needed to document SAMPLE TRIBE’s overall eligibility to compact under P.L. 106-260, the Tribal Self-Governance Amendments of 2000. DISCUSSION Eligibility Criteria A) Tribal Resolution: The attached Tribal Council Resolution No. 2013-XXX-48, adopted June 19, 2013, in part, “authorizes the Chairman and/or his designee, the Health Director and the SAMPLE TRIBE’s legal counsel to initiate and conduct negotiations with the Indian Health Services on a Self-Governance Compact and Funding Agreement.” B) Planning Statement: The attached Tribal Council Resolution No. 2013-XXX-48, adopted June 19, 2013, states, in part, that “a planning process has been completed to the satisfaction on the SAMPLE TRIBE which addressed legal and budgetary issues and internal government planning and organization preparation relating the administration of health programs as required by 42 C.F.R. 137.20.”

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C) Financial management capability and financial stability: Attached is the eligibility determination document on the SAMPLE TRIBE’s 2009, 2010 and 2011 audits. There were no uncorrected significant and material audit exceptions in the audits of the Tribe’s self-determination contracts for the 3 years. RECOMMENDATION I recommend that you determine, by initialing below, that the SAMPLE TRIBE has met all three eligibility criteria to compact under P.L. 106-260, the Tribal Self- Governance Amendments of 2000. This document assumes that the anticipated effective date of the CY 2013 Compact/Funding Agreement is January 1, 2014. Should the actual start date be substantially subsequent to that date, it is possible another audit cycle will have passed and a review of the 2013 audit may be necessary. DECISION Approve: _________ Disapprove: __________ Date: __________ Kevin C. Quinn

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