Indian Health Service (IHS) Grant for Tribal Self-Governance Negotiation Preparation and Engagement

• Applicant must be an “Indian Tribe” as defined in 25 U.S.C. 5304(e); a "Tribal Organization" as defined in 25 U.S.C. 5304(l); or an "Inter-Tribal Consortium" as defined at 42 CFR 137.10. Please note that Tribes prohibited from contracting pursuant to the Indian Self-Determination and Education Assistance Act (ISDEAA) are not eligible. See section 424(a) of the Consolidated Appropriations Act, 2014, Public Law No. 113-76, as amended by section 428 of the Consolidated Appropriations Act, 2018, Public Law No. 115-141, and section 1201 of the Consolidated Appropriations Act, 2021, Public Law No. 116-260.

• Pursuant to 25 U.S.C. 5383(c)(1)(B), applicant must request participation in self-governance by resolution or other official action by the governing body of each Indian Tribe to be served.

• Pursuant to 25 U.S.C. 5383(c)(1)(C), applicant must demonstrate financial stability and financial management capability for 3 fiscal years.

The purpose of this Negotiation Cooperative Agreement is to provide Tribes with resources to help defray the costs associated with preparing for and engaging in Tribal Self-Governance Program (TSGP) negotiations. TSGP negotiations are a dynamic, evolving, and tribally-driven process that requires careful planning, preparation, and sharing of precise, up-to-date information by both Tribal and Federal parties. Because each Tribal situation is unique, a Tribe’s successful transition into the TSGP, or expansion of their current program, requires focused discussions between the Federal and Tribal negotiation teams about the Tribe’s specific health care concerns and plans. One of the hallmarks of the TSGP is the collaborative nature of the negotiations process, which is designed to: 1) enable a Tribe to set its own priorities when assuming responsibility for Indian Health Service (IHS) programs, services, functions, and activities (PSFAs); 2) observe and respect the government-to-government relationship between the U.S. and each Tribe; and 3) involve the active participation of both Tribal and IHS representatives, including the Office of Tribal Self-Governance (OTSG). Negotiations are a method of determining and agreeing upon the terms and provisions of a Tribe’s Compact and FA, the implementation documents required for the Tribe to enter into the TSGP. The Compact sets forth the general terms of the government-to-government relationship between the Tribe and the Secretary of the U.S. Department of Health and Human Services (HHS). The FA: 1) describes the length of the agreement (whether it will be annual or multi-year); 2) identifies the PSFAs, or portions thereof, the Tribe will assume; 3) specifies the amount of funding associated with the Tribal assumption; and 4) includes terms required by Federal statutes and other terms agreed to by the parties. Both documents are required to participate in the TSGP and they are mutually negotiated agreements that become legally binding and mutually enforceable after both parties sign the documents. Either document can be renegotiated at the request of the Tribe.