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Self-Governance Training Negotiation Process IHS Emphasis. March 27, 2012 Vickie Hanvey, CPA MBA. Negotiation Process. Getting Started with IHS: “Tribal Self-Governance A Handbook for Tribal Governments”. Negotiation Process. Major Components of an Ongoing Process Planning Negotiations

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Self-Governance Training Negotiation Process IHS Emphasis

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Self governance training negotiation process ihs emphasis

Self-Governance TrainingNegotiation ProcessIHS Emphasis

March 27, 2012

Vickie Hanvey, CPA MBA


Self governance training negotiation process ihs emphasis

Negotiation Process

Getting Started with IHS:

“Tribal Self-Governance

A Handbook for Tribal Governments”


Self governance training negotiation process ihs emphasis

Negotiation Process

Major Components of an Ongoing Process

  • Planning

  • Negotiations

  • Implementation

  • Monitoring


Self governance training negotiation process ihs emphasis

Negotiation Process

Planning-

  • complete review of existing operations

  • determination of Tribal priorities

  • identification of short and long-term goals

  • establish baseline measures

  • research (financial, legal, programmatic)

  • analysis of information; options

    • efficient & effective use of resources


Self governance training negotiation process ihs emphasis

Negotiation Process

Negotiation-

  • “government-to-government”

  • good faith

  • results in a compromise agreement between the two parties

  • allowed the flexibility to re-design programs and reallocate budgets to meet local needs


Self governance training negotiation process ihs emphasis

Negotiation Process

Negotiation-

  • Ability to negotiate a single compact and funding agreement for all PSFAs

  • Compact:

    • Umbrella agreement

    • General terms

    • Long term

  • FA:

    • PFSAs

    • More specific terms

    • Short term (1-3 years)


Self governance training negotiation process ihs emphasis

Negotiation Process

Negotiation-

  • Funding Tables

    • HQ & Area

    • Stable Base Budgets

  • Residual Amounts

    • federal functions which cannot legally be delegated

  • Retained Services or Buybacks

  • Tribal Shares

    • PFSA Manual


Self governance training negotiation process ihs emphasis

Negotiation Process

Negotiation-

  • Statutorily Mandated Grants

    • Lump sum advance payment

    • Grant terms & conditions apply

    • May not be reallocated / redesigned

  • Final Offer

    • Resolving disputes

    • 45 day review

    • Secretary may only reject due to specific reasons

    • DO NOT submit entire Compact / FA


Self governance training negotiation process ihs emphasis

Negotiation Process

Implementation-

  • Both parties are responsible for executing their respective parts of the negotiated agreement.

  • Regulations can be waived upon request

  • Not required to follow Federal policy

  • OMB circular A-87 (2CFR Part 225) still applies

  • Must be consistent with applicable law and regulations


Self governance training negotiation process ihs emphasis

Negotiation Process

Implementation-


Self governance training negotiation process ihs emphasis

Negotiation Process

Monitoring-

Current:

  • adherence to the negotiated agreement

  • budget

    • earmarked/non-earmarked

  • compliance with applicable laws and regulations

    • programmatic & financial

    • Tribal and Federal


Self governance training negotiation process ihs emphasis

Negotiation Process

Monitoring-

  • Compliance in Summary

    Costs must be

    a) allowable; meet regulations

    b) allocable; belong to this program

    c) reasonable; to a “prudent” person

    d) documented; attached to original source of entry


Self governance training negotiation process ihs emphasis

Negotiation Process

Monitoring-

Current:

  • funding allocations

    • (Did we get our fair share of funding?)

  • payments

    • (Did we get paid accurately & timely?)

  • performance to tribal desired outcomes

    • (Are we efficient and effective in meeting our goals?)


Self governance training negotiation process ihs emphasis

Negotiation Process

Monitoring-

Future:

  • funding distribution methodologies

  • rulemaking or policy developments

  • legislative initiatives

    • beware of lobbying activities

  • identify opportunities/threats regarding assumption, re-design, reprogramming and operation


Self governance training negotiation process ihs emphasis

Negotiation Process

Tribal Self-Governance

demands careful and ongoing

assessment of the Tribal organization

and its operations.


Self governance training negotiation process ihs emphasis

Negotiation Process

Personal Comments/Observations:


Cherokee nation

Cherokee Nation

“ A misconception exists today that our Indian health care is free.

It is not.

It has been paid for by the blood and tears of our ancestors, and by the land our people were forced to give away.”

--Dr. Brenda Stone, Cherokee


What has the cherokee nation paid for its relationship with the u s

What has the Cherokee Nation paid for its relationship with the U.S.?

The Cherokee Nation ceded

81 million acres

of land in the southeastern United States between 1721 and 1835


Self governance training negotiation process ihs emphasis

Negotiation Process

Comments/Observations:

  • Acronyms

  • Develop a Resource Library

  • Develop a SG historical records system

  • Importance of coordination and networking with other Tribes (NCAI, NIHB, TSGAC, etc)

  • Build a “Team” of experts (Legal, Financial, Programmatic, etc)


Self governance training negotiation process ihs emphasis

Negotiation Process

Comments/Observations:

  • Maintain periodic analysis of Funding Tables, Payments, etc

  • Build a “Team” of experts (Legal, Financial, Programmatic, etc)

  • Challenge of obtaining information/response from agencies

  • Resolution to issues can be a slow process


Self governance training negotiation process ihs emphasis

Negotiation Process

Comparisons DOI & IHS:

  • Final Offers

  • Payment (subsequent funding agreement)

  • Tribal Shares/Residuals

  • Formulas / Allocations


Self governance training negotiation process ihs emphasis

Negotiation Process

Example:

Cherokee Nation


Cherokee nation1

Cherokee Nation

  • Sovereign Nation within a Nation

  • Tripartite government

  • 2nd largest Indian Nation (314,000 citizens)

  • 14 county area (over 7,000 sq mi.)

  • Largest employer in northeastern Oklahoma (9,000)

  • Capitol located in Tahlequah, Oklahoma


The cherokee nation existed before the united states and the state of oklahoma

Cherokee Nation

The Cherokee Nation existed before the United States and the State of Oklahoma.

GROUP OF CHEROKEES WHO VISITED LONDON IN 1762


Self governance training negotiation process ihs emphasis

Cherokee Nation

  • Starting in 1993

  • Approached ISDEA assumption in incremental steps

  • Gradually assumed federal programs & reallocated/redesigned federal “cookie cutter” programs into programs and services responsive to our unique, specific needs


Self governance training negotiation process ihs emphasis

Cherokee Nation

  • Systematic approach by first establishing a strong health system

  • Then assuming additional federal activities

    • Limited disruption to patients

    • Health care providers

    • Nation operations

    • Some activities still performed by IHS (Claremore Hospital)


Self governance training negotiation process ihs emphasis

Cherokee Nation

2001 Comprehensive Long Range Plan

  • to meet the health care needs of tribal citizens

  • based on work of tribal and IHS health care teams

  • randomized opinion surveys

    • 1,200 patients

    • 30 health providers

    • 16 tribal leaders and health administrators


Self governance training negotiation process ihs emphasis

Cherokee Nation

2001 Comprehensive Long Range Plan

  • Resulted in two significant changes to achieve our goals:

    • Seamless health care delivery model, where primary and tertiary health care facilities compliment each other, so we can offer state of the art, comprehensive care to our citizens in an efficient and coordinated manner

    • Establishment of a health care facility so services are accessible within a 30 mile radius.


Self governance training negotiation process ihs emphasis

14 County Jurisdictional Boundaries

Will Rogers Health Center

Vinita Health Clinic

Bartlesville Health Clinic

Sam Hider Health Center

Claremore Indian Hospital

A-Mo Health Center

CN WW Hastings Hospital

Legend

Wilma P. Mankiller Health Center

Cherokee Nation Clinic

Hospital

Main Complex

Three Rivers Health Center

Redbird Smith Health Center


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