Facilities Appropriation Advisory Board (FAAB)

1. Facilities Appropriation Advisory Board(FAAB)

2. FAAB Activities • The Indian Health Care Improvement Act, 25 U.S.C. § 1631(c), requires the IHS to: • Re-established the FAABto provide the IHS recommendations on policies, procedures and other OEHE programs pursuant to facilities appropriations. • Every five years update the Health Care Facilities’ Needs Reportto describe the national, comprehensive, ranked list of all facilities’ needs for AI/AN, including newly authorized healthcare facilities. • 2016 Report showed a need of approximately $14.7 billion.

3. FAAB Accomplishments • Distributed the Charter on May 22, 2015:IHS Circular No. 2015-04: Facilities Appropriation Advisory Board. • Established a Facilities Needs Assessment Workgroup to assist updating reports. • Completed and submitted 2016 Report to Congress in July 2016. • Produced and updated an annual OEHE Appropriation Information Package. • FAAB Letters: • To national budget formulation group in support of increasing FY2017 Maintenance and Improvement (M&I) funding. • To IHS Director endorsing Health Care Facilities Construction Priority System. • To IHS Director recommending tribal leaders identify their health care facility’ needs. • To IHS Acting Director recommending all federal and tribal sites to update the Facilities Engineering Deficiency System.

4. IHS AppropriationServices and Facilities

5. IHS Services Appropriation • Clinical Services • Hospitals & Health Clinics • Dental Services • Mental Health • Alcohol & Substance Abuse • Preventive Health • Public Health Nursing • Health Education • Community Health Representatives • Immunization AK • Other Services • Urban Health • Indian Health Professions • Tribal Management Grants • Direct Operations • Self-Governance

6. IHS Facilities Appropriation • Health Care Facilities Construction • Maintenance and Improvement • Equipment • Sanitation Facilities Construction • Facilities and Environmental Support • Facilities Support • Environmental Health Support • Office of Environmental Health and Engineering Support

7. Fort Yuma CA, 1936

9. IHS Completed Construction Projects

10. Health Care Facilities Construction

11. Construction Grandfathered list

12. 2016 Facility Needs Assessment

13. Maintenance and Improvement

14. Sanitation Facilities Construction

15. The IHS continues to have several opportunities to provide critically needed new and renovated facilities including: • The 2018 and 2019 Facilities Appropriation was 60% high than 2017 levels with a large increase in the M&I, SFC and HCFC funding; • IHS has also received well over $120 million in Non-Expended Funds (NEF) facility projects in 2019; • There will be a 2019 solicitation for applications for the $15 million for the Small Ambulatory Program (SAP); • There will be a 2019 solicitation Joint Venture Construction Projects as well; and • The 2019 facilities appropriation allowed IHS to partially fund all of the remaining projects on the 1992 grandfathered priority list.

16. Approved Joint Venture Projects • 2016 – Yakutat Tlingit Tribe, Ysletta del Sur Pueblo, Ponca Tribe of Nebraska, White Earth Band of Chippewa Indians • 2015 – Choctaw Nation, Cherokee Nation, Yukon Kusokwim Health Corp • 2014 – Muskogee (Creek) Nation, Eastern Shoshone/Norther Arapahoe, Alaska Pribilof Island Association • 2011 – Kenaitze Indian Tribe, Mississippi Band of Choctaw, Chickasaw Nation

17. Completed Joint Venture Projects

18. Small Ambulatory Grants Program • The Indian Health Service (IHS) Small Ambulatory Program (SAP) is authorized by Section 306 of the Indian Health Care Improvement Act, Title III, Public Law (P.L.) 94-437. • The SAP is available for American Indian and Alaska Native tribes or tribal organizations to competitively obtain funding for the construction, expansion, or modernization of tribally owned small ambulatory health care facilities. • Applications are currently being accepted and are Due December 1, 2017. • Make sure to review the eligibility criteria prior to submitting.

19. SAP – Completed Projects • OK - Purcell Outpatient Clinic • AK - YKHC Toksook Bay Regional Clinic • CA - Mariposa Indian Health Clinic • CA - Campo Satellite Clinic –Southern Indian Health Council • PO - Tribal Medical & Dental Clinic-The Klamath Tribes • AK - Chenega Bay Health Clinic – Chugachmiut Village • AQ - Pueblo Jemez Health and Dental Clinic • OK - Stigler Clinic –Choctaw Nation of Oklahoma • BI - Chippewa Cree Health Center – Rocky Boy Indian Reservation • CA - Yreka Clinic – Karuk Tribe of California • PO - Cowlitz health Center – Cowlitz Tribe • BE - Ho-Chunk Health Care Center • PO - Cow Creek Satellite Clinic • PO - White Swan Health Clinic – Yakama Nation • PO - Siletz Clinic Expansion – Conf. Tribes of Siletz Indians • CA - Santa Ysabel Health Care Facility • PO – Makah Tribal Health Administration and Wellness Center • PO - Inchelium Health Care Facility – Colville Tribe • AK - Hooper Bay Sub-Regional Clinic - YKHC • PH - Reno-Sparks Indian Colony Clinic • AK - Kake Clinic Expansion – SEARCH Village Kake • PH - Las Vegas Paiute Colony Health Care Facility • CA - Shingle Springs Rancheria Health Clinic • PO - Roger Saux Health Center – Quinault Indian Nation • BE - Lac du Flambeau – Health Clinic replacement • BE - Bad River Replacement Clinic • BE - Bois Forte Health Clinic of Minnesota Chippewa Tribe • PO - Warm Springs Clinic Renovation • NS - Narragansett Indian Health Center

20. Continuing work for the FAAB • Updating and editing an Annual Appropriation Information Package • Preparing for 2021 Facilities Assessment Report • Updating and enhancing the OEHE FEDS database • Review of SDS Guidance Update Comments • Updating and converting the Health System Planning program • Create New Web-Based Version • Developed In-House • Utilizing Existing IHS SQL Server • Maintained and Upgraded In-House • Accessible for Use by Everyone • Uniformity of Procedures • One Version – What’s on the Web. Next Meeting –August13 and 14, 2019: Seattle, WA