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Road to Responsiveness

Road to Responsiveness. An Overview of Self-Governance: One Tribes Perspectives Little River Band of Ottawa Indians Presented by: Jessica L. Burger, Tribal Manager Little River Band of Ottawa Indians 375 River Street Manistee, Michigan. Road to Responsiveness. IHS Guidance Eligibility

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Road to Responsiveness

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  1. Road to Responsiveness An Overview of Self-Governance: One Tribes Perspectives Little River Band of Ottawa Indians Presented by: Jessica L. Burger, Tribal Manager Little River Band of Ottawa Indians 375 River Street Manistee, Michigan

  2. Road to Responsiveness IHS Guidance Eligibility Priorities for Service Operated 2 Programs in 9 counties Contract Health Direct Services LRBOI Reaffirmed in 1994 Title I Contractor in 1996 – HHS/IHS

  3. Road to Responsiveness FY 2000 – The Fork in the Road Title V Negotiated Rulemaking – Self-Governance “When you see a fork in the road, take it!” Yogi Berra Tribes, under self-governance, determine priorities - freedom to redesign & reallocate resources; real time response to Health care delivery needs— Control rests at the LOCAL level.

  4. Road to Responsiveness The Trust Responsibility & Self-Governance “The Secretary is prohibited from waiving, modifying, or diminishing in any way the trust to Indian Tribes and individual Indians that exist under treaties, Executive Orders, other laws, or court decisions.” Why Should a Tribe Pursue Self-Governance? Major benefit of self-governance: “…increase in the involvement and participation of Tribal citizens in Tribal government activities, including the setting of Tribal priorities and policy directions.” Reinfeld

  5. Road to Responsiveness LRBOI: Unfolding the Map Planning Phase – know where we are Capacity Evaluations: OTSG Cooperative Agreement Financial Administration & Controls budget/appropriations authorities purchasing controls audits – 3 years without uncorrected material findings Existing Health Care Delivery System how did we determine priorities & govern our delivery L

  6. Road to Responsiveness Capacity of the Existing Health Care Delivery System Governance Structure Shift from Federal control to Tribal control: Executive, Legislative roles – Determine Priorities/Establish Health Care Laws Health Commission – Regulatory Oversight & Setting Service Delivery Standards Data Mining: What are we doing now? RPMS Data, Community Survey information (CWBS), service delivery area (geography) & growth – establish service priorities Would there be changes? What would those changes be? How were services being delivered? Global perspective on service delivery – who supports health service delivery efforts? What are their roles?

  7. Road to Responsiveness Financial Controls: Changes & Considerations Payment: Lump Sum payment Flexibility: Redesign, merge and assign program funds and the ability to adopt revised regulations (Tribal) Reporting: Single Audit Act Changes focus of Program Design/Delivery Community & Needs Driven Health Care Priorities Real Time Responsiveness to Emergent Needs Outcomes versus jobs Long-term planning – AFA PSFA descriptions Collaboration between Tribal departments (global) Collaboration between Tribe and other governmental entities

  8. Road to Responsiveness Tribal Self-Governance: The “Shelby Model” of Health Care Delivery Responsive, Streamlined with a great deal of horsepower!

  9. Road to Responsiveness QUESTIONS? Miigwech for your time and attention!

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