Indian Self-Determination

To enable Indian tribes to assume the management and operation of programs, functions, services, and activities (PFSA) for the delivery of health care to Indian people. To enter into a self- determination contract or contracts with Indian tribes or tribal organizations (T/TO) interested in transferring the responsibility for the administration and provision of health services from the government to tribal leadership.

Any federally-recognized tribe that formally requests, through a governing body action, a resolution, to enter into a self-determination contract or contracts for the purpose of planning, conducting, and administering programs, or portions thereof, including construction programs, provided that the T/TO submits a contract proposal that conforms to the requirements contained in 25 CFR 900.8 may apply.

Indian tribes will benefit.

A tribe or tribal organization may submit a proposal for a self-determination contract or a proposal to amend or renew an existing contract. Unless there is a declination issue the Secretary shall within 90 days after receiving the proposal, approve the proposal and award a contract to the tribe. Declination issues are: (A) The service to be rendered to the Indian beneficiaries of the particular program or function to be contracted will not be satisfactory; (B) adequate protection of trust resources is not assured; (C) the proposed project or function to be contracted for cannot be properly completed or maintained by the proposed contract; (D) the amount of funds proposed under the contract is in excess of the applicable funding level for the contract as determined under Section 106(a); or (E) the program, function, service, or activity (or portion thereof) that is the subject of the proposal is beyond the scope of programs, functions, services, or activities covered under paragraph (1) because the proposal includes activities that cannot lawfully be carried out by the contractor.

The agency negotiation team and the representatives of the tribe shall develop the agenda for the contract negotiation session(s). The agency negotiation team should assure that any issues identified during the proposal review stage, together with any agency recommendations for overcoming these issues, are raised at the negotiations. Title I contracts are generally awarded at the area office level. They are awarded for a definite period of time (1 to 3 years) or may be designated as "mature" and awarded for a definite or indefinite period of time.