The Tribal Self-Governance Program (TSGP) is more than an Indian Health Service (IHS) program; it is an expression of the government-to-government relationship between the United States (U.S.) and Indian Tribes. Through the TSGP, Tribes negotiate with the IHS to assume Programs, Services, Functions, and Activities (PSFAs), or portions thereof, which gives Tribes the authority to manage and tailor health care programs in a manner that best fits the needs of their communities.
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 TSGP negotiations. TSGP negotiations are a dynamic, evolving, and Tribally-driven process that requires careful planning and 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 its 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:
- Enable a Tribe to set its own priorities when assuming responsibility Indian Health Service (IHS) Programs, Services, Functions, and Activities (PSFAs);
- Observe and respect the government-to-government relationship between the U.S. and each Tribe, and
- Involve the active participation of both Tribal and IHS representatives, including OTSG.
Negotiations are a method of determining and agreeing upon the terms and provisions of a Tribe's Compact and Funding Agreement (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:
Each application that is submitted to the IHS requires that the following assurances and certifications be verified by the signature of the Official signing for the applicant organization. Definitions are provided in the HHS Grants Policy Statement, Rev. January 2007 for all certifications and assurances at https://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf.
The individual that signs and/or submits an application further certifies that the applicant organization will be accountable both for the appropriate use of all grant funds awarded and for the performance of the grant-supported project or activities.
Under Section 106 National Historic Preservation Act (16 U.S.C. 470 et seq.), IHS must consider the effect on historic properties prior to making a funding decision. Historic properties include any district, site, building, structure, or object that is listed on, or is eligible for listing on, the National Register of Historic Places as outlined in National Register (see below).