Linking PSFA’s to Tribal Shares

1. Linking PSFA’s to Tribal Shares OTSG Training- Tucson, March 27, 2012

2. PSFA’s available at all levels • Service Unit or Operating Unit • Direct Program Delivery • Area Office Level- • May be linked to Operating level services- • Headquarters Level- • May be linked to Operating level services

3. Available Tribal Shares • Dr. Trujillo appointed a workgroup in 1994 to provide a recommendation on TS methodologies. Workgroup focused on HQE share and: • Identified what funds might be available • Identified Residual • Calculate total $ available as TS • Determine Methodology to distribute HQE TS funds.

4. Available Tribal Shares • Some shares were referred to special workgroups like OIT and Centrally Paid Expenses Workgroup • Area Offices developed a similar process of identifying TS and residual in each Area in cooperation with Area Tribes. • Once established in 1994 and 1995 the Area and HQE TS have not changed materially except to add inflation and pay act increases. • In 1996 the IHS agreed that TS were eligible for CSC with some special consideration • 20% of tribal share is considered CSC like services

5. Operating Unit PSFA’s • Determined generally by the historic level of services and funding at the operating unit. • For multiple operating units or Service Units funds may be divided out (requiring tribal agreement) • Tribes may choose to leave Function with IHS for multiple reasons • Technical staff and program objectives (OEHE) • Outside the mission of Tribe • Difficulty in supporting at local level (OIT functions) • Inadequate Funding (CHS) PFSA’s left with IHS should be memorialized in the Scope of work or a separate Continuing Service Agreement.

6. Area PSFA’s • Executive Leadership (Include Area Directors Reserve) • Human Resources- must be maintained to support Federal IPA/MOA’s • Finance- mostly residual – some capacity must be maintained to support IPA/MOA ‘s • CHS Management- Available with CHS program locally • Acquisition- Generally available with other local PFSA’s

7. Area PSFA’s • Office of Acquisition Management- normally compacted- • Recruitment and Professional Recruitment – May be critical to leave with Area Office if Tribe relies on Federal Employees. • Planning Evaluation and Statistics- • OEHE services • Office of Information Technology (linked to OU and HQE TS • Networking • EHR/RPMS

8. Headquarters PSFA’s Many Headquarters PSFA’s are linked to program support at the local OU level. Others are stand alone national initiatives Tribes Taking TS from HQE cannot utilize that PSFA from Headquarters . (i.e. Listing Tribal Positions on IHS professional recruiting web site). Tribes must work with technical and professional staff to identify key TS at Headquarters and Area Office Tribes must careful to document services to be retained when funding for PSFA’s are left at Headquarters

9. Office of Information Technology • Supports RPMS, networks, IT security, and Information Technology throughout the IHS • Most complex cost structure and service structure- • Probably the most often retained service by Tribes who often continue to rely on IHS Electronic Health Record. • Tribes should very carefully review the options available under the OIT service options– • Tribes should use OIT professionals and Clinicians to evaluate the options. • Tribes who do not have the technical and OIT capacity on staff should utilize the local and Area OIT staff to fully understand the scope and importance of these services.

10. Selection of PSFA’s • Tribes normally select Area and HQE PSFA to take and retain during Funding Agreement negotiations. • Understanding Complex PSFA like the OIT shares may require workgroups and expertise beyond the negotiation team and outside the negotiation session. • Tribes may negotiate negotiate special prices for some functions that are included within IHS Funding Tables

11. Selection of PSFA’s • PSFA’s may be funded from several lines (sub sub activity) within the Area or HQE Tribal Share Table. • The Tribe should take care to specify and record the scope and level of services that are to be provided by the IHS for retained resources. • The Tribe should evaluate the Retained PSFA through professional staff annually to insure they are current and appropriate. • Tribes may alter the selection of any PSFA share at any time through Amendment to the FA.