Circular No. A-76 -- Appendix 5 (Inherently Governmental Functions) 6. Services in support of acquisition planning. 7. Contractors' providing assistance in contract management (such as where the 8. Contractors' providing technical evaluation of contract proposals. 9. Contractors' providing assistance in the development of statements of work. 10. Contractors' providing support in preparing responses to Freedom of 11. Contractors' working in any situation that permits or might permit them to 12. Contractors' providing information regarding agency policies or regulations, 13. Contractors' participating in any situation where it might be assumed that they 14. Contractors' participating as technical advisors to a source selection board or 15. Contractors' serving as arbitrators or providing alternative methods of dispute 16. Contractors' constructing buildings or structures intended to be secure from 17. Contractors' providing inspection services. 18. Contractors' providing legal advice and interpretations of regulations and 19. Contractors' providing special non-law enforcement, security activities that Return to List of Circulars | Circular A-76 | Table of Contents Return to this article at: http://www.whitehouse.gov/omb/circulars/a076/a076sa5.html Page 11 of 12 Senator Ben Nighthorse Campbell U.S. Senate Committee On Indian Affairs Questions for Dr. Charles W. Grim Indian Health Service 1. "One-HHS Initiative". The ideas behind Secretary Thompson's idea to create "One-HHS” are to reduce waste and create a more efficient HHS to better serve the American people. Yet the idea has not been warmly received by Capitol Hill or by the Tribal Restructuring Initiative Workgroup (RIW) that you appointed. Q: Could you explain the specifics of the initiative to the Committee - especially as it would apply to the IHS? Answer: The "One-HHS" is Secretary Thompson's goal to ensure that the Department functions as a single entity rather than a collection of independent agencies with separate and often duplicative administrative systems. While each of the HHS agencies have separate and specific missions, the over-arching HHS mission enables collaboration and coordination among the agencies that provide a sharing of ideas and in some cases resources. The IHS as an Operating Division of the DHHS supports the Secretary's goal and has enjoyed the benefits of the "One-HHS” goal in annual budget requests. The DHHS has been supportive and sensitive to the special needs the IHS has in its field operations. This is most evident by the recent decisions by the Department to ensure that the IHS's human resource management staff can remain in the field, and yet be part of the HHS overall HR consolidation that will result in increased efficiency and effectiveness of the entire system. Q: After a rough start, is the initiative still on track, i.e. has the plan been revised to reflect the comments and recommendations of the RIW? Answer: Yes. As noted above, the Department has addressed the concerns about 2. FY 2004 Budget. The "One-HHS" plan would involve the transfer 8 FTEs ($838,000) from IHS to HHS. The Tribal concern is that transfer of IHS functions to HHS would lose its "tribal shares" distinction, and, if not tracked properly, could hinder tribal contacting of those functions. Q: How does the department propose to preserve or track tribal shares related to those functions that are moved to the Office of the Secretary? Could these functions and associated dollars be potentially contractible under P.L. 93-638 once they are consolidated under HHS? Answer: Recent decisions by the HHS leave all resources in the IHS and the IHS will pay for consolidated services through the HHS Service and Supply Fund. This will enable the IHS to continue to track tribal shares related to those administrative functions affected by the "One-HHS" consolidations. In the case of the Human Resources' consolidation, the service-level agreement between the HHS and IHS, the IHS will stipulate to the continued tracking of tribal shares in the event such are affected by payments to the HHS Service and Supply Fund. 3. FY 2004 Budget. According to the FY 2004 IHS budget request, IHS will realize a cost "savings" of $21.3 from the reduction of 195 FTEs, and $9.3 million from information technology; savings will come from IHS, Tribal, and Urban programs. The budget request states that, "every effort will be made to minimize the impact at the service delivery level of the organization, however, some impact on programs and services may occur." Q: What specific impacts will there be to the Indian health care service delivery as a result of reduced FTEs and IHS restructuring? Will Indian patients receive even less health care services or will I/T/Us have to eliminate existing programs, e.g. disease prevention or health promotion activities? Answer: The $21.3 million in management savings will be achieved primarily by reducing administrative expenses in both IHS and tribally operated programs. IHS will reduce Federal staff use by 195 FTE, a 1.3% reduction compared to FY 2003 estimated usage. Staffing reductions will be targeted to administration (e.g., achieving the Department-wide staffing goal of 1 human resources employee for every 82 Agency employees) in order to minimize the impact on local service delivery. IHS will carefully review replacement of employees who leave and existing staff may be reassigned to ensure that critical positions remain filled. Other areas IHS will examine include more judicious control of: administrative travel, overtime and purchase of administrative supplies/equipment. The $9.3 million in IT savings will be achieved by reducing the use of maintenance contracts and by limiting enhancement of major systems including RPMS (the information system IHS use to manage patient care and administrative applications at all its IHS hospitals and clinics), telecommunications infrastructure, and the national database. Areas for examination include: reviewing maintenance contracts to see if it would be cheaper to pay for repairs and replacements on an as needed basis, limiting purchase of new hardware/software and limiting development of new applications for RPMS. 4. IHS Consultation Policy. IHS has succeeded in consulting with Tribes on issues small and major, with the RIW being the most recent case. Q: If the "One-HHS" plan goes through, how will the consultation experience be transferred to HHS? Answer: The IHS will continue to consult with Tribes on those "One-HHS" initiatives that impact the IHS organization, programs, and services. 5. One-HHS and Self-Governance. As of FY 2002, nearly 50% of all IHS funding and services is "out-sourced" to Tribes through 638 contracts and self-governance compacts. Q: Does the One-HHS plan include incentives for Tribes to assume responsibility for additional programs and services? Answer: The IHS will continue to respond to those Tribes who decide to SelfDetermine by assuming responsibility for programs, functions, services, and activities. Equally, the IHS will continue to respond to those Tribes who decide to Self-Determine by requesting the IHS to continue to directly provide health care services to their members. Q: Are you aware of any terms or conditions in 638 contracts or self-governance compacts that might be violated if the administrative reorganization is implemented? Answer: It is our belief that there are no terms or conditions in 683 contracts, or self governance compacts that will be violated by the administrative reorganization. The IHS is committed to ensuring that Tribal shares are made available to Tribes who exercise Self-Determination and assume health programs for the benefit of their members. 6. Managerial Reform. Over the years, the success of Tribes with 638 contracts and selfgovernance compacts has resulted in a reduction in IHS headquarters and area office staff. Q: Are there administrative functions that are essentially Federal in nature, such that they cannot be contracted out by tribes? Can you describe what some of those functions might be? Answer: Yes. The following are administrative functions that are inherently governmental: determination and formulation of agency policy; personnel management services; supervision and control of Federal employees; selection (or nonselection) of individuals for Federal government employment; property management; acquisition and grants management including awarding and terminating contracts and grants; administering responses to FOIA requests; determining budget policy, guidance, and strategy; determining the acquisition and disposal of Government property; determining what supplies or services are to be acquired by the Government; and, other official functions that mandate performance by Government employees and require either the exercise of discretion in applying government authority or making decisions for the The IHS has determined its inherently governmental functions in consultation with Tribal governments and has assumed 100 percent contracting/compacting of the IHS program to determine the residual value of its inherently governmental functions. This determination has been performed at each of the twelve Area Offices and Headquarters. 7. Human Resources. I note that the Tribal report listed reasons why consolidating IHS Human Resources with HHS would not be advantageous. Q: What are the primary functions of the Human Resources functions located in the 12 IHS Area offices? Answer: The primary functions in the nine of the 12 IHS Area Offices (Bemidji and Nashville receive their personnel servicing from another Area Office) and Headquarters include: policy advisory, classification; recruitment; staffing; transactions; employee/ labor relations; awards and recognition; retirement counseling; benefits counseling; time and attendance; and, payroll liaison. Q: Are there advantages to having those positions located in the area offices? Would there be advantages in relocating them to headquarters, or another, more central location? Answer: There are advantages to having positions located in the area offices, primarily to support recruitment, management, and development of personnel in the field locations. This proximity enables timely support and processing of personnel actions. Another advantage is the need to support Tribal Self-Determination, particularly in the administrative processes related to Intergovernmental Assignments of civilians and Memoranda of Agreements for Commissioned Corps personnel. The Tribal Restructuring Initiatives Workgroup (RIW) analyzed the advantages of Q: Will the costs of relocation offset any "managerial savings" that may be realized? |