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IHS Updates Guide for Reporting Sanitation Deficiencies for American Indian and Alaska Native Homes and Communities

by Rear Adm. Mark Calkins, P.E., Director of the Division of Sanitation Facilities Construction, Indian Health Service

The IHS Division of Sanitation Facilities Construction published updates to the Sanitation Deficiency System: A Guide for Reporting Sanitation Deficiencies for American Indian and Alaska Native Homes and Communities, also known as the SDS Guide. The SDS Guide provides the standards and procedures for IHS and tribal staff that identify sanitation deficiencies, develop projects to address them, and prioritize the resulting inventory of projects. The Sanitation Facilities Construction Program reports the prioritized sanitation deficiency needs to Congress annually in accordance with the requirements of the Indian Health Care Improvement Act.

The guide was last published in 2003.  The IHS Sanitation Facilities Construction Program saw a need to clarify and update this program guidance. The revision process began in 2015 and incorporated a historically high level of transparency and collaboration, including tribal consultation, multiple rounds of review with internal staff, input from external project funding partners, and modeling of alternative project scoring frameworks. The resulting final guidelines resolve previous inconsistencies in Sanitation Facilities Construction Program delivery and ensure that sanitation deficiency reporting follows the program’s governing statutes. The revised guidance also addresses concerns raised by tribes and by the U.S. Government Accountability Office by improving the allocation of program funding toward infrastructure projects that address the most serious public health risks affecting American Indian and Alaska Native homes and communities. It is notable that this update represents the first time that final program guidance has been issued on the Sanitation Deficiency System.

The IHS Sanitation Facilities Construction Program will be working with its Area offices to develop Area-specific supporting guidance in order to meet the needs of the communities they serve. The program will also work to provide future training opportunities to ensure consistent implementation as required by the Indian Health Care Improvement Act.

I would like to thank all of the contributors across the Sanitation Facilities Construction Program.  Our collaborative partners played a vital role in this significant advancement and in enhancing the delivery of the Sanitation Facilities Construction Program.

Related content:

IHS Division of Sanitation Facilities Construction

Sanitation Deficiency System: A Guide for Reporting Sanitation Deficiencies for American Indian and Alaska Native Homes and Communities

Indian Health Care Improvement Act


Rear Adm. Mark Calkins, P.E., Director of the Division of Sanitation Facilities Construction, Indian Health Service
Rear Adm. Mark Calkins leads the IHS Office of Environmental Health and Engineering Division of Sanitation and Facilities Construction program, the largest engineering program in the Public Health Service, with a staff of over 500 engineers and support personnel. Through his leadership, the program has provided water supply and waste disposal facilities to over 17,000 homes annually throughout Indian Country.