Direct Service Tribes Advisory Committee - Charter

Refer to: OTP

1. BACKGROUND.  Direct Service Tribes (DST) elect, either in whole or in part, to receive primary health care directly from the Indian Health Service (IHS).  The decision to receive primary health care directly is an expression of self-determination and is an acknowledgment that the Federal Government has a legal responsibility and obligation to provide health care to Indian Tribes as defined in treaties, statutes, and executive orders.  This DST status reinforces the Government-to-Government relationship between Indian Tribes and the United States, and it guarantees that the health care needs of the DST shall be met.

2. PURPOSE.  The DST Advisory Committee is established to provide leadership, advocacy, and policy guidance.  The DST Advisory Committee will:
   1. assist and advise on the development of Indian health policy that impacts the delivery of health care for Indian Tribes with an emphasis on policies that impact the DST;
   2. actively participate, to the greatest extent possible, in IHS decision making that affects the delivery of health care; and
   3. provide verbal and written recommendations to the Director, IHS.

3. ROLE.  The DST Advisory Committee will promote and develop positions that contribute to addressing and resolving direct service issues to achieve beneficial outcomes for Indian Tribes.

4. RESPONSIBILITIES.  The DST Advisory Committee is accountable for the following:
   1. Advocate for Indian health policies that advance DST objectives within the IHS, including but not limited to the formulation of the IHS budget.
   2. Review, evaluate, and recommend improvements for any policy or administrative directives that further define the relationship between Indian Tribes and the IHS.
   3. Recommend to the Director, IHS, annual program objectives and priorities, including a methodology to monitor and evaluate progress on specific DST objectives and priorities.
   4. Partner with the IHS on initiatives, missions, goals, and activities that enhance the delivery of health care services to the DST.

5. REPRESENTATION.  Any federally recognized Indian Tribe that receives its primary health care from the IHS is eligible for representation on the DST Advisory Committee.  For the purposes of this charter, primary health care is defined as one or more core services managed or administered by the IHS, e.g., in-patient/outpatient services, prevention programs, sanitation and engineering services, and the like.

6. MEMBERSHIP.
   1. Composition.
      1. The composition of the DST Advisory Committee will change as new Tribal leadership is appointed/selected and/or decisions are made to contract, compact, or retrocede programs, functions, services, or activities.
      2. The DST Advisory Committee will be comprised of elected/appointed Tribal officials or their designee.
   2. Representation.  The DST Advisory Committee shall have nine members and nine alternates representing the Aberdeen, Albuquerque, Bemidji, Billings, Navajo, Oklahoma City, Phoenix, Portland, and Tucson Areas.  These Areas have one or more Indian Tribes that receive primary health care directly from the IHS.
      1. The DST in each Area will determine their elected/appointed Tribal official who represents their respective Area.
      2. Representation is subject to change.
   3. Technical Advisors.  Technical advisors who are elected/appointed Tribal officials or who are designated by members of the DST Advisory Committee to act on their behalf and representatives of the IHS may participate in DST Advisory Committee meetings and activities.  These advisors will not be official members of the advisory committee but will be available to provide guidance and technical assistance.

7. APPOINTMENT PROCESS.
   1. Terms.  Continuity in the DST Advisory Committee is necessary to support DST development and effectiveness.  For initial appointments, three members of the advisory committee shall serve 1-year appointments, three members shall serve 2-year, appointments, and the remaining three members shall serve 3-year appointments.  Staggered terms will permit the committee to maintain continuity and expertise.  After the initial appointments are served, the standard term will be 3 years.
   2. Elections.  Elections for the positions of Chairperson, Vice Chairperson, and Treasurer/Secretary will be held annually.  Co-Chairpersons may be substituted for the positions of Chairperson and Vice Chairperson.
   3. Bylaws.
      1. The DST Advisory Committee bylaws, hereby incorporated by reference, will govern the protocols of the committee activities.
      2. The bylaws will be developed by the DST Advisory Committee at its initial meeting and will govern the protocol of the committee activities.
      3. The bylaws are subject to amendments pending DST Advisory Committee consensus.

8. SUPERSEDURE.  None.

9. EFFECTIVE DATE.  This circular becomes effective on the date of signature.