Quality Assurance/Risk Management Committee (QARMC) - Charter

Refer to: OQ

QUALITY ASSURANCE/RISK MANAGEMENT COMMITTEE (QARMC) - CHARTER

1. PURPOSE.  The purpose of the Quality Assurance Risk Management Committee (QARMC) is to provide senior level oversight and management of complex adverse patient safety events and administrative matters involving significant fraud, waste, abuse, and employee misconduct within Indian Health Service (IHS)-operated hospitals and clinics.  The QARMC will also perform agency-wide clinical and administrative risk management to identify systematic changes needed to improve the quality of health care services and operation of IHS-operated hospitals and clinics.  The QARMC is a component of the overall Enterprise Risk Management (ERM) governance structure.  It is not intended to replace or duplicate required reporting systems to state and federal agencies, or law enforcement.  It is intended to ensure enterprise-wide accountability and effectiveness of those internal and external reporting systems, necessary management responses, and swift and effective corrective actions.
2. AUTHORITY.  Federal Register Vol. 83, No. 246, December 26, 2018.  The QARMC is separate from, but supported by the centralized establishment of the IHS Headquarters Office of Quality (OQ), whose functional responsibilities includes, in part:  oversight of the IHS ERM program; implementing strategies to reduce the risk of harm to patients; liability exposure of health care providers, and financial loss to the IHS; developing and implementing programs to perform incident identification and reporting; identifying and addressing potential tort claims; investigation of medical adverse events; reviewing patient grievances concerning quality of care; performing sentinel event/root cause analysis review and documentation.
3. MEMBERSHIP.
   1. Membership on the QARMC will broadly include the following agency officials:
      1. IHS Deputy Director
      2. IHS Deputy Director for Quality Health Care (Executive Sponsor and QARMC Chair)
      3. IHS Chief Medical Officer (QARMC Co-Chair)
      4. IHS Deputy Director for Field Operations
      5. IHS Deputy Director for Management Operations
      6. IHS Office of Inspector General Liaison
      7. Director, Office of Management Services
      8. Director, OQ, IHS Headquarters (HQ)
      9. Director, Office of Human Resources, IHS HQ
   2. Collaboration and consultation as needed:
      1. Office of Inspector General – Office of Investigations
      2. Office of the General Counsel
4. RESPONSIBILITIES.
   1. QARMC Members.  The QARMC members are responsible for attending meetings called by the QARMC Chair, and providing recommendations and timely follow-up to any action items stemming from the meetings.  The QARMC members acknowledge that they may review and handle materials that are deemed privileged and confidential under the Privacy Act, the Indian Health Care Improvement Act, Health Insurance Portability and Accountability Act and other federal laws.  The QARMC members understand that they are responsible for complying with the requirements of all federal privilege and confidentiality laws.
   2. IHS Office of Quality.  The Director, OQ, is responsible for coordinating the confidential QARMC meeting records, and documenting QA conclusions that will drive required new or updated policy directives of the IHS.
   3. IHS Area Directors.  Area Directors are responsible for reporting high risk issues described above in Section 1 to the IHS Deputy Director for Field Operations or other members of the QARMC for necessary analysis and oversight of actions the QARMC deems necessary in response to the high risk issues(s).
5. MEETINGS.
   1. Scheduled Meetings.  The QARMC will meet monthly at a minimum, to review follow-up actions needed and assigned from the prior meeting(s).
   2. Ad Hoc Meetings.  The QARMC will meet as needed to address new issues as they are reported to the QARMC.
6. SUPERSEDURE.  None.
7. EFFECTIVE DATE.  This charter becomes effective on the date of signature.