U.S. Department of Health and Human Services

Indian Health Service (IHS) Chapter 8-60

SECURING APPROVAL OF ORGANIZATIONAL CHANGES

IHS CHAPTER 8-60
GENERAL ADMINISTRATION MANUAL
IHS TRANSMITTAL 91-1 (10/21/91)

SUBJECT: SECURING APPROVAL OF ORGANIZATIONAL CHANGES

8-60-00 Purpose

8-60-10 Policy
8-60-20 Definitions
8-60-25 Responsibilities
8-60-30 Authority for Approving Organizational Change
8-60-40 Criteria of Organization
8-60-45 Organization Nomenclature
8-60-50 Requests for Organizational Change
8-60-60 Approved Organizational Change

Exhibit 8-60-A Sample Functional Statement
Exhibit 8-60-B Indian Health Service Organizational Change Approval Levels and Echelons
Exhibit 8-60-C Indian Health Service Headquarters Organizational Chart
Exhibit 8-60-D Indian Health Service Area Office Organizational Chart

8-60-00 PURPOSE

This chapter describes the Indian Health Service (IHS) policy governing the development, review, coordination, evaluation, and approval of any organizational change within IHS. It supplements the Department of Health and Human Services (HHS) and Public Health Service (PHS) General Administration Manual, Chapter 8-60, "Securing Approval of Organization Changes." PHS Exhibit 8-60-A planning guidelines may be used for all organizational changes within the IHS.

8-60-10 POLICY

Within the IHS, organizational changes are effected through establishment, abolishment, transfer or consolidation of an organizational component, a change in title, and the addition, abolition or transfer of a function. The reassignment of individuals will not constitute an organizational change. If it becomes necessary to divide an organization's functions and responsibilities, such division must result in at least two subordinate organizations.

To secure approval, organizational change proposals must meet the standards defined within the content of this chapter. All organizational changes will become effective on the date they are approved unless otherwise noted in the approval document.

8-60-20 DEFINITIONS

Organizational Component. The term "organizational component" refers to any part of the IHS organization which has the following characteristics:
1. Established separately as an organizational entity by law, regulation, the Secretary, or an official to whom the Secretary has delegated authority;
2. Has assigned functions or area of responsibility and has an approved Standard Administrative Code (SAC) and title; and
3. Normally requires the full-time services of one or more persons to carry out the functions.
Organizational Change. The term "organizational change" includes:
1. Establishment, abolishment, transfer, or consolidation of an organizational component:
2. Change in the name of an organizational component; and
3. Addition, abolition or transfer of a function.
Functions. The term "functions" refers to the activities conducted within an organizational component to accomplish its assigned mission
Functional Statement. The term "functional statement" denotes a formal description of the mission assigned to an organizational component and the activities conducted within the component to accomplish that mission. (See Exhibit 8-60-A)
Standard Administrative Code. The SAC is used throughout HHS to identify individual organizations and their hierarchial relationship to other organizations. It displays the place of an organization within the organizational structures.
Standard Nomenclature. The term "standard nomenclature" refers to a set or system of terms as used to identify organizational components.
Declension. The term "declension" refers to a downward hierarchial progression
Organizational Level or Echelon. The term "organizational level" or echelon refers to the hierarchial location of an organizational component, regardless of its title, and is based on the reporting relationships specified below: (See Exhibit 8-60-B)
1. First Echelon - The level of an organizational component whose head reports directly to the Assistant Secretary for Health (ASH).
2. Second Echelon - The level of an organizational component whose head reports directly to the Director, IHS.
3. Third Echelon - The level of an organizational component whose head reports directly to a second echelon manager.
4. Fourth Echelon - The level of an organizational component whose head reports directly to a third echelon manager.
5. Fifth Echelon - The level of an organizational component whose head reports directly to a fourth echelon manager.
Office of the Director. The term "Office of the Director" refers collectively to all headquarters organizational components of the IHS which are not in one of the IHS Area Offices.
Headquarters Office. The term "Headquarters office" refers to a second echelon organizitional component headed by an Associate Director who reports directly to the Director, IHS. (See Exhibit 8-60-C)
Headquarters Division. The term "Headquarters division" refers to a third echelon organizational component headed by a Division Director who reports directly to an Associate Director.
Headquarters Branch. The term "Headquarters branch" refers to a fourth echelon organizational component headed by a Branch Chief who reports directly to a Division Director.
Staff. The term "staff" refers to an organizational component which does not meet the designated Full-Time Equivalent (FTE) size requirements for a specific organizational level. It may also refer to a sub-organization which does not meet the designated number of suborganizations required for a specific organizational level.
Field Office. The term "Field Office" encompasses any IHS operated facility, including any Area Office, service unit, hospital, clinic or health center which: (a) is established permanently or is scheduled to operate for at least 1 year; and (b) is staffed by at least 1 FTE position.
Area Office. The term "Area Office" refers to a second echelon organizational component headed by an Area Director who reports directly to the Director, IHS. (See Exhibit 8-60-D)
Area Office Office. The term "Area Office office" refers to a third echelon organizational component headed by an Area Associate Director who reports directly to the Area Director.
Area Office Division. The term "Area Office division" refers to a fourth echelon organizational component headed by an Area Division Director who reports directly to an Area Associate Director.
Area Office Branch. The term "Area Office branch" refers to a fifth echelon organizational component headed by an Area Branch Chief who reports directly to an Area Division Director.
Service Unit. The term "Service Unit" refers to a third echelon organizational component headed by a Service Unit Director who reports directly to the Area Director.
Service Unit Division. The term "Service Unit Division" refers to a fourth echelon organizational component headed by a Service Unit Division Director who reports directly to the Service Unit Director.
Service Unit Branch. The term "Service Unit Branch" refers to a fifth echelon organizational component headed by a Service Unit Branch Chief who reports directly to the Service Unit Division Director.

IHS:
8-60-25 RESPONSIBILITIES

Directors of IHS Offices, Area Offices, and Service Units. The directors of IHS Headquarters offices, Area Offices and service units are responsible for maintaining an effective organizational structure within their areas of authority. The directors of these organizations have the authority to review, institute (within the limits of the authority delegated to them), or recommend organizational changes necessary to further the maintenance of an effective organizational structure. Any planning session to consider organizational changes must involve the Management Analysis and Initiatives Branch (MAI), Division of Management Policy (DMP). Proposed organizational changes must be directed to the Associate Director Office of Administration and Management (OAM), IHS, with a copy to the Director, DMP.
Management Analysis and Initiatives Branch, DMP/OAM/IHS. The MAIB is charged with guiding, directing, and, managing organizational changes within IHS. The MAIB is responsible for providing guidance in the planning of and technical assistance on the development of any proposed organizational changes within IHS. The Branch coordinates the distribution of proposed organizational changes to the Associate Directors; the Director, Equal Employment Opportunity (EEO), and the Director, Division of Personnel Management for review and comment and transmits the recommendations to the initiating office for consideration. The Branch is responsible for processing all IHS organizational change proposals.
Area Directors and Headquarters Associate Directors. Headquarters Associate Directors are responsible for providing written comments related to their review of proposed organizational changes to the Associate Director, OAM. A failure to submit comments will be considered concurrence with the proposed changes. The Associate Director, OAM, is responsible for providing comments received from the Associate Directors review to the office initiating the organizational change.
The Associate Directors should initiate a discussion with the originating office to address the comments made and to make recommendations for resolution of differences. The Area Director or Associate Director initiating the organizational change must resolve differences regarding the proposed organizational changes with the appropriate Associate Director(s) in disagreement. The MAIB functions as a facilitator and provides technical expertise on organizational policy in the resolution meetings. The Associate Director, OAM, must receive a written response on the resolution regardless of the outcome from the Area Director or Headquarters Associate Director who submitted the proposal. In the event that differences cannot be resolved between the Associate Director(s) and the initiating office, the comments on the proposed organizational changes will be submitted to the Deputy Director and Director, IHS, for final resolution.
Director, Deputy Director, and Director of Headquarters Operations, IHS. The Director, Deputy Director, and Director of Headquarters Operations,IHS, are charged with ensuring that organizational changes are consistent with agency policy and procedures and the IHS mission. The Director, IHS, has been delegated the authority to approve third echelon organizational changes. The Deputy Director and Director of Headquarters Operations have been delegated the authority to approve fourth echelon changes. The Director, IHS, and the Deputy Director, IHS, have the authority to approve medical center organizational changes.
Division of Personnel Management, OAM, IHS, and Regional Personnel Offices, HHS. All organizational changes must reflect the clearance of the appropriate servicing personnel office (SPO) to ensure that all personnel matters have been addressed. For Area Offices, the IHS SPO has this direct responsibility, and must indicate clearance in the reorganization package. The Regional Personnel Officer (RPO) should be consulted on any indications of major impact on personnel resources or potential request for reduction-in-force approvals, but need not be a clearance point unless requested by the Area Director. Copies of reorganization documents should be provided to the RPO at each stage of development. A written certification will be provided by the SPO that all personnel matters involved in proposed reorganization or realignment have been considered and all potential personnel actions will be undertaken in accordance with the United States Office of Personnel Management policy and practice.
Management and Union Agreement. The Associate Director, OAM, IHS, will provide the union, through the Division of Personnel Management, IHS, an opportunity to review all Headquarters organizational changes prior to approval. Area Directors are required to provide notice to local bargaining units, where applicable, of pending organizational changes to afford the union their right to negotiate the impact and implementation aspects of such changes. The SPOs/labor relations staff must be consulted concerning the appropriate information, including the timing, to provide to unions. Unions are not to be involved in the developmental and decision-making stages of a reorganization. The Area Director will provide information to the local bargaining unit, where applicable, to enable the union to exercise their right to request bargaining on the implementation and impact of the organizational changes.
Office of the General Counsel, (OGC). The Associate Director, OAM, IHS, is responsible for submitting all organizational changes proposed to establish or abolish an IHS Headquarters office or IHS Area Office to the OGC for review and clearance.

IHS:

8-60-30 AUTHORITY FOR APPROVING ORGANIZATIONAL CHANGE

Table of Authorities. The following table indicates the official to whom a proposal for organizational changes shall be submitted for review and approval. For each echelon at which an organizational change may occur, the table below indicates the corresponding approval official. These officials may approve any proposed organizational change for which they have been delegated authority; unless the proposed change involves, implies, or impels corresponding organizational changes requiring the approval of higher level officials.

TABLE OF AUTHORITIES

ECHELON	ORGANIZATIONAL LEVEL	IHS RECOMMENDING OFFICIAL	ASH RECOMMENDING OFFICIAL	APPROVING OFFICIAL
1st Echelon	IHS	Director, IHS	Assistant Secretary for Health	Secretary HHS
2nd echelon	Headquarters Offices and Area Offices	Director, IHS	Assistant Secretary for Health	Secretay HHS
3rd Echelon	Area Office Offices and Service Units	Area Directors		Director and Deputy Director IHS
3rd Echelon	Headquarters Divisions	Associate Directors		Director and Director of Headquarters Operations, IHS
4th Echelon	Area Office Divisions	Area Directors		Director and Director of Headquarters Operations, IHS
4th Echelon	Service Unit Divisions	Service Unit Directors		Area Directors, IHS
4th Echelon	Headquarters Branches	Associate Directors		Director and Director of Headquarters Operations, IHS
5th Echelon	Area Office Branches	Area Division Directors		Area Director and Area Office Office Directors
5th Echelon	Service Unit Branches	Service Unit Division Directors		Area Director and Service Unit Directors

The function statements for all organizational changes at the 1st, 2nd, and 3rd echelon must be published in the Federal Register.

The fourth echelon includes organizational components in an IHS Area Office or service unit that have a reporting relationship to an Area Office Office Director or Service Unit Director.

The fifth echelon includes organizational components in an IHS Area Office or service unit that have a reporting relationship to an Area Office or Service Unit Division Director.

IHS:

8-60-40 CRITERIA OF ORGANIZATION

General Criteria
1. Organizations will not be established unless it is planned to keep them in existence for more than one year.
2. Organizations will not normally be established solely to conduct specific projects supported in whole or in part by Federal resources, for task forces, or for advisory committees.
3. The establishment of an organization for each assigned function or responsibility is not required and should be avoided except where good management reasons exist.
4. In all cases where one or more functions are assigned to a relatively small group of FTE (usually fewer than 2 FTEs), serious consideration should be given to the option of not establishing a formal organization. Such a grouping will be referred to by the generic term "staff" and if it is considered necessary, identified in relevant position descriptions and/or in the functional statement of the parent organization.

Organization Size

Minimum FTE positions for each Area and Headquarters office, division and Branch organizational level are as follows:

Organizational Level	Minimum FTEs Required
Office	8 - including at least four professional employees
Division	5 - including at least three professional employees
Branch	2 - must be professional employees

*Employees in the grades GS-9 and above are regarded as professionals for this requirement.

Any organization which does not meet this requirement will be referred to as a "Staff" office, regardless of the organizational level.

Exceptions to the minimum FTE requirements specified above must be adequately justified and formally requested for approval of the Director, IHS. Reasons for an exception to the minimum number and or the criteria of organization include:
1. The organization has been mandated by law or by the administrative decision of higher authority;
2. There is a programmatic need for the creation of a SAC; and
3. The organization is part of a larger organizational plan which has been approved and is in general conformity with organizational requirements.
All "staff" offices, regardless of the organizational level, will not be assigned a SAC. Staff offices will utilize the SAC of the organizational component to which it has a reporting relationship, i.e., office, division, branch.

IHS:

8-60-45 ORGANIZATION NOMENCLATURE:

Standard nomenclature will be utilized in all IHS Headquarters and field organizational components. See HHS General Administration Manual Chapter 8-65, "Organization Nomenclature," for standard nomenclature and organizational level. Organizational components below the branch level may follow an established pattern of nomenclature where the pattern has been approved by the Director or Deputy Director, IHS, with concurrence of the Associate Director, OAM, IHS. Approval for any deviation from standard nomenclature or from an approved pattern must be specifically requested in the proposed organizational change.

The standard nomenclature pattern for subordinate organizational components or entities in descending order are as follows:

HHS STANDARD NOMENCLATURE	IHS HEADQUARTRS ECHELON LEVEL	IHS AREA OFFICE ECHELON LEVEL
Office	2nd Echelon (Must be published in the Federal Register)	3rd Echelon (Must be published in the Federal Register)
Division	3rd Echelon (Must be published in the Federal Register)	4th Echelon
Branch	4th Echelon	5th Echelon

General.  The principal organizational entity is the agency and will be defined as "Indian Health Service."  The Director, the Deputy Director, and the Director of Headquarters Operations, IHS, will be identified as an organizational component entitled "Office of the Director" and will be assigned a SAC.  The first declension below the Office of the Director is a Headquarters Office level organizational component which is considered the second echelon level.  Second echelon level changes require approval by the Secretary, HHS, and publication in the Federal Register.
The next declension below a Headquarters office level organizational component is a Headquarters division level organizational component and is considered the third echelon level.  If a Headquarters Office proposes divisions, there must be a minimum of two divisions under the Office.  All third Echelon organizational changes require approval by the Director, IHS, and publication in the Federal Register.  The next declension below the Headquarters "division level" organizational component is a Headquarters "branch level" organizational component which is considered fourth echelon level.  Organizational changes at the fourth echelon level require approval by the Deputy Director or Director of Headquarters Operations, IHS.  If a division proposes branches, there must be a minimum of two branches located under the division.  The principal organizational entity of an Area Office will be identified as "(LOCATION) Area Office" which includes the Area Director.  Area Offices are considered second echelon level and are the first declension below the Office of the Director.  The Area Director will be identified by an organizational component entitled "Office of the Area Director" and will be assigned a SAC.
The first declension below the Office of the Area Director is an Area Office "Office level" organizational component which is considered the third echelon level.  Organizational changes at the Area Office office level require approval by the Director, IHS, and publication in the Federal Register.  The next declension below an Area Office "office level" organizational component is an Area "division level" organizational component which is considered the fourth echelon level.  Organizational changes at the Area division level require approval by the Deputy Director or Director of Headquarters Operations, IHS.  There must be a minimum of two divisions under an office.  The organizational components in the Area Office must be identified as an office, division, branch, or staff.
Standard nomenclature terminology must be used to identify a proposed organizational component.  It should be noted that no organizational component will use "Office of the Chief," "Office of the Director," etc., as a subordinate organization block, to identify the chief of an office, division, or branch.
Number of FTE Positions. It is the policy of the Director, IHS, that all PROPOSED organizational components identified with SACs have at least two FTE professional positions. Any proposed organizational component with less than two FTE professional positions will be designated "Staff" regardless of organizational level.
Approval of Proposed Service Unit Organizations. A service unit is a third echelon level organizational component whose establishment or abolishment must be approved by the Director, IHS. Organizational changes within a service unit may be approved by the Area Director.

IHS:

8-60-50 REQUESTS FOR ORGANIZATIONAL CHANGE

Submission of Requests for Approval at the Second Echelon. All requests for organizational changes at the second echelon level should be developed in accordance with guidelines provided in the General Administration Manual, PHS Chapter 8-60, "Securing Approval of Organization Changes."
Submission of Requests for Approval at the Third Echelon. Requests for approval of reorganization proposals for organizational components at the third echelon will be submitted to the Director, IHS, through the Associate Director, OAM.
1. Format of Requests for Approval. Offices requesting approval of 11 organizational changes at the third echelon must submit an Action Memorandum along with the functional statements, position listings, and organizational charts.
2. Contents of Requests for Approval. This paragraph describes the nature of the material required when requesting approval for organizational changes at the third echelon. Reorganization proposals will vary both in the documents required for the approval process and in the detail and character of data which may be necessary to support requested changes. However, all reorganization proposals will include the following elements:
  1. Action Memorandum
    1. Format. An Action Memorandum addressed to the Director, IHS, is to be prepared by the originating office for organizational proposals requiring the Director's approval. This memorandum is to be prepared on IHS stationary.
    2. Purpose. The Action Memorandum transmits the proposal, serves as the informative summary of change(s) being proposed, states the advantages and disadvantages of the proposal, and contains other necessary information to enable the reviewing and approving officials to understand its consequences and reach an informed decision.
    3. Content. Within the above stated purpose, the Action Memorandum should highlight the principal aspects of the organizational proposal, clearly stating any policy issues and including as a minimum the following:
      1. Purpose. A statement detailing the principal aspects of the organizational proposal, clearly stating the objectives of the request for organizational change.
      2. Discussion. Statements which adequately provide information concerning the background, legislative basis, justification and other pertinent information which support the proposed organizational change.
      3. Discussion of Proposed Organizational Changes. A statement of the changes in function or the assignment of functions involved in the organizational change. A brief statement of the effect, if any, of the proposed change on other organizational components in the subject organization, or IHS. A brief statement that personnel issues have been considered and indicate the effect on grade and employment ceiling. A written certification that all potential personnel actions conform to appropriate IHS management policy and practices.
      4. Summary. A summary statement of the desired effects of the proposed organizational changes.
      5. Recommendation. A statement requesting approval by the authorized IHS official.
  2. Functional Statements. Both current and proposed functional statements should be included with the requesting memorandum incorporating the following criteria:
  1. Functional statements must be established for each organizational component. Functional statements should be concise and identify functions assigned to each component. The statements should not be considered as delegated authority or authorization for specific activities. Such action is accomplished by delegations of authority, individual position descriptions, and standards of performance.
  2. Two sets of functional statements will accompany a request for organizational changes. One set will reflect the functional statements for the approved organizational components and will be identified as CURRENT with approved SACs indicated in parentheses on the same line as the organizational component's title. The other set will reflect the functional statements for the proposed organizational components and will be identified as PROPOSED. Each set of functional statements should be identified in the upper right hand corner as CURRENT or PROPOSED. A SAC will not be indicated for the proposed organizational components as they will be assigned by the MAIB.
3. Position Listings. Both CURRENT and PROPOSED position listings should be included with the requesting memorandum incorporating the following criteria:
  1. The authorized position listing should be enumerated by organizational component in accordance with approved SACs.
  2. The authorized listing shall indicate the grade, series and title of each FTE with a total for each organizational component. The position listing should be printed on white bond paper and identified as CURRENT or PROPOSED. Both the CURRENT and PROPOSED position listing must include the number of positions, professional and support and number of Senior Executive Staff and Commissioned Corps personnel, for each organizational component. Each set of position listings will be identified in the upper right hand corner as CURRENT or PROPOSED.
4. Organization Chart. Organization charts must be included with the requesting memorandum according to the following criteria:
  1. Two separate organization charts will be prepared; one reflecting the current approved organization structure, the other reflecting the proposed organization structure. The organization charts will use HHS standard nomenclature for both the current and proposed structures. Each organization chart will be identified in the upper right hand corner as CURRENT or PROPOSED.
  2. The organization charts should reflect the title and SAC for each of the approved organization components on the CURRENT chart and the title only for each of the organization components on the PROPOSED chart.
  3. Both the CURRENT and PROPOSED organization charts must include the number of positions, professional and support and number of Senior Executive Staff and Commissioned Corps personnel, for each block on the chart. If there is not enough space on the organization chart to reflect the professional and support staff by section and branch, white bond paper should be used to reflect this requirement.
  4. "Staff" offices will be reflected in boxes on the organization chart by broken lines.
Submission of Requests for Approval at the Fourth Echelon. Similar procedures described in Section 8-60-50-B will be followed for fourth echelon changes.
Submission of Requests for Approval at the Fifth Echelon. Similar procedures described in Section 8-60-50-B will be followed for fifth echelon changes. The reason for which a proposed organization change is not acceptable to the Director, IHS, will be communicated to the appropriate Area Director for review and comment.

IHS:

8-60-60 APPROVED ORGANIZATIONAL CHANGE.

After the necessary approvals have been obtained for proposed organizational changes, the Director, DMP, will return the signed and approved organization chart and functional statements to the requesting Area official.