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U.S. Department of Health and Human Services
Indian Health Manual

Chapter 4 - Program Planning For Indian Health Service

Part 4 - Staff Services/Special Programs

Title Section
Purpose 4-4-1A
    Operational Planning System 4-4-1B
      Criteria for Objectives 4-4-1B(1)
      Criteria for Plans 4-4-1B(2)
      Objective and Plan Formats 4-4-1B(3)
    Operational Planning Procedures and Schedule 4-4-1C
      Area Operational Planning System Objectives & Plans 4-4-1C(1)
      Development & Submission of Operational Objectives & Plans 4-4-1C(2)
      Review and Approval of Objectives & Plans 4-4-1C(3)
      Progress Monitoring 4-4-1C(4)
      Problem and Variance Analysis 4-4-1C(5)
      Modification of Objectives and Plans 4-4-1C(6)
      Annual Evaluation in Preparation for Area Program Review 4-4-1C(7)

Exhibit Description
4-4.1B(3) Statement of Objective
4-4.1B(3)d Operational Plan
4-4.C(4) Objective Status Report
4-4.1C(4)a Problem and Variance Analysis

4-4.1A  PURPOSE

The purpose of the Operational Planning System is to provide each Area with an annual operating plan that meets the requirements of good program management.  Operational Planning provides the mechanism to link general or long-range goals to the specific achievements or high priority concerns desired in a single fiscal year.

4-4.1B  OPERATIONAL PLANNING SYSTEM

  1. Criteria for Objectives:
    1. Importance - Objectives should cover activities or programs which are most important in accomplishing the organization?s mission.
    2. Statement of End Results - Objectives should describe the expected end product from efforts and expenditures in a particular program area.  There are two kinds of basic objectives:
      • Output - States results in terms of what will be produced with resources.
      • Impact - States results in terms of the effect that resources and output products will have on a problem or need.

      Impact objectives are preferred to output objectives.  The objective statement should be confined to the accomplishments expected during that fiscal year.

    3. Measurability - Objectives must be in measurable terms.  Managers must be able to determine whether they and their organization unit have achieved what they set out to do by the end of the fiscal year.
    4. Clarity - Objectives must be clearly stated and understood by all parties.
    5. Realistic Commitment - The manager (Area Director) should be sure that the accomplishment of an objective is feasible and realistic.
    6. Significant Effort - Objectives should provide a challenge and stretch the organizational unit?s ability to perform.
  2. Criteria for Plans

    The completion date for each milestone is identified by month.  Milestones for each objective should meet all of the following criteria:

    1. Measurable - Each milestone should be stated in terms that will allow determination of whether or not it has been completed.
    2. Significant - Each milestone should represent a significant step toward achievement of the objective.
    3. Logical - Each milestone should follow from the previous step and lead to future steps.
    4. Complete - Completion of all the milestones listed in the plan should assure achievement of the objective.

      The manager developing the plan is responsible for ensuring that the milestones to be completed by others are completed on time.  Milestones should be defined in such a manner that at least one milestone is completed each two months.  The operational plan will cover only those actions to be taken during the fiscal year.  If an objective is to be multi-year, it should be listed as one of the objectives for each succeeding year necessary for completion.

  3. Objective and Plan Formats

    The following elements are included in the format:

    1. A concise statement of the objective (Exhibit 1).
    2. Identification of resources to be utilized.  This statement should estimate the total monetary resources and a rough estimate of the total man-years required.  Operational objectives and plans must be based on reasonably certain resource availability.  Continuation of the current year?s funding level plus mandatory increases will be used as the basis for developing Area objectives and plans.  (Exhibit 1)
    3. A statement of justification which describes the problem which the objective addresses and how the objective fits into the overall mission of the IHS.  Included in this statement should be a description of the approach outlining how the objective will be achieved.  (Exhibit 1)
    4. An operational plan for achieving the objective.  (Exhibit 2)  An appropriately marked copy of the plan will serve as the primary reporting instrument for the fiscal year.

4-4.1C  OPERATIONAL PLANNING PROCEDURES AND SCHEDULE

  1. Areas Operational Planning System Objectives and Plans.

    By March 1st Headquarters, IHS, will send out suggested emphasis to areas for inclusion in Area OPS objectives and plans.  There may be other needs that Areas would prefer to include instead of those listed.

  2. Development and Submission of Operational Objectives and Plans.

    By August 1st of each year, each Area Director develops and submits to the Director, IHS, not more than ten (10) proposed Area OPS Objectives and Plans.

  3. Review and Approval of Objectives and Plans.

    A review of proposed Area objectives and plans will be conducted by appropriate Headquarters staff and the consolidated comments of the reviews sent to the Area Directors if any revisions are recommended by September 1st.  Revised Area objectives and plans should be received back in Headquarters by October 1st.

  4. Progress Reporting.
    1. Status Report - A status report on all OPS objectives and plans will be submitted quarterly to the Director, Division of Resource Coordination, attention:  Director, Office of Program Planning.  The report is due in Headquarters by the 15th of the month following the end of the quarter (Exhibit 3).  Failure to complete a milestone is to be explained in a Problem and Variance Analysis (Exhibit 4).
    2. Evaluation - Xerox a copy of each objective and fill in the triangle of each milestone that has been completed and indicate any milestone that the completion date has been changed.  Three ratings are used in the ?Overall Evaluation? of the plan:
      • Satisfactory - No problem exists at present nor are any anticipated that will affect the accomplishment of the objective and all milestones now and in the future are on schedule.
      • Minor Problem - There is a problem but it does not at present jeopardize the accomplishment of the objective.  Any deviation from the operational plan requires a rating of ?Minor Problem?.  This, could be merely a delay in a milestone, it might also be a problem of such degree reaching that if corrective action is not taken the problem may become serious to affect the accomplishment of the objective.
      • Major Problem - There is a distinct possibility that the objective will not be completed unless major corrective action is taken.  (Exhibit 4)
  5. Problem and Variance Analysis
    1. A problem and Variance Analysis must be forwarded with the Status Report if:
      • Major problems occur or are anticipated.
      • There is a need to change the statement on completing date of a milestone.
      • There is a change in the funds required to carry out the objective.
      • The objective statement itself must be changed.
      • If a previously reported problem still exists.
    2. A major problem classification can be removed under one of two conditions:
      • The problem is resolved; or
      • The Area obtains approval for a change in the objective or plan.
    3. The Problem and Variance Analysis should clearly describe the problem; why it occurred; what action has been or will be taken.
  6. Modification of Objectives and Plan
    1. Revisions of the objectives and plans are controlled because the approved operational objectives and plans form the basis for subsequent progress analysis and performance measurement.  Two types of revisions do not require higher level approval.
      • Classification of the way an objective is stated without changing the substance.
      • Adding more specific milestones without changing the overall timing.
    2. More important revisions or canceling of an objective must be approved by the same procedure as approval of new objectives.

      New appropriate objectives should be developed to replace those of lesser importance or be added to the list without deleting others on the few occasions that budgetary changes or new administrative initiatives would significantly affect OPS objectives and plans.

      A new objective may be submitted for approval if revisions or cancellation become necessary because an Area would not be able to achieve the original objective during the fiscal year.  If approved, the new objective will be tracked for the remainder of the year.

  7. Annual Evaluation in Preparation for:
    1. Area Program Review

      By November 1st Area Directors will submit to the Director, IHS, a report on each of the prior years OPS Objectives and Plans covering:

      • The objectives agreed upon at the outset of the year, or whenever additional objectives were added.
      • Any revisions or cancellation of objectives and the reasons for this action.
      • An evaluation of actual results.
      • Reasons for or factors leading to failure to fulfill objectives.
      • A list of actions taken to correct any problems which caused failure to complete objectives and the effect that actions taken had on the problem.
      • The latest steps taken to assure that the same problem will not arise again.
      • An estimated completion date for any uncompleted objective or a request to change or drop the objective with the reasons for such action.
    2. This report will be used by the IHS Director in the scheduled annual Area Program Reviews.  Area Directors may also include an evaluation of the usefulness of the Operational Planning System and how it might be improved to increase its value to them.