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U.S. Department of Health and Human Services
Office of Finance and Accounting

Division of Budget Formulation

The Division of Budget Formulation (DBF) coordinates Tribal consultation in formulation of the IHS budget request, manages the preparation of the IHS budget justification and coordinates Congressional appropriations responses and briefings.

Division Priorities

Tribal Budget Consultation

Consultation with Tribes is the foundation of the IHS budget formulation process.  The IHS budget formulation process is comprised of annual forums for Indian Tribes and organizations to interact with the IHS to establish program priorities and budget recommendations.  Tribes, Indian organizations, and other key stakeholders are actively involved in the budget formulation process to ensure the IHS budget reflects the evolving health needs of American Indian and Alaska Native people and communities.

IHS Tribal Budget Consultation begins at the Area level with two Tribal representatives selected to serve as an Area representative on the IHS Budget Formulation Work Group (BFWG).  The BFWG provides input and guidance to the IHS in matters related to the budget formulation cycle and identifies national priorities, policies and budget recommendations.  The BFWG convenes twice annually for a National Work Session and Evaluation/Planning meeting.  The DBF monitors Tribal budget consultation activities and provides technical assistance when appropriate.

The annual budget request of the IHS is the result of the budget formulation and consultation process that involves IHS and tribal Indian health program representatives and providers from the local to the national level.  The tribal priorities identified in the consultation process are also instrumental in informing senior officials of other HHS agencies of the health needs of the American Indian and Alaska Native population, so that they have the opportunity to include those priorities in their individual budget requests to HHS.

IHS policy states that consultation occurs when there is a critical event that may impact Tribes, new or revised policies or programs are proposed, or the IHS budget request and annual performance plan are being developed.  In support of this policy and the Director's priorities to strengthen the IHS partnership with Tribes; the IHS is committed to making our work accountable, fair, and transparent.  For more information on IHS budget formulation please see: IHS Circular No. 2006-01, Sec. 12

Area Budget Formulation Meetings

Area Budget Formulation Sessions ensure Tribal input into the IHS budget formulation process.  Urban Indian health grantees also participate as part of the Urban-confer process authorized in the Indian Health Care Improvement Act, as amended. Area budget consultation occurs on an annual basis during the months of October and November, to develop Area-wide budget recommendations.  Area Budget Formulation Meetings can be found on the IHS Calendar.

IHS Budget Justifications

As a part of the annual President's Budget request to Congress, all federal agencies are required to submit a detailed budget request on or before the first Monday in February for the upcoming fiscal year beginning on October 1.  Formulation and presentation of all budget requests must comply with requirements outlined by law and the OMB Circular A-11.

The DBF is responsible for preparing and managing the annual IHS budget justification to Congress.  The IHS budget formulation process begins with the formal release of Tribal recommendations (usually in March) and ends with the publication of the President's Budget (usually the following February).  During this time, DBF is busy working with IHS staff to prepare and ensure budget estimates effectively communicate the relationship between proposed funding levels and planned performance results.

Congressional Appropriations

The IHS budget is reviewed by the House and Senate Committees on Appropriations.  IHS leadership provides annual testimony to the House Committee on Appropriations, Subcommittee on Interior, Environment and Related Agencies; and the Senate Committee on Indian Affairs.  The information provided in the annual IHS budget justification is reviewed by Congressional staff and assists them in making funding decisions.

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For general inquiries please email IHSHQBudgetFormulation@ihs.gov