February 3, 4, 5, 2003
Washington, D.C.
Agenda for Meeting
Monday, February 3, 2003
Hubert H. Humphrey Build Room 505 A (Phone: 202/205-0029)
200 Independence Avenue, SW
8:30 am
Welcome and Introductions, Facilitator, J. Kauffman
8:45 am
Overview of the Project, DHHS, A. Rock
- Project Overview (Doc: Project Description)
- DHHS Purpose and Expectations of Study
- Roles and Responsibilities of Entities
- Charge to the Technical Work Group
- Tribal Consultation
9:30 am
Establishing Our TWG – Facilitator, J. Kauffman
- Review Agenda and Objectives for Meeting (Doc: Agenda)
- Agree on Our Ground Rules
10:15 am
Break
10:30 am
Background: Legislative History & Literature Review, K. Langwell
- Review Drafts (Docs: Draft Legislative History Report; Draft Literature Review)
- Identify Gaps and New Resources
12 Noon
Lunch
1:30 pm
Seek Input from TWG on Methodology, K. Langwell
- Objectives of the Study (Doc: Draft Work Plan)
- Feasibility Study vs. Evaluation
- Setting the Study Parameters
- Identifying Data Sources
3:00 pm
Break
3:15 pm
Continued Discussion on Feasibility Study Methodology
4:30 pm
Recess
Tuesday, February 4, 2003,
Wilbur J. Cohen Building, Room 5051 “Snow Room” (Phone: 202/401-1523)
330 Independence Avenue, SW
8:30 am
Review agenda and objectives for the day, J. Kauffman
8:45 am
Seek Input and Advice from TWG on Major Study Areas: “What are the Study Questions Needed in each of the Following Areas?”, K. Langwell
(Doc: Draft List of Potential Evaluation Issues and Questions)
- Transitional and Management Issues
- Data Requirements and Information Systems
- Financing Issues
- Measures of Performance and Effectiveness
10:15 am
Break
10:30 am
Continue Discussion of Major Study Areas
- Developing Study Questions
12 Noon
Lunch
1:30 pm
Site Selection: Overview and Discussion, K. Langwell
(Docs: Draft Tribal Matrix Report; Draft Tribal Data Report)
- What are the expected outcomes of Site Visits?
- What should criteria be for site selection?
- What information should be gathered?
- What should be included in site visit protocols?
3:15 pm
Break
3:30 pm
Planning Small Group Discussions: Overview - J. Kauffman, (Doc: Draft Issues for Discussion Groups)
- What are the expected outcomes of Discussions?
- What questions should be asked?
- What are best locations/settings for discussions?
- What are best recruitment strategies?
4:30 pm
Recess
Wednesday, February 5, 2003,
Hubert H. Humphrey Bld., Room 405 A, (Phone: 202/260-7048)
200 Independence Ave., S.W.
8:30 am
Review agenda and discuss objectives for the day, J. Kauffman
8:45 am
Review Next Steps
- Other issues to discuss?, J. Kauffman
- Implementation of Study, K. Langwell
9:30 am
Identify Objectives and Draft Agenda for Next TWG Meeting, J. Kauffman
- Ongoing communication between TWG and contractor (Doc: Draft Communications Strategy Report)
- Mail-out of drafts and other documents
- Second TWG Meeting
10:15 am
Break
10:30 am
Review Consultation Plan, A. Rock
- DHHS/ASPE Consultation Plan with Tribes
- How Do You See Evaluation Consultation?
11:00 am
Closing Comments from TWG, J. Kauffman
12 Noon
Adjourn
Project Description
Evaluation Feasibility Study
The Office of the Assistant Secretary for Planning and Evaluation, DHHS, has funded a one-year project to assemble background information and to assess the availability of data and the feasibility of conducting an evaluation of the effectiveness and impacts of administering and managing health and/or other social service programs under Self-Governance. The primary tasks that will be conducted by Westat and its subcontractors, Project HOPE and Kauffman and Associates, Inc., include:
- Compilation and synthesis of background information and existing research on the legislative history, experience, and effectiveness of Tribal Self-Governance, including identification of gaps in the research and limitations of previous studies.
- Identification of a sample group of Self-Governance Tribes that meet specific criteria, management and data capabilities sufficient to support an evaluation of Tribally-managed programs, and indicating an interest in/willingness to participate in an evaluation.
- Identification of likely research questions for an evaluation and the data that would be required to address each question.
- Assessment of data availability, completeness, and comparability for Tribally-managed programs, relative to data that are available from Federal and State agencies that provide services to non Self-Governance Tribes.
- Consultation and ongoing communication with Tribal leaders and Tribal organizations in designing, conducting, and reviewing findings of the feasibility study.
A Technical Working Group (TWG), consisting of 10 Tribal leaders, directors of Tribally-managed programs, representatives of Tribal organizations (plus informal, ex officio, research and data experts) will advise the project on key issues and review interim and final project findings.
This study extends work begun by IHS (under the now-repealed Section 305 of ISDEAA, including the Baseline Measures Workgroup) and, more recently, grew out of the experience of DHHS’ participation in the Federal-Tribal consultation on Title VI of P.L. 106-260 that mandated a study of the feasibility of conducting a demonstration of Tribal Self-Governance of non-IHS programs. Since evaluation would be a part of a demonstration, and since there has been no conclusive evaluation of Tribal Self-Governance of health programs, the current study will provide information relevant to the possible conduct of an evaluation of Tribal Self-Governance of either health or social services programs, or both.
Contact Information
| Sponsor: | DHHS Project Officers: |
| OASPE/DHHS Room 447D 200 Independence Avenue, SW Washington, DC 20201 |
Andrew Rock 202-260-0398 Tom Hertz 202-690-7779 |
| Start Date: September 2002 | End Date: September 2003 |
| Project Director: | Co-Principal Investigators: |
| W. Sherman Edwards Westat 1650 Research Boulevard Rockville, MD 20850 Telephone: 301-294-3993 Email: EDWARDS1@Westat.com |
Kathryn Langwell Jo Ann Kauffman |
| Project Consultants: | |
|
Pamela Iron |
Draft Work Plan
Draft Literature Review
Draft Literature Review (PDF Version)
List of Potential Evaluation Issues/Questions
SUGGESTED EVALUATION ISSUES, QUESTIONS, DATA REQUIREMENTS
For Discussion with the Technical Working Group
Overview
An evaluation of Tribal Self-Governance could include a wide range of issues and questions, requiring use of existing data, primary data collection, and qualitative data collection. In this handout, we offer a comprehensive set of potential areas that could be examined in an evaluation of health related services. (A separate, similar, analysis will be needed for each non-IHS social services and other that would be included in any evaluation. Topics and data requirements for such an evaluation effort will be discussed by the Working Group during its review of the activities that will take place during site visits to Tribes which manage one or more non-IHS services.)
Qualitative Issues: Management Structures and Processes
This set of evaluation issues focuses on the role and structure of management of Tribal health systems and on internal management processes and systems. Data required to address these issues would be collected through site visits, key informant telephone interviews, and review of internal documents (e.g. policies and procedures). Types of questions that would be addressed include:
- Management Structure and Stability
n What are the management structure, departments, and reporting relationships within the health system?
n How long has each manager served in their current position?
n Has there been significant turnover in management positions since you took over responsibility for management of the health program? If so, what are the reasons?
- Providers and staff
n How many physicians and other provider staff are currently employed or providing health services?
n Are there vacant positions? If so, how many and for what time period?
n What are the challenges for recruiting and retaining physicians and other provider staff?
n Have you developed and implemented any special programs to recruit staff and/or to retain staff?
- Programs and Benefits
n Have you added any new programs since Tribal management of the health system began? Which programs? How did you decide that there was a need for those new programs?
n Have you eliminated any programs? Which programs? What were the reasons that you decided to eliminate those programs?
- Quality and User Satisfaction
n What types of quality of care review and assessment do you have in place?
n Who is responsible for determining the specific areas and baseline measures that are used for quality of care review and assessment?
n What are the most important issues for quality of care and performance measures in your health system? Why are these identified as of greatest importance?
n Do you occasionally or routinely collect information from users on their experiences with providers, staff, health services provided? How do you use the information collected?
n How do you believe quality of care has improved under Tribal management of the health system?
n Do you think that health system users are more satisfied since Tribal management was implemented?
- Management Challenges
n What are the management issues that are most difficult to address for Tribal management of health?
n What changes would be beneficial and result in improved services to Tribal members?
Quantitative Issues: Impacts and Outcomes
|
AVAILABILITY OF SERVICES/ACCESS TO CARE |
|
|
Key Questions |
Data Requirements |
|
What services are available ‘in house’? Have the quantity and type of ‘in-house’ services increased/decreased over the past three years? What is the ratio of primary care physician-to patient users? Dentist-to-patient users? |
At the Service Unit level, most recent year and previous two years:
|
|
What services are referred out to Contract Health Services? Have the quantity and type of Contact Health Services used changed over the past three years? What criteria are used to determine whether a patient is referred for Contract Health Services paid by the Service Unit? Is there ‘rationing’ of Contract Health Services? All year? At some point in the fiscal year? |
|
|
What is the waiting time for a routine appointment? With a Service Unit primary care physician? With a Service Unit Dentist? |
|
|
QUALITY OF CARE: PROCESS |
|
|
Key Questions |
Data Requirements |
|
What proportion of Service Units are JCAHO-accredited or have other accreditation? What proportion of physicians are board-eligible or board-certified? What proportion of nursing and ancillary personnel are licensed and meet federal/state continuing education requirements? |
All Service Units, separately by direct service, contracted, compacted:
|
|
What is the annual ‘turnover rate’ for physicians, dentists, nurses, and ancillary personnel? |
|
|
Does the Service Unit have a Quality Assurance/Review Committee? What are its functions/ How often does it meet? |
For each Service unit:
|
|
What proportion of patients receive routine preventive services? Has the proportion increased/decreased over the past 3 years? |
For each Service Unit, past year and preceding 2 years
|
|
What proportion of people with diabetes receive screening for diabetic complications? Has the proportion increased/decreased over three years? |
For each Service Unit, for all patients with diabetes, three years:
|
|
QUALITY OF CARE: HEALTH OUTCOMES |
|
|
Key Questions |
Data Requirements |
|
What is the breast cancer 5-year survival rate? What is the cervical cancer 5-year survival rate? What percent of births are low-weight or premature? What percent of births are high-weight? |
For each Service Unit:
|
|
What is the proportion of deaths attributable to diabetes What proportion of people with diabetes are diagnosed with diabetic retinopathy? What is the proportion of people with diabetes who have extremities amputated? |
|
|
QUALITY OF CARE: PATIENT SATISFACTION |
|
|
Key Questions |
Data Requirements |
|
What proportion of the population eligible for services uses the SU annually? |
|
|
Does the Service Unit or Tribal Health Department conduct periodic surveys of patients’ experiences and satisfaction? |
|
|
How do SU users rate access to care, their providers, Contract Health Services, and other dimensions of care? What proportion of the eligible population goes outside for services? What are the reasons for using non-IHS or non-Tribal health providers? How do patients who obtain care outside rate their care? |
Remaining questions would require a survey of users/non-users |
|
FINANCIAL PERFORMANCE |
|
|
Key Questions |
Data Requirements |
|
What proportion of users has public or private insurance? |
At the Service Unit level, last year and two preceding years:
|
|
How many total units of service are provided, by type of service? |
|
|
What proportion of potential third-party revenues is billed and collected? |
|
|
Is the Service Unit operating at ‘break even’ or with a ‘surplus’ |
|
|
What is average cost per unit of service? Average cost percapita? |
|
|
What is the current financial condition of the service unit’s balance sheet? |
|
|
Have the prices of services changed? |
|
|
What are average out-of-pocket costs for patients? |
|
Draft Tribal Matrix Report
Draft Tribal Matrix Report (PDF Version)
Issues and Preliminary Topics for Discussion Groups Task
Questions for the Technical Working Group
- How can the small group discussions be useful to conducting the current feasibility study?
- What recommendations do you have regarding the locations, times, and arrangements described in the Discussion Protocol?
- What other Topic Areas and Prompt Questions would add to those suggested in the draft Discussion Protocol?
Small Group Discussions
Draft Discussion Protocol
Purpose: The Small Group Discussions will bring together experienced managers and technical experts in self-governance program management to discuss issues relevant to the study and outlined in the Discussion Guide. It will provide qualitative data, which is derived through interactive review and refinement from within each group discussion. These Small Group Discussions will be analyzed to identify “major themes and issues” that emerge across the board. These major themes will inform additional research, site visit inquiry and overall data analysis.
Target Participants: People who will be recruited to participate in the Small Group Discussions include tribal management and technical staff with direct experience in the administration of Self Governance compacts, including financial managers, MIS directors, legal or regulatory analysts, program administrators and related positions. A $50 honorarium will be provided to each participant. Sign-up sheets will be provided prior to the groups to make sure we have the appropriate mix of expertise in each session and no more than four people per category (ie, financial, MIS, program managers).
Setting, Size, Numbers, Format and Materials: The project design calls for six (6) Small Group Discussions to occur at two (2) different locations. Two major conferences or gatherings will be identified which promise to attract the types participants we will recruit to the discussion groups. At each conference we will hold three (3) different discussion groups. Each discussion group will involve not more than 10 to 12 individuals who represent a mix of interests and areas of expertise. Individuals will be recruited through fliers or inserts in conference packets. The contractor will work closely with conference organizers to ensure that our Discussion Groups are a part of the formal agenda if possible. A monetary payment will be provided to Discussion Group participants. Rooms will be set up in a semi-circle arrangement with flip-chart in the front for recording purposes. A one page hand-out summarizing the project will be provided to each participant. Each participant will be asked to introduce themselves and the Topic Areas and Prompt Questions will act as a general guide for the discussion. It is expected that each Small Group Discussion will last approximately 2 hours each.
Conferences: The Small Group Discussions will occur between February and April, 2003. The following conferences may be utilized for the discussion groups:
NCAI Executive Council Winter Session: Feb. 24-26, 2003; Washington, DC, Wyndham Hotel, Pre-Registration is Feb. 7, Hotel Reservations By Jan. 30.
IHS Self-Governance Spring Conference: Dates and locations have not been set by the IHS to date.
DHHS/ASPE Self Governance Evaluation Feasibility Study
Draft Small Group Participant
Discussion Guide
Thank you for agreeing to participate in this Small Group Discussion for the DHHS’s Self Governance Evaluation Feasibility Study. This study is being funded through the Assistant Secretary for Planning and Evaluation (ASPE) and conducted by ASPE contractor Westat, Inc. with subcontractors Project HOPE and Kauffman and Associates, Inc. (KAI) (a one-page hand-out summarizing the project is attached).
The information generated will provide qualitative data, which is derived through interactive review and refinement from within each group discussion. These Small Group Discussions will be analyzed to identify “major themes and issues” that emerge across the board. These major themes will inform additional research, site visit inquiry and overall data analysis.
It is expected that this meeting will last approximately 2 hours.
The following Topic Areas represents a guide for the Small Group Discussion; not all topics may be covered. We hope to engage in an open discussion. Prompt questions, below, are provided to stimulate a meaningful exchange.
Topic Areas and Prompt Questions:
1. Beginning the Self-Governance process
· What would you advise a tribe that is thinking about SG compacting?
· Are there certain steps to help ensure a smooth transition?
· How would this differ between IHS and other HHS programs?
2. Measuring success
· What data exists to evaluate success? How is it used?
· What other means exist to evaluate success?
· How would this differ between IHS and other HHS programs?
3. Areas of Concern or Difficulty
· What are the “pitfalls” you experienced?
· What potential difficulties do you see for new compacts?
· How would you fix these problem areas?
4. Keys for Success
· What are the most important ingredients to a successful project?
· What are the keys to success for other HHS programs as compared to IHS programs?
DHHS/ASPE Self Governance Evaluation Feasibility Study
Project Description
The Office of the Assistant Secretary for Planning and Evaluation, DHHS, has funded a one-year project to assemble background information and to assess the availability of data and the feasibility of conducting an evaluation of the effectiveness and impacts of administering and managing health and/or other social service programs under Self-Governance. The primary tasks that will be conducted by Westat and its subcontractors, Project HOPE and Kauffman and Associates, Inc., include:
· Compilation and synthesis of background information and existing research on the legislative history, experience, and effectiveness of Tribal Self-Governance, including identification of gaps in the research and limitations of previous studies.
· Identification of a sample group of Self-Governance Tribes that meet specific criteria, management and data capabilities sufficient to support an evaluation of Tribally-managed programs, and indicating an interest in/willingness to participate in an evaluation.
· Identification of likely research questions for an evaluation and the data that would be required to address each question.
· Assessment of data availability, completeness, and comparability for Tribally-managed programs, relative to data that are available from Federal and State agencies that provide services to non Self-Governance Tribes.
· Consultation and ongoing communication with Tribal leaders and Tribal organizations in designing, conducting, and reviewing findings of the feasibility study.
A Technical Working Group (TWG), consisting of 10 Tribal leaders, directors of Tribally-managed programs, representatives of Tribal organizations (plus informal, ex officio, research and data experts) will advise the project on key issues and review interim and final project findings.
This study extends work begun by IHS (under the now-repealed Section 305 of ISDEAA, including the Baseline Measures Workgroup) and, more recently, grew out of the experience of DHHS= participation in the Federal-Tribal consultation on Title VI of P.L. 106-260 that mandated a study of the feasibility of conducting a demonstration of Tribal Self-Governance of non-IHS programs. Since evaluation would be a part of a demonstration, and since there has been no conclusive evaluation of Tribal Self-Governance of health programs, the current study will provide information relevant to the possible conduct of an evaluation of Tribal Self-Governance of either health or social services programs, or both.
DHHS/ASPE Self Governance Evaluation Feasibility Study
Contact Information
Sponsor: DHHS Project Officers:
OASPE/DHHS Andrew Rock
Room 447D 202-260-0398
200 Independence Avenue, SW Tom Hertz
Washington, DC 20201 202-690-7779
Start Date: September 2002 End Date: September 2003
Project Director: Co-Principal Investigators:
W. Sherman Edwards Kathryn Langwell
Westat Project HOPE Center for Health Affairs
1650 Research Boulevard Telephone: 605-584-2414
Rockville, MD 20850 Email: klangwell@projecthope.org
Telephone: 301-294-3993
Email: EDWARDS1@Westat.com Jo Ann Kauffman
Project Consultants:
Pamela Iron
Frank Ryan
Draft Communications Strategy Report
Draft Communications Strategy Report (PDF Version)
Draft Legislative History Report
Draft Legislative History Report (PDF Version)
List of TWG Members
| Name | Contact Information | IHS Area | Comments |
| W. Ron Allen
Tribal Council Chair Merle Boyd Second Chief (Alternate) |
Jamestown S'Klallam Tribe
1033 Old Blyn Highway Sequim, WA 98382 (360) 683-1109 Phone (360) 681-3405 Fax Sac and Fox Nation Route 2, Box 246 Stroud, OK 74079 (918) 968-3526 Phone (918) 968-3887 Fax |
Portland Oklahoma |
|
| Julia Davis-Wheeler
Tribal Council Member |
Nez Perce Tribe
P.O. Box 305 Lapwai, ID 83540 (208) 843-2253 Work (208) 843-2965 Home (208) 843-7354 Fax (208) 843-2965 Home Fax |
Portland | |
| Barbara Fabre
Director of Tribal Child Care Services |
White Earth Band of Chippewa
P.O. Box 418 White Earth, MN 56591 (218) 983-3285 ext. 407 |
Bemidji | |
| Dan Jordan
Tribal Self Governance Coordinator |
Hoopa Valley Indian Reservation
P.O. Box 1348 Hoopa, CA 95546 (530) 625-4211 Phone (530) 625-4594 Fax |
California | |
| Violet Mitchell-Enos
Human Services Department Director |
Salt River Pima Maricopa Indian Community
10005 Osborne Road Scottsdale, AZ 85256 (480) 850-8410 Phone (480) 850-7373 Fax |
Phoenix |
| Name | Contact Information | IHS Area | Comments |
| Myra Munson
Attorney |
Sonosky, Chambers, Sachse, Miller and Munson
318 4th Street Juneau, AK 99801 (907) 586-5880 Phone (907) 586-5883 Fax |
Alaska | |
| Mickey Peercy
Deputy Director of Health |
Choctaw Nation
Drawer 1210 Durant, OK 74702 (580) 924-8280 Phone (580) 924-3393 Fax |
Oklahoma | |
| Gerrie Small
President |
Northern Cheyenne Tribe
PO Box 182 Lame Deer, MT 59043 (406) 477-6284 work (406) 477-6210 fax |
Billings | |
| Anna Whiting Sorrell
Director of Support Services |
Salish & Kootenai Confederated Tribes
P.O. Box 278 Pablo, MT 59855 (406) 675-2700 Phone (406) 675-2806 Fax |
Billings | |
| Alvin Windy Boy
Chairman Tim Martin Executive Director (Alternate) |
Chippewa-Cree Tribe of Rocky Boy
Rocky Boy Route, Box 544 Box Elder, MT 59521 (406) 395-4210 Work (406) 395-4497 Fax (406) 868-2134 Cell United South and Eastern Tribes (USET) 711 Stewarts Ferry Pike, Suite 100 Nashville, TN 37214 (615) 872-7900 Phone (615) 872-7417 Fax |
Billings Nashville |
Biosketches of Project Director and Co-Principal Investigators
Project Director: W. Sherman Edwards
W. Sherman Edwards is a Westat Vice President, and is Project Director for the Master Contract under which this Task Order has been awarded. He has more than 25 years’ experience in the design, conduct, and analysis of social science research, primarily in the area of health services. He is currently Westat’s Project Director for the California Health Interview Survey, a telephone survey of some 55,000 California households that includes an oversample of American Indian/Alaska Native households. He is also currently Westat’s Corporate Officer for two major contracts associated with CAHPS – Westat is conducting the Medicare Managed Care CAHPS for the Centers for Medicare and Medicaid Services, and holds a contract with the Agency for Healthcare Research and Quality to support the CAHPS Survey Users’ Network, maintain and manage the National CAHPS Benchmarking Database, and provide other support services for the overall CAHPS program. Mr. Edwards has done design work or methodological research for many of the Federal government’s major surveys, and has led several Federally-sponsored evaluations of health financing and health services activities. Before joining Westat, Mr. Edwards was Senior Methodologist at the (then) National Center for Health Services Research, where he worked with the Indian Health Service to design and manage the Survey of American Indians and Alaska Natives, a part of the 1987 National Medical Expenditure Survey.
Co-Principal Investigator: Jo Ann Kauffman
Jo Ann Kauffman, MPH, is President of KAI and an enrolled member of the Nez Perce Tribe. She received her Masters of Public Health Administration from the University of California at Berkeley in 1979. She has worked in the field of Indian health for 25 years. In this capacity, she has served as a consultant to Indian tribes and the U.S. Indian Health Service, as Executive Director of the Seattle Indian Health Board and as Executive Director of the Northern Idaho Indian Health Board. In 1998, she was awarded the “Free Spirit Award” from the Freedom Forum, for her work representing tribes and Indian communities as a community activist and advocate on First Amendment issues. In 1998, she also became the founding president for a national alcohol/substance abuse recovery movement called the National Association for Native American Children of Alcoholics (NANACOA). As president of KAI, she assists the U.S. Indian Health Service in health policy evaluation and in facilitating national tribal consultation and dialogue.
Co-Principal Investigator: Kathryn Langwell
Kathryn Langwell, a Senior Fellow at Project HOPE, has over 25 years experience in managing, designing, and conducting research, evaluation, and technical assistance projects. She joined Project HOPE’s Center for Health Affairs in September 2001. She is currently Project Director for a CMS Study of American Indian/Alaska Native Eligibility and Enrollment in Medicaid, SCHIP, and Medicare, and is the Research Core Co-Principal Investigator for an NIH project to conduct research and pilot studies on health disparities issues working with the Montana-Wyoming Tribal Leaders Council. Ms. Langwell has designed and conducted numerous evaluations of government and foundation programs over the past 20 years, including serving as the Project Director and Co-Principal Investigator for HCFA’s Medicare HMO Demonstration Evaluation, Project Director of the Medicare PPO Demonstration Design and Implementation, and Project Director for HCFA’s Medical Group Capitation Demonstration Design. Ms. Langwell was Principal Investigator for The Robert Wood Johnson Foundation’s School-Based Health Center Demonstration Evaluation from 1994 to 2000, and was Project Director for the DoD/OPM Evaluation of the FEHBP Demonstration for Military Retirees. Ms. Langwell served as Deputy Assistant Director for Health at the Congressional Budget Office from 1989 to 1993. She was a Senior Economist at Mathematica Policy Research from 1983 to 1989. She has published extensively on managed care policy and operational issues, performance measurement, health care use and payment policies, and racial/ethnic disparities in health care access and use of services.
Attendance List
| Name | Organization |
|---|---|
| Alexander, Paul | ABW&W |
| Allen, W. Ron | Jamestown S'KlallamTribe |
| Apodaca, Ray | Division of Tribal TANF, ACF, DHHS |
| Belcourt, Lena | Health Board, Chippewa-Cree Tribe of Rocky Boy |
| Broderick, Eric | Office of Intergovernmental Affairs, DHHS |
| Cooper, Sheila | Administration for Native Americans, ACF, DHHS |
| Eagleman, Brian Kelly | Health Board, Chippewa-Cree Tribe of Rocky Boy |
| Edwards, Sherm | Westat |
| Fabre, Barbara | White Earth Band of Chippewa |
| Gorman, Ginny | Child Care Bureau, ACF, DHHS |
| Greenberg, Linda | Centers for Medicare and Medicaid Services, DHHS |
| Halpern, Peggy | Office of Planning and Evaluation, DHHS |
| Helba, Cynthia | Westat |
| Hertz, Thomas | Office of Planning and Evaluation, DHHS |
| Holmes, Cyndi | Jamestown S'Klallam Tribe |
| Imotichey, Jessica | Office of Intergovernmental Affairs, DHHS |
| Jackson, Yvonne | Administration of Aging, DHHS |
| Jones, Dennis | K'ima'w Medical Center |
| Jordan, Daniel | Hoopa Valley Indian Tribe |
| Kauffman, Jo Ann | Kauffman and Associates, Inc. |
| Knight, Melanie | Cherokee Nation |
| LaFrance, Rita | Office of Intergovernmental Affairs, DHHS |
| Landey, Alana | Office of Planning and Evaluation, DHHS |
| Langer, Pam | Office of Intergovernmental Affairs, DHHS |
| Langwell, Kathy | Project HOPE Center for Health Affairs |
| Mitchell-Enos, Violet | Salt River Pima Maricopa Indian Reservation |
| Morgan, Matthew | Chickasaw Nation |
| Munson, Myra | Sonosky, Chambers, Sachse, Miller and Munson |
| Patch, Robin | Office of Planning and Evaluation, DHHS |
| Paternoster, Victor | Kauffman and Associates, Inc. |
| Peercy, Mickey | Choctaw Nation of Oklahoma |
| Pittman, Juliet C. | SENSE INC |
| Rock, Andrew | Office of Planning and Evaluation, DHHS |
| Smith, P. Benjamin | Choctaw Nation; Office of Tribal Self Governance, IHS, DHHS |
| Sorrell, Anna Whiting | Salish and Kootenai Confederated Tribes |
| Sparks, Georgeline | Indian Head Start Board |
| Stearns, Chris | Hobbs Straus/Dean Walker |
| Strommer, Geoff | Hobbs Straus/Dean Walker |
| Tyner-Dawson, Eugenia | Office of Intergovernmental Affairs, DHHS |
| Weston, Richard C. | Agency for Toxic Substance and Disease Registry, DHHS |
| Wiggins, Cliff | Indian Health Service, DHHS |
| Williams, Paula | Office of Tribal Self Governance, IHS, DHHS |
| Windy Boy Sr., Alvin | Chippewa-Cree Tribe of Rocky Boy |