Tribal Self-Governance Health Care and Social Services Delivery Effectiveness Evaluation Feasibility Study: Draft Evaluation Issues, Questions, and Data Requirements. 2.1 Background and Objectives of the Study


In the Self-Governance Amendments of 2000 (P.L. 106-260), Congress re-affirmed its commitment to Tribal self-governance. In the Preamble to the Act, the Congress defined the goal of self-governance as "to permit an orderly transition from Federal domination of programs and services to provide Indian Tribes with meaningful authority, control, funding, and discretion to plan, conduct, redesign, and administer programs, services, functions, and activities (or portions thereof) that meet the needs of individual Tribal communities."

The Act established Tribal Self-Governance of Indian Health Service programs on a permanent basis. In addition, the Congress directed the Secretary of DHHS to "conduct a study to determine the feasibility of a Tribal self-governance demonstration project for appropriate programs, services, functions, and activity (or portions thereof) of the agency [HHS]." The Office of the Assistant Secretary for Planning and Evaluation conducted the Tribal Self-Governance Demonstration Feasibility Study in 2001-2001. The Final Report on the Study, released November 5, 2002, identified 11 DHHS programs as "feasible for inclusion in a Tribal self-governance demonstration project". These 11 programs are:

  • Administration on Aging
    1. Grants for Native Americans
  • Administration for Children and Families
    1. Tribal Temporary Assistance for Needy Families
    2. Low Income Home Energy Assistance
    3. Community Services Block Grant
    4. Child Care and Development Fund
    5. Native Employment Works
    6. Head Start
    7. Child Welfare Services
    8. Promoting Safe and Stable Families
    9. Family Violence Prevention: Grants for Battered Women's Shelters
  • Substance Abuse and Mental Health Services Administration
    1. Targeted Capacity Expansion

There are Tribes currently managing each of these DHHS programs that are recommended for inclusion in a Tribal Self-Governance Demonstration program, under contractual arrangements or grant awards. A Self-Governance Demonstration program, as detailed in the Final Report, could permit a simpler, multiple-program application process and simpler and consolidated reporting requirements. Importantly, the Demonstration program could provide "Tribes with the flexibility to change programs and reallocate funds among programs" (p.19) to better address specific Tribal community priorities.

Initiation of a DHHS Tribal Self-Governance Demonstration requires Congressional action prior to implementation. With the prospect that Congress may act to authorize such a demonstration, DHHS has identified a need to address the absence of conclusive quantitative evaluation to document the successes and outcomes of Tribal management of health and social services programs. DHHS contracted with Westat to conduct the Tribal Self-Governance Evaluation Feasibility Study to provide background information and to assess the feasibility of conducting a rigorous and defensible evaluation of Tribal management of health and social services programs under self-governance compacts and self-determination contracts.