Tribal Self-Governance Health Care and Social Services Delivery Effectiveness Evaluation Feasibility Study: Draft Literature Review - Revised Report. Notes


  1. The information in this section has been drawn from a number of DHHS sources available on the self-governance website (accessed at
  2. The research questions listed are illustrative examples. The actual set of evaluation issues and research questions will be developed by OASPE/DHHS, with input from the Technical Working Group, consultation with Tribal representatives, and based, in part, on findings from the Tribal Self-Governance Evaluation Feasibility Study.
  3. As an example, IHS program staff acknowledge that they do not have a way to make reliable estimates of the number of people who are eligible to use IHS direct service program benefits on specific Reservations, since there are no reliable data on the number of enrolled members of federally recognized Tribes who also live on or near Reservations.
  4. Cox, D. and Langwell, K. Expenditures and Sources of Financing of Native American Health. Report prepared for the Henry J. Kaiser Family Foundation, Washington, DC:November 1998.
  5. Internal IHS report on 10 year expenditure trends, provided by Cliff Wiggins.
  6., accessed 2/24/03.
  7. The comparison between TTANF and State TANF programs is also tainted because work activities vary for TTANF programs and may include activities such as fishing, hunting, and gathering, that are not counted by State TANF programs.
  8. We were not able to conduct a search of the Bureau of Indian Affairs site, because it has been temporarily closed down due to judicial order.