Tribal Self-Governance Health Care and Social Services Delivery Effectiveness Evaluation Feasibility Study: Legislative History and Development of Tribal Self-Governance and Contracting - Revised Report. 1. Overview


The Tribal Self-Governance Evaluation Feasibility Study will provide the Office of the Assistant Secretary for Planning and Evaluation (OASPE) with background information and a detailed review of issues, data availability, and data systems that may affect the extent to which a rigorous and defensible evaluation of Tribal Self-Governance of Indian Health Service, and of other Tribally-managed non-IHS programs within DHHS, can be conducted. While a number of assessments of Tribal self-governance programs have been conducted, these have been primarily qualitative in nature. OASPE is interested in determining the feasibility of conducting an evaluation that examines processes and program changes associated with successful self-governance programs, as well as impacts of Tribal self-governance on outcomes, including access to care, services, quality, costs, financial performance and resources, customer satisfaction, and program stability.

This Draft Report on Legislative History and Development of Tribal Self-Governance and Contracting is one component of the background information that is being assembled to provide a foundation for understanding the legislative stages and implementation steps that have guided the evolution of Tribal Self-Governance that is the focus of the feasibility study. The Draft Report reviews the history of Indian Tribal Self-Government and the legislative activities affecting Indian Tribes, tribal self-determination, and tribal self-governance. It details the impact of past Congressional legislative activities on tribal governments and recent legislation since 1975. The report also integrates Indian health into this history. In this section, a brief overview is provided of Tribal-Federal relations, the Indian Self-Determination and Education Assistance Act (ISDEA) that has been the foundation of current policies that support Tribal Self-Governance, and the central themes that have been important to the evolution of Self-Governance over the past several decades.