The United States has a unique legal and political relationship with Indian tribal governments, established through and confirmed by the Constitution of the United States, treaties, statutes, executive orders, and judicial decisions. In recognition of that special relationship, pursuant to Executive Order 13175 of November 6, 2000, executive departments and agencies are charged with engaging in regular and meaningful consultation and collaboration with tribal officials in the development of Federal policies that have tribal implications, and are responsible for strengthening the government-to-government relationship between the United States and Tribal Nations.
The Federal delivery of health services and funding of programs to maintain and improve the health of American Indian and Alaska Natives (AI/AN) are consonant with the Federal government's historical and unique legal relationship with federally recognized Indian Tribes. In recognition of this, the Department of Health and Human Services (HHS), supports research on improving the health of AIs/ANs.
HHS has also adopted a Tribal Consultation Policy (signed by the Secretary on December 21, 2010) that directs all of its components to establish a process to ensure accountable, meaningful, and timely input by tribal officials in the development of policies that have a significant effect on federally recognized Tribes. To ensure appropriate tribal input into health research processes, the Department is establishing the HHS AI/AN Health Research Advisory Council (HRAC, or "the Council") to provide advice to the Department. The HRAC will serve as a formal avenue through which the Department gathers tribal input on health research matters.
The HRAC will support, and not supplant, any other government-to-government consultation activities that HHS undertakes with regard to health research. It will function much like disease specific advisory groups already do in certain agencies of the Department. HRAC will provide a forum through which Tribes can advise the Department on their health research priorities and needs as well as how best to carry out health research involving AIs/ANs. Through the HRAC, operating and staff divisions of the HHS (herein after referred to as OPDIV and STAFFDIV) representatives can better communicate and coordinate the work of their respective organizations in AI/AN health research, and the Department can disseminate information to Tribes about research findings from HHS-sponsored studies focusing on the health of AI/AN populations.
HRAC delegates will also have a responsibility to communicate critical information, research findings, and any other policy related activity back to their respective Tribes and/or communities.
A unique government-to-government relationship exists between federally recognized AI/AN Tribal Governments and the Federal Government. Treaties and laws, together with court decisions, have defined a relationship between Tribal Governments and the Federal Government. Since the formation of the Union, the United States has recognized Tribal Governments as sovereign nations. The government-to-government relationship between the United States and Tribal Governments dictates that the principal focus for HHS consultation is with individual Tribal Governments.
An integral element of this government-to-government relationship is that consultation occur with Tribal Governments on issues that impact them, and that Tribal Governments participate in the decision making process on issues affecting them to the greatest extent possible. Executive Order 13175 reaffirmed this relationship with Tribes.
The Council will work with senior federal representatives from those OPDIVs/STAFFDIVs of the Department which have joined in this effort. Each federal representative will have experience in AI/AN-related health research. The participating HHS components are: the Office of the Assistant Secretary for Planning and Evaluation (ASPE), the Office of Intergovernmental Affairs (IGA), the Office of Minority Health (OMH), the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC), the Indian Health Service (IHS), and the National Institutes of Health (NIH).
FEDERAL ADVISORY COMMITTEE ACT (FACA)
HRAC will operate under an exemption from the FACA identified in the Unfunded Mandates Reform Act of 1995. The exemption states that FACA does not apply "to actions in support of intergovernmental communications where -
Council delegates, acting in their official capacity, may designate alternates, including Washington representatives of associations. This falls within the exemption (OMB Memorandum M-95-20, dated September 21, 1995, published at 60 FR 50651, 50653 (September 29, 1995)).
- Meetings are held exclusively between Federal officials and elected officers of state, local and tribal governments (or their designated employees with authority to act on their behalf) acting in their official capacities; and
- Such meetings are solely for the purposes of exchanging views, information, or advice relating to the management or implementation of Federal programs established pursuant to public law that explicitly or inherently share intergovernmental responsibilities or administration."
The structure of the HRAC and any subcommittee, if any, is to be consistent with the FACA-exemption guidelines outlined above. The HHS Office of Minority Health will serve as the Executive Secretariat for the Council. As such, OMH will facilitate the solicitation and selection of tribal delegates to the Council. The Council will consist of the following:
Tribal Delegates: Elected or appointed tribal officials from federally-recognized Tribes, acting in their official tribal capacity or their designated employees with authority to act on behalf of the tribal official, from each of the 12 Indian Health Service areas of the country (12 persons) and four National At-Large Tribal Member (NALM) positions, acting in their official tribal capacity or their designated employees with authority to act on behalf of the tribal official.
In accordance with the Federal Advisory Committee Act (FACA) exemption of the Unfunded Mandates Reform Act (UMRA), HHS has incorporated the "National At-Large Member (NALM)" positions as delegates of the HRAC, these tribal leaders, acting in their official tribal capacity are charged with providing specific representation for the regional and national concerns of Tribal Governments. All NALM delegates must either be elected tribal officials, acting in their official capacity as elected officials of their Tribe, or be employees designated by an elected tribal official, in that official's elected capacity, with authority to act on behalf of the tribal official. A NALM should be an elected official or designated representative that is qualified to represent the views of Tribes on a national, collective perspective.
Alternates: Each delegate will have an alternate that has been selected by the HRAC delegate. In the event that the delegate cannot attend a meeting, the alternate council member will be notified. Such alternate shall have the full rights as designated in the letter by the delegate.
The OMH staff will work with the Tribes and HHS to ensure that appointed delegates and alternates from each of the Areas are appropriately designated to act on behalf of elected tribal officials, in their official capacity, as indicated in writing to the Deputy Assistant Secretary of Minority Health. OMH is responsible for ensuring that the delegates (and alternates) meet the FACA exemption's requirements.
As indicated in the background section of this document, the Council will work with senior federal representatives from those operating and staff divisions (OPDIVs/STAFFDIVs) of the Department which have joined in this effort. Each federal representative will have experience in AI/AN-related health research. The participating HHS components are: the Office of the Assistant Secretary for Planning and Evaluation (ASPE), the Office of Intergovernmental Affairs (IGA), the Office of Minority Health (OMH), the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC), the Indian Health Service (IHS), and the National Institutes of Health (NIH).
Delegate and Alternate Selection: The OMH will send a letter to tribal leaders requesting nominations for HRAC delegates from Tribes located in each of the twelve Indian Health Service (IHS) Areas for Area positions as well as nominations for the four NALM delegate positions. The names of each HRAC delegate are to be submitted to the Office of Minority Health (OMH) in an official letter from the Tribe. The OMH will be responsible for selecting and finalizing the body of delegates. Alternates are selected by the HRAC delegates. In the event that the delegate cannot attend a meeting, the alternate council member will be notified. Such alternate shall have the full rights as designated in the letter by the delegate.
HRAC Process: The Council will convene at least annually in person, convene quarterly conference calls, and convene additional interim conference calls as needed. Representatives from each participating OPDIV/STAFFDIV will attend the annual meeting of the group. HRAC will hold meetings that are open to the public, but observers will not be allowed to speak to meet FACA exemption requirements. Tribal delegates will be allowed to have one technical advisor attend meetings (at their own expense) to assist them with duties and responsibilities as an HRAC delegate. The advisor's role is limited to assisting the delegate, and the advisor cannot participate in the meetings of HRAC or vote, unless the advisor has been designated by the elected tribal official to act on behalf of the official at the meeting.
After each session, a summary of tribal recommendations will be developed by OMH. OMH will transmit tribal recommendations to all participating HHS operating and staff divisions (OPDIVs/STAFFDIVs) for consideration. HHS OPDIV/STAFFDIV representatives to HRAC will help to ensure that recommendations are appropriately addressed by their respective organizations, and that recommendations are considered during OPDIV/STAFFDIV strategic planning and budget development. The representatives of the OPDIVs/STAFFDIVs will meet formally at least once per year, shortly after the annual group meeting, to discuss the identified priorities and possible collaborations.
As determined by the HRAC delegates, a portion of the agenda for each HRAC meeting or conference call may include time with HHS OPDIV/STAFFDIV leadership, a principal from one of the participating operating or staff divisions. This will ensure that the input and recommendations provided by tribal leaders will be considered in the HHS decision-making processes and help guide HHS as it strives to protect people's health and safety, provide reliable health information, and improve health through strong partnerships.
Chair: A Chair will be elected or appointed by and from among the HRAC delegates for a one calendar-year term of service. The Chair will be an elected tribal leader. The number of terms is not limited.
Co-Chair: The Co-Chair will be elected or appointed by and from among the HRAC delegates for a one calendar-year term of service. The Co-Chair will be an elected tribal leader. The number of terms is not limited.
Executive Secretary: The Executive Secretary will provide administrative support and will be a representative of the HHS OMH.
Re-election: The Chair and Co-Chair may be re-elected by the HRAC.
PERIOD OF SERVICE
There is no limit to the length of service on the HRAC. The tribal leadership may remove or change their representative at any time.
When a delegate vacancy occurs, the affected Area's Tribal Leadership will be notified of the vacancy in writing by the Chairman of the HRAC and/or OMH, as Executive Secretary of the HRAC. The affected Area(s) Tribal Leadership, in their official capacity, will be asked to nominate another tribal leader, acting in his/her elected tribal capacity or his or her designated employee with authority to act on his/her behalf to fill the vacant seat. As such, the Tribal Leadership will submit to HHS in writing the name and contact information of their new nominee.
If an HRAC delegate is no longer an elected or appointed official, they should remove themselves from the HRAC as indicated in writing to the OMH. If a delegate or their alternate does not participate in a meeting or teleconference on three successive occasions, the Tribes will be notified by the Chairman of the HRAC and asked to submit nominations.
Depending on availability of funds, the HRAC will convene a minimum of one face-to-face meeting on a fiscal year basis with to be held in Washington, DC. HRAC conference calls will be held quarterly and additional meetings may be scheduled depending on need and availability of funds and meet all FACA exemption requirements. The rules contained in the current edition of Robert's Rules of Order Newly Revised (RONR) shall govern the HRAC meetings in all cases to which they are applicable and in which they are not inconsistent with rules outlined in this charter and any special rules of order the HRAC may adopt. (RONR [10th ed.], p. 15, l. 17-25; p. 561-62, 569).
The HRAC will operate by consensus and where a consensus cannot be reached, then the HRAC will vote to resolve any differences as outlined in RONR. Each HRAC seat (delegate, alternate or his or her designee) will be allowed one vote. HRAC delegates may vote in person or via conference call.
A quorum is established with a majority of voting delegates present in person or by conference call (9 of 16). In the event HRAC is not able to establish a quorum for its meeting, then in the alternative, the co-chairs in their discretion can arrange for polling of delegates via conference call or other manner at a later time.
No compensation will be paid to tribal representatives for their participation in this group. However, travel and lodging costs for the tribal representatives that are selected to participate in this Council will be reimbursed within three months via funding established under an interagency agreement set up to establish this research advisory group, pursuant to applicable Federal travel regulations.
OMH will assure that all HRAC meeting proceedings and recommendations are formally recorded and provided to HRAC delegates and alternates, and the participating HHS OPDIV and STAFFDIV representatives through written minutes following the HRAC meeting.
Once approved, they also will be posted on the HRAC website so that the information is accessible to all Tribal Governments. The HRAC Executive Secretary will be responsible for maintaining the website.
OMH will assure that all HRAC meetings, proceedings and recommended actions are made available to HHS leaders and will post minutes and reports on the HHS website. OMH will track actions on HRAC recommendations and report progress to the HRAC annually.
OMH will prepare a report every year to provide Tribes with information on HHS-supported health research specifically relevant to AIs/ANs, and the findings of such research.
OMH, working with other participating HHS components and the HRAC Chair and Co-Chair, will arrange meeting logistics. This includes coordinating hotel and airline travel arrangements for HRAC delegates, and audio/visual coordination. Travel arrangements and/or reimbursements will be handled through a logistics contractor.
On an annual basis, OMH will work with the HRAC Co-Chairs to develop the HRAC budget, including travel, per diem, communication, printing, personnel and other related expenses. This proposed budget will be provided to participating HHS OPDIVs and STAFFDIVs on an annual basis for each subsequent fiscal year.
This HRAC Charter shall be effective until changed by the Council and participating OPDIVs and STAFFDIVs.
Glossary of Terms
AHRQ Agency for Healthcare Research and Quality
AI/AN American Indian/Alaska Native
ASPE Office of the Assistant Secretary for Planning and Evaluation
CDC Centers for Disease Control and Prevention
FACA Federal Advisory Committee Act
HHS Department of Health and Human Services
HRAC Health Research Advisory Council
IGA Office of Intergovernmental Affairs
NALM National At-Large Member
IHS Indian Health Service
NIH National Institutes of Health
OMH Office of Minority Health