Memorandum of Agreement Between the Indian Health Service and the Department of Interior; Bureau of Indian Affairs and Bureau of Indian Education, 16427-16430 [2011-6826]
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Federal Register / Vol. 76, No. 56 / Wednesday, March 23, 2011 / Notices
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2011–N–0002]
Risk Communication Advisory
Committee; Notice of Meeting
AGENCY:
Food and Drug Administration,
HHS.
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ACTION:
Notice.
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If FDA is unable to post the background
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material on its Web site prior to the
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Notice of this meeting is given under
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Dated: March 17, 2011.
Leslie Kux,
Acting Assistant Commissioner for Policy.
[FR Doc. 2011–6788 Filed 3–22–11; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Indian Health Service
Memorandum of Agreement Between
the Indian Health Service and the
Department of Interior; Bureau of
Indian Affairs and Bureau of Indian
Education
AGENCY:
ACTION:
Indian Health Service, HHS.
Notice.
The Indian Health Service
(IHS) is providing notice of a
Memorandum of Agreement (MOA)
between the IHS and the Department of
the Interior (DOI), signed in 2009, and
has developed an amendment to that
MOA that includes language consistent
with Section 703 of the Indian Health
Care Improvement Act (IHCIA), Public
Law 94–437, as amended. The purpose
of the MOA and the amendment is to
advance our partnership with Tribes
and Federal stakeholders on alcohol and
substance abuse prevention and
treatment. The Patient Protection and
Affordable Care Act’s, Public Law 111–
148, permanent authorization of the
Indian Health Care Improvement Act
(IHCIA) establishes timelines and
requirements for coordinated actions by
the Department of Interior (DOI), the
Department of Health and Human
Services (HHS), Tribes and Tribal
organizations. Specifically, Section 703
of the IHCIA provides new authorities
that permit the DOI and HHS, acting
through the Indian Health Service (IHS),
to develop and enter into a
Memorandum of Agreement (MOA), or
review and update any existing
memoranda of agreement, as required by
Section 4205 of the Indian Alcohol and
Substance Abuse Prevention and
Treatment Act of 1986 (25 U.S.C.2411).
DOI and IHS signed an MOA on this
topic in 2009, and have developed an
amendment to that MOA that includes
language consistent with the new IHCIA
provision. In accordance with Section
703 of the IHCIA, which states that the
MOA between the IHS and DOI shall be
published in the Federal Register, the
agency is publishing notice of this MOA
and the amendment to this MOA.
SUMMARY:
The original MOA was effective
on December 12, 2009. The amendment
is effective March 1, 2011.
DATES:
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Dr.
Rose Weahkee, Director, Division of
Behavioral Health, Office of Clinical and
Preventive Services, Indian Health
Service, 801 Thompson Avenue,
Rockville, MD 20852, (301) 443–2038.
FOR FURTHER INFORMATION CONTACT:
In
accordance with Section 703 of the
Indian Health Care Improvement Act
(IHCIA), Public Law No. 94–437, as
amended, which states that the MOA
between the IHS and DOI shall be
published in the Federal Register, the
agency is publishing notice of this MOA
and the amendment to this MOA.
SUPPLEMENTARY INFORMATION:
Dated: March 17, 2011.
Yvette Roubideaux,
Director, Indian Health Service.
OCTOBER 2009
MEMORANDUM OF AGREEMENT
BETWEEN
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
INDIAN HEALTH SERVICE
AND
DEPARTMENT OF THE INTERIOR
BUREAU OF INDIAN AFFAIRS
AND
BUREAU OF INDIAN EDUCATION
ON
INDIAN ALCOHOL AND SUBSTANCE
ABUSE PREVENTION
I. PURPOSE
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The Memorandum of Agreement (MOA)
emphasizes assisting tribal governments
in their efforts to address substance
abuse. It affirms the importance of a
systematic approach to enhance the
quality of life. This MOA shall include
coordination of data collection,
resources, and programs of the Indian
Health Service (IHS), the Bureau of
Indian Affairs (BIA), and the Bureau of
Indian Education (BIE).
The Department of Health and Human
Services (DHHS) and the Department of
the Interior (DOI) shall coordinate and
collaborate pursuant to this MOA.
Special acknowledgment is given to the
rights of tribes in accordance with
Indian Self-Determination and
Education Assistance Act (25 U.S.C.
450, et seq.) and local control in
accordance with Section 1130 of the
Education Amendments of 1978 (25
U.S.C. 2010).
The tribes, in conjunction with Federal
and state entities, will identify the need
for services and their best applications.
16:46 Mar 22, 2011
To promote tribal communities that are
safe, healthy, and productive by the
following means:
• Increase collaboration and
coordination among the BIA, BIE, IHS,
and tribes.
• Facilitate resource sharing (funding,
personnel, information, knowledge, and
skills) among the BIA, the BIE, IHS, and
tribes.
• Support and assist local BIA
agencies, schools, BIE line offices, and
IHS area and service units in working
with tribes in developing and
implementing joint programs and
services.
III. BACKGROUND
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II. GOAL
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Substance abuse, including alcohol,
illegal drugs, and controlled substances,
impact the whole community. Probable
consequences include depression,
domestic violence, child neglect and
abuse, elderly abuse, property damage,
gang activity, and violent crime. It
increases the burden on communities
and on those Federal, state, and tribal
governments attempting to assist these
communities.
The production, distribution, and use of
substances such as methamphetamine
(meth) are not a new problem.
Substance abuse threatens not only the
user but threatens the well-being of the
community. Related illicit acts
encourage gang activities as well as
organized crime on Indian lands. The
production of meth results in toxic byproducts that are left in buildings,
fields, and waterways. Some of these
chemicals can cause disfigurement,
illness, or death.
American Indian youth, ages 12–17,
have the highest percentage rate for
illegal drug use according to the
Substance Abuse and Mental Health
Services Administration (SAMHSA).
Prevention efforts targeting youth and
young adults are the most cost-effective
in addressing this problem. It has been
clearly demonstrated that the younger
an individual is when he/she
encounters a prevention message, the
better the outcome.
Illegal drugs and controlled substances
present a special challenge to agencies
and organizations. Supply reduction, in
combination with demand reduction,
must be undertaken through a
comprehensive and multi-disciplinary
approach if they are to be successful.
The illegal production, distribution, and
use of controlled substances within
Indian Country is at an epidemic level.
These challenges necessitate a
comprehensive evaluation by the BIA,
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BIE, and IHS in order to address these
issues.
IV. STATEMENT OF PURPOSE
A. Coordination Efforts
1. Juvenile and Adult Detention Centers
The IHS and BIA will collaborate to
expand substance abuse resources for
detoxification, treatment, and postdetention community re-entry and
aftercare planning.
2. Youth Regional Treatment Centers
(YRTC)
The IHS will continue to provide
funding support for the operation of
existing centers and to advocate for
additional resources. The IHS will
include BIE in the planning and
identification of educational resources
(curriculum, libraries, recreational
facilities, computers, funds for teachers,
etc.) for IHS-operated YRTC’s. The BIE
will be active in considering the needs
of tribally-operated YRTC’s. The BIE
and IHS will collaborate regarding the
most suitable placement to meet the
needs of the individuals.
3. Residential Schools
The IHS, BIA and BIE will coordinate
delivery of healthcare and wellness
support services to boarding school
residents and their families. The
agencies will support efforts to align
policies such that residents have
appropriate access to healthcare services
including a range of behavioral health
services on-site. Such services will,
where possible, be part of an integrated,
holistic approach to student support
that includes appropriate recognition
and targeting of interventions to both
general student populations and high
risk students.
4. Community Based Adult Services
The IHS, BIA, and BIE will collaborate
with tribes to enhance program
coordination, planning, and
implementation of community based
prevention, referral, enforcement,
treatment (both individual and family),
recovery models, and implementation of
programs with linkages to adjunct
community services. These efforts will
be implemented at the BIA agency, BIE
line office, and IHS service unit levels
jointly with the affected tribes.
5. Child Protection and Child Welfare
The BIA will include the BIE, IHS, and
tribes in planning and implementation
activities. These shall include defining
the scope of services appropriate to
tribal area needs and identifying
resources to address the continuum of
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care for American Indian children at
risk for abuse and/or neglect.
The BIA, BIE, and the IHS will obtain
input from local tribes on planning
initiatives. This will strengthen the
coordinated interagency
multidisciplinary response for the
protection of children and the
prevention of child abuse and neglect in
American Indian and Alaska Native
communities, especially for drug
endangered children. These agencies
will continually reaffirm the need for
coordinated approaches to prevent child
abuse and neglect and its long-term
social and economic consequences
(poor academic performance, substance
use, multiple disorders, suicides, etc.)
and promote a full range of effective
services for abused American Indian
and Alaska Native children and their
families.
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6. Data Collection, Analysis, and
Sharing
The BIA, BIE, and IHS will consult with
the tribes to determine the need for
sharing information, data collection
systems that are compatible with
current systems in use, and data
resources on substance abuse and
collaboration and coordination on
information collection and reporting
will be encouraged. Linkages will be
forged with other Federal, state, and
local entities. This will facilitate
appropriate recommendations and
decisions about programs and
initiatives.
7. Joint Multi-Disciplinary Meetings
The BIA and BIE Central Offices and
IHS Headquarters staff, including
participation by regional, line, and area
office staff, will jointly conduct
multidisciplinary meetings to discuss
coordination and collaboration issues
and identify barriers to the
implementation of this MOA. These
meetings will occur not less than every
6 months.
In addition, an annual,
multidisciplinary meeting will be
planned and coordinated that focuses
on local BIA agency superintendents
and BIE line officers (including
superintendents or education
specialists, IHS service unit chief
executive officers, and tribal health
directors and facility directors). It will
address organizational coordination and
effective responses to the impact of
substance abuse in Indian Country.
B. Organizational Responsibility
1. Central Office/Headquarters
The BIA and BIE Central Office and IHS
Headquarters are responsible for:
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• Designing and delivering training
and technical assistance;
• Identifying and advocating for
financial resources; and
• Developing a biennial program
plan, including specific objectives,
performance improvement measures,
benchmarks/milestones, and
organizational responsibilities to be
completed within 6 months of the last
signature of this MOA.
2. BIA Regions, BIE Line Offices, and
IHS Area Offices
The BIA regional directors, BIE line
officers, and IHS area directors are
responsible for encouraging the
development of local MOA’s between
the IHS, BIA, and BIE in working with
the local tribe(s) to increase
collaboration and cooperation, facilitate
resource sharing, and to develop joint
programs/services to address substance
abuse.
The BIA regional directors, BIE line
officers, and IHS area directors are
responsible for designating a staff
member to attend the semi-annual
organizational planning and
implementation meetings (see item
IV.A.7) and report activities
(accomplished, ongoing, and
unaccomplished) to BIA and BIE Central
Offices and IHS Headquarters.
The BIA Central Office will compile a
comprehensive list of Indian Country
activities (accomplished, ongoing, and
unaccomplished) semiannually for
distribution to all BIA regions and
agencies (through the Deputy Bureau
Director for Field Operations), BIE line
offices (through the BIE Deputy
Director, School Operations), and IHS
service unit chief executive officers
(through the IHS Director).
V. IDENTIFICATION OF
STATUTORY AUTHORITIES
1. Snyder Act of November 2, 1921 (42
Stat. 208; 25 U.S.C. 13)
2. Economy Act of September 13, 1982
(96 Stat. 933; 31 U.S.C. 1535)
3. Indian Self-Determination and
Education Assistance Act of January
4, 1975 (88 Stat. 2203; 25 U.S.C. 450
et seq.)
4. Anti-Drug Abuse Act of 1988 (102
Stat. 4181; 21 U.S.C. 1501)
5. Indian Alcohol and Substance Abuse
Prevention and Treatment Act of
1986 (100 Stat. 3207–137; 25 U.S.C.
2401)
6. Indian Health Care Improvement Act
of September 30, 1976 (90 Stat.
1400; 25 U.S.C. 1600 et seq.)
7. Indian Child Protection and Family
Violence Prevention Act of
November 28, 1990 (104 Stat. 4544;
25 U.S.C. 3201)
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16429
8. No Child Left Behind Act of 2001
(115 Stat. 1425; 20 U.S.C. 6301)
9. Johnson-O’Malley Act of April 16,
1934, (48 Stat. 596; 25 U.S.C. 452 et
seq.)
10. Victims of Child Abuse Act of
November 29, 1990 (104 Stat. 4792;
42 U.S.C. 13001 et seq.)
11. Education Amendments of
November 1, 1978 (92 Stat. 2143; 25
U.S.C. 2010 et seq.)
VI. ADMINISTRATIVE
PROVISIONS
1. Nothing in this MOA may be
construed to obligate BIA, BIE, IHS,
or the United States to any current
or future expenditures of resources
in advance of the availability of
appropriations from Congress. This
MOA does not obligate BIA, BIE,
IHS, or the United States to spend
funds on any particular project or
purpose, even if funds are available.
2. This MOA in no way restricts BIA,
BIE, or IHS from participating in
similar activities or arrangements
with other public or private
agencies, organizations, or
individuals.
3. BIA, BIE, and IHS will comply with
the Federal Advisory Committee
Act to the extent it applies.
4. Upon the last signature, this MOA
shall remain in effect, unless
modified or terminated by the
Assistant Secretary—Indian Affairs
or the Director, Indian Health
Service upon 60 days written
notice. The Assistant Secretary—
Indian Affairs, Director, BIA,
Director, BIE, and Director, IHS
shall review this MOA on a biennial
basis.
VII. SIGNATURES OF EACH PARTY
Approved and accepted by:
/Larry Echohawk/
Assistant Secretary—Indian Affairs
/Yvette Roubideaux/
Director, Indian Health Service
/Spike Bighorn/
(Acting) Director, Bureau of Indian Education
/Jerry Gidner/
Director, Bureau of Indian Affairs
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Date
12/16/09
Date
10/15/09
Date
10/20/09
Date
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entities. IHS and BIE will work
collaboratively to meet the needs of the
YRTC residents.
(3) A new paragraph is added to
Section IV A. Coordination Efforts:
(4) A new paragraph is added to
Section IV B. Organizational
Responsibility:
Indian Health Service
8. Certain Behavioral Health Issues
and
IHS, BIA, and BIE will collaborate to:
(a) Assess the scope and nature of
mental illness and dysfunctional and
self-destructive behavior, including
substance abuse, child abuse, and
family violence, among Indians;
(b) Identify existing Federal, tribal,
State, local, and private services,
resources, and programs available to
provide behavioral health services for
Indians;
(c) Determine the unmet need for
additional services, resources, and
programs necessary to improve the
mental and behavioral health of Indians;
(d) Support the right of Indians, as
citizens of the United States and of the
States in which they reside, to have
access to behavioral health services to
which all citizens have access;
(e) Delineate the responsibilities of IHS
and BIA, including mental illness
identification, prevention, education,
referral, and treatment services
(including services through
multidisciplinary resource teams), at the
central, area, and agency and service
unit, service area, and headquarters
levels;
(f) Develop a strategy for the
comprehensive coordination of
behavioral health services provided by
IHS and BIA, including:
(i) the coordination of alcohol and
substance abuse programs of IHS, BIA,
and Indian tribes and tribal
organizations developed under the
Indian Alcohol and Substance Abuse
Prevention and Treatment Act with
behavioral health initiatives,
particularly with respect to the referral
and treatment of dually diagnosed
individuals requiring behavioral health
and substance abuse treatment, and;
(ii) ensuring that IHS and BIA programs
and services (including
multidisciplinary resource teams)
addressing child abuse and family
violence are coordinated with such nonFederal programs and services.
(g) Direct appropriate officials,
particularly at the agency and service
unit levels of BIA and IHS, to cooperate
fully with tribal requests made pursuant
to community behavioral health plans
adopted under section 702(c) [25 U.S.C.
§ 1665a(c)] and section 4206 of the
Indian Alcohol and Substance Abuse
Prevention and Treatment Act.
(a) the determination of the scope of the
problem of alcohol and substance abuse
among Indians, including the number of
Indians within the jurisdiction of the
Service who are directly or indirectly
affected by alcohol and substance abuse
and the financial and human cost;
Amendment to Memorandum of
Agreement
between
Department of Health and Human
Services
The Department of the Interior
Bureau of Indian Affairs and Bureau of
Indian Education
on
Indian Alcohol and Substance Abuse
Prevention
PURPOSE
Pursuant to the Patient Protection and
Affordable Care Act, Pub. L. No. 111–
148, Title X, Subtitle B, Part III,
§ 10221(a), 124 Stat. 119, 935 (amending
25 U.S.C. §§ 1665, 1665a, and 2411),
this amendment updates the ‘‘October
2009 Memorandum of Agreement
(MOA) between the Department of
Health and Human Services (DHHS)
Indian Health Service (IHS) and the
Department of the Interior (DOI) Bureau
of Indian Affairs (BIA) and Bureau of
Indian Education (BIE) on Indian
Alcohol and Substance Abuse
Prevention.’’
AMENDMENTS
The October 2009 MOA is amended,
as follows:
(1) The first sentence of SECTION I is
amended to read:
I. PURPOSE
The Memorandum of Agreement
(MOA) emphasizes assisting tribal
governments in their efforts to address
certain behavioral health issues among
Indians, specifically mental illness and
dysfunctional and self-destructive
behavior, including substance abuse,
child abuse, and family violence.
(2) Section IV A. is amended to read
as follows:
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2. Youth Regional Treatment Centers
(YRTC)
The IHS will continue to provide
funding support for the operation of
existing centers and the implementation
within the centers of alcohol and
substance abuse treatment programs.
IHS will also advocate for additional
resources. The BIE will provide
resources and funding for the education
of the young people receiving treatment
in the YRTCs (curriculum, libraries,
recreational facilities, computers, funds
for teachers, etc.), and will actively
identify and seek funding and resources
available from the states and other
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3. IHS shall assume responsibility for:
(b) an assessment of the existing and
needed resources necessary for the
prevention of alcohol and substance
abuse and the treatment of Indians
affected by alcohol and substance abuse,
and;
(c) an estimate of the funding necessary
to adequately support a program of
prevention of alcohol and substance
abuse and treatment of Indians affected
by alcohol and substance abuse.
(5) A new paragraph is added to
Section VI ADMINISTRATIVE
PROVISIONS:
5. The Secretaries of DHHS and DOI
will conduct an annual review of
this MOA which will be provided
to Congress and Indian tribes and
tribal organizations.
(6) Paragraph (4) in Section VI is
amended to read:
4. Upon the last signature, this MOA
shall remain in effect, unless
modified or terminated by the
Assistant Secretary—Indian Affairs
or the Director, Indian Health
Service or the Director, Bureau of
Indian Education, or the Director,
Bureau of Indian Affairs, upon 60
days’ written notice.
(7) Section V is amended to read:
6. Indian Health Care Improvement Act
of September 30, 1976 (90 Stat.
1400; 25 U.S.C. 1600 et seq.) as
amended by Patient Protection and
Affordable Care Act, Pub. L. No.
111–148, Title X, Subtitle B, Part III,
§ 10221(a), 124 Stat. 119, 935
(amending 25 U.S.C. §§ 1665,
1665a, 2411).
Signatures of Each Party
/Yvette Roubideaux/
Director, Indian Health Service
Department of Health and Human Services
Date: March 1, 2011
/Larry Echohawk/
Assistant Secretary—Indian Affairs
Department of the Interior
Date: March 1, 2011
[FR Doc. 2011–6826 Filed 3–22–11; 8:45 am]
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[Federal Register Volume 76, Number 56 (Wednesday, March 23, 2011)]
[Notices]
[Pages 16427-16430]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-6826]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Memorandum of Agreement Between the Indian Health Service and the
Department of Interior; Bureau of Indian Affairs and Bureau of Indian
Education
AGENCY: Indian Health Service, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Indian Health Service (IHS) is providing notice of a
Memorandum of Agreement (MOA) between the IHS and the Department of the
Interior (DOI), signed in 2009, and has developed an amendment to that
MOA that includes language consistent with Section 703 of the Indian
Health Care Improvement Act (IHCIA), Public Law 94-437, as amended. The
purpose of the MOA and the amendment is to advance our partnership with
Tribes and Federal stakeholders on alcohol and substance abuse
prevention and treatment. The Patient Protection and Affordable Care
Act's, Public Law 111-148, permanent authorization of the Indian Health
Care Improvement Act (IHCIA) establishes timelines and requirements for
coordinated actions by the Department of Interior (DOI), the Department
of Health and Human Services (HHS), Tribes and Tribal organizations.
Specifically, Section 703 of the IHCIA provides new authorities that
permit the DOI and HHS, acting through the Indian Health Service (IHS),
to develop and enter into a Memorandum of Agreement (MOA), or review
and update any existing memoranda of agreement, as required by Section
4205 of the Indian Alcohol and Substance Abuse Prevention and Treatment
Act of 1986 (25 U.S.C.2411). DOI and IHS signed an MOA on this topic in
2009, and have developed an amendment to that MOA that includes
language consistent with the new IHCIA provision. In accordance with
Section 703 of the IHCIA, which states that the MOA between the IHS and
DOI shall be published in the Federal Register, the agency is
publishing notice of this MOA and the amendment to this MOA.
DATES: The original MOA was effective on December 12, 2009. The
amendment is effective March 1, 2011.
[[Page 16428]]
FOR FURTHER INFORMATION CONTACT: Dr. Rose Weahkee, Director, Division
of Behavioral Health, Office of Clinical and Preventive Services,
Indian Health Service, 801 Thompson Avenue, Rockville, MD 20852, (301)
443-2038.
SUPPLEMENTARY INFORMATION: In accordance with Section 703 of the Indian
Health Care Improvement Act (IHCIA), Public Law No. 94-437, as amended,
which states that the MOA between the IHS and DOI shall be published in
the Federal Register, the agency is publishing notice of this MOA and
the amendment to this MOA.
Dated: March 17, 2011.
Yvette Roubideaux,
Director, Indian Health Service.
3-CPS-10-0011
OCTOBER 2009
MEMORANDUM OF AGREEMENT
BETWEEN
DEPARTMENT OF HEALTH AND HUMAN SERVICES
INDIAN HEALTH SERVICE
AND
DEPARTMENT OF THE INTERIOR
BUREAU OF INDIAN AFFAIRS
AND
BUREAU OF INDIAN EDUCATION
ON
INDIAN ALCOHOL AND SUBSTANCE ABUSE PREVENTION
I. PURPOSE
The Memorandum of Agreement (MOA) emphasizes assisting tribal
governments in their efforts to address substance abuse. It affirms the
importance of a systematic approach to enhance the quality of life.
This MOA shall include coordination of data collection, resources, and
programs of the Indian Health Service (IHS), the Bureau of Indian
Affairs (BIA), and the Bureau of Indian Education (BIE).
The Department of Health and Human Services (DHHS) and the Department
of the Interior (DOI) shall coordinate and collaborate pursuant to this
MOA. Special acknowledgment is given to the rights of tribes in
accordance with Indian Self-Determination and Education Assistance Act
(25 U.S.C. 450, et seq.) and local control in accordance with Section
1130 of the Education Amendments of 1978 (25 U.S.C. 2010).
The tribes, in conjunction with Federal and state entities, will
identify the need for services and their best applications.
II. GOAL
To promote tribal communities that are safe, healthy, and productive by
the following means:
Increase collaboration and coordination among the BIA,
BIE, IHS, and tribes.
Facilitate resource sharing (funding, personnel,
information, knowledge, and skills) among the BIA, the BIE, IHS, and
tribes.
Support and assist local BIA agencies, schools, BIE line
offices, and IHS area and service units in working with tribes in
developing and implementing joint programs and services.
III. BACKGROUND
Substance abuse, including alcohol, illegal drugs, and controlled
substances, impact the whole community. Probable consequences include
depression, domestic violence, child neglect and abuse, elderly abuse,
property damage, gang activity, and violent crime. It increases the
burden on communities and on those Federal, state, and tribal
governments attempting to assist these communities.
The production, distribution, and use of substances such as
methamphetamine (meth) are not a new problem. Substance abuse threatens
not only the user but threatens the well-being of the community.
Related illicit acts encourage gang activities as well as organized
crime on Indian lands. The production of meth results in toxic by-
products that are left in buildings, fields, and waterways. Some of
these chemicals can cause disfigurement, illness, or death.
American Indian youth, ages 12-17, have the highest percentage rate for
illegal drug use according to the Substance Abuse and Mental Health
Services Administration (SAMHSA). Prevention efforts targeting youth
and young adults are the most cost-effective in addressing this
problem. It has been clearly demonstrated that the younger an
individual is when he/she encounters a prevention message, the better
the outcome.
Illegal drugs and controlled substances present a special challenge to
agencies and organizations. Supply reduction, in combination with
demand reduction, must be undertaken through a comprehensive and multi-
disciplinary approach if they are to be successful. The illegal
production, distribution, and use of controlled substances within
Indian Country is at an epidemic level. These challenges necessitate a
comprehensive evaluation by the BIA, BIE, and IHS in order to address
these issues.
IV. STATEMENT OF PURPOSE
A. Coordination Efforts
1. Juvenile and Adult Detention Centers
The IHS and BIA will collaborate to expand substance abuse resources
for detoxification, treatment, and post-detention community re-entry
and aftercare planning.
2. Youth Regional Treatment Centers (YRTC)
The IHS will continue to provide funding support for the operation of
existing centers and to advocate for additional resources. The IHS will
include BIE in the planning and identification of educational resources
(curriculum, libraries, recreational facilities, computers, funds for
teachers, etc.) for IHS-operated YRTC's. The BIE will be active in
considering the needs of tribally-operated YRTC's. The BIE and IHS will
collaborate regarding the most suitable placement to meet the needs of
the individuals.
3. Residential Schools
The IHS, BIA and BIE will coordinate delivery of healthcare and
wellness support services to boarding school residents and their
families. The agencies will support efforts to align policies such that
residents have appropriate access to healthcare services including a
range of behavioral health services on-site. Such services will, where
possible, be part of an integrated, holistic approach to student
support that includes appropriate recognition and targeting of
interventions to both general student populations and high risk
students.
4. Community Based Adult Services
The IHS, BIA, and BIE will collaborate with tribes to enhance program
coordination, planning, and implementation of community based
prevention, referral, enforcement, treatment (both individual and
family), recovery models, and implementation of programs with linkages
to adjunct community services. These efforts will be implemented at the
BIA agency, BIE line office, and IHS service unit levels jointly with
the affected tribes.
5. Child Protection and Child Welfare
The BIA will include the BIE, IHS, and tribes in planning and
implementation activities. These shall include defining the scope of
services appropriate to tribal area needs and identifying resources to
address the continuum of
[[Page 16429]]
care for American Indian children at risk for abuse and/or neglect.
The BIA, BIE, and the IHS will obtain input from local tribes on
planning initiatives. This will strengthen the coordinated interagency
multidisciplinary response for the protection of children and the
prevention of child abuse and neglect in American Indian and Alaska
Native communities, especially for drug endangered children. These
agencies will continually reaffirm the need for coordinated approaches
to prevent child abuse and neglect and its long-term social and
economic consequences (poor academic performance, substance use,
multiple disorders, suicides, etc.) and promote a full range of
effective services for abused American Indian and Alaska Native
children and their families.
6. Data Collection, Analysis, and Sharing
The BIA, BIE, and IHS will consult with the tribes to determine the
need for sharing information, data collection systems that are
compatible with current systems in use, and data resources on substance
abuse and collaboration and coordination on information collection and
reporting will be encouraged. Linkages will be forged with other
Federal, state, and local entities. This will facilitate appropriate
recommendations and decisions about programs and initiatives.
7. Joint Multi-Disciplinary Meetings
The BIA and BIE Central Offices and IHS Headquarters staff, including
participation by regional, line, and area office staff, will jointly
conduct multidisciplinary meetings to discuss coordination and
collaboration issues and identify barriers to the implementation of
this MOA. These meetings will occur not less than every 6 months.
In addition, an annual, multidisciplinary meeting will be planned and
coordinated that focuses on local BIA agency superintendents and BIE
line officers (including superintendents or education specialists, IHS
service unit chief executive officers, and tribal health directors and
facility directors). It will address organizational coordination and
effective responses to the impact of substance abuse in Indian Country.
B. Organizational Responsibility
1. Central Office/Headquarters
The BIA and BIE Central Office and IHS Headquarters are responsible
for:
Designing and delivering training and technical
assistance;
Identifying and advocating for financial resources; and
Developing a biennial program plan, including specific
objectives, performance improvement measures, benchmarks/milestones,
and organizational responsibilities to be completed within 6 months of
the last signature of this MOA.
2. BIA Regions, BIE Line Offices, and IHS Area Offices
The BIA regional directors, BIE line officers, and IHS area directors
are responsible for encouraging the development of local MOA's between
the IHS, BIA, and BIE in working with the local tribe(s) to increase
collaboration and cooperation, facilitate resource sharing, and to
develop joint programs/services to address substance abuse.
The BIA regional directors, BIE line officers, and IHS area directors
are responsible for designating a staff member to attend the semi-
annual organizational planning and implementation meetings (see item
IV.A.7) and report activities (accomplished, ongoing, and
unaccomplished) to BIA and BIE Central Offices and IHS Headquarters.
The BIA Central Office will compile a comprehensive list of Indian
Country activities (accomplished, ongoing, and unaccomplished)
semiannually for distribution to all BIA regions and agencies (through
the Deputy Bureau Director for Field Operations), BIE line offices
(through the BIE Deputy Director, School Operations), and IHS service
unit chief executive officers (through the IHS Director).
V. IDENTIFICATION OF STATUTORY AUTHORITIES
1. Snyder Act of November 2, 1921 (42 Stat. 208; 25 U.S.C. 13)
2. Economy Act of September 13, 1982 (96 Stat. 933; 31 U.S.C. 1535)
3. Indian Self-Determination and Education Assistance Act of January 4,
1975 (88 Stat. 2203; 25 U.S.C. 450 et seq.)
4. Anti-Drug Abuse Act of 1988 (102 Stat. 4181; 21 U.S.C. 1501)
5. Indian Alcohol and Substance Abuse Prevention and Treatment Act of
1986 (100 Stat. 3207-137; 25 U.S.C. 2401)
6. Indian Health Care Improvement Act of September 30, 1976 (90 Stat.
1400; 25 U.S.C. 1600 et seq.)
7. Indian Child Protection and Family Violence Prevention Act of
November 28, 1990 (104 Stat. 4544; 25 U.S.C. 3201)
8. No Child Left Behind Act of 2001 (115 Stat. 1425; 20 U.S.C. 6301)
9. Johnson-O'Malley Act of April 16, 1934, (48 Stat. 596; 25 U.S.C. 452
et seq.)
10. Victims of Child Abuse Act of November 29, 1990 (104 Stat. 4792; 42
U.S.C. 13001 et seq.)
11. Education Amendments of November 1, 1978 (92 Stat. 2143; 25 U.S.C.
2010 et seq.)
VI. ADMINISTRATIVE PROVISIONS
1. Nothing in this MOA may be construed to obligate BIA, BIE, IHS, or
the United States to any current or future expenditures of resources in
advance of the availability of appropriations from Congress. This MOA
does not obligate BIA, BIE, IHS, or the United States to spend funds on
any particular project or purpose, even if funds are available.
2. This MOA in no way restricts BIA, BIE, or IHS from participating in
similar activities or arrangements with other public or private
agencies, organizations, or individuals.
3. BIA, BIE, and IHS will comply with the Federal Advisory Committee
Act to the extent it applies.
4. Upon the last signature, this MOA shall remain in effect, unless
modified or terminated by the Assistant Secretary--Indian Affairs or
the Director, Indian Health Service upon 60 days written notice. The
Assistant Secretary--Indian Affairs, Director, BIA, Director, BIE, and
Director, IHS shall review this MOA on a biennial basis.
VII. SIGNATURES OF EACH PARTY
Approved and accepted by:
/Larry Echohawk/ 10/13/09
Assistant Secretary--Indian Affairs Date
/Yvette Roubideaux/ 12/16/09
Director, Indian Health Service Date
/Spike Bighorn/ 10/15/09
(Acting) Director, Bureau of Indian Education Date
/Jerry Gidner/ 10/20/09
Director, Bureau of Indian Affairs Date
[[Page 16430]]
Amendment to Memorandum of Agreement
between
Department of Health and Human Services
Indian Health Service
and
The Department of the Interior
Bureau of Indian Affairs and Bureau of Indian Education
on
Indian Alcohol and Substance Abuse Prevention
PURPOSE
Pursuant to the Patient Protection and Affordable Care Act, Pub. L. No.
111-148, Title X, Subtitle B, Part III, Sec. 10221(a), 124 Stat. 119,
935 (amending 25 U.S.C. Sec. Sec. 1665, 1665a, and 2411), this
amendment updates the ``October 2009 Memorandum of Agreement (MOA)
between the Department of Health and Human Services (DHHS) Indian
Health Service (IHS) and the Department of the Interior (DOI) Bureau of
Indian Affairs (BIA) and Bureau of Indian Education (BIE) on Indian
Alcohol and Substance Abuse Prevention.''
AMENDMENTS
The October 2009 MOA is amended, as follows:
(1) The first sentence of Section I is amended to read:
I. PURPOSE
The Memorandum of Agreement (MOA) emphasizes assisting tribal
governments in their efforts to address certain behavioral health
issues among Indians, specifically mental illness and dysfunctional and
self-destructive behavior, including substance abuse, child abuse, and
family violence.
(2) Section IV A. is amended to read as follows:
2. Youth Regional Treatment Centers (YRTC)
The IHS will continue to provide funding support for the operation of
existing centers and the implementation within the centers of alcohol
and substance abuse treatment programs. IHS will also advocate for
additional resources. The BIE will provide resources and funding for
the education of the young people receiving treatment in the YRTCs
(curriculum, libraries, recreational facilities, computers, funds for
teachers, etc.), and will actively identify and seek funding and
resources available from the states and other entities. IHS and BIE
will work collaboratively to meet the needs of the YRTC residents.
(3) A new paragraph is added to Section IV A. Coordination Efforts:
8. Certain Behavioral Health Issues
IHS, BIA, and BIE will collaborate to:
(a) Assess the scope and nature of mental illness and dysfunctional and
self-destructive behavior, including substance abuse, child abuse, and
family violence, among Indians;
(b) Identify existing Federal, tribal, State, local, and private
services, resources, and programs available to provide behavioral
health services for Indians;
(c) Determine the unmet need for additional services, resources, and
programs necessary to improve the mental and behavioral health of
Indians;
(d) Support the right of Indians, as citizens of the United States and
of the States in which they reside, to have access to behavioral health
services to which all citizens have access;
(e) Delineate the responsibilities of IHS and BIA, including mental
illness identification, prevention, education, referral, and treatment
services (including services through multidisciplinary resource teams),
at the central, area, and agency and service unit, service area, and
headquarters levels;
(f) Develop a strategy for the comprehensive coordination of behavioral
health services provided by IHS and BIA, including:
(i) the coordination of alcohol and substance abuse programs of IHS,
BIA, and Indian tribes and tribal organizations developed under the
Indian Alcohol and Substance Abuse Prevention and Treatment Act with
behavioral health initiatives, particularly with respect to the
referral and treatment of dually diagnosed individuals requiring
behavioral health and substance abuse treatment, and;
(ii) ensuring that IHS and BIA programs and services (including
multidisciplinary resource teams) addressing child abuse and family
violence are coordinated with such non-Federal programs and services.
(g) Direct appropriate officials, particularly at the agency and
service unit levels of BIA and IHS, to cooperate fully with tribal
requests made pursuant to community behavioral health plans adopted
under section 702(c) [25 U.S.C. Sec. 1665a(c)] and section 4206 of the
Indian Alcohol and Substance Abuse Prevention and Treatment Act.
(4) A new paragraph is added to Section IV B. Organizational
Responsibility:
3. IHS shall assume responsibility for:
(a) the determination of the scope of the problem of alcohol and
substance abuse among Indians, including the number of Indians within
the jurisdiction of the Service who are directly or indirectly affected
by alcohol and substance abuse and the financial and human cost;
(b) an assessment of the existing and needed resources necessary for
the prevention of alcohol and substance abuse and the treatment of
Indians affected by alcohol and substance abuse, and;
(c) an estimate of the funding necessary to adequately support a
program of prevention of alcohol and substance abuse and treatment of
Indians affected by alcohol and substance abuse.
(5) A new paragraph is added to Section VI ADMINISTRATIVE
PROVISIONS:
5. The Secretaries of DHHS and DOI will conduct an annual review of
this MOA which will be provided to Congress and Indian tribes and
tribal organizations.
(6) Paragraph (4) in Section VI is amended to read:
4. Upon the last signature, this MOA shall remain in effect, unless
modified or terminated by the Assistant Secretary--Indian Affairs or
the Director, Indian Health Service or the Director, Bureau of Indian
Education, or the Director, Bureau of Indian Affairs, upon 60 days'
written notice.
(7) Section V is amended to read:
6. Indian Health Care Improvement Act of September 30, 1976 (90 Stat.
1400; 25 U.S.C. 1600 et seq.) as amended by Patient Protection and
Affordable Care Act, Pub. L. No. 111-148, Title X, Subtitle B, Part
III, Sec. 10221(a), 124 Stat. 119, 935 (amending 25 U.S.C. Sec. Sec.
1665, 1665a, 2411).
Signatures of Each Party
/Yvette Roubideaux/
Director, Indian Health Service
Department of Health and Human Services
Date: March 1, 2011
/Larry Echohawk/
Assistant Secretary--Indian Affairs
Department of the Interior
Date: March 1, 2011
[FR Doc. 2011-6826 Filed 3-22-11; 8:45 am]
BILLING CODE 4165-16-P
