Tribal Self-Governance Negotiation

The TSGP allows Tribes to negotiate with the IHS to assume Programs, Services, Functions, and Activities (PSFAs), in whole or in part. This gives Tribes the authority to manage and tailor health care programs to best suit the needs of their communities. Participation in the TSGP gives Tribes flexibility to tailor their health care needs by choosing one of three ways to get health care from the Federal Government for their citizens.

Tribes can choose to:

Get health care services directly from the IHS.

Contract with the IHS to administer individual programs and services the IHS would otherwise provide (referred to as Title I Self-Determination Contracting).

Compact with the IHS to assume control over health care programs the IHS would otherwise provide (referred to as Title V Self-Governance Compacting or the TSGP).

These options are not exclusive. Tribes may choose to combine options based on their individual needs and circumstances.This Negotiation Cooperative Agreement’s purpose is to help Tribes cover the costs associated with preparing for and participating these negotiations.