1. Role of the Area GPRA Coordinator in Area Tribal Budget Formulation Meetings 2010 GPRA Coordinators’ Conference November 8, 2010

2. Agenda Why brief Tribes at the Area level? Why brief Tribes at the Area level? Annual Budget Cycle in the IHS Annual Budget Cycle in the IHS Tribal performance presentations already given Tribal performance presentations already given –National Tribal Budget Formulation Workgroup Evaluation Meeting –Northwest Portland Area Indian Health Board Quarterly Meeting

3. Why brief Tribes at the Area level? The request was made of the GPRA performance team after several meetings with the National Tribal Budget Formulation Workgroup (NTBFWG). The request was made of the GPRA performance team after several meetings with the National Tribal Budget Formulation Workgroup (NTBFWG). The tribal representatives to the NTBFWG understood the relationship between budget and performance integration at their FY 2012 evaluation meeting in June 2010. The tribal representatives to the NTBFWG understood the relationship between budget and performance integration at their FY 2012 evaluation meeting in June 2010.

4. Why brief Tribes at the Area level? They asked for a performance update at each annual meeting. They asked for a performance update at each annual meeting. They also asked that this information be shared at the Area level so that Area tribes understand budget and performance integration concepts. They also asked that this information be shared at the Area level so that Area tribes understand budget and performance integration concepts. Area GPRA Coordinators will be asked to become involved in the Area level Tribal Budget Formulation meetings. Area GPRA Coordinators will be asked to become involved in the Area level Tribal Budget Formulation meetings.

5. Annual Budget Cycle in the Indian Health Service GPRA requires federal budgets to be integrated with performance

6. Health and Human Services Justification (HHSJ) It is an opportunity for each HHS agency to let the Secretary know what funds they need for the fiscal year. It is an opportunity for each HHS agency to let the Secretary know what funds they need for the fiscal year. It is prepared in May and submitted the 1st week of June. It is prepared in May and submitted the 1st week of June. The budget is justified in the program narratives. The budget is justified in the program narratives. Performance targets are calculated based upon the budget request and the programs write to those targets. Performance targets are calculated based upon the budget request and the programs write to those targets. IHS receives Department passback by the end of July or early August. IHS receives Department passback by the end of July or early August.

7. OMBJ and the Online Performance Appendix (OPA) This is the agency’s request for funds based upon the Department passback of the HHSJ. This is the agency’s request for funds based upon the Department passback of the HHSJ. It is prepared in August and submitted to OMB the 2nd week of September. It is prepared in August and submitted to OMB the 2nd week of September. Performance targets are calculated and programs write to those targets. Performance targets are calculated and programs write to those targets. The Monday after Thanksgiving is when IHS receives the OMB passback. The Monday after Thanksgiving is when IHS receives the OMB passback. Final passback is mid-December, but IHS has received it as late as January 2. Final passback is mid-December, but IHS has received it as late as January 2.

8. OMBJ and the Online Performance Appendix (OPA), cont The passback has comments and questions about anything written in each document: the budget tables, program narratives, performance discussions in either the OMBJ or OPA. The passback has comments and questions about anything written in each document: the budget tables, program narratives, performance discussions in either the OMBJ or OPA. The OPA meets the agency’s requirement to submit a performance plan and a performance report since both the plan and the report are discussed in the OPA. The OPA meets the agency’s requirement to submit a performance plan and a performance report since both the plan and the report are discussed in the OPA.

9. Congressional Justification (CJ) and the OPA The CJ and OPA are prepared during December and January. The CJ and OPA are prepared during December and January. The most current performance results are entered into each document (e.g., for the FY 2012 CJ, IHS will enter FY 2010 clinical GPRA results and other GPRA and PART results that are available). The most current performance results are entered into each document (e.g., for the FY 2012 CJ, IHS will enter FY 2010 clinical GPRA results and other GPRA and PART results that are available). Performance targets are again calculated and programs write to those targets. Performance targets are again calculated and programs write to those targets.

10. Congressional Justification (CJ) and the OPA, cont February 7, 2011 is when the FY 2012 CJ and OPA will be “published” on the IHS Budget Formulation webpage. February 7, 2011 is when the FY 2012 CJ and OPA will be “published” on the IHS Budget Formulation webpage. http://www.ihs.gov/NonMedicalProgra ms/BudgetFormulation/bf_cong_justifi cations.asp http://www.ihs.gov/NonMedicalProgra ms/BudgetFormulation/bf_cong_justifi cations.asp

11. Dental Examples Congressional Justification Congressional Justification –OUTCOMES table: All GPRA and PART measures –OUTPUTS table are program specific measures tracked by the program OPA OPA –OMB instructions for performance measures require that tables display 6 years of data as well as provide supporting narrative on each measure.

12. Outcomes and Outputs Tables from FY 2011 IHS CJ

13. Dental Access Example in FY 2011 OPA

14. Performance Measures Targets Update, 6/29/10 Presentation for the National Tribal Budget Formulation Workgroup Evaluation Meeting. Presentation for the National Tribal Budget Formulation Workgroup Evaluation Meeting. Overall, the presentation was well received. Overall, the presentation was well received. The group requested that similar information be provided at the FY 2013 Area Tribal Budget Meetings. The group requested that similar information be provided at the FY 2013 Area Tribal Budget Meetings. We volunteered to brief the Area GPRA Coordinators and provide a power point for their use at Area Tribal Budget Meetings. We volunteered to brief the Area GPRA Coordinators and provide a power point for their use at Area Tribal Budget Meetings.

15. HHS Agency measures in FY 2011 OPAs Administration on Aging – 16 Administration on Aging – 16 Administration for Children & Families – 91 Administration for Children & Families – 91 Agency for Health Care Research & Quality – 43 Agency for Health Care Research & Quality – 43 Centers for Disease Control & Prevention - 142 Centers for Disease Control & Prevention - 142 Centers for Medicare & Medicaid Svcs – 49 Centers for Medicare & Medicaid Svcs – 49 Health Resources & Services Administration – 135 Health Resources & Services Administration – 135 Indian Health Service – 53 Indian Health Service – 53 National Institutes of Health – 91 National Institutes of Health – 91 Substance Abuse & Mental Hlth Svcs Administration - 190 Substance Abuse & Mental Hlth Svcs Administration - 190

16. Tribal Performance Reporting Update, 10/20/10 This conference call presentation was to the Northwest Portland Area Indian Health Board Quarterly Meeting. This conference call presentation was to the Northwest Portland Area Indian Health Board Quarterly Meeting. This was an expanded version of the June presentation to the National Tribal Budget Formulation Workgroup. This was an expanded version of the June presentation to the National Tribal Budget Formulation Workgroup. This includes annual Tribal PART reporting required in the IHS Budget and OPA. This includes annual Tribal PART reporting required in the IHS Budget and OPA. There was one slide on the status of non- RPMS reporting by Tribes who are replacing RPMS with commercial software. There was one slide on the status of non- RPMS reporting by Tribes who are replacing RPMS with commercial software.