1. IHS Budget Formulation Indian Health Service 2013 Virtual Tribal Consultation Summit November 5, 2013

2. Presentation Overview IHS Budget IHS Budget Process –Background –Process –Current Activities – FY 2016 Budget Formulation –Additional Training Resources 1

3. IHS Budget The IHS FY 2013 budget consisted of discretionary and mandatory appropriations as well as third party collections. FY 2013 Full-Year CR level –$4.130B discretionary budget authority –$147M mandatory appropriation (SDPI) –$997M (est) collections 2

4. Budget Updates FY 2014 President’s Budget - $4.4 Billion –House Markup is $4.1 Billion –Senate Markup is $4.4 Billion –Tribal recommendation is 22.58% increase over FY 2012 Enacted FY 2015 Tribal Recommendation –19.7% increase over FY 2014 PB –$5.3 Billion total (approx. $870 million increase) 3

5. IHS Budget Since 2008, the IHS budget has increased by 23%. –CHS budget has increased by 38%; this means increased access to care for patients IHS partnership with Tribes has been key IHS continues to be a priority for this Administration 4

6. IHS Budget Formulation Background First convened to develop FY 2000 request Purpose: to ensure Tribes, Indian organizations and other key stakeholders are actively involved and have meaningful input in the IHS budget formulation process Prior to FY 2000 and internal “enhancement” process used with Tribal consultation occurring at the national level with NIHB 5

7. 6 IHS Budget Formulation Process HHS Consultation March Evaluation Session June Individual Area Worksessions Oct-Dec National Budget Worksession Feb IHS Preliminary Budget Submission June

8. Budget Formulation Activity October – December: Area work sessions February – March: National Budget meeting –Consolidate budget recommendations March – HHS Tribal Consultation May – June: Evaluation/Planning Meeting –Evaluates and Plans process 7

9. 8 Formulation Present to Congress Execution Planning IHS, Tribes, Urbans HHS OMB Approps SubComm/Full Comm Full House & Senate Conference Committee IHS, Tribes, Urbans IHS IHS Budget Phases

10. BFWG Composition Co-chairs selected Two Tribal representatives from each of the 12 IHS Areas Technical staff participate and support Area reps National Indian organizations also participate at discretion of the IHS Director 9

11. Tribal Budget Recommendations FY 2015 Phase-In Full Funding of IHS over 12 years Fully fund Current Services Protect Prior Year Health Care Gains & Advance Tribal Health Increases for: –Hospitals and Health Clinics –Mental Health –Purchased/Referred Care –Contract Support Costs –Alcohol & Substance Abuse Services –Health Care Facilities Construction 10

12. Current Activities - FY 2016 Area Sessions – now through December Area recommendations due to HQ  Budget tables – December 20, 2013  All other deliverables – December 31, 2013 Area roll-up tables to national worksession participants – January 30, 2014 National Budget Formulation Worksession – February 11-13, 2014, Washington, D.C. Metro Area  Half-Day Afternoon Orientation – February 11, 2014  Worksession – February 12-13, 2014 11

13. IHS Budget Formulation For more information about IHS Budget Formulation contact: –IHS Office of Finance and Accounting, Division of Budget Formulation, 301-443-1270 –www.ihs.gov/BudgetFormulationwww.ihs.gov/BudgetFormulation 12

14. Thank you! Questions? 13