1. Facilities Appropriation Advisory Committee Update – (FAAB) CRIHB-NPAIHB Joint Biennial Board Meeting Thunder Valley Casino Resort Jim Roberts, Policy Analyst July 9, 2015

2. FAAB has not been active since ~ FY 2007 Last FAAB meeting held October 27, 2009 with the IHS Director November 12, 2009 was later official correspondence on the following: 1.Should IHS move forward with the revised HFCPS currently awaiting clearance at OMB? 2.What changes would the FAAB recommend to improve the IHS budget formulation process? 3.What role should the FAAB play in the IHS tribal consultation process? IHCIA passed in March 23, 2010 & statutorily mandates the FAAB as IHS advisory committee to the Director Authorizes Facilities Needs Assessment Workgroup FAAB Re-established

3. DTLL July 3, 2012 initiated consultation on health facilities program and FAAB nominations Last year FAAB members were officially seated by IHS Director FAAB Meeting Schedule: First meeting held April 29-30 th in Seattle, WA Second meeting held July 24-25 th in Albuquerque, NM Next meeting set for November 12-13 th in Sacramento, CA March 31-April 2, 2015 meeting in Rockville Next meeting August 4-6, 2015 North Carolina FAAB Update

4. Four FAAB Meetings w/observations March 3-4, 2014: Limited participation due to snow storm. Only three members attended meeting held in Rockville, MD. Very preliminary. No progress on issues due to logistics. April 29-30, 2014, Seattle, WA: First official meeting of FAAB (w/quorum). Orientation for new members. Only two members from past FAAB...Portland and Bemidji. June 24-25, 2014, Albuquerque, NM: Second official meeting of the FAAB. Starting to make progress on issues. Still very preliminary and orienting of issues for new members. November 12-13, 2014: Most FAAB members understand their role and work that needs to be done March 31-April 2, 2015:

5. Seattle Meeting Agenda: Action Items & Observations Held April 29-30, 2014 in Seattle, WA The FAAB focused on revamping its Charter for the IHS Director FACA issues were addressed Acquainting itself with past FAAB work and recommendations – Revised HCFPS Discussed report to Congress required under the IHCIA New IHCIA Authorities for facilities construction & adopting new authorities into Revised HCFPS Preparation for next Area Master Planning Process

6. Albuqueque Meeting Agenda: Action Items & Observations Meeting held June 24-25, 2014 Review changes to revised HCFPS Preparation for next report to Congress due March 23, 2016 Finalize recommendations to FAAB Charge & Needs Assessment Workgroup Continue to evaluate new authorities & how these implicate new HCFPS & next report to Congress Continue orientation of new FAAB members

7. Sacramento Meeting Agenda: Call with IHS Director clarifies roles and expectations  FAAB clarifies next report to Congress to be submitted on time FAAB sends letter to IHS Director recommending endorsing their support of revised HCFPS developed by past FAAB FAAB sends letter to IHS National Budget Formulation Workgroup re: funding for M&I FAAB affirms role of FAAB Needs Assessment Workgroup (NAW) to serve as technical advisors to the FAAB membership FAAB appoints NAW to attend Jan/Feb. 2015 teleconference & begin process to develop master planning criteria

8. March 31-April 2 Rockville Meeting Discussion about Facilities Budget and JV Application Updates Preparation for 2016 Report to Congress Report Contents Direction to Technical Group Technical Workgroup began to develop work plan to submit report to Congress Preparation of Dear Tribal Leader Letter for consultation on top five facilities priorities

9. FAAB will recommend to the IHS Director that the revised HFCPS sitting at OMB continue onto approval and be submitted to Congress pursuant to FY 2000 Interior Appropriations language. FAAB members felt that continued work would not develop any changes OEHE recommended that most types of facilities authorized in the IHCIA could be scored using the existing system with some modifications. Letter will be sent by FAAB Chair to IHS Director making this recommendation Key Decision Points/Issues

10. Total Needs Report Deadline March 23, 2016 Director needs to decide if Agency will submit report on time Decision drives the amount of resources required for Area Master Plans and amount of time/work for Needs Assessment Workgroup If decision to submit report late, than this will allow a more concerted effort to develop facility types authorized under law, completion of Area Master Plans, and to conduct Tribal consultation Key Decision Points/Issues

11. Area Master Plans FAAB must develop consistent criteria for Areas to conduct Master Planning process FAAB needs to provide guidance on types of facilities to be included in Area Master Plans FAAB will need to develop recommendations for evaluating and scoring new facility types with revised HFCPS Data from above process informs the number, type, and costs of facilities reported to Congress Tribal consultation at various steps in this process Key Decision Points/Issues

12. April 8, 2015 Dear Tribal Leader Letter IHS must submit a national needs list to Congress in 2016 Explains the new authorities in the IHCIA Specialized health care facilities Long Term Care Substance Abuse Treatment Dialysis facilities Psychiatric facilities Wellness Centers Requested Tribes to submit their top 5 priorities Expected the FAAB will review and prioritize consultation results at August 4-5 th meeting in North Carolina

13. Whether to submit report on time to Congress. If so, need resources to make this happen. (Due in 18 months) Area Master Plans Fast-track Tribal consultation Develop report and score projects Submit report late: allows for more deliberate and comprehensive report Better consultation to identify types of facilities More time to prepare for Master Planning process More time for consultation to develop report Additional time to develop scoring criteria for new authorities Summary: