IHS Organizational Model with Block Grant Type Functions

Purpose The objective of this study was to research organizational models for the management of block grants, to identify the functions and responsibilities of the current Indian Health Service (IHS) organization, to estimate the staffing and overhead costs for IHS, and to determine a model for IHS in the event that all direct health care services are delivered by tribal organizations instead of IHS. The purpose of the study was to identify an organizational structure, staffing, and cost estimate for an IHS organization which is focused on the responsibilities of managing tribal self-governance and Indian Self-Determination Act funds. Methods The analysis required research on organizational structure, managerial responsibilities, and operational issues for a variety of Federal agencies, including Substance Abuse and Mental Health Services Administration, the Health Resources and Services Administration, the Centers for Disease Control and Prevention, and the National Institutes of Health. The analysis also involved obtaining, processing, tabulating, and summarizing IHS agency-wide budget and staffing, personnel costs, overhead costs, and other factors which impact on the budget needs of IHS under a structure which is block grant management oriented. Results The IHS Headquarters organization could be restructured to fully carry out the self-governance program management and support mission in Rockville, Maryland. The IHS Area Offices could be reorganized to carry out technical assistance and data collection and evaluation, as well as direct liaison with the Tribes. Conclusion This analysis reviews the potential changes within IHS, if all health care service delivery is turned over to the tribes

Span of Control and IHS Staffing Patterns

The objective of this study was to research the subject of span of control as it applies to the management of work, to assess factors impacting supervisory ratios, to assess Indian Health Service (IHS) staffing data to determine supervisory ratios, to identify relevant industry span of control supervisory ratios, and to make findings and recommendations. The purpose of this study was to assess whether or not the IHS\\u27s span of control is consistent with industry standards.The analysis required research on managerial span of control standards and ratios from variety of sources, including health care organization literature, Office of Personnel Management (OPM) documentary material, Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards and manuals, and health care industry staffing data. The analysis also involved obtaining, processing, tabulating, and summarizing IHS agency-wide staffing data by occupational series, location, and function to determine span of control supervisory ratios, and similar data from the American Hospital Association (AHA) on staffing patterns.Corporate responsibilities are organized functionally, but direct health care operations are performed on a team basis. In the field of health care delivery, the literature does not specify recommended span of control. The statutory mandates do not speak to span of control. Rather, they support a mission, which is critical and complex. There was no data found on supervisory ratios for the private sector. The IHS staffing patterns at hospitals and health centers are consistent with the unique IHS mission.The authors recommend conducting a management review/case study to obtain a realistic view of the supervisory ratios for IHS hospitals and health centers. Case studies of the total staffing profile, (including non-IHS employees), the organizational structure, team responsibilities, and span of control at three IHS hospitals would be a useful starting point. Also, a roundtable conference on organization issues for health care delivery facilities may prove beneficial. This study suggests the need for an IHS health facility profile database. The database may include information on locations, organizations, FTEs, budget, program descriptions, workload measures, contracting/compacting data, CHS/fiscal intermediary data, etc., to support IHS Headquarters management and analysis needs

ARCSIM Newsletter, February 2024

ARCSIM approaches fives years and expands services to entire UMS research community. The research enterprise at UMaine has experienced rapid growth in recent years, and with that growth comes accompanying computing, data security, and operational needs. The Advanced Research Computing, Security, and Information Management (ARCSIM) group, led by Director Shane Moeykens, is taking steps to meet these needs by further expanding the computing resources and related services available to UMS faculty and students