HRAC Charter

PURPOSE

The Federal delivery of health services and funding of programs to maintain and improve the health of American Indian and Alaska Natives (AI/AN) are consonant with the Federal Government's historical and unique legal relationship with Indian Tribes. In recognition of this, the Department of Health and Human Services (HHS) supports research on improving the health of AIs/ANs.

HHS has also adopted a Tribal Consultation Policy (signed by the Secretary on January 21, 2005) that directs that all of its components establish a process to ensure accountable, meaningful, and timely input by Tribal officials in the development of policies that have Tribal implications. To ensure appropriate tribal input into health research processes, the Department is establishing the HHS AI/AN Health Research Advisory Council (HRAC, or “the Council”) to provide advice to the Department. The HRAC will serve as a formal avenue through which the Department gathers tribal input on health research matters.

The HRAC will support, and not supplant, any other government-to-government consultation activities that HHS undertakes with regard to health research. It will function much like disease-specific advisory groups already do in certain agencies of the Department. HRAC will provide a forum through which tribes can advise the Department on their health research priorities and needs as well as how best to carry out health research involving AIs/ANs. Through the HRAC, operating and staff divisions of the HHS (herein after referred to as OPDIV and STAFFDIV) representatives can better communicate and coordinate the work of their respective organizations in AI/AN health research, and the Department can disseminate information to tribes about research findings from HHS-sponsored studies focusing on the health of AI/AN populations. HRAC members will also have a responsibility to communicate critical information, research findings, and any other policy related activity back to their respective tribes and/or communities.

BACKGROUND

A unique government-to-government relationship exists between AI/AN Tribal Governments and the Federal government. The Constitution, treaties and laws, together with court decisions, have defined a relationship between Tribal Governments and the Federal Government. Since the formation of the Union, the United States has recognized Tribal Governments as sovereign nations. The government-to-government relationship between the United States and Tribal Governments dictates that the principal focus for HHS consultation is with individual Tribal Governments.

An integral element of this government-to-government relationship is that consultation occur with Tribal Governments on issues that impact them, and that Tribal Governments participate in the decision making process on issues affecting them to the greatest extent possible. Executive Order 13175 reaffirmed this relationship with Tribes.

The Council will work with senior federal representatives from those OPDIVs/STAFFDIVs of the Department which have joined in this effort. Each federal representative will have experience in AI/AN-related health research. The participating HHS components are: the Office of the Assistant Secretary for Planning and Evaluation (ASPE), the Office of Intergovernmental Affairs (IGA), the Office of Minority Health (OMH), the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC), the Indian Health Service (IHS), and the National Institutes of Health (NIH).

FEDERAL ADVISORY COMMITTEE ACT (FACA)

HRAC will operate under an exemption from the FACA identified in the Unfunded Mandates Reform Act of 1995. The exemption states that FACA does not apply “to actions in support of intergovernmental communications where—(1) meetings are held exclusively between Federal officials and elected officers of State, local and Tribal governments (or their designated employees with authority to act on their behalf) acting in their official capacities; and (2) such meetings are solely for the purposes of exchanging views, information, or advice relating to the management or implementation of Federal programs established pursuant to public law that explicitly or inherently share intergovernmental responsibilities or administration.” Washington representatives of associations designated by elected officials of tribal governments to act on their behalf also fall within the exemption (OMB Memorandum M-95-20, dated September 21, 1995, published at 60 FR 50651, 50653 (September 29, 1995)) .

STRUCTURE

The structure of the HRAC is to be consistent with the FACA-exemption guidelines outlined above. The HHS Office of Minority Health will serve as the Executive Secretariat for the Council As such, OMH will facilitate the solicitation and selection of Tribal representatives to the Council. The Council will consist of the following:

Tribal Members: Elected and/or appointed tribal officials from federally-recognized tribes from each of the 12 Indian Health Service areas of the country (12 persons):

One Tribal representative and one alternate from each of the 12 IHS Areas. The Area Health Boards or Area Tribal Consortia, or Area Tribal Caucus (hereinafter referred to as the appointing body) may choose how their HRAC representatives are selected from each Area but should institute clear procedures as to how these representatives will keep their constituents informed of HRAC activities. The OMH staff will work with the appointing body and HHS to ensure that representatives from each of the Areas are appropriately designated as indicated in writing to the Deputy Assistant Secretary of Minority Health. OMH is responsible for ensuring that the representatives (and alternates) meet the FACA exempt requirements for representation.

Representatives from each of the four Washington-based national tribal organizations:

One representative and one alternate from each organization. The Washington-based national organizations are: the National Congress of American Indians, the National Indian Health Board, the Direct Services tribal organization, and the Self-Governance tribal organization. OMH will work with the national organizations to ensure that representatives to the HRAC have been designated to act on the behalf of elected tribal officials.

As indicated in the background section of this document, the Council will work with senior federal representatives from those operating and staff divisions (OPDIVs/STAFFDIVs) of the Department which have joined in this effort. Each federal representative will have experience in AI/AN-related health research. The participating HHS components are: the Office of the Assistant Secretary for Planning and Evaluation (ASPE), the Office of Intergovernmental Affairs (IGA), the Office of Minority Health (OMH), the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC), the Indian Health Service (IHS), and the National Institutes of Health (NIH).

PROCESS

The Council will convene at least annually in person, convene quarterly conference calls, and convene additional interim conference calls as needed. Representatives from each participating OPDIV/STAFFDIV will attend the annual meeting of the group. After each session, a summary of tribal recommendations will be developed by OMH. OMH will transmit tribal recommendations to all participating HHS operating and staff divisions (OPDIVs/STAFFDIVs) for consideration. HHS OPDIV/STAFFDIV representatives to HRAC will help to ensure that recommendations are appropriately addressed by their respective organizations, and that recommendations are considered during OPDIV/STAFFDIV strategic planning and budget development. The representatives of the OPDIVs/STAFFDIVs will meet formally at least once per year, shortly after the annual group meeting, to discuss the identified priorities and possible collaborations.

MEANINGFUL ACCESS

As determined by the HRAC membership, a portion of the agenda for each HRAC meeting or conference call may include time with HHS OPDIV/STAFFDIV leadership, a principal from one of the participating operating or staff divisions. This will ensure that the input and recommendations provided by Tribal leaders will be considered in the HHS decision-making processes and help guide HHS as it strives to protect people's health and safety, provide reliable health information, and improve health through strong partnerships.

LEADERSHIP

Chair: A Chair will be elected or appointed by and from among the HRAC members for a one calendar-year term of service. The Chair will be an elected Tribal leader. The number of terms is not limited.

Co-Chair: The Co-Chair will be elected or appointed by and from among the HRAC members for a one calendar-year term of service. The Co-Chair will be an elected Tribal leader. The number of terms is not limited.

Executive Secretary: The Executive Secretary will provide administrative support and will be designated by the HHS OMH.

Re-election: The Chair and Co-Chair may be re-elected by the HRAC.

PERIOD OF SERVICE

There is no limit to the length of service on the HRAC. The appointing group may remove or change their representative at any time.

VACANCY

When a principal or alternate vacancy occurs, the appointing body will be notified of the vacancy in writing by the Chairman of the HRAC and/or OMH, as Executive Secretary of the HRAC. The affected Area or the national Tribal organization will be asked to work with their respective Tribal Leadership to select another representative. As such, the appointing body will notify HHS in writing as to the name and contact information of the new appointee. In the event of a vacancy, the alternate will attend meetings until such a time as the vacancy is officially filled.

REMOVAL

If an HRAC member is no longer an elected or appointed official, they should remove themselves from the HRAC as indicated in writing to the OMH and their appointing body. If a designated representative or their alternate does not participate in a meeting or teleconference on three successive occasions, the appointing body will be notified by the Chairman of the HRAC and requested to replace their representative(s) with one who is able to participate regularly.

MEETINGS

Depending on availability of funds, the HRAC will convene a minimum of one face-to-face meeting on a fiscal year basis with to be held in Washington , DC . HRAC conference calls will be held quarterly and additional meetings may be scheduled depending on need and availability of funds. The rules contained in the current edition of Robert's Rules of Order Newly Revised (RONR) shall govern the HRAC meetings in all cases to which they are applicable and in which they are not inconsistent with rules outlined in this charter and any special rules of order the HRAC may adopt. ( RONR [10th ed.], p. 15, l. 17-25; p. 561-62, 569).

VOTING

The HRAC will operate by consensus and where a consensus cannot be reached, then the HRAC will vote to resolve any differences as outlined in RONR. Each HRAC seat (primary member, alternate member or his or her designee) will be allowed one vote. HRAC members may vote in person or via conference call.

QUORUM

A quorum is established with a majority of voting members present in person or by conference call (9 of 16). In the event HRAC is not able to establish a quorum for its meeting, then in the alternative, the co-chairs in their discretion can arrange for polling of members via conference call or other manner at a later time.

COMPENSATION

No compensation will be paid to tribal representatives for their participation in this group. However, travel and lodging costs for the Tribal Representatives that are selected to participate in this Council will be reimbursed within three months via funding established under an interagency agreement set up to establish this research advisory group, pursuant to applicable Federal travel regulations.

REPORTS

OMH will assure that all HRAC meeting proceedings and recommendations are formally recorded and provided to HRAC primary and alternate members, and the participating HHS OPDIV and STAFFDIV representatives through written minutes following the HRAC meeting. Once approved, they also will be posted on the HRAC website so that the information is accessible to all Tribal Governments. The HRAC Executive Secretary will be responsible for maintaining the website.

OMH will assure that all HRAC meetings, proceedings and recommended actions are made available to HHS leaders and will post minutes and reports on the HHS website.

OMH will track actions on HRAC recommendations and report progress to the HRAC annually.

OMH will prepare a report every year to provide tribes with information on HHS-supported health research specifically relevant to AIs/ANs, and the findings of such research.

MEETING LOGISTICS

OMH working with other participating HHS components and the HRAC Chair and Co-Chair, will arrange meeting logistics. This includes coordinating hotel and airline travel arrangements for HRAC members, and audio/visual coordination. Travel arrangements and/or reimbursements will be handled through a logistics contractor,

HRAC BUDGET

On an annual basis, OMH will work with the HRAC Co-Chairs to develop the HRAC budget, including travel, per diem, communication, printing, personnel and other related expenses. This proposed budget will be provided to participating HHS OPDIVs and STAFFDIVs on an annual basis for each subsequent fiscal year.

TERMINATION DATE

This HRAC Charter shall be effective until changed by the Council and participating OPDIVs and STAFFDIVs.

Glossary of Terms

AHRQ Agency for Healthcare Research and Quality

AI/AN American Indian/Alaska Native

ASPE Office of the Assistant Secretary for Planning and Evaluation

CDC Centers for Disease Control and Prevention

FACA Federal Advisory Committee Act

HHS Department of Health and Human Services

HRAC Health Research Advisory Council

IGA Office of Intergovernmental Affairs

IHS Indian Health Service

NIH National Institutes of Health

OMH/HHS Office of Minority Health