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LN T H E UNITED STATES COURT O F FEDERAL CLAIMS
SAMISH INDIAN NATION, a federally recognized lndian tribe, Plaintiff, v. THE UNITED STATES OF AMERICA, Defendant.
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Case No. 02-1383L (Chief Judge Edward J. Damich)
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DECLARATION OF DAVID T. MATHER I, David T. Mather, do hereby declare: 1. I am a health care consultant. I work primarily with tribes and tribal
organizations1that are operating health facilities and programs funded through the Indian Health Service (IHS) under the Indian Self Determination Act (ISDA). 2. I obtained my doctorate in pubIic health from the University of California at
Berkeley with an emphasis on health economics and the delivery of public health services. I obtained my Masters in public health from the University of North Carolina at Chapel Hill. A true and correct copy of my professional resume is attached to this declaration.
I For the purpose of this declaration I will utilize the term "tribe" to refer to both tribes and tribal organizations as defined in the Indian Self-Determination Act, which are those tribes that are recognized by the federal government as eligible for the special programs and services provided by the United States to Indians because of their status as Indians.
EXHIBIT 32
87096 1
In Support of Plaintiff's Opposition to Motion to Dismiss on TPA & IHS Samish v. U.S., No. 02-13831.
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3.
In my current capacity as a consultant and in my former employment, I have
gained extensive personal knowledge of the IHS budgeting and resource allocation practices. This knowledge derives from experiences consulting with tribes from across the nation, including tribes in seven of the 12 IHS Area Offices. In addition, my knowledge stems from my previous employment in which I worked directly for two tribal organizations in Alaska as Chief Financial Officer, Deputy Director and Health Services Director. For example in one of these positions with the Tanana Chiefs Conference, Inc., an Alaskan inter-tribal organization, I was responsible for negotiating annual ISDA contracts with the IHS for health services to over 13,000 Alaska Native beneficiaries living in lnterior Alaska.
4.
During my professional career as both an employee and a consultant I have
provided financial analysis and assisted in the negotiation of over 200 ISDA contract funding agreements. These contacts range in size and scope from agreements to provide limited services to very small tribes of less than 200 members to the largest ISDA funding agreement in the country for the Alaska Native Tribal Health Consortium, an inter-tribal organization, which provides secondary and tertiary health care services to over 130,000 Alaska Natives who are members of 225 tribes. 5. During my professional career, I have also served on several national IHS
workgroups devoted to developing funding methodologies to fairly allocate IHS funding to tribes. These workgroup were convened at the request of the IHS Director to recommend formulas which were subsequently adopted by the agency. The workgroups were comprised of representatives of tribes, tribal health care providers, and the IHS. These workgroups included the Contract Support Costs Workgroup, which was first established in 1990 and developed
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several IHS circulars that define how Contract Support costs2 are distributed; the Joint Allocation Methodology Workgroup on Headquarters Tribal Shares, established in April 1994; and the TribalIIHSlHHS Workgroup on Centrally Paid Expenses, established in 2000, which reviewed costs paid directly from headquarters for services to all IHS operating units. I have also worked with tribes at both the IHS Area Office and national level to provide technical analysis to tribal representatives recommending IHS funding mechanisms for several other categories of funding. These workgroups recommended to the IHS Director methodologies to allocate funding increases in the contract health program; Indian healthcare improvement fund; diabetes; and tribal share funding for both Headquarters and Area Office tribal shares. Each of these workgroups operated with the understanding that each tribe was entitled to IHS services and funding whether those services were provided by the Tribe under an ISDA contract (in which case contract support funding might be available), or directly from the IHS. In general these tribal recommendations were adopted by the IHS Director without material changes.
6.
During my career I have also completed analyses and authored or co-authored
reports on the IHS funding process and tribal allocations on Area Office Tribal Shares, Contract Support Costs, Centrally Paid Expenses, and overall funding allocations of the IHS among Area Offices.
7.
I am familiar with the facts and background of the issues presented in this case.
Contract Support Costs are statutorily defined in the [SDA in section 106(1)(2) as funds added to an ISDA agreement to support costs not normally incurred by the Secretary in support of the services to be provided by the tribe under contract or are provided from resources not provided to the tribe under the contract.
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Background
8.
The IHS funding from Congress consists of annual appropriations currently in the
range of $3.2 billion dollars. This is broken into three appropriation lines. The largest, the "services" appropriation (currently approximately $2.7 billion) is primarily for personnel and
pi-lhlic.health F P ~ V ~ S P E : ''f~~ilifie~''qpropribion ($357 mi!.lion? -r?'--G!-.: z -==:+=! The I r"LLLULL1
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investment account for the construction, maintenance and support of health and environmental health facilities, and the "diabetes" appropriation ($1 50 million) is for tribal and IHS grant programs targeted to diabetes treatment and prevention. The same breakdown in IHS appropriations has been used for appropriations of IHS funds in the past.
9.
Congress intends the vast majority of these annual appropriations to be used in
local healthcare programs to maintain health services for Indian people. The vast majority of appropriated funds are, and historically have been, disbursed annually to local or regional "operating units" which are composed of the hundreds of IHS or tribal health care programs operated in hospitals, ambulatory clinics, or other facilities located in 35 states. Operating units are normally administrative and budgeting units which include the IHS facilities and programs operated in one geographical area. These operating units may be tribally operated (as the majority are now) or operated with federal employees directly by the IHS. Operating units may serve only one tribe as the Samish operating unit (which was established after confirmation of the Tribe's status as a federally-recognized tribe), or a consortium of tribes, or they may serve an
A much smaller portion o f funding may be distributed to the IHS headquarters, and IHS Area Offices to support the administrative infrastructure necessary to develop and operate the health services provided by IHS and or the tribe.
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entire IHS Area as the Alaska Native Medical Center and Phoenix Indian Medical Center. A tribe may receive services from one or more operating units in the general geographical area.
10.
IHS funding generally maintains previously existing levels of personal health and
public health services provided from IHS or tribally operated facilities or through the Contract Health program4 Recallse IHS f?!r?dingis fnr cnsts zcch zs pe:sc.?.;l,e! 2nd f:ci!itics
ccsts -h k ;i c
continue from year to year, annual allocations of funding to IHS or tribal "operating unit" budgets are predominantly fixed and recur from year to year. This fixed amount of funding is normally referred to as "base" funding. In addition, small amounts of new funding may be added to this base amount for tribal programs or IHS direct budgets each year for inflation, population growth, Congressional earmarks, or by formula5 for selected operating units.
11.
The IHS may also provide a small portion of funding to operating units using
"program formulas." These program formula allocations are also normally stable but they may allow small adjustments up or down from year to year based on changes in the objective criteria used in the allocation formula. These program formulas rely on program workload or other rational allocation criteria to allocate funding from these categories of funds. For example the allocation of funding to maintain IHS and tribal facilities is based on the size, condition, age and
The Contract Health Program, or Contract Health Services (CHS) is an IHS Program funded by an appropriation sub line item (sub sub activity) that primarily is used by both tribes and IHS to purchase heath care services from the private (non federal) medical care sector in circumstances where a health care service was not available directly from a tribal or IHS-operated facility. Tribes may contract with IHS to operate a CHS program under the authority of the ISDA. The Indian Health Care Improvement Fund when appropriated is allocated by the Federal Disparity Index (FDI) which relies on a formula based on the amount the agency spends on each tribe eligible for services in the IHS. The FDI is used to determine the current "tribal expenditure" for each tribe in relation to a national benchmark, it is used to appropriate the Indian Health Care Improvement Fund when this fund is appropriated by Congress and as a general measure of adequacy of tribal fknding levels for personnel health services (disparity) compared to the costs of a mid range Federal Health Care Plan for federal employees.
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use or type of facility. Normally, however, the hnding levels from these "program formulas" are also reasonably stable6from year to year. 12. The IHS also provides a small amount of funding under grants to address capacity
development, specific public health problems or manpower development issues. Grants for these
d~d ly purposes may be awarded competitively QT p r ~ ~ i ~ n - c ~ m p n t i t i v e on 2 "program $srmuls"
basis to tribes or tribal members. The largest category of grant funds supports the Diabetes Program. In this program about $105 million of the total $150 million appropriation is awarded to tribes on a non-competitive basis. These non competitive "program formulay'grants are also generally stable with little variation from year to year unless appropriation levels for the programs significantly change. Appropriation levels for these categorical grant programs may result in proportionate changes for this categorical grant funding for all tribes.
Funding Allocation History
13.
How the IHS defines an operating unit and allocates funding to operating units
has changed over time. Before the passage of the Self Determination Act in 1975, the IHS was entirely operated as a federal program. The IHS headquarters received funding and distributed it to Area Offices based primarily on the previous year's base funding. Area Offices in turn distributed the base funding to Service Units which were geographically defined and normally served one7 larger tribe or several smaller tribes which were located in the geographic area.
The material exception to this would be construction appropriation from the "facilities" appropriation which would be associated directly with a health or environmental health facility to be constructed and will only be provided to complete the construction project. Funding for health facility construction however only affects a very small percentage of IHS operating units in a given year. In the case of the largest tribes, such as the Cherokee Nation and Navajo Nation, the tribe could be served by more than one service unit.
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14.
With the passage of the ISDA in 1975 the allocation of IHS resources to tribes
became more systematic. Tribes were given specific and detailed rights to obtain a statutorily defined amount of funding from the IHS to operate their own health services. The agency was required to identify the full amount of funds that were being used at the local operating or service unit8 level to benefit a tribe, and if requested provide part or all of those funds directly to the tribe to operate their own health services. Funding was first determined at the service unit level. Once an allocation was determined for a tribal contract, the tribe was entitled to this "base funding" amount of funds and that base amount of funding could only be reduced in subsequent years for specific reasons stated in the ISDA statute in section 106(a). In addition IHS was required by the ISDA statute to demonstrate that the amount of funds identified and provided for one tribe did not "adversely affect" the health services to other tribes. 15. To implement ISDA contracting activities the IHS modified its resource
allocation process to develop the capacity to identify all funds that were expended in support of health services to each tribe. This was required to insure that all IHS funds expended to benefit a tribe were appropriately identified as available to the tribes for ISDA contracting and also to insure that tribes not choosing to contract under the ISDA were not "adversely affected" by tribal contracting. The IHS developed systematic methodologies for allocating IHS funds to determine the "tribal share" or the true amount of funds which were expended on behalf of the IHS health programs and service for each tribe. These methodologies relied on historical utilization of IHS services9by a tribe. In cases where multiple tribes shared an IHS service unit and historical
The initial statute did not require that IHS funds for Area and Headquarters offices of IHS associated with the tribe's programs be transferred to the tribe as well. Later amendments to the law required that IHS funds from IHS Headquarters and Area Offices also be allocated and available to tribes. The IHS usually relied on "active user" wunt as the primary method of determining historical utilization. An "active user" is defined by the IHS as the number of tribal members who have registered to use an IHS or tribal
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87096.1
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tribal specific budget data was not available, the IHS relied primarily on the number of "active users" from each tribe to divide the historical funding level among tribes. In some programs other objective criteria or variables were also used in program specific "program formulas" to determine the appropriate proportionate tribal allocation for certain categories of funding. These tribal allocations were used by the agency when a tribe requested a new or expanded ISDA contract, to inform the tribe of what level of funding was available to it under 106(a)(l) of the ISDA. 16. In Area Offices where tribal contracting predominated, such as the California,
Alaska and Portland Areas, as ISDA contracting progressed older IHS designated Service units'' were oflen abandoned and replaced with budgetary "operating units" which were aligned with tribal ISDA contracts providing for "base funding" for tribal health programs. In the Portland Area, these operating units became for the most part synonymous with a specific tribe or in some cases served a confederation of tribes. These tribally defined "operating units" each had a recurring base amount which the agency utilized for annual budgeting purposes and each operating unit could expect to receive this base amount each year to continue to provide services.
health service in the past three years that report tribal membership and residence in service area of the tribal operating unit (CHSDA or reservation). In the Portland Area, the Puget Sound Service Unit was dissolved into separate tribal operating units in 1994 due to extensive tribal ISDA contracting in this service unit The Sarnish Indian Nation is located within the service area formerly covered by the Puget Sound Service Unit.
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Area and Headquarters Tribal shares" Resource Allocation
17. In 1988 and 1994 ISDA was amended to clarify that additional resources from
Headquarters and the Area Office budgets be directly provided to Tribal health programs. These amendments required the agency to identify all of the administrative resources expended in
care activities frnm the LJ~&q!!~rf~rs fhe Area OfCce and, provided nr support of local h~ealth
these services were not required to be carried out by federal employees (and defined as "residual" to the agency), provide these "tribal shares" dollars directly to the tribe, if requested through an ISDA award. These funds are normally referred to as "Area and Headquarters Tribal Shares." 18. The IHS responded to this requirement by developing a tribal share resource
allocation methodology(s) which would allocate 100% of these available resources to the recognized tribes served by the IHS. All federally recognized tribes - including both tribes that ran their own IHS-funded programs under an ISDA agreement and those tribes that did not - had a calculated tribal share of these resources although only programs being operated under an ISDA agreement were actually eligible to obtain these funds through the ISDA award. 19. The Headquarters tribal shares in FY2006 totaled approximately 105 million
dollars. The formula used to allocate these funds is called the Tribal Size Adjustment Formula. This formula relied primarily on two driving variables, the number of active users from a tribe (for approximately 92% of the total allocation) and a variable factor which measured tribal size which allow smaller tribes to receive a small adjustment factor for relatively higher costs of
' I For the purpose of this declaration when I refer to funds that are expended or available to be expended on behalf of a tribe, I am referring both to funds that the agency expends through contracts, compacts or grants directly to the tribe as well as all funds which are expended by the IHS or another tribal organization directly or indirectly to provide personnel health, public health, or other IHS program functions services or activities to the tribal members.
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providing a unit of care in a smaller tribe. Since 1996, the IHS has maintained a database in ~ e a d ~ u a r t e rwhich has provided for an allocated share of the total Headquarters Tribal Share s'~ funds to each recognized tribe regardless of whether the tribe has requested these funds under ISDA or not. In cases where tribes operated programs serving more than one tribe, the Headquarters Tribal Share amount for each tribe was summed to provide the total Headquarters tribal share that was available to the operating unit under an ISDA contract if requested. To prevent adverse impacts to remaining tribes from the distribution of these funds to ISDA tribes and to insure that tribes that contract under the ISDA would still have access to these funds, tribes which received services from a federally operated IHS operating unit also have a share of their allocation of Headquarters tribal share funds calculated even though they did not obtain these funds from Headquarters to support the local budget.
20.
Area Offices also developed area tribal share allocation policies which were
developed on a similar basis to the Headquarters methodology. Again, each Area Office allocated all available area "tribal share" resources to tribally defined operating units based on common, objective criteria. Although these allocation methodologies have all been developed within each of the 12 area offices and may differ somewhat across area offices, they are applied consistently within area offices and are designed to be inclusive of every tribe and all the Area Office Tribal Share resources across the country. They provide for or reserve a tribal share for each federally recognized tribe.
This database has been maintained by Mr. Cliff Wiggins, Special Assistant to the Director of IHS, and is currently being redesigned and will be transferred to the OGce of Financial Management in FYZOOS.
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Other IHS funding methodologies
21.
Other funding methodologies adopted by IHS after 1975 also increasingly relied
on tribally defined operating units which provided an allocation for each tribe based on number of tribalusers, size of tribe, disease prevalence, etc. Each of these programs which utilize
"
program formi.~las" allocate f ~ n d i n g to uti!ize differing nkjertive crit~rjz z ! ! ~ $ tnerv fi~ndino k e
D
to each operating unit and for the most part, each federally recognized tribe will be entitled to a defined allocation. These methodologies included funding for the Diabetes Grant program,13for the Indian Health Care Improvement Fund, population growth finds, etc.
Federal Disparity indexf4 ($or allocating Indian Health Care Improvement Fund)
22.
The Indian Health Care Improvement Act, enacted in 1976, calls for "eliminating
the deficiencies in health status and resources for all tribes." All federally recognized tribes are entitled to these funds. Congress has directed the IHS to report health care deficiencies in resources for all tribes and has from time to time appropriated resources directly to a specific fund, known as the Indian Health Care Improvement Fund (IHCIF) to eliminate deficiencies for the specific tribes with the greatest need.15 In 1998 through 2000 the IHS, working with Tribal representatives, developed the Federal Disparity 1ndex16(FDI) to measure the resource
13 In 2006 about $105 million of $150 million in diabetes funding is allocated to 333 agreements on a noncompetitive basis by tribally developed formula tied to tribe size, user population, disease burden and inflation.
The Federal Disparity Index was originally called the Level of Need Funded (LNF) when originally developed. Both names refer to the same index. In FY03 the IHS distributed 70% of the IHCIF to tribes with FDI scores less than 40% and the remaining 30% of the lHCIF to tribes with FDI scores less than 60%. Congress directed the agency to continue to use this allocation methodology in the FY2005 appropriation for IHCLF.
l6
15
14
The FDI was formerly called the Level ofNeed Funded (LNF).
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deficiency for each tribe.'' This FDI uses an index to compare the level of personal health care services provided to each Indian tribe to the level of health care provided in a mainstream private health insurance plan. This index first calculates a theoretical benchmark of the total cost for personal health
service^'^ which would be provided to tribal members if they were insured by a
mainstream health benefit package. This benchmark relies on the cost of the Federal Employees Health Benefits Plan which is adjusted for several factors specific to the tribal members including age structure, morbidity, location, and regional prices. 23. After the determination of the benchmark for the tribal user, the IHS identifies all
the IHS funds currently expended for personal health services for each tribe. These resources may be provided at one or more operating units. This provides a tribal allocation of IHS funding for the Tribe as it includes the total budget allowance for an operating unit plus a portion of area wide and IHS wide funds provided in support of these services. IHS funds provided in support of wrap around or public health and preventative services are not included in this amount. The funding level for each tribe is then expressed as a percent of the need for each tribal user to reach the computed benchmark. This is called the Federal Disparity Index or FDI. (Available $/needed $ = FDI %). This index is used for determination of how the Indian Health Care Improvement fund is distributed when appropriations are received from Congress for this purpose.
In some cases where several smaller tribes were served by a single consortium a single FDI was developed for the consortium. The FDI index measures only personal health services and does not include wrap around public health, preventative and environmental services. It also only measures the deficiency for tribal members that currently access IHS or tribal health services and does not include services needed for tribal members that never access this system due to distance or other barriers.
17
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Summary of ZHS funding allocations
24.
While the mechanisms for funding various IHS activities are complex, certain
principles are clear. First, the broad Congressional mandate for IHS is, and has been, to provide health care to members of every federally recognized tribe. Second, consistent with that objective the IHS has in fact since 1975, to the best of my know!~.dge.~ e~penrled mnney fo benefit every federally recognized tribe. Third, the IHS is required to inform any tribe that seeks a Self Determination Act contract to run an IHS program of the amount of program funds that IHS has been using to benefit that tribe. Fourth, IHS has the capacity to determine the amount of program funds that it is using to benefit each federally recognized tribe - whether the Tribe enters a Self Determination Act contract or not, and has been able to make such determinations for the IHS programs operated at the local operating or service unit level since the late 1970s. Fifth, in addition to program funds, IHS has determined the "Headquarters and Area Office tribal shares" - that is, the administrative support resources provided by the IHS Headquarters and Area Offices - for every federally recognized tribe. Sixth, for purposes of allocating resources appropriated by Congress with the Indian Health Care Improvement Fund, IHS has calculated since at least 1999, the health deficiency of each federally recognized tribe, using Level of Need or a Federal Disparity Index. Seventh, IHS' longstanding practice has been to allocate IHS funding - through the mechanisms described here and others -to benefit each federally recognized Tribe. Eighth, the amounts allocated to each federally recognized tribe have been or can be ascertained by IHS. Ninth, Congress is aware of the fact that IHS allocates funds to every federally recognized tribe, and it appropriates fbnds with that understanding.
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Impacts of Wrongful Denial of Recognition on Tribal Funding
25.
In my experience, lack of federal recognition meant that the Samish Indian Nation
was excluded from IHS funding allocations until its federal recognition was restored. Lack of federal recognition also denied the Tribe access to other IHS resources, like direct grant funding
from the I trihz! grznt manlgemen!: fwding program. This is a long skndifig g a n i pp2g:am H
utilized by many small tribes for health planning and evaluation and to invest in improved health management information technology infrastructure. This lack of planning and investment in health management structure and information technology will have continuing impacts on the ability of a tribe to identify and collect or utilize third party revenue from tribal members; to achieve the most efficient purchase price in contract care programs; and, to develop new health programs which are responsive to tribal needs.
I declare under penalty of perjury of the laws of the United States, that the foregoing is
true and correct.
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David TI@ Mather 1569 Northfield Rd. Fairbanks, AK 99709 907456380 (home) 907-455-6942(work) 907-455-7391(fax) [email protected]
University of California, Berkeley, CA Dodor of Public Health, December 1990 School of Public Health Department of Health Policy and Administration Qualified for Doctorate of Public Health "with distinction" University of North Carolina, Chapel Hill, N. C Mastem of Science in Public Health, May 1977 School of Public Health Department of Health Adminisbation Duke University, Durham, N. C Bachelor of Arts, May 1973 Majors: Chemistry Anthropology
Consultant, President of Mather and Associates, consulting firm to health and human service organizationsconcentratingon evaluation and quality assurance,.strategic planning, capital project development, training and human resource development and facilitation for effective decision making. Recent projects include:
Alaska Department of Health and Social Services, hmeau, AK Uniform Client Identifier Feasibility Study . Alaska Child Health Plan (3-volume plan) Lmg-tern Care Nee& Assessment of the Yukon-Kuskokwim Region Healthy K i m . S D T Rogram Evaluation and Plan Public Health Nursing Capacity Workload Study Division of Mental Health and Developmental Disabilities Planning Facilitation Alaska Native Heafth Board, Anchorage, A K ANMUArea Regional Support Center -Contmct Development, Project Consultant Management Review of the Alaska Native Health S t ~ c Area Office e Project Planning for the Alaska Native Medical Center PL. 93-638 Alaska Tribal Health Compad (I3 biboi Health Corporations) Planning and Consultation Support for the Alaska T n i l Health Compact
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Alaska Nafive Tribal HeaM Consortium, Anchorage, AK Business Plan for Capital Development Numerous on-going projects on financial management budget development issues Tanana Chiefs Conference Inc., Fairbanks, AK Project Director for the Development of Adolescent Alcohol Treatment Center Lead Negotiatodl'roject Coordinator for the Development of the Chief Andrew Isaac Health Center Replacement Project.
Review of Health Senices in McGrath Sub-region and strategic plan for improvement Nwnsous on going projects on furanaal management and budget process developmenf
Fairbanks M~JIJoM~ Ho~nifd~ Fairbanks. A K Facilitator for long term planning for Community Mental Health Service Development Facilitator for Community Action Plau for Chronic Public Inebriates Ar& Slope Naiive Associahahon, m w , AK B Development and Training of Board of Directors Development of Proposal for Bureau of Indian Affairs Services in NSB Feasibility Stndy for Conkad for the US Public Health Seivice Hospital in Barrow Hospital Conkact Development and L a d Negotiator
Kodiak Area Native Associaa'on, Kodiak, AK Provide Feasibility Analysis, Fundona1 Space Planning and Financial Consultation for Construction of 20,000 square foot Ambulatory Care Center
Yukon Kuskokwim Health Corporcrlion,Bethel, AK Strategic Planning for Community Health Savices Capital Planning Assistance for 54,000 square foot Admi~strative d Community Health Sexvices a Center Sourfiat Alaska Regional Health Consortium, Juneau and Sitka, AK Financial Comlting, Management Consulting of misc. projects Beitre1 Communiiy SemTYIces, Bethel AK Development of StrategicPlan for Board of Directors Maniiloq Assodation, Kokebue, AK Financial Analysis of Nursing Home Operation Briktol Bay Nafive Assodrriion,DiIlingham. AK Capital Project Assistance for Planning, F i c i n g and Construction of 12,000 square foot Administrative Center Feasibility study for Assisted Living Facilities in the BBAHC region
Kmemk, Nome, AK Capital hoject Assistance for Planning, F i c i n g and Acquisition of -13,000 square f&t Adminishative Center
Notion Sound Health Corporaiion,Nome, AK StrategicPlanning and Board Training for Self-Governance Resource Allocation Feasibility Stndy Eastern Band of Cherokee, Cherokee, NC planning and development t Assume Cherokee Hospital under PL 93-638 o Cherokee Nation of Okiahoma,Tahlequah, OK Business Plan for the Strategic Health Plan for the Cherokee Nation Tuba Ciiy Regional HehIh Care Corporation.Tuba City, AZ Planning and development and proposal development to assume Tuba Indian Medical Center under PL 93-638,
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National Indian Health Board, Denver, CO Study of Indian Determination in Health Care Management N d n a l Congress of Indians, Washington. D.C. Study of the Impact on Contract Support Costs on Self Determination Contracting
Director of Finance and Administration, (7/88 - 9/91). Tanana Chiefs Conference Inc., 201 1st Avenue, Fairbanks, Alaska. The Tanana Chiefs Conference Inc., is a human r-i n providincg health
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Program Planner, (10/7 - 3/78). Bristol Bay Area Health Corporation. Duties included: preparation, submission and negotiation of a l l grants and contracts for the organization; project coordination for the implementation of a mid-level practitioner project funded k d e r the National Health ~ e ~Corps; traveling to 32 villages of the reaon to assist c e village governments on such health related projects as health clinic construction;and coordination of planning and construction of village sanitationfacilities.
Consultant, (5/77 - l O / n ) . Wlggins and Rimer, Consulting Engineers, Durham, NC Duties included: sampling protocol development, survey bias testing, and compiling a 32 volume survey of municipal drinkingwater systems in North Carolina.
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2001: IHS National Council Of Executive Officers, Superior Contributions and Outstanding Leadership on IHS Workgroup on Centrally Paid Expenses, India Health Seruice, National Council of Executive Ofjicers,May, 2001 1996: Secnday's ~ & u dfor Distinguished Service, Department of Health and Human Services, Rockville, Maryland. 1994: Governor's Transition Team for Human Services, Chair for Health Services
C. ,..mu,, .h.-- : ,,
uuvr"**-u..Ly,
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u r l c u ~ ruco..u.
Al-,G-
1990- 1992: Member of Health Resources and Access Task Force of the Alaska State Legislature, Juneau,Alaska. 1988 - 1991: Commissioner on the City of Fairbanks Health and Social Services Commission, Fairbanks, Alaska. 1988 - 1991: Association of Regional Fiance Directors; President, 1990through 1991. 1988: Grossman Fellowship - University of California at Berkeley. 1987, i988: Wellness Fellowship - University of M o m i a at'kkeley. 1985: Mayors Transition Team, Fairbanks N r h Star Borough, Fairbanks, Alaska. ot 1981- 1986: Assodation of Regional Health Directors; President, 1983through1985. 1984 - 1986: Instructor, Rural Health Systems Class, WAMI Medical Program, University of Alaska-Fairbnb. 1981 1985: Board of Directors, Fairbanks Youth Services, Fairbanks, Alaska. 1983- 1985: Local Operating Board, Fairbanks M m r a Hospital, ex-offiao member, eoil Fairbanks, Alaska.
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David Mather, Dr. P H. - Dr. Mather has worked extensively in nonprofit health and human service . organizations and small rural hospitals for the past 25 years. He is founder of Mather and Associates, a management consulting fing providing strategic planning, project planning and management, and financial analysis and services for governmental and non profit and tribal health service organizations. Dr. Mather has held executive level positions in the Tanana Chiefs Conference, Inc., both as Chief Financial Officer and as Health Director, and as Deputy Director of the Bristol Bay Area Health Corporation. Dr. Mather holds degrees from Duke University, the University of North Carolina at Chapel Hill and a doctorate f o rm the University of California at Berkeley School of Public Health with a focus on organizational behavior
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Dr. Mather has consulted extensively with a wide range tribal heakb organizations operating nual hospitals and ambulatory care networks. His clients include the: Eastern Band of Cherokee, Cherokee Tribe, Tuba City Health Care Corporation, Alaska Tribal Health Consortium (ANMC), Southeast Alaska Region4 Health Consortium (Mt. Edgecumbe), Bristol Bay Regional Health Corporation (Kanakanak), Yukon Kuskokwim Health Corporation(YK Delta Hospital) ,Maniilaq (Maniilaq Medical Center)., Arctic Slope . Native Association (Samuel Sinuneons Memorial), L d ,Norton Sound Health Corporation (Nome), Tuba t. City Regional Medical Center, and with the Indian Health Service at both national and area office level.
He h.as also coniulted with clients on several national projects involving evaluation and development of Indian Health Care Services including the India Health Service, National Indian Health Board, National Congress of Arderican Indians, and Navajo Health Systems Corporation
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