Department of Health and Human Services 
OFFICE OF 
INSPECTOR GENERAL 
THE INDIAN HEALTH SERVICE EQUAL 
EMPLOYMENT OPPORTUNITY 
COMPLAINTS PROCESS 
A Management Review 
JUNE GIBBS BROWN 
Inspector General 
JULY 2000 
OEI-05-99-00290  OFFICE OF INSPECTOR GENERAL 
The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, is to 
protect the integrity of the Department of Health and Human Services programs as well as the 
health and welfare of beneficiaries served by them.  This statutory mission is carried out through a 
nationwide program of audits, investigations, inspections, sanctions, and fraud alerts.  The 
Inspector General informs the Secretary of program and management problems and recommends 
legislative, regulatory, and operational approaches to correct them. 
Office of Evaluation and Inspections 
The Office of Evaluation and Inspections (OEI) is one of several components of the Office of 
Inspector General.  It conducts short-term management and program evaluations (called 
inspections) that focus on issues of concern to the Department, the Congress, and the public.  The 
inspection reports provide findings and recommendations on the efficiency, vulnerability, and 
effectiveness of departmental programs. 
OEI's Chicago office prepared this report under the direction of William C. Moran, Regional 
Inspector General and Natalie Coen, Deputy Regional Inspector General.  Principal OEI staff 
included: 
REGION  HEADQUARTERS 
Joe Penkrot, Project Leader  Alan Levine, Program Specialist

Emily Melnick, Program Analyst

Ianna Kachoris, Program Analyst

To obtain copies of this report, please call the Chicago Regional Office at 312-353-9867. 
Reports are also available on the World Wide Web at our home page address: 
http://www.dhhs.gov/progorg/oei  E X E C U T I V E   S U M M A R Y   
PURPOSE 
To conduct a management review of the Equal Employment Opportunity (EEO) 
complaint process of the Indian Health Service (IHS). 
BACKGROUND 
The IHS Director requested that the Inspector General conduct an EEO management 
review including the following issues:  timeliness, management practices, delegations of 
authority, conflict of interest, confidentiality, and training of EEO personnel at 
Headquarters and Area Offices. 
The Assistant Secretary for Management and Budget (ASMB) has departmental 
responsibility to provide technical assistance and policy guidance to the operating divisions 
(OPDIVS).  The OPDIV EEO offices are responsible for establishing and maintaining 
EEO programs and processing EEO complaints.  The ASMB has primary responsibility 
for preparing final agency decisions on formal EEO complaints. 
The IHS has delegated EEO responsibility for the Albuquerque, Nashville, Navajo, and 
Oklahoma City Area Offices and Headquarters West to the Oklahoma City Area Office. 
We reviewed EEO policies and procedures, complainant files, and any other available 
documentation relating to the six issues we evaluated.  We compared the EEO process at 
the Area Offices, Service Units and both Headquarters to the standards established in EEO 
laws and regulations and by ASMBs EEO Complaints Processing Checklist.  In 
Headquarters East and Oklahoma City, we reviewed 31 formal complaint files closed in 
the last 2 years.  We reviewed all 26 of the available informal complaint files closed in the 
last 2 years at Area Offices and Service Units.  Using structured discussion guides, we 
interviewed a total of 223 respondents at Headquarters, Area Offices and Service Units. 
FINDINGS 
The IHS Operates under Four Conditions Which Complicate the EEO Complaints 
Process: Indian Preference, Commissioned Corps, Tribal Contracting/ 
Compacting, and Downsizing 
Complaints involving the Commissioned Corps, Indian Preference or where tribal 
1 
EEO AND IHS  OEI-05-99-00290  contracting has occurred, create confusion in the IHS EEO complaints process.  These 
issues, as well as downsizing, impact the scope and structure of the EEO process. 
Inconsistencies in the EEO System Result in Unequal Treatment of Complaints 
Significant differences in the structure and approaches to handling complaints result from 
the IHS decision to divide EEO responsibilities between Headquarters East and Oklahoma 
City.  The delegation of authority has resulted in considerable differences regarding the 
acceptance of formal EEO complaints between Headquarters East and Oklahoma City. 
Inconsistencies also exist in IHS 12 Area Offices.  The Area Directors make their own 
EEO staffing decisions, determining whether or not to have an on-site, full-time EEO 
manager and/or counselors. 
The IHS EEO Program Lacks Direction, Potentially Weakening its Effectiveness 
The IHS has no systematic way of knowing whether their counselors or staff act 
appropriately on individual complaints.  Neither the Headquarters East director nor the 
Oklahoma City EEO manager directly supervise EEO activities occurring in Area Offices 
or Service Units.  There is a lack of uniformity in record keeping and retention, resulting 
in the inability to determine timeliness in the EEO complaint process. 
Management involvement in individual EEO complaints represents a conflict of interest 
and undermines confidentiality.  In many cases, EEO staff, counselors, or others involved 
with EEO informal complaints routinely provide specific case information to the Area or 
Service Unit Director.  Despite requirements that the EEO process be separate from 
personnel functions, we found IHS personnel office staff directly involved in the handling 
of EEO complaints in several Area Offices.  Appearances of conflict of interest, even if 
inaccurate, raise questions about EEOs impartiality. 
Many EEO staff and counselors believe that they need intermediate level or refresher 
training to advance or maintain their skills.  Most EEO training is restricted to 
management staff. 
We found no evidence of any periodic self-evaluations by IHS of its own EEO process. 
Employee Distrust of EEO Is Widespread Throughout IHS and Undermines 
Effectiveness of the EEO Process 
There is widespread fear of reprisal among many IHS employees.  Nearly two-thirds of the 
respondents, including some supervisory staff, indicated that they would not feel 
comfortable filing an EEO complaint.  In addition, most IHS staff is unaware of IHS 
upper management support of and commitment to EEO principles. 
2 
EEO AND IHS  OEI-05-99-00290  RECOMMENDATIONS 
In order to address the issues identified in this report, IHS should: 
Address IHS-specific Issues Pertaining to Indian Preference, Commissioned 
Corps, Tribal Compacting/contracting and Downsizing 
Standardize the Handling of EEO Complaints 
Improve Counselor Performance and Supervision 
Standardize Complaint Reporting, Recording, and File Retention 
Implement Policy Guidance on Confidentiality 
Eliminate Conflicts of Interest and the Potential for Conflicts of Interest 
Improve Communication and Expand EEO Training and Educational 
Opportunities to All IHS Employees, EEO Staff and Counselors 
Increase Employee Trust in the EEO Process 
We provide specific details on how these recommendations can be carried out in the 
recommendations section at the end of the report. 
In order to ensure proper oversight and accountability, we also recommend that ASMB 
should: 
Perform a Follow-up Evaluation and Periodic Reviews on the Implementation of 
the OIG Recommendations 
AGENCY COMMENTS 
We received comments on the draft report from the Indian Health Service (IHS) and the 
Assistant Secretary for Management and Budget (ASMB).  Both concur with the vast 
majority of our 10 recommendations and the 34 ways of achieving them.  Where 
appropriate, we changed the report to reflect their comments.  The full IHS and ASMB 
comments are contained in Appendix B. 
The IHS believes our recommendations will provide opportunities for much needed 
improvement in the administration and management of the IHS EEO program.  The 
3 
EEO AND IHS  OEI-05-99-00290  IHS actions to date include development of an EEO website, a Fact Sheet explaining 
differences between Indian Preference and Title VII discriminatory practices, and new 
EEO posters.  We appreciate the cooperation of IHS in conducting this inspection and 
look forward to working with IHS in the development of their action plan in response to 
our recommendations. 
Of the 34 ways of achieving the recommendations, IHS did not concur with the following 
four: 
The IHS does not concur with elevating EEO supervisory responsibilities to IHS 
Headquarters.  The IHS responded that they were unclear about the recommended 
organizational location of upper management.  To clarify, we are recommending that an 
IHS upper manager at Headquarters provide management supervision (line authority) to 
both the EEO Director in Headquarters East and the EEO manager in Oklahoma City to 
provide more accountability.  We are not recommending line authority over Area EEO 
Managers through Headquarters staff offices. 
The IHS does not concur with our recommendation to implement standardized 
performance requirements and evaluation methods for EEO managers, staff and 
counselors which are reviewed/conducted by the EEO Director in Headquarters East 
and/or the EEO manager in Oklahoma City.  It is unclear if IHS disagrees with our 
recommendation to implement performance requirements and evaluation methods and/or 
the line authority for evaluating performance.  In either case, in order to measure EEO 
staff improvement, we believe this recommendation is necessary. 
The IHS does not concur with our recommendations to establish a counselor selection 
criteria and to prohibit managers and personnel staff from becoming counselors.  We 
believe that regardless of whether objectivity can be maintained, having managers and 
personnel staff who are EEO counselors creates an appearance of a conflict of interest. 
This is detrimental to the ability of the IHS EEO program to establish an overall sense of 
trust and impartiality among IHS employees. 
The IHS does not concur with our recommendation to ensure that EEO settlements are 
paid from a central fund, rather than an Area Directors operating expenses, or otherwise 
ensure that an Area Director does not have decision-making authority over the settlement 
amount.  We agree with IHS that, Areas related to each EEO issue should bear the cost 
of settling those issues.  However we believe that it creates a conflict of interest to have 
the Area Director decide the amount of the award. 
The ASMB concurs with the need to improve staff performance.  However,  they believe 
there are other ways of achieving staff supplements beside increased staffing levels and 
suggest that IHS consider term appointments, contracting and job sharing etc.  We agree 
that staff performance can be improved through various mechanisms and would 
4 
EEO AND IHS  OEI-05-99-00290  encourage IHS to utilize any and all available to them. 
The ASMB does not concur with the recommendation that IHS ensure that EEO 
settlements are paid from a central fund, rather than an Area Directors operation 
expenses. While we agree with ASMB that Area Offices should be held accountable, we 
stand by our belief that an Area Directors ability to decide the monetary amount of a 
complaint settlement creates a conflict of interest. 
5 
EEO AND IHS  OEI-05-99-00290  T A B L E   O F   C O N T E N T S  
PAGE 
EXECUTIVE SUMMARY 
INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

FINDINGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  13

Conditions Affecting IHS EEO Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Inconsistencies in the EEO System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Management Direction of EEO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Employee Distrust of the EEO System  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

RECOMMENDATIONS  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  24

AGENCY COMMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  28

APPENDIX A  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . .  30

APPENDIX B  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  32

IHS Comments  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  33 

ASMB Comments  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  41 

6 
EEO AND IHS  OEI-05-99-00290  I N T R O D U C T I O N  
PURPOSE 
To conduct a management review of the Equal Employment Opportunity (EEO) 
complaints process of the Indian Health Service (IHS). 
BACKGROUND 
The IHS Director requested that the Inspector General conduct an EEO management 
review including the following issues:  timeliness, management practices, delegations of 
authority, conflict of interest, confidentiality, and training of EEO personnel at 
Headquarters and Area Offices. 
Legal Responsibility for EEO 
The Assistant Secretary for Management and Budget (ASMB) has departmental 
responsibility to provide technical assistance and policy guidance to the operating divisions 
(OPDIV).  The OPDIV EEO offices are responsible for establishing and maintaining 
EEO programs and processing EEO complaints.  According to 29 CFR 1614.102(a)(1), 
each agency must provide sufficient resources to its EEO program to ensure efficient and 
successful operation.  The ASMB has primary responsibility for preparing final agency 
decisions on formal EEO complaints. 
Timeliness 
The OPDIVS follow a 9-step process (See Appendix) issued by the Equal Employment 
Opportunities Commission (EEOC) to handle individual complaints of discrimination.  The 
process outlines complainant, EEO counselor and OPDIV responsibilities and time frames 
to complete requisite steps in resolving an EEO complaint.  The specific time frames for 
completing EEO actions are specified in 29 CFR 1614.105(a)ff and are defined for EEO 
staff and counselors in the EEOCs EEO Management Directive For 29 CFR. Part 1614 
(MD-110).1 
1	 Subsequent to our field work, EEOC updated MD-110. The new MD-110 issuance endorses the 
principles we cite and provides additional support for some of our recommendations. All 
MD-110 citations shown in this report reflect those in place at the time of our field work. 
7 
EEO AND IHS  OEI-05-99-00290  Management Practices 
In early 1999, ASMB released an EEO Complaints Processing Evaluation Checklist to 
EEO directors throughout the Department of Health and Human Services (DHHS).  This 
checklist serves as a guide for measuring effective management of EEO complaints 
processing and allows OPDIVS and Headquarters staff to evaluate how well they perform 
their EEO complaints functions.  The checklist also provides OPDIVS guidance as to 
acceptable counselor selection, training and performance, alternative dispute resolution 
(ADR), and complaint tracking and reporting.  In addition, according to 29 CFR 
1614.102(a)(11), each agency must establish a system for periodically evaluating the 
effect of the agencys overall EEO effort. 
Delegations of Authority 
According to 29 CFR 1614.607, an agency head may delegate EEO authority to one or 
more designees.  In 1997, IHS delegated EEO responsibility for the Albuquerque, Navajo, 
and Oklahoma City Area Offices and Headquarters West to the Oklahoma City Area 
Office.  In 1998, IHS further delegated EEO responsibilities for the Nashville Area Office 
to Oklahoma City.  Headquarters East retained EEO responsibilities for the Aberdeen, 
Alaska, Bemidji, Billings, Phoenix, Portland, Sacramento, and Tucson Area Offices and 
Headquarters East. 
Each of the twelve Area Directors has the authority to select an EEO Manager and to 
determine whether the position will be designated as a collateral or full-time position. 
Two Area Offices have their own full-time EEO Manager:  Phoenix and Alaska2. 
Aberdeen and Bemidji share a full-time EEO Manager.  Albuquerque, Headquarters West, 
Nashville, Navajo and Oklahoma City share the full-time EEO Manager in Oklahoma City. 
The Billings, Sacramento and Tucson Area Offices designate the EEO Manager position 
as collateral to their regular duties.  Most Area Offices and Service Units have at least one 
EEO counselor on-site who has collateral duties. 
Conflict of Interest 
Conflict of interest can occur on EEO complaints when those who make policy or are

involved in the EEO process improperly insert themselves into the EEO process or fail to

recuse themselves when they have a personal involvement in the matter.  The MD-110

specifically prohibits several activities:

C  any management involvement in individual EEO complaints is inappropriate

C  EEO staff are prohibited from acting as advocates for either party involved in an

2	 Alaska did not have a full-time EEO Manager for 8 months. An EEO Manager was appointed 2 
days prior to our visit. 
8 
EEO AND IHS  OEI-05-99-00290  EEO complaint 
C  the EEO complaint process must be kept separate from the personnel function 
C	 internal investigators cannot be used in certain situations (e.g., particularly 
sensitive cases involving high officials). 
Confidentiality 
Confidentiality is guaranteed to employees making informal EEO complaints by 
29 CFR 1614.105(g) and MD-110.  Both citations require specific authorization by the 
complainant before a counselor can reveal their identity.  Otherwise, anonymity for the 
complainant cannot be compromised. 
Confidentiality is no longer promised once a formal EEO complaint is filed.3  If employees 
want to file formal complaints, EEO counselors must advise complainants that their 
complaint file may be shared with those involved in their case who need access to the file. 
The MD-110, VI, C. 4, states those needing access may include the EEO Officer, agency 
EEO officials and those identified as being responsible for actions giving rise to the 
complaint. 
Training 
The IHS is required to provide all managers and staff information about EEO policies and 
programs.  According to 29 CFR 1614.102(a)(5), agencies must provide orientation, 
training and advice to managers and supervisors to assure their understanding and 
implementation of the EEO program.  Similarly, 29 CFR 1614.102(b)(4) requires 
agencies to make written materials available to all employees ... informing them of the 
variety of EEO programs and administrative and judicial remedial procedures available to 
them. 
Alternative Dispute Resolution 
The ADR process intends to resolve EEO complaints through early intervention using an 
impartial outside party to mediate the issues.  An EEO counselor should routinely advise 
complainants of the availability of ADR services.  If the complainant agrees to ADR 
mediation, a trained mediator will hear the issues involved and work with the involved 
3	 Technically, informal complaints are presented rather than filed. For this report, we use 
filed when discussing the informal complaint process since that is how respondents described 
the process to us. 
9 
EEO AND IHS  OEI-05-99-00290  parties towards a resolution.4  The law requires agencies to ensure that parties be 
entitled to participate in the selection of an arbitrator.  The mediators communications 
with the involved parties are confidential.  If a complaint is resolved through ADR, the 
complainant cannot file an EEO complaint based on the same issue. 
New EEOC rules, effective November 9, 1999, made several ADR changes.  Federal 
agencies now must offer ADR at all stages of the EEO process. 
Recent EEO Reviews at IHS 
In May 1998, the IHS 1998 Employee EEO Survey5 found that additional EEO training 
is warranted to reduce anti-feminist and anti-minority perceptions and attitudes in the 
IHS workforce.  In addition, the types of discrimination most often reported were race (16 
percent), gender (13 percent), and sexual harassment (9 percent).  A little over half of the 
respondents (54 percent) indicated they would file an EEO complaint if they felt they had 
been discriminated against and the majority of respondents (69 percent) indicated they 
would not be hesitant to contact someone in EEO for information and or counseling. 
Most respondents felt the EEO program was necessary.  Finally, there was considerable 
variation in the respondents perception of the degree to which IHS management supports 
the EEO program. 
Numbers of EEO Complaints at IHS 
As of May 1999, there are more than 14,000 IHS employees located in 12 Area Offices, 
individual Service Units, Headquarters East (in Washington, D.C.), and Headquarters 
West (in Albuquerque, New Mexico).  At the end of fiscal year (FY) 1999, IHS reported 
that EEO counselors handled 220 informal complaints/contacts, a relatively consistent 
number when compared to the previous 3 years. 
If informal EEO counseling does not resolve the matter, aggrieved parties can file a formal 
complaint.  In FY 1999, DHHS employees filed 395 formal complaints.  The IHS, 
National Institutes of Health (NIH) and Food and Drug Administration (FDA) account for 
nearly 70 percent of the total number of complaints.  In FY 1999, IHS employees filed 88 
4	 The Administrative Dispute Resolution Act of 1996 (P.L. 104-320) says that the mediator should 
be a neutral party and  may be a permanent or temporary officer or employee of the Federal 
Government or any other individual who is acceptable to the parties to a dispute resolution 
proceeding. A neutral shall have no official, financial, or personal conflict of interest with 
respect to the issues in controversy, unless such interest is fully disclosed in writing to all parties 
and all parties agree that the neutral may serve. A neutral who serves as a conciliator, facilitator, 
or mediator serves at the will of the parties. 
5	 This survey was mailed to a stratified random sample of 1,000 IHS employees with a response 
rate of 40%. 
10 
EEO AND IHS  OEI-05-99-00290  formal complaints, the second most complaints filed among the DHHS' OPDIVs. 
Employees of NIH filed 136 formal complaints and FDA employees filed 51.6  At the end 
of FY 1999, IHS had 192 open formal complaints, second only to NIH with 232 open 
formal complaints. 
In FY 1999, IHS employees filed a total of 308 formal and informal EEO complaints. 
Five Areas accounted for 70 percent of IHS EEO complaints: Navajo (79), Portland (47), 
Aberdeen (37), Oklahoma (28), Headquarters East (27). 
Bases for EEO Complaints 
Under EEO authorities, organizations must not discriminate against individuals on the 
basis of race, color, sex, religion, national origin, age or handicap.7 The leading 
categories of discrimination alleged in EEO IHS complaints in FY 1998 were: sex (41), 
age (36),  race (28), and national origin (25).  Employees also filed 57 complaints alleging 
reprisals were taken against them for filing complaints.  The issues most frequently raised 
in the 1998 EEO complaints were harassment, non-sexual (28), EPMS performance 
appraisal (25), promotion (21), and assignment of duties (18). 
SCOPE AND METHODOLOGY 
We evaluated the EEO process at Headquarters East and West, all 12 IHS Area Offices, 
and one Service Unit in each Area we visited.  We compared the EEO process at the Area 
Offices and both Headquarters to the standards established in EEO laws and regulations 
and to ASMBs EEO Complaints Processing Checklist.  We obtained available 
documentation for any of the issues IHS requested we reviewed. 
The sample included both informal and formal EEO complaints.  In Headquarters East and 
Oklahoma City, we reviewed 31 formal complaint files closed in the last 2 years.  We 
reviewed all of the available informal complaint files closed in the last 2 years at the Area 
Offices and Service Units, a total of 26 complaints. 
In each Area Office, Service Unit and headquarters, we reviewed EEO policies, 
procedures, complainant files, and any other documentation relating to the six issues we 
evaluated.  At each office, we spoke with all available EEO staff, counselors and IHS 
employees who had EEO complaints closed in the last 2 years.  We also met with Area 
and Service Unit directors, and a purposively selected sample of managers and other staff. 
Using structured discussion guides, we interviewed a total of 223 respondents.  A 
6  The NIH has 16,010 employees; the FDA has 9,500 employees. 
7  Indian Health Service Circular No. 85, Appendix A, pg. 12 
11 
EEO AND IHS  OEI-05-99-00290  breakdown of these respondents follows: 
C  IHS staff with EEO complaints closed after FY 1997 (20)

C  EEO staff and counselors (31)

C  EEO managers (10)

C  Area and Service Unit directors (24)

C  IHS non-management employees (73)

C  IHS managers (46)

C  IHS upper management (2)

C  Others involved in the EEO process including ASMB, the Investigations

Manager, the ADR contractor, and Office of General Counsel regional 
attorneys (17) 
We did not review any open EEO complaints.  We did not compare the IHS EEO 
program to other Department or Federal EEO programs except for numbers of complaints 
filed. 
Our review was conducted in accordance with the Quality Standards for Inspections 
issued by the President's Council on Integrity and Efficiency. 
12 
EEO AND IHS  OEI-05-99-00290  F I N D I N G S  
The IHS operates under four conditions which complicate 
the EEO complaints process: Indian Preference, 
Commissioned Corps, Tribal Contracting/Compacting, and 
Downsizing 
The IHS unique health care delivery system brings services to many diverse communities. 
Health care professionals and support staff from native populations, Commissioned Corps 
officers and others work together to serve Indian health care needs.  Laws governing the 
rights of tribes and Indians sometimes create misconceptions regarding the rights and 
responsibilities among these groups. 
During our on-site visits, we observed several situations pertaining to the EEO program 
caused by these misunderstandings.  These misunderstandings can lead to missed deadlines 
for filing and/or acting on complaints, wasted time and efforts for EEO staff and 
counselors, ill feelings among staff, workplace disruption and loss of productivity. 
Complaints involving the Indian Preference Law are being handled 
inappropriately through the EEO process 
In our discussions with respondents and observations we made during our site visits, we 
found that IHS employees are confused about the Indian Preference Law which provides a 
legal basis for preferential treatment to qualified Indian applicants and employees.8  Some 
non-Indian employees do not realize that Indian preference extends beyond hiring and 
applies to personnel actions (e.g., promotions).  These employees felt they were 
consistently discriminated against throughout their careers.  The EEO remedies do not 
apply to employees who believe they are treated unfairly primarily as a result of Indian 
preference being applied.  In these complaints, employees should file a personnel grievance 
or use any other grievance procedure negotiated with a recognized labor organization.9  In 
a few complaints we reviewed, we noticed that EEO counselors handling complaints 
involving Indian preference as the primary issue and erroneously treating them as EEO 
matters based on race. 
8  Civil Rights Act of 1964, Title VII, Section 703(i) 
9  Indian Health Service Circular No. 87-2. 
13 
EEO AND IHS  OEI-05-99-00290  Commissioned Corps EEO rules are still not understood in IHS, which may cause 
delays in resolving these EEO complaints 
Recent changes in handling EEO complaints from Commissioned Corps officers created 
confusion among EEO staff and counselors.10  The DHHS Personnel Instruction issued in 
August 1999 stipulates that Commissioned Corps officers must now file EEO complaints 
through the Commissioned Corps EEO process.11  However, from October 1996 to 
October 1998, Commissioned Corps officers followed the IHS EEO procedure.  Many 
EEO staff and counselors were unsure how to handle these EEO complaints from October 
1996 to August 1999 when new procedures for the Commissioned Corps went into effect. 
Some IHS staff do not understand they have, and have always had, the right to file an 
EEO complaint against a Commissioned Corps officer. 
Even though Commissioned Corps officers are now directed to use their own EEO 
process under the new procedures, IHS EEO counselors play a role in handling these 
complaints. Commissioned Corps officers who wish informal resolution of their 
complaints may either seek informal counseling through the IHS EEO office or may seek 
informal resolution through the Commissioned Corps administrative chain.12  Despite 
these changes, some IHS employees believe that Commissioned Corps officers are not 
entitled to use IHS EEO complaint processes. 
Employees rights to EEO under tribal contracting/compacting have not been 
legally determined, potentially limiting employees access to the EEO process 
The IHS actions to turn over the operation of IHS facilities to Indian tribes created 
additional disparities in treating EEO complaints.  The Indian Self-Determination and 
Education Assistance Act affords tribes the option to administer and operate IHS health 
services and programs in their communities, or remain in the IHS direct health system.13 
When tribes assume operations of these facilities, IHS employees working there become 
contracted Federal employees of the tribe. The right of contracted Federal employees to 
access IHS EEO has not been legally determined.  Headquarters East EEO believes that 
contracted employees are not covered, while other IHS managers and regional attorneys 
feel that these employees have a legal claim to IHS EEO services.  The Alaska Area Office 
makes EEO services available to employees under tribal management while other Area 
EEO offices do not. 
10  Nearly one of seven IHS employees is a Commissioned Corps officer.

11  The Commissioned Corps Personnel Manual Regulation CC46.1, p. 2

12  Ibid., p. 7

13  Public Law 93-638, as amended

14 
EEO AND IHS  OEI-05-99-00290  Downsizing restricted access to EEO services in some areas 
Although IHS workforce has remained relatively constant since 1993, there has been a 
reduction in the numbers of staff at Headquarters and Area Offices by more than 50 
percent.  As noted in the background, the level of EEO complaints has remained relatively 
constant, but there are now fewer EEO staff and counselors available to handle these 
complaints.  In looking for ways to consolidate positions during downsizing, IHS upper 
management allowed Area Offices to determine what duties would remain.  Consequently, 
each Area Office could determine how to staff the EEO position. Two Area Offices 
employ a full-time EEO manager while three Area Offices staff the position as a collateral 
duty.  Six Area Offices and Headquarters West share the services of an EEO manager. 
Inconsistencies in the EEO system result in unequal 
treatment of complaints 
Significant differences in the structure and approaches to handling complaints result from 
IHS dividing EEO responsibilities between Headquarters East and Oklahoma City and 
from Area Directors making their own EEO staffing decisions.  All Area Offices reporting 
to Headquarters East use an Area EEO manager and contracted investigators for all 
formal EEO complaints.  In contrast, Area Offices under Oklahoma City use the 
Oklahoma City EEO manager to manage their EEO process.  Instead of a full-time EEO 
manager, areas under Oklahoma City have either individual EEO counselors or employee 
relations specialists who serve as local EEO contacts.  In addition, these offices primarily 
use an EEO specialist in Oklahoma City to investigate formal complaints 
Acceptance of EEO complaints varies 
Based on our interviews and complaint reviews, there appears to be considerable 
differences regarding the acceptance of formal EEO complaints between Headquarters 
East and Oklahoma City.  Oklahoma City routinely rejects complaints for timeliness or 
other procedural reasons, while Headquarters East sometimes accepts complaints that do 
not always meet these standards.  Several IHS managers and regional attorneys 
volunteered that Headquarters East readily accepts complaints that do not have an EEO 
basis for complaint. 
Throughout IHS, many EEO staff and counselors understanding differs about what 
constitutes a basis for an EEO complaint.  Several regional attorneys believe that many 
EEO complaints are accepted that have no legal merit.  Area Offices differ in the way 
sexual harassment issues are handled as well.  One Area Office treats sexual harassment 
15 
EEO AND IHS  OEI-05-99-00290  as a conduct issue, rather than an EEO issue.14  Consequently, unlike sexual harassment 
complainants in other IHS sites, complainants in this area have no EEO redress for their 
complaints. 
Little alternative dispute resolution is being used to resolve EEO complaints 
We found little evidence of ADR being practiced.  The DHHS urges its OPDIVS to 
institute ADR processes aimed at resolving issues at the lowest possible level to avoid 
protracted and expensive litigation.  To provide mediation services during the informal 
complaint process, IHS contracts with the Departmental Appeal Board Mediation 
Program (DABMP).  In FY 1999, DABMP mediated 9 IHS complaints, a decrease from 
12 complaints the prior year and used $22,500 of the $65,000 allotted for travel to 
provide mediation services for IHS employees. 
The Phoenix Area Office employs a EEO complaint resolution process not used in other 
Area Offices or Service Units.  There, the EEO counselor meets with complainants to 
determine if a valid EEO issue exists or if another type of grievance should be filed.  If the 
counselor decides an EEO issue exists, the complaint is presented to a five-member 
management committee to determine what steps should be taken.  If complainants are not 
satisfied with the results, they can file formal EEO complaints.  While this model has been 
touted by Headquarters East to be an ADR model, this process does not follow 
conventional ADR principles and improperly involves management in the process.15 
Timeliness cannot be accurately determined due to the inconsistency and 
unavailability of records 
We were able to review some closed formal complaint files. In these cases, the dates 
recorded in the files indicated the cases were handled in a timely manner. However, 
several respondents reported instances where there were delays in processing their 
informal EEO complaints.  One complaint we reviewed showed that an EEO manager did 
not respond to an initial complaint made via e-mail until the complainant followed up 
months later.  Respondents had considerably more negative comments concerning timely 
actions and resolution on formal complaints than on informal complaints. 
14  According to Section 703, Title VII of the Civil Rights Act of 1964, as amended, sexual 
harassment is a form of discrimination for which an EEO complaint can be filed. 
15	 Recent EEOC guidance explains that involving supervisors in the mediation process may lead 
employees to feel that officials within the chain of command will more readily believe the 
supervisors version of events. In the case of Cheng-Canindin v. Renaissance Hotel Associates, 
et.al., the California Supreme Court held that a review panel consisting of managers and chosen 
without input from a complainant is inherently slanted in managements direction. (98 Daily 
Journal D.A.R. 13193) 
16 
EEO AND IHS  OEI-05-99-00290  The lack of uniformity in documentation and record retention on informal cases by EEO 
counselors is problematic.  We attempted to review informal complaint files at Area 
Offices or Service Units.  Files were unavailable in some sites and we could not always 
determine the timeliness or appropriateness of actions taken on complaints we reviewed. 
Collateral duties affect EEO counselors ability to complete their actions in a timely 
manner.  Nearly all EEO counselors we spoke with have collateral duties.  As a result, 
their EEO responsibilities are secondary to their primary jobs.  Collateral duties add to the 
difficulty in coordinating meetings with complainants and supervisors.  All parties involved 
may have different leave, travel or work schedules which can contribute to problems in 
meeting the mandated deadlines to respond to EEO complaints. 
Complaint reporting system is flawed 
The ASMB guidance to OPDIVS calls for a tracking system to help manage the

complaints process.  At a minimum, the system should be able to track and report ... case

status, prevent cases from getting lost, allow any staff member to find cases to provide

quick and accurate status reports, and identify problems or potential problems in work

flow.

The IHS listing of which EEO complaints are open or closed is inaccurate.  In our

attempts to review closed formal complaint files in Headquarters East and Oklahoma City,

we found that nearly one-third of the closed complaints we tried to review from that

listing were still open.

The EEO Area Offices maintain and track informal EEO complaints in different ways. 

The EEO counselors usually report to their EEO manager both when they receive an

informal complaint and when they complete their fact-finding.  But, when a complaint

proceeds to the formal stages, Headquarters East does not routinely advise EEO managers

in the Area Offices.  Similarly, the Oklahoma City EEO manager does not inform

counselors that a complaint has been accepted or rejected as a formal EEO complaint or

provide updates of the complaint status or final outcome.

The lack of a uniform reporting and tracking system also results in notification problems

for EEO complainants and others.  Very often, complainants do not know the status of

their complaints and may not hear how their complaints are resolved.16  If not informed of

the outcome of their informal complaints, complainants do not know whether or when

they may file a formal EEO complaint.  Those charged with discrimination may also be

unaware of the complaint outcome.  At the formal stages, not informing involved parties

16	 In one site we visited, the human resource person who handles informal EEO complaints advised 
that she tells complainants they may never hear how their complaint is resolved. A complainant 
verified this process during our interview. 
17 
EEO AND IHS  OEI-05-99-00290  of the status of their complaint can have repercussions involving filing appeals and the 
continued disruption to the workplace environment.  At present, MD-110 does not require 
this notification. 
The IHS EEO program lacks direction, potentially weakening 
its effectiveness 
IHS management has no systematic oversight of EEO staff or counselors 
The IHS EEO managers have no systematic way of knowing whether their staff or 
counselors act appropriately on individual informal or formal complaints.  Only two Area 
Office EEO managers exercise direct oversight of their counselors EEO activities.  They 
provide regular guidance for EEO policies and procedures, opportunities for training, 
monitor progress on individual complaints, and remind counselors of processing deadlines. 
Neither Headquarters East nor the Oklahoma City EEO manager directly supervise EEO 
activities occurring in Area Offices or Service Units. 
This lack of supervisory control allows counselors to unknowingly make incorrect 
decisions or conduct themselves in an unprofessional manner.  Some respondents said that 
some EEO counselors see themselves as either advocates or investigators, instead of 
impartial fact-gatherers.  A regional attorney pointed out that EEO counselors should not 
be making findings of discrimination.  Such improper actions make it very difficult, if not 
impossible, for DHHS to defend itself and may cost the agency considerable funds in 
settlements.  Several complainants said that during the course of settling their complaints, 
EEO staff raised their voices at them, trying to threaten or intimidate them. 
The lack of IHS management direction over EEO counselor selection results in an 
imbalance of counselor coverage throughout IHS.  Not all Area Offices or Service Units 
have EEO counselors.  While ASMB guidance to OPDIVS states that procedures should 
be in place to replace counselors as needed, IHS does not use a consistent method or 
particular protocol or criteria to select EEO counselors, nor specify the time allowed for 
EEO activities. 
Due to IHS decentralization, Area Directors and some Service Unit Directors now 
exercise considerable influence over EEO activities.  They hire EEO managers, counselors 
and support staff, approve training and travel and allocate physical space for EEO staff 
and counselors.  In some instances the Area Director or Service Unit Director appoints 
staff members to include EEO counseling as collateral to their regular duties.  In 
18 
EEO AND IHS  OEI-05-99-00290  other sites, counselors volunteer or are elected to assume EEO duties in addition to their 
regular jobs. 
Some respondents feel that IHS management does not provide sufficient technical 
direction to EEO staff and counselors.  A Headquarters East EEO respondent said their 
office does not provide unsolicited guidance to the field.  Some respondents indicated that 
the EEO system does not respond to their technical needs and that there is a 
communications gap between EEO management and Area staff.  Many Area Office and 
Service Unit EEO staff and counselors have infrequent contact with the EEO director in 
Headquarters East or the EEO manager in Oklahoma City. 
We found no evidence of any periodic self-evaluation by IHS of its own EEO process, 
although ASMB recently provided all OPDIVS with an EEO self-evaluation tool. 
Although IHS sampled some employees opinions in the 1998 Employee EEO Survey, 
they did not disseminate the survey results to EEO staff and counselors, or to other IHS 
managers and staff. 
Management involvement in individual EEO complaints is a conflict of interest 
and raises questions about EEOs impartiality 
The delegation of authority to Area Directors for EEO gave Area Directors line authority 
over EEO staff in their offices.  In many cases, EEO staff, counselors, or others involved 
with EEO informal complaints routinely provide specific complaint information to the 
Area or Service Unit Director.  In one file we reviewed, the EEO manager informed the 
Service Unit Director by letter of the status of the informal complaint.  In some Areas, the 
EEO manager, or in one case, a personnel specialist who tracks EEO complaints for the 
Area, routinely meets with the Area Director to provide detailed individual updates on 
formal and informal complaints.  The delegation of authority regarding EEO matters from 
IHS Headquarters to its Area Directors cannot encompass this extent of involvement on 
individual cases and is prohibited by 29 CFR 1614.105(g). 
Many IHS employees, both staff and management, told us they feel that the EEO staff and 
process are biased.  Area Directors must approve any EEO settlement of complaints 
involving managers in their Area, unless a settlement amount exceeds $10,000.  Some 
respondents expressed the feeling that since any monetary settlement on these EEO 
complaints must be paid from Area Directors operating funds, it may be difficult for the 
Area Director to be objective in these cases. 
Some respondents expressed concern that EEO counselors do not understand conflict of 
interest or how to handle an EEO complaint when conflict of interest is an issue.  As 
mentioned above, some EEO staff and counselors see themselves as advocates for either 
complainants or management.  According to MD-110, EEO counselors, EEO officers, 
and EEO managers cannot serve as representatives for complainants or for agencies in 
19 
EEO AND IHS  OEI-05-99-00290  connection with the processing of discrimination complaints as it is inconsistent with 
their neutral roles.  Appearances of conflict of interest, even if inaccurate, raise questions 
about EEOs impartiality.17  Two-thirds of the IHS respondents and 43 percent of the 
EEO staff and counselors said they are unfamiliar with the policy on conflict of interest. 
Personnels involvement with EEO is improper. 
Despite MD-110, which stipulates that the EEO process be separate from personnel 
functions, we found IHS personnel office staff directly involved in the handling of EEO 
complaints in several Area Offices.  Conflicts of interest between personnel and EEO exist 
because many EEO complaints arise out of personnel actions.  Most EEO counselors and 
managers are unaware that these types of conflict of interest represent a potential problem 
in handling EEO complaints.  In some cases, personnel staff investigate EEO complaints. 
Use of an in-house investigator appears to be a conflict of interest. 
According to MD-110, an EEO investigator should not occupy a position in the agency 
that is directly or indirectly under the jurisdiction of the head of that part of the agency in 
which the complaint arose.  This language may prohibit the EEO specialist from 
investigating complaints in the Oklahoma Area, all areas using Oklahoma City EEO 
services, and/or those naming the Area Director(s) in the complaint.  Oklahoma Citys use 
of an EEO specialist to investigate formal EEO complaints may represent a conflict of 
interest and an inability to maintain the appearance of being unbiased.18 
EEO staff and counselors feel they need additional training to effectively perform 
their jobs 
More than half of the EEO staff and counselors (57 percent) believe that they need 
intermediate level or refresher training to advance or maintain their skills.  Nearly half of 
the EEO counselors (49 percent) said that they had not received any training in several 
years.  One Service Unit EEO counselor said that he had to convince his supervisor to pay 
for EEO training out of their departments training funds, since there was no EEO money 
available for training.  This long-time counselor is resigning from his counselor duties, in 
part because of IHS failure to provide additional training. 
The ASMB guidance to OPDIVs indicates that agencies should review the adequacy of 
17	 In Ceriale v. Amco Insurance Company, the California Supreme Court vacated an arbitrators 
decision, based in part on their consideration of whether the record reveals facts which might 
create an impression of possible bias. (96 Daily Journal D.A.R. 9847) 
18  Management Directive-110, 5-5 C. 
20 
EEO AND IHS  OEI-05-99-00290  training provided to counselors and to provide refresher training if it is needed.  The IHS 
does not mandate training for its counselors beyond the basic EEO counselor training. 
The IHS does not require its EEO counselors to receive a core of training classes, nor to 
periodically test to certify their competency.  Some counselors are unsure of handling 
certain issues.  Counselors identified the following training needs: sexual harassment 
complaints, personnel issues, formal complaints, report writing, EEO law, mediation, 
ADR dispute resolution, the non-EEO grievance processes, and the bases for complaints 
handled by EEOC. 
Coordinating training is sometimes difficult for EEO counselors with collateral duties.  For 
many Service Unit counselors involved in direct patient care, finding both time to attend 
training and someone to perform their collateral duties becomes problematic.  Further, 
supervisors may be hesitant to grant them time away from their primary responsibilities to 
attend training and fulfill their EEO duties. 
Many IHS non-supervisory staff do not receive EEO training.  Counselors indicated that 
they are frequently faced with personnel grievance or working condition complaints from 
staff that do not qualify as a basis for an EEO complaint.  Many of the respondents we 
spoke with were unaware who their EEO counselors are,19 what actions might constitute 
an EEO violation, or what their EEO rights are.  Much of the EEO training is restricted to 
management staff.  Although managers may be required to attend these sessions, their 
work schedules may interfere with their ability to attend scheduled EEO training. 
Employee distrust of EEO is widespread throughout IHS and 
undermines its effectiveness 
Confidentiality is compromised 
Some Area and Service Unit Directors require identifying details from EEO managers or 
counselors when informal EEO complaints are filed.  This violates EEO rules of 
confidentiality.  Area and Service Unit Directors may wish to be informed when their 
managers may have stepped out of line or want to protect the complainant against 
reprisals.  However well-intentioned, unless the complainant has waived their right of 
confidentiality, this notification is improper.20  The IHS also violates EEO complainant 
confidentiality in its sexual harassment zero tolerance policy.  This policy requires that 
Area Directors, Service Unit Directors and EEO managers are to be notified of specific 
complaint details when an informal sexual harassment EEO complaint is filed. 
19	 The ASMB guidance to OPDIVS suggests one way to measure effectiveness is to determine if 
EEO counselors names and telephone numbers are publicized to employees. 
20  MD-110, Attachment A, Section A.1.a., pp 2-27. 
21 
EEO AND IHS  OEI-05-99-00290  Many respondents do not understand the EEO confidentiality standards.  Although many 
respondents said that complainants and supervisors named in a complaint most often 
violate confidentiality on their complaint, several respondents said that EEO counselors 
and staff also violate these standards.  Some respondents volunteered that they would not 
file an EEO complaint because of a perceived lack of confidentiality. 
Employees fear reprisals 
The EEOC advises Federal agencies must make assurances that employees who make 
complaints of harassment or provide information related to such complaints will be 
protected against retaliation.21 
Many IHS employees we spoke with feel that filing an EEO complaint will result in a 
reprisal by management.  Employees fear being ostracized, and or stigmatized as 
troublemakers.  Some employees report they are too intimidated to pursue EEO 
complaints. 
Nearly two-thirds of our respondents (62 percent), including some supervisory staff, 
indicated that they would not feel comfortable filing an EEO complaint, a considerably 
higher number than indicated in IHS 1998 Employee EEO Survey.  Some respondents are 
fearful of approaching EEO counselors with questions and of being seen going to the EEO 
office.  In response to this concern, Alaska Area Office management moved the EEO 
office to a floor separate from management.  One complainant, alluding to potential 
reprisals, pointed out that reading material on EEO complaint filing that is posted on a 
hallway bulletin board may not be the best way for employees to learn about the process. 
Employees believe that EEO and management are enmeshed 
Some employees feel that management plays too great a role in the EEO program and that 
it is a tool of management.  Others fear that the EEO counselor or EEO manager acts as a 
go-between to management.  Others articulated their perception that management usually 
wins EEO complaints.  Some respondents believe that the goal of IHS EEO is to defend 
the agency. 
Further, some employees fear that their confidentiality might be compromised due to 
managements role in the EEO process.  In a few instances, IHS managers function in the 
capacity of an EEO counselor.  A managers participation in this process and knowledge 
of a complainants identity establishes a potential avenue for reprisal or a means to inhibit 
the process on behalf of management. 
21	 EEOC guidance, June 18,1999 sets out standards of liabilities for employers for unlawful 
harassment by supervisors. 
22 
EEO AND IHS  OEI-05-99-00290  A few respondents indicated that they would pursue their EEO complaints elsewhere or 
take it to a higher level rather than at the Service Unit, because they did not believe they 
would get needed support.  In some cases, management prevented employees from seeing 
the EEO manager or counselor.  One manager required that an employee provide a weeks 
notice before approving time for the employee to see an EEO counselor. 
The IHS upper management plays little role in ensuring that EEO program goals are 
communicated and accomplished.  One Headquarters East manager indicated that most 
IHS managers support EEO, but because IHS is highly decentralized, upper management 
needs to get the EEO message to all managers and staff.  The bulk of the employees are at 
the Service Unit and any IHS message of EEO support does not get to the field offices. 
23 
EEO AND IHS  OEI-05-99-00290  R E C O M M E N D A T  I O N S  
The IHS EEO system functions with little oversight and direct guidance on implementing 
and executing EEO policies and procedures.  The structure and management of IHS EEO 
program contribute to problems concerning confidentiality, conflict of interest, reprisals 
and managements involvement in the EEO process.  Problems include a lack of 
management direction and oversight, inconsistent and inaccurate reporting system, 
minimal communication, and inadequate training.  In addition, most IHS staff is unaware 
of IHS upper management support of and commitment to EEO principles. 
Many respondents conveyed a lack of confidence in the EEO program.  They are 
intimidated and hesitant to use the system intended to protect their employment rights. 
Employees perceptions about the process, confidentiality and impartiality are vital to 
sustaining a credible, viable EEO program.  Employees must feel they can pursue a 
complaint with the confidence that it will be handled fairly, timely and confidentially by a 
well-trained EEO counselor, and that no adverse actions will be taken against them. 
Without overcoming widely-held perceptions of distrust, IHS EEO program cannot 
succeed. 
In order to have a more consistent, unified EEO program and complaints processing 
system which addresses the difficulties outlined above, we recommend that IHS: 
Address IHS-specific issues pertaining to Indian preference, commissioned 
corps, tribal compacting/contracting and downsizing 
C	 Issue a memo to all employees explaining the differences between Indian 
Preference and discriminatory practices 
C	 Issue a memo to all employees detailing the process for Commissioned Corps 
employees to file a compliant and the right to lodge complaints against 
Commissioned Corps employees 
C	 Obtain legal advice from the Office of the General Counsel and a definitive  ruling 
on the status of employees working under a Memorandum of Agreement with 
Tribal Organizations and their EEO rights 
C	 In consultation with ASMB, and based on comparisons with other Federal and 
Departmental agencies, provide firm guidance on the ratio of EEO counselors to 
staff, ensure that these counselors are hired and trained and that they are replaced 
timely when vacancies occur 
24 
EEO AND IHS  OEI-05-99-00290  Standardize the handling of EEO complaints 
C  Clarify and codify the roles and responsibilities of Headquarters East and 
Oklahoma City to their areas and each other 
C  Provide upper management supervision to both the EEO Director in Headquarters 
East and the EEO manager in Oklahoma city 
C	 Communicate and convey in a clear manner the bases for EEO complaints, the 
process to pursue complaints, and how to handle all issues including timeliness, 
confidentiality, and conflict of interest to all EEO staff and counselors 
C  Develop a specific ADR policy and process that is made available to all employees 
Improve counselor performance and supervision 
C  Increase EEO staffing levels, requirements and support to include at a minimum: 
<  A full-time EEO manager in each Area Office, reporting to Headquarters 
East or Oklahoma City 
<  A full-time EEO counselor in each Area Office and/or a full-time counselor 
who serves the entire Area or more than one Service Unit 
C	 Implement performance requirements and a standardized method for evaluating 
counselor performance for EEO managers, staff and counselors which are 
reviewed/conducted by the EEO Director in Headquarters East and/or the EEO 
manager in Oklahoma City 
C	 Establish counselor selection criteria   managers and personnel staff should not 
be counselors 
Standardize Complaint Reporting, Recording, and File Retention 
C  Standardize EEO policies and procedures for maintaining complaint data 
throughout EEO including an update of the 1985 EEO Policy Circular 
C  Create a standardized system so Headquarters and EEO field staff can track 
complaint status and generate reports 
Implement policy guidance on confidentiality 
C  Provide guidance on the role of Area and Service Unit directors in both the 
informal and formal stages and in sexual harassment cases 
C  Provide guidelines on the maintenance of counselors informal notes 
25 
EEO AND IHS  OEI-05-99-00290  Improve management oversight and accountability 
C	 Use ASMBs self-evaluation tool to help ensure the effective management of EEO 
complaints processing 
C	 Establish both short-term and long-term EEO goals and objectives to restore 
confidence in the EEO process by: 
<  mounting a national initiative that demonstrates IHS commitment to 
providing a discrimination-free workplace, where EEO matters can get 
quickly and fairly resolved 
<  publicizing the availability of counseling services and training 
<  regularly evaluating EEO goals and objectives 
C	 Provide sufficient staff in Headquarters East and Oklahoma City to carry out the 
recommendations contained in this report 
Eliminate conflicts of interest and the potential for conflicts of interest 
C	 Seek legal advice about the extent of EEO investigations allowed to be performed 
by an EEO specialist 
C	 Ensure that EEO settlements are paid from a central fund, rather than an Area 
Directors operating expenses, or otherwise ensure that an Area Director does not 
have decision-making authority over the settlement amount 
Improve communication and expand EEO training and educational opportunities 
to all IHS employees, EEO staff and counselors including 
C  Conduct a annual national meeting for EEO staff and counselors

C  Conduct regular area-wide regional meetings for EEO staff and counselors

C  The EEO manager in Oklahoma City, the EEO Director and Headquarters EEO

staff should regularly visit all Area Offices 
C	 The EEO manager in Oklahoma City, the EEO Director and Headquarters EEO 
staff should regularly communicate with Area Office EEO staff and counselors 
through e-mail, bulletins and training 
C  The EEO staff and counselors in Area Offices and Service Units should hold 
regularly scheduled information sessions, and updates to staff 
C  Assemble a comprehensive reference book for EEO counselors with information 
specific to IHS EEO concerns 
C  Establish an IHS-wide EEO web site 
C  Conduct training focusing on the bases for complaints and an explanation of the 
EEO process 
C  Establish a counselor training curriculum 
C  Conduct training to counselors at regular interval 
C  Conduct training that includes complaint prevention activities 
26 
EEO AND IHS  OEI-05-99-00290  C	 Offer interactive training for supervisors unable to attend in person because of 
work requirements or leave 
Increase employee trust in the EEO process 
C  Management must demonstrate through both words and actions a zero tolerance 
for reprisals 
C  Increase and make more visible upper managements commitment and support of 
the EEO program 
In order to ensure proper oversight and accountability, we also recommend that ASMBs 
Office of Human Resources EEO Programs Group provide technical assistance and 
guidance, as well as regular evaluations of IHS progress towards meeting their EEO 
goals and objectives. We recommend that: 
The ASMB EEO programs group should complete a 1 year follow-up evaluation 
on the implementation of the OIG recommendations and perform subsequent 
annual reviews 
27 
EEO AND IHS  OEI-05-99-00290  A G E N C Y   C O M M E N T S  
We received comments on the draft report from the Indian Health Service (IHS) and the 
Assistant Secretary for Management and Budget (ASMB).  Both concur with the vast 
majority of our 10 recommendations and the 34 ways of achieving them.  Where 
appropriate, we changed the report to reflect their comments.  The full IHS and ASMB 
comments are contained in Appendix B. 
The IHS believes our recommendations will provide opportunities for much needed 
improvement in the administration and management of the IHS EEO program.  The 
IHS actions to date include development of an EEO website, a Fact Sheet explaining 
differences between Indian Preference and Title VII discriminatory practices, and new 
EEO posters.  We appreciate the cooperation of IHS in conducting this inspection and 
look forward to working with IHS in the development of their action plan in response to 
our recommendations. 
Of the 34 ways of achieving the recommendations, IHS did not concur with the following 
four: 
The IHS does not concur with elevating EEO supervisory responsibilities to IHS 
Headquarters.  The IHS responded that they were unclear about the recommended 
organizational location of upper management.  To clarify, we are recommending that an 
IHS upper manager at Headquarters provide management supervision (line authority) to 
both the EEO Director in Headquarters East and the EEO manager in Oklahoma City to 
provide more accountability.  We are not recommending line authority over Area EEO 
Managers through Headquarters staff offices. 
The IHS does not concur with our recommendation to implement standardized 
performance requirements and evaluation methods for EEO managers, staff and 
counselors which are reviewed/conducted by the EEO Director in Headquarters East 
and/or the EEO manager in Oklahoma City.  It is unclear if IHS disagrees with our 
recommendation to implement performance requirements and evaluation methods and/or 
the line authority for evaluating performance.  In either case, in order to measure EEO 
staff improvement, we believe this recommendation is necessary. 
The IHS does not concur with our recommendations to establish a counselor selection 
criteria and to prohibit managers and personnel staff from becoming counselors.  We 
believe that regardless of whether objectivity can be maintained, having managers and 
personnel staff who are EEO counselors creates an appearance of a conflict of interest. 
This is detrimental to the ability of the IHS EEO program to establish an overall sense of 
28 
EEO AND IHS  OEI-05-99-00290  trust and impartiality among IHS employees. 
The IHS does not concur with our recommendation to ensure that EEO settlements are 
paid from a central fund, rather than an Area Directors operating expenses, or otherwise 
ensure that an Area Director does not have decision-making authority over the settlement 
amount.  We agree with IHS that, Areas related to each EEO issue should bear the cost 
of settling those issues.  However we believe that it creates a conflict of interest to have 
the Area Director decide the amount of the award. 
The ASMB concurs with the need to improve staff performance.  However,  they believe 
there are other ways of achieving staff supplements beside increased staffing levels and 
suggest that IHS consider term appointments, contracting and job sharing etc.  We agree 
that staff performance can be improved through various mechanisms and would encourage 
IHS to utilize any and all available to them. 
The ASMB does not concur with the recommendation that IHS ensure that EEO 
settlements are paid from a central fund, rather than an Area Directors operation 
expenses. While we agree with ASMB that Area Offices should be held accountable, we 
stand by our belief that an Area Directors ability to decide the monetary amount of a 
complaint settlement creates a conflict of interest. 
29 
EEO AND IHS  OEI-05-99-00290  APPENDIX A 
30 
EEO AND IHS  OEI-05-99-00290  31 
EEO AND IHS  OEI-05-99-00290  APPENDIX B 
32 
EEO AND IHS  OEI-05-99-00290  33 
EEO AND IHS  OEI-05-99-00290  34 
EEO AND IHS  OEI-05-99-00290  35 
EEO AND IHS  OEI-05-99-00290  36 
EEO AND IHS  OEI-05-99-00290  37 
EEO AND IHS  OEI-05-99-00290  38 
EEO AND IHS  OEI-05-99-00290  39 
EEO AND IHS  OEI-05-99-00290  40 
EEO AND IHS  OEI-05-99-00290  41 
EEO AND IHS  OEI-05-99-00290  42 
EEO AND IHS  OEI-05-99-00290