Department of Health and Human Services 
OFFICE OF 
INSPECTOR GENERAL 
INDIAN HEALTH SERVICE 
A Management Evaluation of 
Program Integrity and Ethics Functions 
JUNE GIBBS BROWN 
Inspector General 
NOVEMBER 1998 
OEI-04-97-00060  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 Atlanta Regional Office prepared this report under the direction of Jesse Flowers, Regional 
Inspector General, and Christopher Koehler, Deputy Regional Inspector General.  Principal OEI 
staff included: 
REGION  HEADQUARTERS 
Peggy Daniel, Project Leader  Al Levine, Program Specialist

Ron Kalil, Team Leader

Jackie Watkins, Program Analyst

Graham Rawsthorn, Program Analyst

Betty Apt, Program Analyst

To obtain copies of this report, please call the Atlanta Regional Office at (404) 562-7732. 
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 determine whether or not the program integrity and ethics function within the Indian Health 
Service is organized, staffed, and operating effectively. 
BACKGROUND 
Within the Department of Health and Human Services, the Indian Health Service (IHS) is the 
primary provider of health care to an estimated 1.4 million American Indians and Alaska Natives. 
The IHS employs about 14,000 people nationwide.  Its Fiscal Year 1997 budget was $2.3 billion. 
The program integrity and ethics staff have three major responsibilities.  They 
<  investigate complaints and allegations about IHS and tribal employees, 
<  perform ethics activities, and 
<  coordinate personnel suitability investigations. 
The IHS Director asked the Office of Inspector General to evaluate, for effectiveness, the 
operation of its program integrity and ethics function.  We did so by comparing IHS program 
integrity and ethics operations to those of four other organizations.  The four selected 
organizations were the Food and Drug Administration (FDA), National Institutes of Health 
(NIH), Centers for Disease Control and Prevention (CDC), and Health Resources and Services 
Administration (HRSA).  We also surveyed and interviewed staff  at IHS headquarters and 11 of 
its 12 area offices. 
FINDINGS 
The Mission, Policies, and Procedures for Program Integrity and Ethics Are Not Clear 
Staff at IHS headquarters seem to understand the mission, policies, and procedures for program 
integrity and ethics.  However, over half of the staff at area offices said the mission, policies, and 
procedures are not clear to them.  The IHS has not finalized its operating policies and procedures 
which have been in draft for over 2 12 years.  Over half of the IHS area offices had not received 
copies of the draft manual.  Because of confusion over policies and procedures, personnel 
suitability functions were not completed or not completed timely. 
Organizational Structure Obscures Visibility and Prominence 
The program integrity and ethics function is not clearly identifiable in the current organizational 
structure.  Its visibility and prominence was obscured during a March 1997 reorganization. 
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i  Organizational Placement Fragments Responsibility for Personnel Suitability 
Responsibility for one program integrity and ethics function--personnel suitability is fragmented. 
The conduct of personnel suitability investigations is shared by several IHS components.  IHS 
policies and procedural guidance does not clearly delineate the specific responsibilities of each 
organization, or the processes for sharing responsibilities. The four other organizations we 
reviewed all placed the personnel suitability function in one office--Division of Human Resources. 
Staffing May Be Inadequate 
The IHS had one program integrity and ethics staff member for every 4,666 agency employees. 
This ratio was less than that of any of the other four organizations we reviewed. 
RECOMMENDATIONS 
Effective administration of IHS program integrity and ethics function can be improved by 
clarifying responsibilities, and enhancing visibility and prominence within the organization. 
We recommend that the IHS Director 
<	 Finalize its policies and procedures manual and distribute it to all offices as soon as 
possible.  The manual should clearly delineate the integrity and ethics responsibilities of all 
IHS components, and procedures for components to follow in carrying out IHS' overall 
policy. 
<	 Disseminate materials such as letters, brochures, and pamphlets to all IHS staff.  Such 
materials should explain the program integrity and ethics functions and how they are 
carried out. 
Regarding the question on adequacy of staff for effective accomplishment of program integrity 
and ethics functions, we recognize that this difficult decision can only be made by IHS 
management.  In making the decision, management must consider many variables, including the 
relative importance of all organizational goals and objectives, the priority use of limited staff 
resources for accomplishment of those goals and objectives, and the relative strengths of assigned 
staff.  Simply increasing staff size may or may not be the solution for meeting IHS program 
integrity and ethics objectives, although this may be one consideration.  Another option that 
management could consider is transferring some functions to other organizational components. 
For example, the personnel suitability function could be transferred to the Division of Human 
Resources.  These and other such staffing options could help assure effective and timely 
completion of IHS program integrity and ethics objectives. 
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ii  AGENCY COMMENTS 
We received comments from the Assistant Secretary for Management and Budget (ASMB) who 
concurred with our recommendation that IHS finalize its policies and procedures manual and 
distribute it to all offices as soon as possible.  However, ASMB raised questions about the 
significance of our original finding on the organizational location of the personnel suitability 
function.  We revised our findings to emphasize that the unspecified sharing of duties and 
responsibilities among the two components has resulted in confusion and inconsistent 
administration of the personnel suitability duty. 
The IHS did not comment on the draft report, but plans to provide comments on the final report. 
Appendix C shows the full text of ASMBs comments. 
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iii  T A B L E  O F  C O N T E N T S

PAGE 
EXECUTIVE SUMMARY

INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

FINDINGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Mission, Policies, Procedures Unclear  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Visibility and Prominence Obscured . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Personnel Suitability Responsibility Fragmented.  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Staffing May Be Inadequate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  7

RECOMMENDATIONS  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

AGENCY COMMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  10

APPENDICES

Former Organizational Charts  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1

Current Organizational Charts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-1

Text of Agency Comments  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-1
 I N T R O D U C T I O N

PURPOSE 
To determine whether or not the program integrity and ethics function within the Indian Health 
Service is organized, staffed, and operating effectively. 
BACKGROUND 
Indian Health Service 
Within the Department of Health and Human Services, the Indian Health Service (IHS) is the 
primary provider of health care to an estimated 1.4 million American Indians and Alaska Natives. 
The IHS employs about 14,000 people nationwide.  Its Fiscal Year 1997 budget was $2.3 billion. 
Program Integrity and Ethics 
The program integrity and ethics staff is located in IHS headquarters in Rockville, Maryland. 
Organizationally, program integrity and ethics is located within the Office of Management 
Support.  The Office of Management Support is one of three major components of the IHS.  The 
two remaining components are the Office of Director and Office of Public Health. 
The program integrity and ethics staff have three major responsibilities.  They 
<  investigate complaints and allegations about IHS and tribal employees, 
<  perform ethics activities, and 
<  coordinate personnel suitability investigations. 
Complaints and allegations may be submitted to the IHS or referred by the Office of Inspector 
General, Office of  Investigations.  Ethics activities include providing ethics training, coordinating 
outside activities reports and financial disclosure reports.  Personnel suitability generally refers to 
verification of a person's character, reputation, trustworthiness, and fitness for Federal service. 
METHODOLOGY 
The IHS Director asked the Office of Inspector General (OIG) to conduct a management review 
on the effectiveness of the organization of its program integrity and ethics function. 
Specifically, the IHS Director asked us to determine whether or not the IHS program integrity 
and ethics function is organized, staffed, and operating effectively.  We did so by comparing the 
operations of IHS' program integrity and ethics function to the program integrity and ethics 
operations of four other organizations.  The organizations selected for comparison were the Food 
and Drug Administration (FDA), National Institutes of Health (NIH), Centers for Disease Control 
and Prevention (CDC), and Health Resources and Services Administration (HRSA). 
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1  At IHS and each selected organization, we examined the organizational structure, staffing 
numbers and types, workload, policies, and operating procedures and practices.  At each selected 
organization, we conducted on-site reviews of program integrity and ethics operations. 
We also obtained opinions from staff at IHS headquarters, including the program integrity and 
ethics staff, and 11 of the 12 IHS area offices.1  One area office did not respond to our survey. 
We personally interviewed IHS headquarters staff and the staff of one area office during on-site 
reviews.  We obtained operating data and opinions from staff at the remaining ten area offices 
through use of a mail survey questionnaire.  As necessary for clarification, we followed up by 
conducting telephone interviews with area office staff. 
We also conducted telephone interviews with OIG hotline staff to determine referral and 
investigative procedures for allegations and complaints about the IHS, and for the other 
organizations.  Further, we interviewed, by telephone, staff at the Office of Government Ethics to 
determine its relationship with the IHS and other organizations on ethics requirements. 
Finally, we reviewed mission statements, policies, procedures, and program operations at the IHS 
for the program integrity and ethics function, and at each organization selected for comparison. 
---------------
We conducted our inspection between April 1997 and August 1997.  We conducted the 
inspection in accordance with Quality Standards for Inspections issued by the President's Council 
on Integrity and Efficiency. 
1The 12 Area Offices are Aberdeen, Albuquerque, Alaska, Bemidji, Billings, California, Nashville, 
Navajo, Oklahoma City, Phoenix, Portland, and Tucson. 
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2  F I N D I N G S

MISSION, POLICIES, AND PROCEDURES ARE NOT CLEAR 
Staff at IHS headquarters seem to understand the mission, policies, and procedures for program 
integrity and ethics.  However, over half of the staff at area offices said the mission, policies, and 
procedures are not clear to them.  They did not understand what the program integrity and ethics 
staff was expected to accomplish, or how it operated.  Staff at a few area offices said they have 
limited communications with the program integrity and ethics staff because they do not 
understand the purpose and procedures.  Staff at one area office said training is needed to help 
clarify the role of the program integrity and ethics staff. 
IHS Has Not Finalized Policies and Procedures 
One reason the mission, policies, and procedures are not clear for the program integrity and ethics 
function is that the IHS has not published final operating policies and procedures.  At the time of 
our inspection, the policies and procedures manual had been in draft for over 2 12 years. 
More significantly, over half of area office staff responding to our inspection survey said they had 
not been provided copies of the draft manual. 
Also, the draft manual itself needs further revisions.  It covers a wide range of program integrity 
and ethics functions, but policies and procedures for some functions appear to be incomplete.  To 
illustrate, the draft policies and procedures manual requires the program integrity and ethics staff 
to receive, investigate, and track complaints received through the OIG hotline referral process. 
However, it is silent on what to do with complaints that are received directly by area offices. 
Likewise, the manual lacks clarity on the responsibilities, relationships, and procedures for IHS 
components that share program integrity and ethics duties. 
To illustrate, IHS area office staff have directly received complaints and allegations about IHS 
employees.  The area office staff did not refer such complaints to the program integrity and ethics 
staff, nor did they notify them of the existence or resolution of complaints.  The area office staffs 
told us they do not coordinate with the program integrity and ethics staff on complaints they 
receive directly because they have not been instructed to do so.  As a result, the program integrity 
and ethics staff may be unaware of any complaints and allegations received directly by area 
offices. 
Lack of Clarity in IHS Draft Policies and Procedures Leads to Inefficiencies and 
Ineffectiveness Particularly for Personnel Suitability 
IHS area offices, program integrity and ethics staff, and Division of Human Resources share 
certain responsibilities for personnel suitability investigations with the Federal Office of Personnel 
Management (OPM).  The area offices work with OPM to review cases for area office positions. 
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3  However, the program integrity and ethics staff also review some area office cases, and those for 
headquarters positions.  Likewise, the IHS program integrity and ethics staff share responsibilities 
with OPM and the IHS Division of Human Resources for processing personnel suitability cases 
within the IHS. 
Responsibilities Are Not Clearly Delineated Between IHS Organizational Components 
The overlapping and sharing of responsibilities within and outside the IHS does not necessarily 
create inefficiency or ineffectiveness.  However, IHS policies and procedural guidance does not 
clearly delineate the specific responsibilities of each organization, or the processes for sharing 
responsibilities. 
As a result, personnel suitability case investigations do not flow smoothly and timely through the 
organization.  To illustrate, the OPM normally sends personnel suitability cases for 2 of the 11 
area offices directly to the appropriate area office rather than to the program integrity and ethics 
staff.  This procedure seems to conflict with IHS draft policy and procedure guidance.  However, 
this seems to be the procedure preferred by most area office staff. 
Conversely, the OPM normally sends personnel suitability cases for 8 of the 11 area offices to 
IHS program integrity and ethics staff.  This procedure seems to be consistent with IHS draft 
policy manual.  However, area office staffs said that they prefer OPM to send the cases directly to 
the area office. 
Staff at the remaining area office said they did not know whether or not OPM normally sends 
personnel suitability cases to its area office or to the program integrity and ethics staff. 
Routing Personnel Suitability Cases Through Program Integrity and Ethics Staff May Be 
Unnecessary and Ineffective 
In instances where OPM sent area office cases to the program integrity and ethics staff, that staff 
largely performed only a pass-thru function.  The cases typically were not reviewed by the 
program integrity and ethics staff, but instead were rerouted to the appropriate area office for 
review. 
Area office staffs said that routing personnel suitability cases through the program integrity and 
ethics staff is an unnecessary step that makes the review and approval process untimely.  Further, 
some said that the program integrity and ethics staff were not always timely in rerouting cases to 
the appropriate area offices for their review. 
For example, staff at one area office said the program integrity and ethics staff took about a year 
to route some cases to them.  Staff at another area office said the program integrity and ethics 
staff routed them the personnel suitability cases for another area office.  Thus, the personnel 
suitability reviews were not completed timely. 
Finally, area office staffs seemed confused about which organizational component had what 
responsibility.  To illustrate, staff at 8 of the 11 area offices responding to our survey said they 
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4  contact and rely on the Division of Human Resources for help with personnel suitability issues. 
The remaining 3 said they use the program integrity and ethics staff.  This practice may or may 
not result in communication of consistent information and guidance to area offices on personnel 
suitability issues. 
ORGANIZATIONAL STRUCTURE OBSCURES VISIBILITY AND PROMINENCE 
Prior to March 1997, program integrity and ethics was a staff function under the IHS Office of 
Administration and Management (See Chart 1).  According to some IHS staff, this organizational 
scheme gave the program integrity and ethics function a clearly visible, identifiable position on 
IHS' organizational chart.  Appendix A provides a detailed organizational chart. 
CHART 1

FORMER ORGANIZATIONAL CHART

OFFICE OF THE DIRECTOR 
OFFICE OF  OFFICE OF 
OFFICE OF  OFFICE OF  OFFICE OF 
PLANNING,  OFFICE OF  OFFICE OF  HEALTH  OFFICE OF 
ADMINISTRATION  ENVIRONMENTAL  INFORMATION 
EVALUATION  TRIBAL  HEALTH  PROGRAM  HUMAN 
AND  HEALTH AND  RESOURCES 
AND  ACTIVITIES  PROGRAMS  RESEARCH AND  RESOURCES 
MANAGEMENT  ENGINEERING  MANAGEMENT 
LEGISLATION  DEVELOPMENT 
PROGRAM INTEGRITY 
AND ETHICS STAFF 
The visibility and prominence of the program integrity and ethics function was obscured, 
however, during a March 1997 reorganization (See Chart 2).  At that time, the program integrity 
and ethics function was blended into the Office of Management Support.  The program integrity 
and ethics function is no longer clearly visible on the organizational chart.  The oversight and 
results of the program integrity and ethics function flow through the Director, Office of 
Management Support.  Appendix B provides a more detailed organizational chart. 
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5  CHART 2

CURRENT ORGANIZATIONAL CHART

OFFICE OF THE 
DIRECTOR 
OFFICE OF 
OFFICE OF PUBLIC 
MANAGEMENT 
HEALTH 
SUPPORT 
DIVISION OF  DIVISION OF  DIVISION OF  DIVISION OF  DIVISION OF  DIVISION OF  DIVISION OF 
ADMINISTRATIVE  FINANCIAL  ACQUISITION AND  HUMAN  INFORMATION  REGULATORY  HEALTH 
SUPPORT  MANAGEMENT  GRANTS  RESOURCES  TECHNOLOGY  AND LEGAL  PROFESSIONS 
MANAGEMENT  SUPORT  AFFAIRS 
As can be seen, the new organizational chart does not specifically identify the location of program 
integrity and ethics staff.  A May 1997 Office of Government Ethics review also pointed out the 
lack of visibility and prominence for the program integrity and ethics function in the revised 
organizational structure. 
ORGANIZATIONAL PLACEMENT FRAGMENTS RESPONSIBILITY FOR 
PERSONNEL SUITABILITY 
In the March 1997 reorganization, the IHS placed both the program integrity and ethics staff and 
the Division of Human Resources staff under one head--the Office of Management Support. 
Therefore, after the reorganization, the Director, Office of Management Support had overall 
responsibility for integrity, ethics, and personnel suitability functions.  Within that Office, 
however, the personnel suitability function remains fragmented between the Directors Office and 
the Division of Human Resources.  Those duties are also shared by area offices.  As observed 
elsewhere in this report, this unspecified sharing of duties has resulted in confusion and 
inconsistent administration of duties. 
We observed that the selected organizations we reviewed all located the personnel suitability 
function in one office.  They generally chose to locate this function in the Office of Human 
Resources.  (See Table 1).  We did not evaluate the efficiency and effectiveness of the personnel 
suitability function in the selected organizations, however, it seems logical that they chose not to 
fragment such functions. 
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6  TABLE 1

ORGANIZATIONAL LOCATION OF PROGRAM INTEGRITY AND

ETHICS FUNCTIONS

FUNCTION  IHS  FDA  CDC  NIH  HRSA 
Integrity  Office of  Commissioner's  Office of  Office of  Office of 
(Complaints)  Management  Office  Management  Management  Management & 
Support  Operations  Assessment  Program Support 
Ethics  Office of  Office of  Office of  Office of  Office of Human 
(Training and  Management  Human  Human  Human  Resources 
Other  Support  Resources  Resources  Resources 
Activities) 
Personnel  Office of  Office of  Office of  Office of  Office of Human 
Suitability  Management  Human  Human  Human  Resources 
Support  Resources  Resources  Resources 
STAFFING MAY BE INADEQUATE 
Program Integrity and Ethics Staffing Is Smaller than That of Other Organizations 
At June 17, 1997, IHS had 1 program integrity and ethics staff member for every 4,666

employees in the agency.  This ratio of program integrity and ethics staff to agency

employees was much less than that of any of the other four selected organizations we examined

(See Table 2). 

Our finding corroborated findings reported by the Office of Government Ethics in its 1997 report.

TABLE 2

COMPARISON OF IHS HEADQUARTERS PROGRAM INTEGRITY AND ETHICS

STAFFING TO THAT OF OTHER SELECTED ORGANIZATIONS

Headquarters Staff Assigned  Ratio of Integrity, Ethics, and 
Agency  to Integrity, Ethics, and  Personnel Suitability Staff to 
Agency  Employees  Personnel Suitability  Agency Employees 
IHS  14,000  3  1:4,666 
FDA  9,000  29  1:310 
CDC  6,000  11  1:545 
NIH  17,000  16  1:1,062 
HRSA  1,800  2  1:90 
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7  Program Integrity and Ethics Staffing Has Decreased Over the Past Few Years
From December 1993 to June 1997, IHS' program integrity and ethics staffing decreased from
seven staff members to three (See Chart 3).
CHART 3
 PROGRAM INTEGRITY AND ETHICS STAFFING
Number of Staff
Functions Were Not Completed Timely
The Office of Government Ethics reported in 1997 that certain ethics functions had not been
completed, or were not completed timely--particularly financial disclosures and training functions. 
The Office of Government Ethics expressed concern that IHS had not allocated sufficient staffing
resources to administer such ethics functions, while also administering integrity functions.  At the
time, IHS had four members assigned to its program integrity and ethics function.
Our findings corroborated those of the Office of Government Ethics.2  Also, we found that IHS
had not responded timely to OIG hotline complaints about IHS employees and programs.  Some
IHS staff told us that integrity and ethics functions were not completed timely because the small
program integrity and ethics staff gave priority to the personnel suitability function. However, as
discussed earlier in this report, personnel suitability investigations were also not always done in a
timely manner.
Coordinating and investigating personnel suitability, according to IHS headquarters staff, requires
significant staff resources.  To illustrate, the Indian Child Protection and Family Violence
Prevention Act requires character investigations on all individuals who have regular contact with,
or control over Indian children.  Also, such investigations must be done for every potential IHS
employee.  Therefore, little time is left for program integrity and ethics staff to do other functions.
2Office of General Counsel, Office of Government Ethics, United States Department of Health and Human
Services, Office of Government Ethics Review of IHS Ethics Program, May  6, 1997.
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8 R E C O M M E N D A T I O N S

Effective administration of IHS program integrity and ethics function can be improved by 
clarifying responsibilities, and enhancing visibility and prominence within the organization. 
We recommend that the IHS Director 
<	 Finalize its policies and procedures manual and distribute it to all offices as soon as 
possible.  The manual should clearly delineate the integrity and ethics responsibilities of all 
IHS components, and procedures for components to follow in carrying out IHS' overall 
policy. 
<	 Disseminate materials such as letters, brochures, and pamphlets to all IHS staff.  Such 
materials should explain the program integrity and ethics functions and how they are 
carried out. 
Regarding the question on adequacy of staff for effective accomplishment of program integrity 
and ethics functions, we recognize that this difficult decision can only be made by IHS 
management.  In making the decision, management must consider many variables, including the 
relative importance of all organizational goals and objectives, the priority use of limited staff 
resources for accomplishment of those goals and objectives, and the relative strengths of assigned 
staff.  Simply increasing staff size may or may not be the solution to meeting IHS program 
integrity and ethics objectives, although this may be one consideration.  Another option that 
management could consider is transferring some functions to other organizational components. 
For example, the personnel suitability function could be transferred to the Division of Human 
Resources.  These and other such staffing options could help assure effective and timely 
completion of IHS program integrity and ethics objectives. 
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9  A G E N C Y  C O M M E N T S

We received comments from the Assistant Secretary for Management and Budget (ASMB) who 
concurred with our recommendation that IHS finalize its policies and procedures manual and 
distribute it to all offices as soon as possible.  However, ASMB raised questions about the 
significance of our original finding on the organizational location of the personnel suitability 
function.  We revised our findings to emphasize that the unspecified sharing of duties and 
responsibilities among the two components has resulted in confusion and inconsistent 
administration of the personnel suitability duty. 
The IHS did not comment on the draft report, but plans to provide comments on the final report. 
Appendix C shows the full text of ASMBs comments. 
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10  A P P E N D I X  A

FORMER ORGANIZATIONAL CHARTS

POLICY REVIEW AND 
COORDINATION STAFF 
OFFICE OF THE 
COMMUNICATIONS STAFF 
DIRECTOR
EQUAL EMPLOYMENT 
OPPORTUNITY AND CIVIL 
RIGHTS STAFF 
OFFICE OF TRIBAL 
SELF-GOVERNANCE 
OFFICE OF  OFFICE OF  OFFICE OF  OFFICE OF  OFFICE OF  OFFICE OF  OFFICE OF  OFFICE OF 
ADMINISTRATION  PLANNING,  TRIBAL  HEALTH  ENVIRONMENTAL  HEALTH  INFORMATION  HUMAN 
EVALUATION  HEALTH AND  PROGRAM  RESOURCES 
AND  ACTIVITIES  PROGRAMS  RESOURCES 
AND  ENGINEERING  RESEARCH AND  MANAGEMENT 
MANAGEMENT  LEGISLATION  DEVELOPMENT 
AREA 
OFFICES 
OFFICE OF  PROGRAM 
ADMINISTRATION  INTEGRITY 
AND MANAGEMENT  AND ETHICS 
D IVISI ON OF  DIVIS ION OF  DIVISION OF  DIVIS ION O F  DIVISION OF  DIVISION OF 
MANAGEM ENT  AD MINI STRATIVE  RESOURCES  CONT RACT S AND  SUPPLY  ACQU ISIT ION AND 
POL ICY  SERVIC ES  MANAGEM ENT  GRANTS  M ANAGE MENT  GRA NTS 
M ANAGEM ENT  OPERATIONS 
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A - 1  A P P E N D I X  B

CURRENT ORGANIZATIONAL CHARTS 
OFFICE OF THE 
DIRECTOR 
OFFICE OF 
OFFICE OF 
MANAGEMENT 
PUBLIC HEALTH 
SUPPORT 
OFFICE OF 
MANAGEMENT 
SUPPORT 
MANAGEMENT 
EXECUTIVE 
POLICY SUPPORT 
SECRETARIAT 
STAFF 
DIVISION OF  DIVISION OF  DIVISION OF 
DVISION OF  DIVISION OF  DIVISION OF  DIVISION OF 
ACQUISITION AND  INFORMATION  REGULATORY 
ADMINISTRATIVE  FINANCIAL  HUMAN  HEALTH 
GRANTS  TECHNOLOGY  AND LEGAL 
SUPPORT  MANAGEMENT  RESOURCES  PROFESSIONS 
MANAGEMENT  SUPPORT  AFFAIRS 
(Note that the program integrity and ethics staff cannot be identified on this organizational chart.) 
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B - 1  A P P E N D I X  C

ASMB COMMENTS

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C - 1
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C - 2
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C - 3