35012 Federal Register / Vol. 83, No. 142 / Tuesday, July 24, 2018 / Notices 

Columbia, Court of Federal Claims No: 

18–0797V 

11. Lisa Taylor, Elyria, Ohio, Court of Federal 

Claims No: 18–0798V 

12. Scott Germaine on behalf of C.G., 

Richmond, Texas, Court of Federal 

Claims No: 18–0800V 

13. Crystal Jensen, Tacoma, Washington, 

Court of Federal Claims No: 18–0802V 

14. Christian M. Hayes, Helena, Montana, 

Court of Federal Claims No: 18–0804V 

15. Matthew Hussong, Davenport, Iowa, 

Court of Federal Claims No: 18–0805V 

16. Gordon Ernst, Washington, District of 

Columbia, Court of Federal Claims No: 

18–0806V 

17. Susan V. Torrey, Nampa, Idaho, Court of 

Federal Claims No: 18–0807V 

18. George Segal, Austintown, Ohio, Court of 

Federal Claims No: 18–0809V 

19. Balbina Ibe, Fountain Valley, California, 

Court of Federal Claims No: 18–0810V 

20. James Clark, Marietta, Georgia, Court of 

Federal Claims No: 18–0813V 

21. Jiaqian Wu, Houston, Texas, Court of 

Federal Claims No: 18–0814V 

22. Michelle Marie Cobenias, Red Lake, 

Minnesota, Court of Federal Claims No: 

18–0815V 

23. Ali Fadhil, M.D., Chicago, Illinois, Court 

of Federal Claims No: 18–0816V 

24. Calvin Johnson, Washington, District of 

Columbia, Court of Federal Claims No: 

18–0817V 

25. Willis H. Gibbs, Murfreesboro, Tennessee, 

Court of Federal Claims No: 18–0818V 

26. Edward A. Clendon, Greensboro, North 

Carolina, Court of Federal Claims No: 

18–0819V 

27. Daniel Hedlund, Minneapolis, Minnesota, 

Court of Federal Claims No: 18–0820V 

28. Ashley T. Hunsucker, Stanfield, North 

Carolina, Court of Federal Claims No: 

18–0821V 

29. Esther Mutema, Poughkeepsie, New York, 

Court of Federal Claims No: 18–0822V 

30. Mary Ligouri, Phoenix, Arizona, Court of 

Federal Claims No: 18–0824V 

31. Jerome Debeltz, Ely, Minnesota, Court of 

Federal Claims No: 18–0825V 

32. Brandi Blessike and Barry Blessike on 

behalf of B.B., Alpharetta, Georgia, Court 

of Federal Claims No: 18–0827V 

33. Erica Turner, Macon, Georgia, Court of 

Federal Claims No: 18–0828V 

34. Kimberly A. Purtill, Charlotte, North 

Carolina, Court of Federal Claims No: 

18–0832V 

35. Susan Wigley, Aurora, Colorado, Court of 

Federal Claims No: 18–0834V 

36. Donald Sipes, Camp Hill, Pennsylvania, 

Court of Federal Claims No: 18–0835V 

37. Ana Marie Provencio, Phoenix, Arizona, 

Court of Federal Claims No: 18–0836V 

38. Angela Overall, Vancouver, Washington, 

Court of Federal Claims No: 18–0838V 

39. Mary Miceli, Staten Island, New York, 

Court of Federal Claims No: 18–0839V 

40. Ronald Schneider, Union Grove, 

Wisconsin, Court of Federal Claims No: 

18–0843V 

41. Michelle Daniels, Marysville, 

Washington, Court of Federal Claims No: 

18–0850V 

42. Dennis Long, Springfield, Illinois, Court 

of Federal Claims No: 18–0857V 

43. Bruce A. Ling, J.R., Quincy, Florida, 

Court of Federal Claims No: 18–0858V 

44. Marianne Simeneta, Augusta, Georgia, 

Court of Federal Claims No: 18–0859V 

45. Donna Skwiat, Jackson, New Jersey, Court 

of Federal Claims No: 18–0865V 

46. Elizabeth McCann, Huntington Valley, 

Pennsylvania, Court of Federal Claims 

No: 18–0866V 

47. Rhett Malpass, Troy, Michigan, Court of 

Federal Claims No: 18–0867V 

48. Kellee Matlock, Washington, District of 

Columbia, Court of Federal Claims No: 

18–0868V 

49. Morgan Tirone, Englewood, New Jersey, 

Court of Federal Claims No: 18–0869V 

50. Tonya DeCoursey, Washington, District of 

Columbia, Court of Federal Claims No: 

18–0870V 

51. Jim B. Bynum, Panama City Beach, 

Florida, Court of Federal Claims No: 18– 

0874V 

52. Timothy J. Loken on behalf of G.L., 

Charlotte, North Carolina, Court of 

Federal Claims No: 18–0876V 

53. Tiffany Wilson, Phoenix, Arizona, Court 

of Federal Claims No: 18–0877V 

54. Christy L. Harrup, Greensboro, North 

Carolina, Court of Federal Claims No: 

18–0880V 

55. Mindy Lawson, Washington, District of 

Columbia, Court of Federal Claims No: 

18–0882V 

56. Kelsey Reed, London, Kentucky, Court of 

Federal Claims No: 18–0884V 

57. Patricia L. Guzowski, Notre Dame, 

Indiana, Court of Federal Claims No: 18– 

0885V 

58. Janardhana Donga, Sacramento, 

California, Court of Federal Claims No: 

18–0886V 

59. Lisa Sargent, Washington, District of 

Columbia, Court of Federal Claims No: 

18–0888V 

60. Daniel E. Bragg, Portland, Maine, Court 

of Federal Claims No: 18–0890V 

61. Margaret Mitchell, Woodbury, 

Massachusetts, Court of Federal Claims 

No: 18–0892V 

62. Candace M. Berlin, Winter Haven, 

Florida, Court of Federal Claims No: 18– 

0893V 

63. Jeffrey Foster on behalf of B.N.F., 

Chattanooga, Tennessee, Court of Federal 

Claims No: 18–0904V 

64. Catherine M. Raby, Nampa, Idaho, Court 

of Federal Claims No: 18–0906V 

65. Audrey Henning, Ocean City, New Jersey, 

Court of Federal Claims No: 18–0907V 

66. Carla Pavao, Hudson, Massachusetts, 

Court of Federal Claims No: 18–0908V 

67. Rachelle Meyers, Summit, New Jersey, 

Court of Federal Claims No: 18–0909V 

68. Charles W. Morrill, West Covina, 

California, Court of Federal Claims No: 

18–0910V 

69. Michael Volle, Burgettstown, 

Pennsylvania, Court of Federal Claims 

No: 18–0911V 

70. Nicole Webb, Chicago, Illinois, Court of 

Federal Claims No: 18–0912V 

71. Anderson Roy Dunn, III, North Bend, 

Washington, Court of Federal Claims No: 

18–0913V 

72. Adam Salky, Los Angeles, California, 

Court of Federal Claims No: 18–0914V 

73. Brandon Keck and Jessica Cook on behalf 

of A.K., Fort Riley, Kansas, Court of 

Federal Claims No: 18–0915V 

74. Jessica Sobczyk on behalf of I.S., San 

Antonio, Texas, Court of Federal Claims 

No: 18–0917V 

75. Mary Freehling, Vienna, Virginia, Court 

of Federal Claims No: 18–0918V 

76. Maria Jill Vandergriff and Jon-Michael 

Vandergriff on behalf of Roark 

Vandergriff, Deceased, Vienna, Virginia, 

Court of Federal Claims No: 18–0919V 

77. Kevin Delapaz, Vienna, Virginia, Court of 

Federal Claims No: 18–0922V 

78. Jacqueline Robinson, Vienna, Virginia, 

Court of Federal Claims No: 18–0924V 

79. Jose Gamboa-Avila, Denver, Colorado, 

Court of Federal Claims No: 18–0925V 

80. David Colucci, Henderson, Nevada, Court 

of Federal Claims No: 18–0926V 

81. Ligia Gairdo, Cranberry Township, 

Pennsylvania, Court of Federal Claims 

No: 18–0929V 

82. Donna Carmichael, Mankato, Minnesota, 

Court of Federal Claims No: 18–0930V 

83. Susanna J Howard, Greensboro, North 

Carolina, Court of Federal Claims No: 

18–0931V 

84.Vanessa Nelson, Dresher, Pennsylvania, 

Court of Federal Claims No: 18–0932V 

85. Terry Catching, White Plains, New York, 

Court of Federal Claims No: 18–0933V 

86. Renee Smith, Beverly Hills, California, 

Court of Federal Claims No: 18–0936V 

87. Michael Patton, Beverly Hills, California, 

Court of Federal Claims No: 18–0937V 

88. James Owens, Beverly Hills, California, 

Court of Federal Claims No: 18–0938V 

89. Theresa Ukpo, Beverly Hills, California, 

Court of Federal Claims No: 18–0939V 

90. Kailey Kinslow, Beverly Hills, California, 

Court of Federal Claims No: 18–0940V 

91. Barbara Goldman, Beverly Hills, 

California, Court of Federal Claims No: 

18–0941V 

92. Barbara A. Brown, White Plains, New 

York, Court of Federal Claims No: 18– 

0943V 

93. Tracey Harris on behalf of C.H., Boston, 

Massachusetts, Court of Federal Claims 

No: 18–0944V 

94. Sandra Williams, Dresher, Pennsylvania, 

Court of Federal Claims No: 18–0947V 

[FR Doc. 2018–15739 Filed 7–23–18; 8:45 am] 

BILLING CODE 4165–15–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Indian Health Service 

Draft Indian Health Service Strategic 

Plan Fiscal Year 2018–2022 

AGENCY: Indian Health Service, IHS. 

ACTION: Request for comments; notice of 

Tribal Consultation and Urban Indian 

Confer. 

SUMMARY: The Indian Health Service 

(IHS) is developing an Agency-wide 

Strategic Plan to guide the work and 

strengthen partnerships with Tribes and 

Urban Indian Organizations. The IHS is 


jstallworth on DSKBBY8HB2PROD with NOTICES
Federal Register / Vol. 83, No. 142 / Tuesday, July 24, 2018 / Notices 35013 

seeking public comment on its Draft IHS 

Strategic Plan fiscal year (FY) 2018– 

2022 (Draft IHS Strategic Plan FY 2018– 

2022). Additionally, notice is given that 

the IHS will conduct a Tribal 

Consultation and Urban Indian Confer 

regarding the Draft IHS Strategic Plan 

FY 2018–2022. In addition to the virtual 

town hall sessions, the IHS will seek 

other opportunities to solicit input from 

Tribal and Urban Indian programs on 

the Draft IHS Strategic Plan FY 2018– 

2022 during the comment period. For 

IHS Strategic Plan events during the 

comment period, please check the IHS 

Event Calendar at: https://www.ihs.gov/ 

ihscalendar/. 

DATES: Comments due by August 23, 

2018. 

The IHS virtual town hall sessions: 

1. Urban Indian Confer on August 3 

2018, from 2:00 p.m.–3:30 p.m. (Eastern 

Time). 

2. Tribal Consultation on August 6, 

2018, from 2:00 p.m.–3:30 p.m. (Eastern 

Time). 

ADDRESSES: Written comments on the 

Draft IHS Strategic Plan FY 2018–2022 

may be provided by email, or by United 

States (U.S.) postal mail. 

E-mail addresses are as follows: 

For Tribes: consultation@ihs.gov. 

For Urban Indian Organizations: 

urbanconfer@ihs.gov. 

For IHS Employees and the General 

Public: IHSStrategicPlan@ihs.gov. 

Please use ‘‘DRAFT IHS STRATEGIC 

PLAN FY 2018–2022’’ as the subject 

line. 

U.S. Postal Mail: RADM Michael D. 

Weahkee, MBA, MHSA, Acting Director, 

ATTN: Draft IHS Strategic Plan FY 

2018–2022, Indian Health Service, 5600 

Fishers Lane, Mailstop: 08E86, 

Rockville, Maryland 20857. 

FOR FURTHER INFORMATION CONTACT: 

CAPT Francis Frazier, Director, Office of 

Public Health Support, IHS, 5600 

Fishers Lane, Mail Stop: 09E10D, 

Rockville, Maryland 20857. Telephone 

(301) 443–0222 (This is not a toll-free 

number). 

SUPPLEMENTARY INFORMATION: The IHS 

participated in a strategic planning 

process informed by feedback received 

from Tribes, Urban Indian 

Organizations, and staff, as described in 

more detail below, to develop the Draft 

IHS Strategic Plan FY 2018–2022 for 

consideration. The IHS is committed to 

improving health care delivery services 

and enhancing critical public health 

services to strengthen the health status 

of American Indian and Alaska Native 

people throughout the health system. 

The Draft IHS Strategic Plan FY 2018– 

2022 includes a revised IHS Mission 

statement, a new IHS Vision statement, 

and articulates how the IHS will achieve 

its mission through three strategic goals. 

The three strategic goals are: (1) To 

ensure that comprehensive, culturally 

acceptable personal and public health 

services are available and accessible to 

American Indian and Alaska Native 

people; (2) To promote excellence and 

quality through innovation of the Indian 

health system into an optimally 

performing organization; and (3) To 

strengthen IHS program management 

and operations. Each goal is supported 

by objectives and strategies. To review 

the current IHS Mission statement and 

priorities, please visit: https://

www.ihs.gov/aboutihs/overview/. 

The strategic planning Consultation 

and Confer process is an opportunity for 

the IHS to further refine and strengthen 

the Draft IHS Strategic Plan FY 2018– 

2022. The IHS appreciates the 

invaluable feedback received to date on 

the Draft IHS Strategic Plan FY 2018– 

2022 and seeks to ensure all Agency 

stakeholders have the opportunity to 

comment. As we build on the current 

Draft IHS Strategic Plan FY 2018–2022, 

we look forward to receiving your 

comments by August 23, 2018. 

The Urban Indian Confer on August 3, 

2018, and the Tribal Consultation on 

August 6, 2018, will be held 

telephonically and by webinar. A letter 

will be sent to Urban Indian 

Organization Leaders and Tribal Leaders 

to notify them about details associated 

with conference call and webinar 

schedules and call-in information. 

To develop the Draft IHS Strategic 

Plan FY 2018–2022, the IHS used a 

process similar to the U.S. Department 

of Health and Human Services (HHS) 

Strategic Plan FY 2018–2022, including 

use of goals; objectives and strategies; 

environmental scans; Strengths, 

Weaknesses, Opportunities, and Threats 

(SWOT) analysis; and workgroup 

participation. The environmental scan 

reviewed several IHS Areas, 

Headquarters Offices, and other 

available documents, and the SWOT 

exercise was conducted with IHS staff. 

Informed by these documents and 

analysis, the IHS developed an initial 

framework for review and comment by 

Tribes, Urban Indian Organizations, and 

IHS staff. The IHS first initiated Tribal 

Consultation and Urban Indian Confer 

on the IHS Strategic Plan initial 

framework on September 15, 2017, and 

formed an IHS Federal-Tribal Strategic 

Planning Workgroup (workgroup) to 

review all comments and recommend a 

list of final goals and objectives for IHS 

leadership review and approval. 

During the initial framework 

comment period (September 15, 2017– 

October 31, 2017), the IHS held 

listening sessions, presented at Tribal 

meetings, and held conference calls 

with Tribal and Urban Indian 

Organization leaders. The workgroup 

membership included IHS staff at the 

Area, Service Unit, and Headquarters 

levels (including a representative from 

the IHS Office of Urban Indian Health 

Programs); Tribal leaders or their 

designees. The workgroup reviewed the 

comments received from 150 Tribes, 

Tribal Organizations, Urban Indian 

Organizations and IHS staff on the 

initial framework and suggested 

strategies during six meetings over a 3- 

month period, resulting in final 

recommendations on the IHS Mission, 

Vision, Goals, Objectives, and 

Strategies. These recommendations are 

the basis of the Draft IHS Strategic Plan 

FY 2018–2022. 

Since initiating Tribal Consultation 

and Urban Indian Confer on the IHS 

Strategic Plan initial framework, the IHS 

has issued four letters to Tribal Leaders 

and Urban Indian Organization Leaders 

to update Tribes and Urban Indian 

Organizations on progress. Additionally, 

the IHS issued several communications 

stating that comments on the Draft IHS 

Strategic Plan FY 2018–2022 will be 

accepted throughout the strategic 

planning process. The IHS strategic 

planning Web site includes more 

information about the IHS strategic plan 

timeline, as well as links to the Tribal 

Leader letters, Urban Indian 

Organization Leader letters, and 

workgroup activities. 

The IHS values all feedback and input 

regarding the Draft IHS Strategic Plan 

FY 2018–2022 and invites Tribes, Tribal 

Leaders, and/or their designees to 

Consult and Urban Indian Organization 

Leaders to Confer on the Draft IHS 

Strategic Plan FY 2018–2022. Tribal 

Consultation will be conducted with 

elected or appointed leaders of Tribal 

Governments and their designated 

representatives. Those wishing to 

participate in the Tribal Consultation as 

a designee must have a copy of a letter 

signed by an elected or appointed Tribal 

official or their designee that authorizes 

them to serve as the representative of 

the Tribe. Urban Indian Confer will be 

conducted with recognized 

representatives from Urban Indian 

Organizations, as defined by 25 U.S.C. 

1603(29). Representatives from other 

Tribal Organizations and Native nonprofit organizations are welcome as 

observers. Those wishing to be 

recognized representatives from Urban 

Indian Organizations should provide 

documentation that their organization 

meets the definition at 25 U.S.C. 

1603(29) and that the selected 

participant has the official capacity to 


jstallworth on DSKBBY8HB2PROD with NOTICES
35014 Federal Register / Vol. 83, No. 142 / Tuesday, July 24, 2018 / Notices 

represent the organization. This 

documentation should be submitted by 

e-mail no later than 3 days in advance 

of the Tribal Consultation and Urban 

Indian Confer session to the address that 

follows: IHSStrategicPlan@ihs.gov. 

The text of the Draft IHS Strategic 

Plan FY 2018–2022 is available at the 

IHS Web site at: https://www.ihs.gov/ 

strategicplan/and below. 

Indian Health Service (IHS) 

Draft IHS Strategic Plan Fiscal Year 2018– 

2022 

The Indian Health Service (IHS) provides 

a wide range of clinical, public health, 

community and facilities infrastructure 

services to approximately 2.2 million 

American Indians and Alaska Natives (AI/ 

AN) from 573 federally recognized Tribes in 

37 States. Comprehensive primary health 

care and disease prevention services are 

provided through a network of hospitals, 

clinics, and health stations on or near Indian 

reservations. These facilities are 

predominately located in rural and primary 

care settings and are managed by IHS, Tribes, 

and Tribal Organizations. In addition, IHS 

contracts with Urban Indian Organizations 

for health care services provided in urban 

centers. The Draft IHS Strategic Plan FY 

2018–2022 includes the Mission statement, a 

new Vision statement and articulates how the 

IHS will achieve its mission through three 

strategic goals. Each goal is supported by 

objectives and strategies. 

Mission: To raise the physical, mental, 

social, and spiritual health of American 

Indians and Alaska Natives to the highest 

level. 

Vision: Healthy communities and quality 

health care systems through strong 

partnerships and culturally relevant 

practices. 

Goal 1: To ensure that comprehensive, 

culturally acceptable personal and public 

health services are available and accessible to 

American Indian and Alaska Native people. 

Goal Explanation: The Indian Health 

Service (IHS) provides comprehensive 

primary health care and public health 

services, which are critical to improving the 

health of AI/AN people. The Indian health 

system delivers care through health care 

services provided in IHS, Tribal, and Urban 

(I/T/U) health facilities (e.g., hospitals, 

clinics) and by supporting the purchase of 

essential health care services not available in 

IHS and Tribal health care facilities, known 

as the Purchased/Referred Care (PRC) 

program. Additional services include 

environmental health improvements as well 

as traditional healing to complement the 

medical, dental, pharmacy, laboratory, 

behavioral health and other primary care 

medical programs. Expanding access to these 

services in AI/AN communities is essential to 

improving the health status of the AI/AN 

population. This goal includes securing the 

needed workforce, strengthening 

collaboration with a range of public and 

private, Tribal, and Urban Indian providers 

and expanding access to quality health care 

services to promote the health needs of AI/ 

AN communities. 

Objective 1.1: Recruit, develop, and retain 

a dedicated, competent, and caring 

workforce. 

Objective Explanation: Consistent, skilled, 

and well-trained leadership is essential to 

recruiting and retaining well-qualified health 

care professionals and administrative 

professionals. Attracting, developing, and 

retaining the needed staff will require 

streamlining hiring practices and other 

resources that optimize health care outcomes. 

Within the Indian health system, staff 

development through orientation, job 

experience, mentoring, and short and longterm training and education opportunities are 

essential for maintaining and expanding 

quality services and maintaining 

accreditation of facilities. Also, continuing 

education and training opportunities are 

necessary to increase employees’ skill sets 

and knowledge to keep pace in rapidly 

evolving areas of medical science, prevention 

science, improvement science, and 

information technology, as well as to increase 

opportunities for employee career 

advancement and/or to maintain necessary 

professional credentialing and accreditation. 

Strategies—The following strategies 

support this objective: 

Health Care Recruitment and Retention: 

1. Improve and innovate a process that 

increases recruitment and retention of 

talented, motivated, desirable, and competent 

workers, including through partnerships with 

Tribal communities and others. 

2. Continue and expand the utilization of 

the IHS and Health Resources and Services 

Administration’s National Health Service 

Corps scholarship and loan repayment 

programs, as authorized by the law, to 

increase health care providers at I/T/U 

facilities. 

3. Support IHS sponsorship of fellowship 

slots in certain specialized leadership 

programs for recruitment of future physician 

leaders. 

4. Evaluate new organizational structure 

options and reporting relationships to 

improve oversight of the Indian Health 

Professions program. 

5. Expand the use of paraprofessionals and 

mid-level practitioners to increase the 

workforce and provide needed services. 

6. Develop training programs in 

partnership with health professional schools 

and training hospitals and expand 

opportunities to educate and mentor Native 

youth interested in obtaining health science 

degrees. 

7. Enhance and streamline IHS Human 

Resources infrastructure to hire wellqualified personnel. 

Staff Capacity Building: 

8. Strengthen the workforce to improve 

access to, and quality of, services. 

9. Improve leadership skills, adopt a 

consistent leadership model, and develop 

mentoring programs. 

10. Improve continuity processes and 

knowledge sharing of critical employee, 

administrative, and operational functions 

through written communications and 

documentation within IHS. 

11. Improve workplace organizational 

climate with staff development addressing 

teamwork, communication, and equity. 

12. Strengthen employee performance and 

responsiveness to the Agency, Tribes, and 

patients by improving employee orientation 

and opportunities for training and education, 

including, customer service skills. 

Objective 1.2: Build, strengthen, and 

sustain collaborative relationships. 

Objective Explanation: Collaboration 

fostered through an environment that values 

partnership is vital to expanding the types of 

services to improve population health 

outcomes that can be achieved within the 

health care delivery system. These 

relationships include those between Tribes, 

Urban Indian programs, communities, other 

government agencies, not-for-profits, 

universities/schools, foundations, private 

industry, as well as internal cooperation 

within the Agency and collaborative project 

management. 

Strategies—The following strategies 

support this objective: 

Enhancing Collaboration: 

1. Collaborate with Tribes in the 

development of community-based health 

programs, including health promotion and 

disease prevention programs and 

interventions that will increase access to 

quality health programs. 

2. Develop a community feedback system/ 

program where community members can 

provide suggestions regarding services 

required and received. 

3. Support cross collaboration and 

partnerships among I/T/U stakeholders. 

Service Expansion: 

4. Promote collaborations between IHS, 

other Federal agencies, Tribes, and Tribal 

Organizations to expand services, streamline 

functions and funding, and advance health 

care goals and initiatives. 

5. Work with community partners to 

develop new programs responsive to local 

needs. 

Objective 1.3: Increase access to quality 

health care services. 

Objective Explanation: Expanded access to 

health care services, including individual 

and community health services, requires 

using many approaches and is critical to 

improving the health of AI/AN people and 

reducing the leading causes of death risk 

factors. Among the needs identified are 

increased prevention, specialty care, 

innovative use of health care providers, 

traditional medicine, long-term and aftercare 

services (which may require advancing 

holistic and culturally centered population 

health models), and expanded facilities and 

locations. To assess the success of these 

efforts, measures are needed to evaluate 

provider productivity, patient satisfaction, 

and align improvements in support 

operations (e.g., human resources, 

contracting, technology) to optimize access to 

quality health care services. 

Strategies—The following strategies 

support this objective: 

Health Care Service Access Expansion: 

1. Develop and support a system to 

increase access to preventive care services 

and quality health care in Indian Country. 

2. Develop and expand programs in 

locations where AI/AN people have no 

access to quality health care services. 

3. Overcome or mitigate challenges and 

enhance partnerships across programs and 


jstallworth on DSKBBY8HB2PROD with NOTICES
Federal Register / Vol. 83, No. 142 / Tuesday, July 24, 2018 / Notices 35015 

1High reliability health care means consistent 

excellence in quality and safety for every patient, 

every time. High reliability in health care improves: 

organizational effectiveness, efficiency, culture, 

customer satisfaction, compliance, and 

documentation. For more information about High 

Reliability Organizations, please see: https://

psnet.ahrq.gov/primers/primer/31/high-reliability. 

2The IHS Quality Framework 2016–2017 is 

available at: https://www.ihs.gov/newsroom/ 

includes/themes/newihstheme/display_objects/ 

documents/IHS_2016-2017_

QualityFramework.PDF. 

agencies by identifying, prioritizing, and 

reducing access limitations to health care for 

local AI/AN stakeholders. 

4. Increase access to quality community, 

direct/specialty, long-term care and support 

services, and referred health care services 

and identify barriers to care for Tribal 

communities. 

5. Leverage technologies such as 

telemedicine and asynchronous electronic 

consultation systems to include a more 

diverse array of specialties and to expand, 

standardize, and increase access to health 

care through telemedicine. 

6. Improve team effectiveness in the care 

setting to optimize patient flow and 

efficiency of care delivery. 

7. Reduce health disparities in the AI/AN 

population. 

8. Provide evidence-based specialty and 

preventive care that reduces the incidence of 

the leading causes of death for the AI/AN 

population. 

9. Incorporate Traditional cultural 

practices in existing health and wellness 

programs, as appropriate. 

10. Improve the ability to account for 

complexity of care for each patient to gauge 

provider productivity more accurately. 

11. Hold staff and management 

accountable to outcomes and customer 

service through satisfaction surveys. 

Facilities and Locations: 

12. In consultation with Tribes, modernize 

health care facilities to expand access to 

quality health care services. 

13. In consultation with Tribes, review and 

incorporate a resource allocation structure to 

ensure equity among Tribes. 

14. Develop and execute a coordinated 

plan (including health care, environmental 

engineering, environmental health, and 

health facilities engineering services) to 

effectively and efficiently execute response, 

recovery, and mitigation to disasters and 

public health emergencies. 

Goal 2: To promote excellence and quality 

through innovation of the Indian health 

system into an optimally performing 

organization. 

Goal Explanation: In pursuit of high 

reliability health care services 1 and care that 

is free from harm, the IHS has implemented 

several innovations in health care delivery to 

advance the population health needs of AI/ 

AN communities. In many cases, innovations 

are developed to meet health care needs at 

the local level and subsequently adopted 

across the Indian health system, as 

appropriate. IHS will continue to promote 

excellence and quality through innovation by 

building upon existing quality initiatives and 

integrating appropriate clinical and public 

health best practices. Recent IHS efforts have 

been aimed at strengthening the underlying 

quality foundation of federally operated 

facilities, standardizing processes, and 

sharing health care best practices with other 

Federal, State, Tribal, and Urban Indian 

programs. 

Objective 2.1: Create quality improvement 

capability at all levels of the organization. 

Objective Explanation: Ensure quality 

improvement is operational in all direct care, 

public health, administrative, and 

management services throughout the system. 

Quality improvement will be achieved at all 

levels of the organization including 

Headquarters, Area Offices, and Service 

Units and will be made available to Tribes, 

Tribal Organizations, and Urban Indian 

Organizations, as requested. Creating quality 

improvement capability at all levels will 

require training, resources, commitment, and 

consistency to assure that every employee 

shares a role in continuous quality 

improvement in all IHS operations and 

services. This objective will build upon 

current efforts of the 2016–2017 IHS Quality 

Framework 2 to strengthen quality 

improvement related to data, training, and 

standards of care. 

Strategies—The following strategies 

support this objective: 

Quality Data: 

1. Improve the quality of data collected 

regarding health care services and program 

outcomes. 

2. Develop and integrate quality standards 

and metrics into governance, management, 

and operations. 

3. Standardize quality metrics across the 

IHS and use results to share information on 

best practices, performance trends, and 

identification of emerging needs. 

Continuous Quality Improvement: 

4. Provide training, coaching, and 

mentoring to ensure continuous quality 

improvement and accountability of staff at all 

levels of the organization. 

5. Evaluate training efforts and staff 

implementation of improvements, as 

appropriate. 

Standards of Care: 

6. Develop and provide standards of care 

to improve quality and efficiency of health 

services across IHS. 

7. Adopt the Model of Improvement in all 

clinical, public health, and administrative 

activities in the Indian health system. 

8. Adopt patient-centered models of care, 

including patient centered medical home 

recognition and care integration. 

Objective 2.2: Provide care to better meet 

the health care needs of Indian communities. 

Objective Explanation: Key to improving 

health outcomes and sustaining population 

health is culturally responsive health care 

that is patient-centered and community 

supported. IHS will implement culturally 

appropriate and effective clinical and public 

health tools, as appropriate, to improve and 

better meet the health care needs of AI/AN 

communities. This objective reinforces 

current efforts addressing culturally 

appropriate care and support dissemination 

of best practices. 

Strategies—The following strategies 

support this objective: 

Culturally Appropriate Care: 

1. Strengthen culturally competent 

organizational efforts and reinforce 

implementation of culturally appropriate and 

effective care models and programs. 

2. Promote and evaluate excellence and 

quality of care through innovative, culturally 

appropriate programs. 

3. Promote the total health integration 

within a continuum of care that integrates 

acute, primary, behavioral, and preventive 

health care. 

4. Explore environmental and social 

determinants of health and trauma-informed 

care in health care delivery. Expand best 

practices across the IHS. 

5. Continue to develop and implement 

trauma-informed care models and programs. 

Sharing Best Practices: 

6. Work collaboratively within IHS, and 

among other Federal, State, Tribal programs, 

and Urban Indian programs to improve 

health care by sharing best practices. 

Goal 3: To Strengthen IHS program 

management and operations. 

Goal Explanation: This goal addresses 

issues of management, accountability, 

communication, and modernized information 

systems. IHS is committed to the principles 

of improved internal and external 

communication, and sound management. 

Assuring the availability and ongoing 

development of a comprehensive information 

technology (IT) system is essential to 

improving access to integrated clinical, 

administrative, and financial data to support 

individual patient care, and decision-making. 

Objective 3.1: Improve communication 

within the organization with Tribes and other 

stakeholders, and with the general public. 

Objective Explanation: This objective 

addresses the critical need to improve 

communication throughout the IHS, with 

employees and patients, with Tribes, with 

Urban Indian Organizations, with the many 

organizations working with IHS and with the 

general public. Most important is to assist 

Tribes, Urban programs, and IHS in better 

understanding Tribal and Urban Indian 

needs and IHS program needs, to encourage 

full participation in information exchange, 

and to engage Tribes and Urban programs in 

partnership and coalition building. This 

includes defining and characterizing 

community needs and health program needs, 

modifying health programs as needed, and 

monitoring the effectiveness of programs and 

program modifications. 

Strategies—The following strategies 

support this objective: 

Communication Improvements: 

1. Improve communication and 

transparency among all employees, 

managers, and senior leadership. 

2. Develop and define proactive 

communications plans for internal and 

external stakeholders. 

3. Enhance health-related outreach and 

education activities to patients and families. 

4. Design social media platforms that will 

ensure wide dissemination of information to 

interested and affected individuals and 

organizations. 

Strengthened Partnership: 

5. Assure quality reporting relationships 

between service units, Area offices, and 


jstallworth on DSKBBY8HB2PROD with NOTICES
35016 Federal Register / Vol. 83, No. 142 / Tuesday, July 24, 2018 / Notices 

3 Data federation provides an organization with 

the ability to aggregate data from disparate sources 

in a virtual database so it can be used for business 

intelligence or other analysis. 

headquarters are clearly defined and 

implemented. 

6. Effectively collaborate with other IHS 

offices (e.g., the Loan Repayment Program) 

and HHS Staff and Operating Divisions 

where missions, goals, and authorities 

overlap. 

Objective 3.2: Secure and effectively 

manage the assets and resources. 

Objective Explanation: This objective 

supports the delivery of health care through 

improved management of all types of assets 

and non-workforce resources. To elevate the 

health status of the AI/AN population and 

increase access to medical care, IHS must 

continue to help ensure patients understand 

their health care options and improve 

business process and efficiencies to the 

health care system. IHS will also increase the 

effectiveness of operations and reporting, 

while providing more assistance and 

infrastructure support to Areas and facilities. 

Strategies—The following strategies 

support this objective: 

Infrastructure, Capacity, and 

Sustainability: 

1. Enhance transparency of the IHS 

management and accountability 

infrastructure to properly manage and secure 

assets. 

2. Ensure that Federal, State, Tribal, 

territorial, and local Tribal health programs 

have the necessary infrastructure to 

effectively provide essential public health 

services. 

3. Provide technical assistance to 

strengthen the capacity of service units and 

Area Offices to enhance effective 

management and oversight. 

4. Apply economic principles and methods 

to assure ongoing security and sustainability 

of Federal, Tribal and Urban Indian facilities. 

Improved Business Process: 

5. Routinely review management 

operations to effectively improve key 

business management practices. 

6. Optimize business functions to ensure 

IHS is engaged in discussions on value-based 

purchasing. 

7. Develop policies, use tools, and apply 

models that ensure efficient use of assets and 

resources. 

8. Strengthen management and operations 

through effective oversight. 

9. Develop standardized management 

strategies for grants, contracts, and other 

funding opportunities to promote innovation 

and excellence in operations and outcomes. 

Patient Education and Resources: 

10. Strengthen patients’ awareness of their 

health care options, including Medicaid and 

Medicare enrollment, which may increase 

access to health care and optimize third party 

reimbursements. 

Objective 3.3: Modernize information 

technology and information systems to 

support data driven decisions. 

Objective Explanation: This objective is to 

assure the availability and ongoing 

improvement of a comprehensive 

information technology (IT) system that 

meets the needs of providers, patients, and 

I/T/Us, including using technology to 

provide improved, timely access to care and 

to reduce the need for transit. This objective 

recognizes that qualified and capable IT staff 

and leadership are fundamental in achieving 

the strategies listed below and further 

reinforces the workforce objectives outlined 

elsewhere in the plan. An improved Indian 

health IT network increases access to 

integrated clinical, administrative, and 

financial data to support individual patient 

care, decision-making, and advocacy. The 

need for data will require the development of 

a system integrated with Tribal and Urban 

Indian programs that will address the current 

and projected clinical, administrative, and 

fiscal data needs. Timely fiscal data 

dissemination to all Federal partners when 

developing budgets is necessary to accurately 

address health care needs of Indian 

communities. Data quality (i.e., accuracy, 

reliability, and validity) and quality patient 

care will continue to play a highly visible 

role both within and outside the IHS. Data 

quality is only partially dependent upon 

technology. Improved data quality also 

reflects other sustained initiatives, such as 

accuracy of data entry, legibility of 

handwriting, appropriate and timely data 

exports, and accuracy of coding. 

Strategies—The following strategies 

support this objective: 

Health Information Technology (HIT): 

1. Evaluate electronic health record needs 

of the IHS and the ability for the health 

information systems to meet those needs, 

create seamless data linkages, and meet data 

access needs for Tribes and Tribal program 

health information systems. 

2. Develop a consistent, robust, stable, 

secure, state-of-the-art HIT system to support 

clinicians workflow, improve data collection, 

and provide regular and ongoing data 

analysis. 

3. Modernize the HIT system for IHS 

Resource and Patient Management System 

(RPMS) or commercial off-the-shelf packages. 

4. Align with universal patient record 

systems to link off-reservation care systems 

that serve AI/AN. 

5. Enhance and expand technology such as 

the IHS telecom to provide access for 

consultative care, stabilization of care, 

decreased transportation, and timeliness of 

care at any IHS-funded health program. 

Data Process: 

6. Provide available data to inform decision 

making for internal and external 

stakeholders. 

7. Act upon performance data and 

standardize data and reporting requirements. 

8. Assure system of data sharing to solidify 

partnerships with Tribal Epidemiology 

Centers and other Tribal programs. 

9. Establish capability for data federation 3

so that data analytics/business intelligence 

may be applied to disparate data stored in a 

single, general-purpose database that can 

hold many types of data and distribute that 

data to users anywhere on the network. 

Note: This draft plan is developed for 

public consideration, it is intended to 

improve the management and administration 

of the IHS and strategic direction of the 

Agency over the next 5 years, and it is not 

intended to create any right, benefit, or legal 

responsibility, substantive or procedural, 

enforceable at law by a party against the 

United States, its agencies, or any person. 

The IHS will publish an additional 

Federal Register Notice with the final 

IHS Strategic Plan FY 2018–2022 after 

all comments are received and 

considered. 

Dated: July 16, 2018. 

Michael D. Weahkee, 

RADM, Assistant Surgeon General, U.S. 

Public Health Service, Acting Director, Indian 

Health Service. 

[FR Doc. 2018–15740 Filed 7–23–18; 8:45 am] 

BILLING CODE 4165–16–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

National Institutes of Health 

National Cancer Institute; Notice of 

Closed Meetings 

Pursuant to section 10(d) of the 

Federal Advisory Committee Act, as 

amended, notice is hereby given of the 

following meetings. 

The meetings will be closed to the 

public in accordance with the 

provisions set forth in sections 

552b(c)(4) and 552b(c)(6), Title 5 U.S.C., 

as amended. The grant applications and 

the discussions could disclose 

confidential trade secrets or commercial 

property such as patentable material, 

and personal information concerning 

individuals associated with grant 

applications, the disclosure of which 

would constitute a clearly unwarranted 

invasion of personal privacy. 

Name of Committee: National Cancer 

Institute Special Emphasis Panel; NCI 

Program Project I (P01). 

Date: September 17–18, 2018. 

Time: 3:00 p.m. to 5:00 p.m. 

Agenda: To review and evaluate grant 

applications. 

Place: Bethesda North Marriott Hotel & 

Conference Center, 5701 Marinelli Road, 

North Bethesda, MD 20852. 

Contact Person: Mukesh Kumar, Ph.D., 

Scientific Review Officer, Research Program 

Review Branch, Division of Extramural 

Activities, National Cancer Institute, NIH, 

9609 Medical Center Drive, Room 7W618, 

Bethesda, MD 20892–9750, 240–276–6611, 

mukesh.kumar3@nih.gov. 

Name of Committee: National Cancer 

Institute Special Emphasis Panel; NCI SPORE 

I (P50) Review. 

Date: September 25, 2018. 

Time: 8:00 a.m. to 2:00 p.m. 

Agenda: To review and evaluate grant 

applications. 

Place: Gaithersburg Marriott 

Washingtonian Center, 9751 Washington 

Boulevard, Gaithersburg, MD 20878. 


jstallworth on DSKBBY8HB2PROD with NOTICES