Opinion ID: 4565245
Heading Depth: 2
Heading Rank: 1

Heading: Background of Section 325

Text: Until the 1970s, the federal government administered health care programs and provided health services directly to Alaska Natives and American Indians through the Indian Health Service (“IHS”), an agency within the Department of Health and Human Services (“DHHS”). Thereafter, federal policy shifted towards empowering tribes and tribal organizations to manage and operate federal programs offered for the benefit of Alaska Natives and American Indians. See 25 U.S.C. § 5301. With that goal in mind, Congress passed the Indian Self-Determination and Education Assistance Act of 1975 (“ISDEAA”) to promote a “meaningful Indian self-determination policy which will permit an orderly transition from the Federal domination of programs for, and services to, Indians to effective and meaningful participation by the Indian people in the planning, conduct, and administration of those programs and services.” Id. § 5302. In other words, the ISDEAA provides Indian tribes with the authority, discretion, and funds to administer programs that the federal government would otherwise provide. In the mid-1990s, IHS began constructing a new Alaska Native Medical Center (“ANMC”) building in Anchorage to serve Alaska Natives around the state. IHS planned to transfer control of the ANMC to Alaska tribal entities, but over 200 Alaska tribes and tribal organizations could not agree on a management structure. To break the deadlock, Congress enacted Section 325 in 1997, which created an intertribal consortium “to provide all statewide health services provided by the [IHS] of the [DHHS] through the SOUTHCENTRAL FOUNDATION V. ANTHC 5 Alaska Native Medical Center.” Pub. L. No. 105-83, § 325, 111 Stat. 1543, 1597 (1997). Section 325 outlines the formation and governance of the consortium in the following key terms: (a) Notwithstanding any other provision of law, and except as provided in this section, [thirteen regional tribal health organizations, including Southcentral Foundation] . . . are authorized to form a consortium (hereinafter “the Consortium”) to enter into contracts, compacts, or funding agreements . . . to provide all statewide health services provided by the [IHS] through the [ANMC] Office. Each specified “regional health entity” shall maintain that status for purposes of participating in the Consortium only so long as it operates a regional health program for the [IHS] under Public Law 93-638 (25 U.S.C. 450 et seq.), as amended. (b) The Consortium shall be governed by a 15-member Board of Directors, which shall be composed of one representative of each regional health entity listed in subsection (a) above, and two additional persons who shall represent Indian tribes, as defined in 25 U.S.C. 450b(e), and sub-regional tribal organizations which operate health programs not affiliated with the regional health entities listed above and Indian tribes not receiving health services from any tribal, regional or sub-regional health provider. Each member of the Board of Directors shall be entitled to cast one vote. Decisions of the Board of 6 SOUTHCENTRAL FOUNDATION V. ANTHC Directors shall be made by consensus whenever possible, and by majority vote in the event that no consensus can be reached. Id., 111 Stat. at 1597–98 (emphases added). ANTHC was established as the statutorily-authorized Consortium to provide statewide health services under Section 325 shortly after its enactment. ANTHC’s Board of Directors (the “Board”) held its first meeting in January 1998 and concurrently adopted its original bylaws (the “Bylaws”).