The purpose of this study is to evaluate present levels of local health board involvement and to develop and implement plans to increase the involvement of the board in local health services delivery. The primary objectives of the evaluation were to establish criteria for identification of health board involvement in the decision-making process, and to develop methods and techniques to determine current and desired level of involvement. The secondary objective was to enable the results of the report to be used to establish baseline information in health board development to help in identifying kinds of assistance needed. This report is a follow-up to an earlier study that identified specific problems and issues based on Indian community opinions. Phase I was based on information gathered at a series of meetings in self-selected Indian communities. Phase II includes a board self-evaluation master tool, developed from interviews with a number of local boards in Indian communities. The evaluation used a management and. responsive-oriented technique and was a formative type of evaluation. It also provided a summary evaluation that included findings and recommendations. In the process of evaluation, four tools were used at various times to determine the growth of levels of involvement relating to the established goals and objectives. The report includes the evaluation forms used in Phase II, the definition of terms used in these forms, and the results of the evaluation. It also includes the evaluation forms used to measure the four tools. The process served as a means of enabling Indian Health Service (IHS), with the help of the Tribal council, to recognize the National Indian Health Board (NIHB) and accomplish the objective of limiting their responsibilities to health care, which in turn encouraged strong support from tribal administration. The process enabled greater consumer participation and made them more aware of the function of IHS. It enabled the committee to tap local resources. The feedback from the evaluation enabled the boards to participate in, and examine the planning and implementation processes preferred or used. This allowed the board to raise questions and provide answers. The feedback helped IHS and area health boards to perform their functions effectively. It also provided the Indian communities with another type of process that in future will help them to achieve their level of functional capability. The last part of the evaluation report makes the following recommendations: 1) The Colorado River Health Committee and the Crow Creek Health Board should be provided with training and technical assistance to develop their capabilities and increase their potential and effectiveness; 2) The Service Units should be encouraged to actively participate in the developmental experiences; 3) Serious consideration should be given to the Phase II evaluation process and its implementation on a nation-wide basis; 4) IHS through NIHB, needs to develop a refined technical assistance capability in order to address the needs of the local health boards in the areas of training in health issues, board management evaluation planning, and financial management.
Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-65).
Drew RS. Evaluation of local Indian health board involvement in the management of Indian Health Service delivery system. Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-65). :1-90 1975