Indian Nation agreements (INA) and scope of work for behavioral health services
With the integration of the Division of Behavioral Health and Recovery (DBHR) into the Health Care Authority (HCA) from the Department of Social and Health Services (DSHS), Tribal agreements for behavioral health programs transitioned to HCA through the Indian Nation Agreement (INA). The INA was completed through negotiation with Tribes during formal Consultation in October 2019.
On this page
About the INA
The INA has two main components, including the umbrella agreement that is focused on the general terms and conditions of the INA and the scope of work for behavioral health services, (schedule 1 & schedule 1.a.). Additional scopes of work have been added for various Tribes as funding has expanded through either pilot projects, additional funding available, competitive, and noncompetitive grant submissions.
This page provides a collaborative space for Indian Nations and HCA to review and develop agreements.
INA Restatement - Newly named Sovereign Nation Agreement (SNA) for July 1, 2025
On April 17, 2025, OTA completed a Consultation on the INA Restatement Umbrella Agreement, newly named the Sovereign Nation Agreement. The SNA will replace the INA for July 1, 2025. See Consultation meeting details.
- Download the Sovereign Nation Agreement Template - Final Template
- Summary of Changes INA restatement (SNA)
- Service Level Agreement Template - coming soon
Subrecipient monitoring plan
HCA performs biennial desk monitoring of the activities funded under the INA as outlined in the INA Scope of Work for Behavioral Health Services. Under 45 CFR Part 75, HCA is legally obligated to monitor the activities of subrecipients of federal funds for compliance with applicable federal rules, including 2 CFR Part 200 and 45 CFR Part 75.
- Biennial Monitoring Desk Review checklist: This form serves as the monitoring tools for the INA biennial desk monitoring review for SFY 2024-2025.
Risk Assessment and Monitoring Plan
On July 7, 2023, HCA finalized the Indian Nation Agreement and Urban Indian Organization (INA/UIO) Risk Assessment and Monitoring Plan Tool following Consultation held on May 28, 2023, and the Risk Assessment was conducted for State Fiscal Year (SFY) 2024 and 2025.
During our implementation, HCA identified that the risk assessment did not accurately reflect the level of risk based on contract monitoring concerns. HCA has revised the risk assessment and monitoring plan tool to clarify risk categories and has made the following changes:
- Clarification and expansion of existing risk categories reflect certain scenarios that were missing from the prior tool.
- Split the timeliness and spending pattern category from one category with both topics to two risk categories.
- Dear Tribal Leader Letter INA UIO Risk Assessment
- Revised Risk Assessment and Monitoring Plan Tool: This revised document serves as the new risk assessment and monitoring plan tool.
Background: The purpose of the INA and UIO Risk Assessment is to comply with federal regulations (2 CFR 200.332) over subrecipient monitoring related to risk assessments and contract monitoring based on risk.
Sovereign Nation Agreement monthly workgroup
Please join us for a Tribal-state workgroup to improve our shared work on the SNAs starting May 2025. Meetings will be held via TEAMS on the fourth Thursday of every month at 2:00 p.m.
How to submit your feedback
To submit comments and advice contact Tribal Affairs.