Indian Nation agreements (INA) and scope of work for behavioral health services

New INA documents and INA restatement for July 1, 2025

INA Umbrella Agreement

This serves as an umbrella general terms and conditions contract between HCA and the Tribe.

• Download the Indian Nation Agreement - final version
  • This version shows the changes made by HCA as well as provides explanation for those changes.
• INA Restatement - The INA Umbrella Agreement has been in place for over 5 years and HCA is seeking to update the INA with the following goals:
  • Update INA structure to improve organization and clarity of Various scopes of work through a task order structure called Service Level Agreements.
  • Update monitoring section to align with new risk assessment process negotiated in 2023.
  • Move and clarify INA negotiated terms to the GTCs for SLA streamlining across programs.
  • Clarify task order structure with appropriate numbering and language to distinguish INA SLA projects within the GTC umbrella agreement.
    • Quarterly reporting options and timelines
    • One plan across SLAs rather than multiple plans
    • SLA template across all behavioral health projects and scopes of work
  • Update risk assessment to accurately reflect risk levels
• INA Restatement (Sovereign Nation Agreement) Draft
• Summary of Changes INA Restatement (SNA)
• INA Risk Assessment Update Draft (coming soon) 

Please join us for a series of workgroups, roundtables, and consultations on this topic.

Indian Nation Program Agreement for Behavioral Health Services (Schedule 1 and Schedule 1.a.)

This will cover DBHR-funded programs under the Indian Nation Agreement. We anticipate having other program agreements for certain other HCA programs in the future, but the Indian Nation Agreement and Program Agreement framework will not replace any of the existing contracts that HCA has with Tribes.

In response to some tribes’ interest in receiving these DBHR-funds on a reimbursement basis, HCA has prepared the Indian Nation Agreement for Behavioral Health Services so that each Tribe will select one of two options on how to receive funding:

Advance funding with quarterly expenditure reports

• This option will follow the existing DSHS consolidated contract model, where the Tribe receives funds for each state fiscal biennium in advance and then submits quarterly expenditure reports on how the funds have been expended. Due to the requirements to close out a fiscal year before releasing funds for the next fiscal year, this option often results in delayed funding to Tribes at the start of each state fiscal year.

Quarterly or monthly reimbursement

• This option will follow the typical reimbursement model, where the Tribe receives funds after submitting reimbursement requests every quarter, every two months, or every month. With this option, the Tribe spends the funds on the program and is then reimbursed.

In addition, HCA has prepared the Indian Nation Program Agreement for Behavioral Health Services so that the Tribe will prepare a single Tribal plan for all DBHR-funded programs covered by the agreement, although there may be some DBHR-funded programs that will fall under a different program agreement in certain circumstances.

Except for these differences, HCA has tried to keep the Indian Nation Agreements and the Indian Nation Program Agreements for Behavioral Health Services substantively similar to the DSHS consolidated contracts.

The HCA completed Consultation on the draft agreements on March 24, 2021, to reflect the new Schedule 1.a. (Scope of Work for Behavioral Health Services) and Indian Nation Agreement monitoring tools for biennial monitoring. The final schedule and monitoring tool, which was agreed upon during Consultation is posted below.

Updated Schedule 1

• Scope of Work for Behavioral Health Services: This document serves as the new scope of work between HCA and the Tribe for SFY 2022 - SFY 2024.
• Biennial monitoring desk review checklist: This form serves as the monitoring tools for the INA biennial desk monitoring review for SFY 2022 – 2023.

Risk Assessment and Monitoring Plan

On May 28, 2023, the Health Care Authority held a Consultation on the Indian Nation Agreement and Urban Indian Organization (INA/UIO) Risk Assessment and Monitoring Plan tool. During this meeting the Tribes and HCA agreed to move forward with the implementation of the risk assessment tool presented during the Consultation.

• Dear Tribal Leader Letter INA UIO Risk Assessment
• Risk Assessment and Monitoring Plan Tool: This document serves as the risk assessment and monitoring plan tool.

HCA would like to thank all Tribal and Urban Indian health program representatives and leaders who participated in the workgroup, roundtable, and Consultation, to help us to achieve an improved tool. Per our discussion, HCA will begin implementation of the Risk Assessment and Monitoring Plan tool as soon as possible, and completed tools will be shared with the Tribe. Delays and errors directly caused by HCA internal processes will not result in negative impacts to the Indian Nation or UIO’s risk assessment and monitoring plan.

Update to the INA

The current INA umbrella agreement will be ending on 6/30/2024. HCA is beginning the process to update the umbrella agreement and the scope of work for behavioral health services. HCA does not foresee many changes to the agreement base agreements; however, we will be going through a Tribal engagement process. We will be seeking participation from Tribal representatives to participate on a workgroup to review the INA documents during the fall of 2024. If you would like to participate in the workgroup, please contact Lucilla Mendoza.