Governance

Native American Indian tribes who have established federal recognition are considered by the United States to be "domestic dependent nations." The Cherokee Nation is a federally recognized Indian tribe with a democratic, tripartite form of government operated through constitutional order.

The tribe's present constitution was ratified in 1976. It is currently being revised through the work of a Constitution Commission and delegates to a convention held in February and March of this year. Changes proposed by the Commission and negotiated by the delegation will be presented to the electorate in the near future. These changes may reconfigure the government in terms of how many legislators represent the people, the length of their terms and so forth. Special attention is being given to the balance of power among the executive, legislative and judicial branches of the government.

Under the current constitution, the Principal and Deputy Principal Chiefs are elected by the membership at large for four-year terms. The Chiefs are the executive branch of the Cherokee government. They and their appointed staff are responsible for all tribal operations, including the Health service.

The Deputy Principal Chief is also the "president" of a fifteen member Tribal Council, serving as the chair for official monthly meetings.

The fifteen Tribal Council members are elected from nine voting districts, and are the legislative branch of tribal government. Standing committees of the Tribal Council are formed from the full body to discuss and debate issues of concern, and to regulate business conducted by the administrative staff. The Health Committee is one of the largest standing committees of the Cherokee Tribal Council. It meets monthly for consideration of business prior to presentation before the full Council.

Executive directors are appointed by the Principal Chief for each major function of the business organization, including the Health Service. These directors and their staff are responsible for managing the departments and programs under their leadership within established organizational policies (i.e. Administrative Policies of the Executive Branch and Human Resources Policies and Procedures). In Health, clinical direction is also provided through the Office of the Medical Director.

Budgets, prepared by the administrators for the Chief, are submitted to the Council annually. Appropriation of funds through the approval of budgets is one of the most important functions of the Council.

Tribal sovereignty is the right to self-governance. It is essentially the right to decide issues which effect the good of the population; to design and implement programs in response to specific needs of the population; and, to establish goals for the improvement of the organization's ability to achieve program objectives. Self-governance is a federal "Indian policy" established by law in 1989 as a way to promote tribal self-sufficiency. The Cherokee Nation entered into its first Self-governance agreement with the United States under the new law in 1990.

Some of the annual budgets submitted to the Tribal Council for approval are based on federal program funding. Funding of tribal programs by the federal government is in fulfillment of a trust responsibility toward tribes established in the U.S. Constitution and reinforced by subsequent treaties, statutes and legislation. Program design outlines specific use of funds in an application submitted to a particular federal agency, and the approval of that application establishes an obligation on the part of the tribe to use the funds as indicated. Financial accountability on the part of the tribe is demonstrated through required reporting. So, although the tribe establishes funding priority and sets goals, the federal government still has the right to audit programs administered by tribes to assure that funds authorized for specific purposes are being expended within the rule of law.

The tribal health service enjoys a distinct position in relationship to its federal funding agency. Cherokee Nation Health Service and the Indian Health Service have maintained a partner relationship for many years. This has allowed the Health Service to provide significant leadership in the implementation of tribal Self-governance. In fact, since 1989, when the federal legislation was passed, the Cherokee Nation Health Service has made marked improvement and expansion to our clinical service sites (see Clinic Service Sites).

In 1998, an independent health board was formed to assist health management and the Tribal Council Health Committee in deciding issues of a health-professional nature. The Service Unit Directors of the two Indian Health Service hospitals located in the tribal jurisdictional service area (and still under IHS management) are included in this body as ex-officio members. Thus, they have a voice in decisions which impact patients served by both entities, although they do not act in an official governing capacity.

Other, unofficial professional bodies which guide the tribal health administration in deciding various issues are advisory boards composed of physicians, nurses and program administrators appointed to oversee the activities of the clinical programs. An Institutional Review Board was also established in 1995 to review proposed clinical research involving Cherokee people.

Native American Indian tribes who have established federal recognition are considered by the United States to be "domestic dependent nations." The Cherokee Nation is a federally recognized Indian tribe with a democratic, tripartite form of government operated through constitutional order.

The tribe's present constitution was ratified in 1976. It is currently being revised through the work of a Constitution Commission and delegates to a convention held in February and March of this year. Changes proposed by the Commission and negotiated by the delegation will be presented to the electorate in the near future. These changes may reconfigure the government in terms of how many legislators represent the people, the length of their terms and so forth. Special attention is being given to the balance of power among the executive, legislative and judicial branches of the government.

Under the current constitution, the Principal and Deputy Principal Chiefs are elected by the membership at large for four-year terms. The Chiefs are the executive branch of the Cherokee government. They and their appointed staff are responsible for all tribal operations, including the Health service.

The Deputy Principal Chief is also the "president" of a fifteen member Tribal Council, serving as the chair for official monthly meetings.

The fifteen Tribal Council members are elected from nine voting districts, and are the legislative branch of tribal government. Standing committees of the Tribal Council are formed from the full body to discuss and debate issues of concern, and to regulate business conducted by the administrative staff. The Health Committee is one of the largest standing committees of the Cherokee Tribal Council. It meets monthly for consideration of business prior to presentation before the full Council.

Executive directors are appointed by the Principal Chief for each major function of the business organization, including the Health Service. These directors and their staff are responsible for managing the departments and programs under their leadership within established organizational policies (i.e. Administrative Policies of the Executive Branch and Human Resources Policies and Procedures). In Health, clinical direction is also provided through the Office of the Medical Director.

Budgets, prepared by the administrators for the Chief, are submitted to the Council annually. Appropriation of funds through the approval of budgets is one of the most important functions of the Council.

Tribal sovereignty is the right to self-governance. It is essentially the right to decide issues which effect the good of the population; to design and implement programs in response to specific needs of the population; and, to establish goals for the improvement of the organization's ability to achieve program objectives. Self-governance is a federal "Indian policy" established by law in 1989 as a way to promote tribal self-sufficiency. The Cherokee Nation entered into its first Self-governance agreement with the United States under the new law in 1990.

Some of the annual budgets submitted to the Tribal Council for approval are based on federal program funding. Funding of tribal programs by the federal government is in fulfillment of a trust responsibility toward tribes established in the U.S. Constitution and reinforced by subsequent treaties, statutes and legislation. Program design outlines specific use of funds in an application submitted to a particular federal agency, and the approval of that application establishes an obligation on the part of the tribe to use the funds as indicated. Financial accountability on the part of the tribe is demonstrated through required reporting. So, although the tribe establishes funding priority and sets goals, the federal government still has the right to audit programs administered by tribes to assure that funds authorized for specific purposes are being expended within the rule of law.

The tribal health service enjoys a distinct position in relationship to its federal funding agency. Cherokee Nation Health Service and the Indian Health Service have maintained a partner relationship for many years. This has allowed the Health Service to provide significant leadership in the implementation of tribal Self-governance. In fact, since 1989, when the federal legislation was passed, the Cherokee Nation Health Service has made marked improvement and expansion to our clinical service sites (see Clinic Service Sites).

In 1998, an independent health board was formed to assist health management and the Tribal Council Health Committee in deciding issues of a health-professional nature. The Service Unit Directors of the two Indian Health Service hospitals located in the tribal jurisdictional service area (and still under IHS management) are included in this body as ex-officio members. Thus, they have a voice in decisions which impact patients served by both entities, although they do not act in an official governing capacity.

Other, unofficial professional bodies which guide the tribal health administration in deciding various issues are advisory boards composed of physicians, nurses and program administrators appointed to oversee the activities of the clinical programs. An Institutional Review Board was also established in 1995 to review proposed clinical research involving Cherokee people.