Puyallup Tribal Health Authority Development Project - The Puyallup Tribal Health Authority (PTHA) is dedicated to advancing healthcare service delivery for the Puyallup Tribal community and Native people across the greater Pierce County region. The purpose of this proposed project is to strategically enhance PTHA’s management capabilities through technical assistance from experts in assessment, planning, and training. As the primary health management structure of the Puyallup Tribe of Indians, PTHA is responsible for overseeing a wide range of programs, functions, services, and activities (PFSAs) under the Tribe’s Indian Health Service contract, serving over 12,500 American Indian and Alaska Native people. To strengthen PTHA’s leadership and management, executive and management staff will focus on addressing areas of need through three project objectives. First, PTHA will conduct a comprehensive needs assessment to increase the participation of key stakeholders in PTHA’s growth and development. This will include engagement with PTHA patients, staff, and community members during data collection and analysis activities. The findings will inform strategic planning, helping guide decisions around service or organizational change, resource allocation, and community health priorities. The final phase will involve the design and implementation of culturally attuned leadership training, ensuring that PTHA’s team is well-equipped to carry out the strategic plan and achieve sustained success. As the scale of PTHA’s PFSAs and service population continues to grow, so does the need for efficient management systems to support this expansion. To address this, PTHA will engage two consulting firms with experience in Tribal health programs and workforce development. These firms will provide vital support in producing data-driven plans and building robust management systems, which will not only meet the immediate needs of the community but also ensure long-term organizational advancement. PTHA anticipates that this project will lead to improvements in clinical operations and overall health outcomes among its patient population, as measured through ongoing evaluation efforts. These intentions align with the purpose of the TMG program and will provide for the continued success of the Puyallup Tribe’s Title I Indian Self-Determination and Education Assistance Act of 1975 contract.