Manzanita Healing Hands Tribal Self-Governance Negotiation Initiative - The Manzanita Band of Diegueño Mission Indians of the Manzanita Reservation ("Manzanita Band" or "Tribe"), a federally recognized Indian Tribe in San Diego County, California, proposes to engage in formal negotiations with the Indian Health Service (IHS) to establish a Self-Governance Contract and Annual Funding Agreement under Title I of the Indian Self-Determination and Education Assistance Act (ISDEAA). This initiative is part of the Tribe’s broader vision to develop a tribally operated, culturally responsive health care system that serves Manzanita Tribal citizens and other eligible individuals in its designated Service Delivery Area. The purpose of this project is to support the Tribe’s transition from receiving services through a multi-Tribal consortium to operating its own 638 health clinics in San Diego County and Imperial County, California. Funding will be used to support legal, technical, and administrative activities necessary to complete the negotiation process with IHS, including the preparation of program documentation, community engagement, and capacity-building for future implementation. Expected outcomes include the successful negotiation and execution of a Self-Governance Contract and eventually a Compact and Annual Funding Agreement, the establishment of a clear scope of Programs, Functions, Services, and Activities (PFSAs) to be managed by the Tribe, and the foundation for launching tribally controlled health services. This project will enhance Tribal sovereignty, improve health care access, and position the Manzanita Band to build a sustainable, self-governed health system tailored to the needs of its people. The Tribe looks forward to making informed decisions about which PFSA’s to assume and what organizational changes to make based on IHS support.
