Alaska Tribal Health Compact

The Alaska Tribal Health Compact (ATHC) which authorizes tribes and tribal health organizations to operate health and health-related programs, was formed on October 1, 1994. The Compact is the umbrella agreement that sets forth the terms and conditions of the government-to-government relationship between Alaska Native tribes and/or tribal organizations, and the United States government through the Indian Health Service.

The ATHC was and is the only multi-party compact in the nation. It is a single compact covering multiple tribes and tribal organizations, known as Co-Signers, and now has 25 individual funding agreements for each Co-Signer. The ATHC was established early in the Self Governance process and has led the nation in resolving many difficult issues which have arisen in the process of implementing Self Governance Compacts

On behalf of the ATHC, ANHB facilitates Pre and Final Negotiations, tribal caucus, disseminates information and coordinates workgroups as needed. The ATHC is built on several fundamental principles which have been supported and preserved throughout the history of the ATHC. These include:

  • Government to Government Relationship– the ATHC negotiations are built on the Government to Government relationship between the Federal Government and the Tribal governments represented in the ATHC.
  • Respect for all participants– every tribe and their representatives will have the opportunity to participate through a designated tribal representative. Decisions affecting the negotiations are made in the tribal caucus of the ATHC. This caucus is open to all tribal representatives from Alaska.
  • Consensus– decisions in the ATHC tribal caucus are made using the formal consensus process. It is the responsibility of all tribal participants to understand the rules of this process.
  • Transparency– the Co-Signers have shared analysis and information on the IHS to provide a full understanding of the actions of the agency and the impacts of these actions on all Co-Signers.
  • Unity– the Co-Signers have adopted a unified approach to the maximum extent possible to support and enhance the Alaska Tribal Health System and to increase influence nationally within the IHS.
  • Access to Information– the Co-Signers work to provide access and analysis of information to all ATHC members. This includes sharing funding agreements and open negotiations for individual agreements.
  • Uniqueness– the Co-Signers have developed unique solutions to ATHC problems when necessary and recognizes the individual sovereignty of each member of the ATHC.