Indian Health Service, Health Management Development Program

The Department of Health and Human Services Indian Health Service is accepting applications to develop and enhance management infrastructure of federally recognized tribes and tribal organizations to assume all or part of existing IHS programs, functions, services, and activities under Assistance Listing 93.228, with the most recent grant award issued September 1, 2026.

The program funds a diverse portfolio of tribal health capacity-building and service expansion projects. Recent awards demonstrate two principal funding streams: dementia care initiatives for American Indian and Alaska Native elders and caregivers, and community health workforce development including the Community Health Aide Program (CHAP) and tribal management infrastructure modernization. Representative recent awards include the Healing Through Memory dementia care initiative at Indian Family Health Clinic in Montana ($199 thousand, Cooperative Agreement, September 2026), Community Health Aide Program implementation at Fort Peck Tribes focused on behavioral health workforce training ($519 thousand, Project Grant, July 2026), and the California Rural Indian Health Board's statewide CHAP implementation spanning 70 California tribes ($1.33 million, Project Grant, July 2026). Other funded activities encompass electronic health record modernization, billing system optimization, health management strategic planning, traditional healing program integration, and quality assurance infrastructure development at tribal health centers.

The program is dominated by Project Grants, which represent 96 percent of 2,812 awards, with Block Grants and Cooperative Agreements each comprising 2 percent of the portfolio. The Department of Health and Human Services Indian Health Service has obligated $1.3 billion in combined federal dollars across 2,924 awards since 1996. Award volume has averaged roughly 20 grants annually over the past five years, with 28 awards in 2025 and 6 awards through September 2026. Typical award magnitudes range from approximately $50 thousand for feasibility planning to $1.3 million for multi-year CHAP implementation across regional consortia; smaller awards for single-tribe planning or compliance projects typically fall between $50 thousand and $300 thousand.

Two grant opportunities are currently open. HHS-2026-IHS-TMD-0001 (Tribal Management Development, posted August 6, 2026, forecast) forecasts five to sixteen awards supporting tribal capacity development for assuming IHS programs under Public Law 93-638. HHS-2025-IHS-TMD-0002 (Tribal Management Grant Program, posted August 26, 2024, due April 28, 2025) supports health management structure development and is open to federally recognized tribes, tribal organizations, and 501(c)(3) nonprofits.

Eligible applicants are federally recognized tribes and tribally sanctioned tribal organizations. Grants are awarded on a competitive basis with final approval by IHS Headquarters within 90 days of application receipt. Applications require submission 90 days prior to the proposed project start date; contact the IHS Headquarters Office for specific deadlines. Renewal is year-to-year via non-competing continuation applications. Grant appeals follow PHS procedures under 42 CFR Part 50, Subpart D and DHHS procedures under 45 CFR 16. Grantees must maintain records for three years after final expenditure report submission unless litigation or other action extends the retention requirement.