Self-determination, federal funding, and rural hospital strategy.
Advisory engagements for tribes evaluating a 638 self-determination contract, an FQHC or FQHC Look-Alike designation, or a Critical Access Hospital strategy. Delivered by operators who have run the math and the operations, not by pure strategists.
Three pathways. Separate engagements, or combined scope.
638 self-determination
Feasibility, financial modeling, tribal resolution support, contract proposal development, compliance infrastructure design, and transition planning. We map the pathway end-to-end before anyone signs anything.
FQHC / FQHC-LA
Needs assessment, governance structuring, sliding-fee-scale design, board composition strategy, HRSA application support, and post-designation compliance. Federally Qualified Health Center development for tribal and urban Indian programs.
Critical Access Hospital
CAH feasibility analysis, swing-bed strategy, distance-requirement evaluation, reimbursement modeling, and partnership scoping with existing CAH operators. Rural tribal hospital pathway evaluation.
A live 638 transition is underway.
IHA is currently executing a 638 self-determination transition for a tribal partner. The clinic opens June 2026 and converts to tribal operation under a 638 contract in July 2026. The engagement covers tribal resolution support, contract proposal, compliance architecture, staffing model, and transition governance.
This page exists in the consulting pillar because the advisory work is available to tribes that want 638 pathway support without also having IHA operate a clinic. Advisory-only engagements are a legitimate scope.
Scoping a 638, FQHC, or CAH move?
Start with a 30-minute scoping call. We will tell you honestly whether the pathway fits your community and whether we are the right advisory team.
Book a discovery callWant the operator-side pathway?
The clinic-side pathway page walks through how IHA stands up and transitions a clinic under 638.
See the 638 pathway