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White House Holds

Tribal Nations Summit: 

President Biden Issues New Executive Order on Tribal Funding and Revised IHS/VA Reimbursement Agreement

What is Happening: 

The 2023 White House Tribal Nations Summit (WHTNS) took place this week, December 6 – 7. The Summit is an opportunity for Tribal leaders from all 574 federally recognized Tribes to share their priorities for new policy and for the federal government to share important updates on new actions impacting Tribes.  

At the Summit, President Biden signed an Executive Order intended to “usher in the next era of Tribal self-determination.” The Executive Order requires agencies to “better embrace” their trust responsibilities and assess the extent of unmet federal obligations. It addresses Tribal funding needs by directing federal agencies to take action to make federal funding more “accessible, flexible, and equitable.” Additionally, the President announced the launch of Access to Capital Clearinghouse, an online database meant to increase access to and awareness of funding opportunities for Tribes across several federal agencies. Many of the items in this executive order reflect long-standing priorities of Tribal nations, and have been elevated by NIHB. Read the fact sheet on these announcements here.  

Additionally, Indian Health Service (IHS) Director Roselyn Tso announced a revised agreement to facilitate reimbursement by the Department of Veterans Affairs (VA) to IHS for eligible American Indian/Alaska Native (AI/AN) Veterans’ health care and related services. Under the new agreement, the VA will now reimburse IHS for Purchased/Referred Care (PRC) and contracted travel. IHS published a Dear Tribal Leader Letter on December 6 summarizing this revised agreement. The revised agreement is available to read here.  

Why the Executive Order Matters:

The Executive Order includes provisions that “promote compacting, contracting, co-management, co-stewardship” with Tribes, representing a heightened federal commitment to empowering the expansion of Tribal self-determination. The Executive Order takes several measures to make funding more accessible to Tribes, including streamlining funding applications and reporting processes, allowing Tribes to self-certify data when permitted by statute, and identifying funding programs that can support Tribal set-asides. Furthermore, the Executive Order directs federal agencies to assess how federal funding has fallen short of meeting the federal trust responsibility owed to Tribes and report their findings to the Office of Management and Budget (OMB) and the President. These reports will inform the development of the next President’s Budget, which influences regular funding negotiations. 

Why the VA Reimbursement Agreement Matters:

The inclusion of PRC and contracted travel as reimbursable services represents a significant step forward in the federal government honoring its trust responsibility. Including PRC in the updated reimbursement agreement will expand the scope of health care services that the VA reimburses and ensure that AI/AN veterans receive well-coordinated and much-earned health care. The VA has reimbursed health care services delivered within the Indian health system for over 15,000 AI/AN veterans since 2012. As IHS and the VA implement the agreement, both agencies request comments and continued feedback.

Tribes, Tribal leaders, and Tribal organizations wishing to submit feedback should send written comments to [email protected] and [email protected] by January 23, 2024, with the subject line “REVISED IHS-VA REIMBURSEMENT AGREEMENT.” 

National Indian Health Board | www.nihb.org | 202-507-4070

Visit the NIHB COVID-19 Tribal Resource Center at:

 www.nihb.org/covid-19

For media inquiries, contact Ned Johnson at [email protected].

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