November 16, 2021 | Issue 21-33 |
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Congress Continues Work on Funding the Government as the Continuing Resolution Expires December 3 |
Congress has passed a Continuing Resolution which will fund the government until December 3, 2021. The House of Representatives has passed its Appropriations bills for FY 2022 and recommends Indian Health Service (IHS) funding at $8.114 Billion, an increase of $1.884 Billion over the FY 2021 level. The full Senate has not passed any Appropriations bills for FY 2022.
One particularly noteworthy funding authorization and level included in the Senate draft bill is $6.58 billion in advance appropriations for IHS for FY 2023. In addition, the Senate draft bill includes funding for the following two items in which NIHB has engaged:
- $24.9 million to address Missing and Murdered Indigenous Women cases in Indian Country. The Committee recommendation includes both funding and directives under the Bureau of Indian Affairs and the Indian Health Service to improve the Federal response to this epidemic; and
- $7 million for a new Indian Boarding School Initiative to conduct a comprehensive review of the troubled legacy of federal boarding school policies.
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President Signs Executive Order on Improving Public Safety, including Notable Health Initiatives |
It further requires the Secretary of the HHS, in consultation with the Secretary of the Interior and Tribal Nations, to develop a comprehensive plan to support prevention efforts that reduce risk factors for victimization of Native Americans and increase protective factors, including by enhancing the delivery of services for Native American victims and survivors, as well as their families and advocates.
The National Indian Health Board stands ready to work with Tribal Nations and the Administration to improve federal responses for health promotion, prevention, and other public health approaches supporting public safety and justice in Tribal communities. |
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UPDATES FROM THE FEDERAL & STATE ADMINISTRATIONS |
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Final Recommendations of the COVID-19 Health Equity Task Force |
On October 28, the COVID-19 Health Equity Task Force released their final recommendations. The Task Force was established by President Biden to serve as an advisory board to mitigate health inequalities due to COVID-19 in vulnerable communities. As part of these final recommendations the Task Force will host stakeholder briefings with the Department of Health and Human Services (HHS) Office of Intergovernmental and External Affairs and with the White House of Public Engagement.
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The Marketplace Open Enrollment is Now Open |
On November 1, individuals can preview 2022 health insurance plans through HealthCare.gov. The Marketplace Open Enrollment Period will run from November 1 to January 15. 2022 and is the perfect opportunity for individuals who are looking to change health care coverage or who are interested in applying for coverage. This Open Enrollment Period the Centers for Medicare and Medicaid Services (CMS) has announced more plan choices with lower costs thanks to the Biden-Harris administration American Rescue Plan (ARP) funding. To add to these advancements, CMS has also released a Qualified Health Plans (QHPs) Landscape Report to analyze the enhanced premium tax credits passed in the ARP. In addition, CMS has also awarded 60 navigator organization 80 million in grants for 2022.
These changes may be helpful for American Indian and Alaska Native people who have families of mixed decent and who are interested in changing their health care plan or enrolling in a new plan. For additional assistance click here or visit your I/T/U facility and see your enrollment assister to help you through the application process. For an updated fact sheet click here.
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Additional Health Insurance Marketplace Enrollment Updates |
On November 1, the Health Insurance Marketplace opened. December 15 is the last day to enroll for the Marketplace and have an effective date of January 1, 2021. This means that enrollment assisters and patient benefit coordinators in Tribal communities will be quite busy and due to the Biden administration, the American Rescue Plan (ARP) will lower prices and allow more people to qualify. It is important for enrollment assisters and patient benefit coordinators to understand these changes meant to help more people enroll into health insurance. Other recent changes include a Partner Toolkit which is designed to provide access to partners to Marketplace outreach resources. For resources related to social media outreach click here. For graphics click here, and for talking points click here. For specific resources related to AI/ANs please click here. For Tribal outreach materials to help with educating individuals on the Marketplace, please go to the CMS Division of Tribal Affairs Outreach page here.
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Now Open, Medicare Open Enrollment |
The Medicare Open Enrollment period began October 15, 2021 and will end on December 7, 2021. If an individual enrolls during this time, Medicare health care coverage will begin on January 1, 2022. During this time individuals should assess their current health care coverage and determine if the plan they have now meets their needs. Items to consider when enrolling in a plan or switching plans include, checking to see if your doctors are still in network, understanding that the lowest cost plan may not be the best for your specific health care needs, remembering to check the deductible or lowest monthly premium of the plan and understanding that some plans have extra benefits associated with them. It is important for you and your Tribal community to assess current health care plans, especially for elders. For more information on Tribal resources when selecting Medicare coverage click here. To order materials for your Tribal community on Medicare health care coverage click here. To compare your current plan or to find the best plan for you, please visit, Medicare.gov. For enrollment assistance 24 hours a day please call 1-800-MEDICARE.
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New Informational Bulletin from CMS on Enrollment into Medicare Savings Programs |
On November 1, the Centers for Medicare and Medicaid Services (CMS) released an informational bulletin on guidance for states to help individuals enroll in Medicare Savings Programs (MSPs). These programs are intended to make health care more affordable and cover Medicare Part A and B premiums along with cost sharing for low-income individuals. Specifically, the bulletin highlights two ways states can increase enrollment in these programs. Through Medicare Part D Low Income Subsidy (LIS) data or through maximizing MSP Qualifying Individuals enrolment. CMS has also added a state-by-state percentage of LIS enrollees who are eligible for these programs, but not enrolled. You can find that list with your state here. This information may be beneficial to Tribal enrollment assisters and other individuals in Tribal communities who work on enrollment into Medicare. For additional information from CMS on the Medicare Savings Program for American Indians and Alaska Natives please click here.
For additional assistance with the enrollment process, visit your local I/T/U facility and request to speak to a benefit coordinator or enrollment assister.
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Centers for Medicare and Medicaid Services (CMS) Issues Final Rule with Comment (IFC) on COVID-19 Vaccine Mandate |
On November 5, 2021, the Centers for Medicare and Medicaid Services (CMS) published a regulation regarding vaccination requirements for staff of Medicare and Medicaid-certified facilities. It aims to protect those fighting this virus on the front lines while also assuring individuals and their families that they will be protected when seeking care.
This emergency regulation is effective as of November 5, 2021. It provides guidance on staff vaccination requirements applicable to Medicare and Medicaid-certified facilities that are regulated under the Medicare Conditions of Participation (CoPs), which includes Indian Health Service (IHS) facilities. By December 5, 2021, these facilities must have a process or plan in place for vaccinating staff, providing exemptions and accommodations, and tracking and documenting vaccinations.
In order to remain compliant, facilities must establish a policy that ensures all eligible staff have received:
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the first dose of either the Pfizer or Moderna two-dose vaccine by December 5, 2021, and the second dose by January 4, 2022, or
- the one-dose Johnson & Johnson vaccine by December 5, 2021.
Unlike other vaccine mandates, this regulation does not include a testing alternative for unvaccinated staff. Facilities may voluntarily include testing alongside other prevention measures such as physical distancing and source control. This regulation does not establish any new data reporting requirements.
CMS requires that exemptions be permitted to staff for recognized medical conditions or religious beliefs, observances, and practices as legally required under the Americans with Disabilities Act and Title VII of the Civil Rights Act of 1964. Facilities have flexibility in establishing their exemption processes.
CMS will be hosting an all-Tribes webinar on this interim final rule on Thursday, November 18, 2021 from 2:00-3:30 PM Eastern Time. The purpose of this call is to provide an overview of the rule and to answer any questions that Tribes might have. Register by clicking HERE.
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Upcoming Events from CMS for AI/AN Heritage Month |
“Native Wellness Institute: Historical Trauma and AIAN Resilience”: Gene Tagaban, “One Crazy Raven,” who is a storyteller, speaker, mentor, teacher and counselor of the spirit, as well as a board member and trainer with the Native Wellness Institute. He will speak on historical trauma, healing and resilience.
Date/Time: Tuesday, November 16, 2021, from 2:00 p.m. to 3:00 p.m. (ET)
Teleconference: 1-833-568-8864; Access code: 161 581 1152; Passcode: 275427
“Native Cuisine with Chef Craig”: Nephi Craig, who is an Apache chef and the Native American Culinary Association founder. His goal is to use food as medicine for his Native people. He will speak on Native American cuisines and food practices.
Date/Time: Tuesday, November 23, 2021, from 1:00 p.m. to 2:00 p.m. (ET)
Teleconference: 1-646-828-7666; Access code: 161 095 9325; Passcode: 921487
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Administration for Children and Families Seeking Nominations for Tribal Advisory Committee |
- Billings Alternate
- California Alternate
Vacancies will be filled on a rolling basis. Click here to learn more.
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USDA Releases $1.15 Billion to Expand Access to Broadband in Rural America |
On October 22, the Department of Agriculture (USDA) released added funds through the ReConnect Program to improve access to broadband in rural communities. In total $1.15 billion in loans and grants will be awarded with $35 million in grant set asides for Tribal Nations. Applications will be evaluated in a competitive process. To see the funding opportunity announcement and to access the application, click here.
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HRSA Seeking Nominations for a Tribal Advisory Council |
The Health Resources and Services Administration (HRSA) is seeking nominations for their Tribal Advisory Council (TAC). These individuals are required to be Tribal officials who have the authority within their Tribe to act on behalf of their communities and who represent the collective views of the Tribes in the area from which they were nominated. These individuals when nominated will serve a length of two years before new nominations will take place. Currently, the areas open for nomination include the California Area, Phoenix Area, and the Tucson Area. To see the work the National Indian Health Board (NIHB) has done on Tribal Advisory Committees please click here. Eligibility criteria for those interested in applying can be found here.
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Visit the NIHB COVID-19 Tribal Resource Center at:
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