NPAIHB COVID-19 Legislative & Policy  Update
Wednesday May 20, 2020
H.R. 6800 HEROES Act
Introduced 5/12/20
The Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act is a $3 trillion fourth legislative package. Tribal-specific provisions include $2.1 billion overall for IHS; $100 million tribal-set aside through the Centers for Disease Control and Prevention (CDC); and $150 million tribal set-aside through the Substance Abuse and Mental Health Service Administration (SAMHSA). The HEROES Act does not have full Senate support so negotiations on this bill or other legislation is anticipated in the future. 

Prior NPAIHB COVID-19 Legislative and Policy Updates are available at: 
IHS DTLL: IHS Distribution Decisions for $750 million in New COVID-19 Resources
Published 5/19/20
Announces that IHS has decided how to spend the $750 million to support testing and testing related activities in tribal communities, authorized by the Paycheck Protection Program and Health Care Enhancement Act. IHS has decided to spend the funds as follows: $550 million for IHS and THPs; $50 million for urban Indian programs; $100 million for the IHS National Supply Service Center to purchase supplies and testing kits for IHS and tribally operated programs; and $50 million for nation-wide coordination, epidemiological, surveillance, and public health support in Indian Country. The funds will not be automatically added to the ISDEAA agreements, funds will be received through modifications/amendments to their existing ISDEAA agreements. A one-time detailed budget and spending plan must be submitted. 

IHS Trauma Informed Care Policy and Weekly Update
Issued 5/18/20
Guides IHS in delivering trauma-informed care services and prepares our workforce to be trauma informed. Delivering trauma-informed services requires an understanding of the effects trauma and violence can have on individuals, families, and communities. Trauma-informed  policies, practices, and interventions, enhance capacity for promoting relational well-being and improve patient outcomes.

CMS Guidance: Nursing Home Reopening Recommendations for State and Local Officials
Released 5/18/20
Outlines recommendations for reopening, visitation, and testing requirements to help determine the level of mitigation in Medicare/Medicaid certified nursing homes. Recommendations include the following: (1) criteria for relaxing certain restrictions and mitigating the risk of resurgence through a phased approach; (2) considerations allowing visitation and services in each phase; and (3) restoration for certain surveys in each phase. 

President Trump announces plan to restructure the Strategic National Stockpile
Announced 5/14/20
Releases a plan to restructure the Strategic National Stockpile, implementing lessons learned from recent pandemics. The plan increases supplies for critically-needed items, integrating predictive analytics to determine need, provide real-time availability of supply chains. Currently, only 28% of needed supplies are stocked and contain only a month's worth of key items. 

CMS Guidance: Medicaid Managed Care Options in Responding to COVID-19
Issued 5/14/20
Provides states several options to consider under their Medicaid managed care contracts to modify provider payment methodologies and capitation rates. Options for states includes: (1) adjusting managed care capitation rates exclusively to reflect temporary increases in Medicaid fee-for-service (FFS) provider payment rates; (2) requiring managed care plans to make certain retainer payments allowable to certain habilitation and personal care provider to maintain provider capacity and access to services; and (3) utilizing state directed payments to require managed care plans to temporarily enhance provider payment under the contract. CMS will also consider state requests to retroactively amend or implement risk mitigation strategies for the purposes of responding to the COVID-19 pandemic. 

Health Resources and Services Administration (HRSA) Tribal Advisory Council Nominations (Due July 6)
Published 2/6/20
Requests nominations from the 12 IHS Areas on the establishment of the HRSA Tribal Advisory Council. There should be one designated alternate for each TAC member. HRSA TAC members will have the opportunity to engage in meaningful consultation with agency officials, and to share a range of views determining the impact of HRSA programs on the I/T/U healthcare system and the AI/AN patient population. Additionally, HRSA seeks tribal guidance in crafting innovative approaches to deliver health care and assisting with effective consultations. 

Protocols now available for opening bars, outdoor pools, on boarding seasonal workers
Published 5/18/20
Releases the protocols for bars/breweries/wineries/distilleries and outdoor pools/splashpads/waterparks to open in Stage 3 of the Idaho Rebounds plan. Protocols are also available for on boarding seasonal or temporary workers.

Small Businesses can access 30-day supply of PPE as state opens for Stage 2 of Idaho Rebounds plan 
Announced 5/14/20
Provides information that small businesses have a new resources to access masks, gloves, and sanitizer as the state enters Stage 2 of the four-stage Idaho Rebounds plan. Idaho small businesses can obtain a 30-day supply of PPE for their employees and patrons through an Idaho supplies website (included below). Governor Little announced that Idaho has met the criteria to enter Stage 2 on Saturday. Ninety percent of businesses were able to open their doors on May 1 when Idaho entered into Stage 1. As Idaho enters Stage 2, 95 percent of Idaho businesses will be able to open their doors as long as the protocols are followed. Governor Little did move the opening of bars up from Stage 4 to Stage 3 (May 30) due to downwards trends, which is two weeks earlier than anticipated. 

Idaho partners with Battelle to decontaminate N95 masks at no cost
Issued 5/6/20
Announces the Critical Care Decontamination System (CCDS) in Idaho co-located with the Idaho National Laboratory site in Idaho Falls. The CCDS can decontaminate up to 80,000 N95-type respirators each day, allowing reuse multiple times. There is no cost to use the service.  Entities can request Battelle CCDS services here:

Protocols now available for indoor gyms, recreational facilities
Released 5/6/20
Outlines protocols for indoor gyms, recreational facilities, restaurants, and close contact services to implement in order to open in stage 2 of the Idaho Rebounds Plan. Stage 2 of the Plan begins on May 16 if Idaho meets the criteria to re-open the economy safely. Stage 2 is In Stage 1 protocols included for daycare, youth activities, and places of worship. 


Governor Brown issues finalized Phase I Guidance for building a safe and strong Oregon
Released 5/15/20
Provides a finalized statewide and county guidance and counties and businesses across the state begin the reopening process. Physical distancing, infection control through proper hygiene and cleaning, and use of face coverings are the key tools. New guidance was released for summer school, summer camps and youth activities, public transit, face coverings, as well as homeless and services providers. For the 31 counties entering Phase I guidance for restaurants and bars, gyms, personal services, as well as malls and shopping centers.

Governor Brown announces Phase I Counties Reopening
Published 5/14/20
Updates the state that the counties can begin entering Phase I of reopening on May 15. Qualifying counties demonstrated that they met all of Oregon's safety and preparedness prerequisites for reopening, as well as declining prevalence of COVID-19. Of the 33 counties that applied to reopen on May 15, 28 counties were approved. The applications for Marion and Polk counties were not approved and will be monitored to see if conditions improve. the announcement includes guidelines that take effect or remain in effect beginning May 15. 

Governor Brown releases plan for rebuilding a safe and strong Oregon
Announced 5/7/20
Release of new guidance for counties and businesses on the phased reopening process. The new guidance fo reopening calls for the widespread use of face coverings, maintaining physical distance of six feet between individuals as much as possible, and following good hygiene and disinfection practices. Phase I will begin the limited reopening of additional businesses beginning as early as May 15 if they have demonstrated that they have met all prerequisites for reopening. Counties must remain in Phase I for at least 21 days before becoming eligible to advance to Phase II. 


Governor Inslee announces restart of all medical services in Washington
Published 5/18/20
Releases the state's plan for all elective procedures to resume. Each medical or dental practice will assess their own readiness and their communities' COVID-19 activity to determine whether, and to what degree, they will reopen. 

Governor Inslee issues guidance for resuming personal services and professional services in Phase 2
Released 5/13/20
Provides guidance for resuming personal services and professional services for counties granted variance under the Safe Start Phase 2 recovery plan. For counties granted variance to move to Phase 2, personal services may resume, effective May 13. Personal services include cosmetologists, hairstylists, barbers, estheticians, manicurists, nail salon workers, electrologists, makeup artists, tattoo artists, cosmetology schools, and esthetics school.

Governor Inslee announces contact tracing initiative
Issued 5/12/20
Launches a statewide contact tracing plan to allow more businesses to open and more people to be active in public while helping to slow and prevent the spread. Local health departments will lead these efforts and the state Department of Health and its partners will support this work. The information is only used by public health professionals and is confidential, it will not be shared. Contacts will not be told the name of the person who may have exposed them to COVID-19. The contact tracers will include members of the Washington State National Guard and the Department of Health will continue training more workers and volunteers to replace them over time. 

Governor Inslee issues guidance for partially resuming in-store retail and additional manufacturing operations in Phase 2
Published 5/12/20
Outlines guidance for partially resuming limited in-store retail and manufacturing operations for counties granted variance under the Safe Start Phase 2 recovery plan, effective May 12. 

Governor Inslee issues guidance for partially resuming the dine-in restaurant and tavern industry in Phase 2
Released 5/11/20
Provides guidance for partially resuming the dine-in restaurant and tavern industry for counties granted variance under the Safe Start Phase 2 recovery plan. Through the Safe Start plan, counties with a population of less than 75,000 that have not had a new case of COVID-19 in the past three weeks can apply for a variance to move to Phase 2 before other parts of the state. For counties granted variance to move to Phase 2, restaurant operations may resume with limitations after meeting specific criteria effective May 11. 

Governor Inslee extends nine proclamations relating to COVID-19
Published 5/11/20
Announces the extension of nine provocations in response to the continuing COVID-19 pandemic. The proclamations were extended until July 8, 2020. The following are a few examples of the extended proclamations: 20-26.2 Health Care Facilities and Hand Sanitizer; 20-37.2 DSHS Registered Nursing Assistant (NAR) Training Waiver; 20-38.2 DSHS Facilities; 20-44.1 Nursing Home Transfer or Discharge for COVID-19 Cohorting Process; 20-43.1 Annual Leave and Pay Procedures; and 20-52.1 Statewide Order Relating to Long-Term Care.

Governor Inslee issues guidance for restarting essential workforce development programs
Issued 5/7/20
Releases guidance for restarting essential workforce development programs under the Safe Start Phase I recovery plan. Through the Washington Safe Start plan, more businesses and activities will re-open in subsequent phases with adequate social distancing measures and worker safety and healthy standards in place. Each phase will be at least three weeks - metrics and data will guide when eh state can move from one phase to another. In Phase I, low-risk higher education and critical infrastructure workforce training work are allowed to resume, effective May 5. 
For more information
  Laura Platero, Executive Director
Sarah Sullivan, Health Policy Analyst
(503) 228-4185