NPAIHB Legislative & Policy  Update
Friday, September 27, 2019

IMPORTANT DATES
September 30- October 1
IHS Tribal Self-Governance Advisory Committee Quarterly Meeting
Washington D.C.

October 1-2
IHS Direct Service Tribal Advisory Committee Quarterly Meeting
Washington D.C.

October 2
11:00am PST: NIHB MMPC Monthly Call

October 3
12:30pm PST:  IHS All Tribal and Urban Indian Organization Leaders Call
Dial in: 800-857-5577; Passcode:  670929
Webinar:   https://ihs.cosocloud.com/r4k6jib09mj/; Passcode: ihs123

October 7-10
ATNI Fall Annual Convention
Suquamish, WA

October 9-10
Tribal Leaders Diabetes Committee Meeting
Buellton, CA 

October 16-17
IHS Purchased and Referred Care Workgroup
Rockville, MD

October 20-25
NCAI Annual Convention & Marketplace
Albuquerque, NM

October 21
11:30am PST: Tribal Budget Consultation and Area Instructions Webinar #2
Webinar:   https://ihs.cosocloud.com/rkaxopiwgsi5/; Passcode: ihs123
Dial in:  800-832-0736; Passcode:  4242095

October 21-24
NPAIHB Quarterly Board Meeting
Pendleton, OR
ACTION ALERTS
HRSA Shortage Designation Modernization Project (SDMP)
HRSA is continuing to modernize the shortage designation and scoring processes. In response to several concerns from IHS, tribal, and urban Indian facilities (I/T/U), HRSA uploaded additional data from IHS and disseminated updated scores to I/T/Us. I/T/U with low scores may also upload supplemental data to the Auto-HPSA Portal. A webinar training on the Auto-HPSA Portal is available on the SDMP website. 

IHS DTLL: IHS seeks comments on NTAC Behavioral Health initiative funding recommendations (Comments Due 10/1)
8/ 2 Issued
Seeks input on recommendations made by NTAC to address the explanatory statement in the Consolidated Appropriations Act of 2018 which encourages and contracts instead of grants.
Enclosure: NTAC recommendations

HRSA Rural Access to Health Care Services Request for Information
(Comments Due 10/9)
Seeks information about measuring access to health care in rural communities through a set of "Questions for Public Comment." 
RFI

IHS DTLL: FY 2020 IHS Joint Venture Construction Program (JVCP) Pre-Application (Application Due 10/11)
8/7 Issued
Requests for applications for  a federally recognized tribe  for  construction of a health care facility that meets the IHS planning, environmental review, sustainability, design, and construction requirements. In exchange, the IHS will request that Congress fund the staffing and operations of the health care facility under a no-cost, 20-year lease.

CMS Information Collection: Review and Approval Process for Waivers for State Innovation (Comments Due: 10/11)
8/12 Issued
Seeks information on State's specific terms and conditions for Tribal consultations as part of State's 1332 waiver approval.
 POLICY UPDATES

CMS Press Release that Medicare Advantage and Part D Premiums for Seniors Expected to Decline in 2020
Released 9/24
Announces that in 2020 Medicare Advantage premiums are expected to decline 23 percent, on average, from 2018 while plan choices, benefits and enrollment continue to increase.

STAC Vacancy - National At-Large Primary Delegate (Deadline 10/23)
There is one opening for a National At-Large Primary Delegate on the HHS Secretary's Tribal Advisory Committee. 

CMS Final Rule on Medicare, Medicaid, and Children's Health Insurance Programs: Program Integrity Enhancements to the Provider Enrollment Process  (Comments Due 11/4, 5pm EST)
Issued 9/10; Effective 11/4  
Implements statutory provisions that require Medicare, Medicaid, and Children's Health Insurance Program (CHIP) providers and suppliers to disclose certain current and previous affiliations with other providers and suppliers. In addition, it provides the agency with additional authority to deny or revoke a provider's or supplier's Medicare enrollment in certain specified circumstances.

IHS DTLL Tribal Consultation and Urban Confer on VA MOU
Posted 9/4
Announces that several Tribal Consultations and Urban Confers will be conducted to seek input on the memorandum of understanding (MOU) and related performance measures between the Department of Veterans Affairs, Veterans Health Administration and the Department of Health and Human Services, Indian Health Service. 

HHS Proposed Rule on Confidentiality of Substance Use Disorder Patient Records (42 CFR Part 2) (Comments Due 10/25, 5pm EST)
Issued 8/26  
Proposes changes to the Confidentiality of Substance Use Disorder Patient Records regulations. These proposals were prompted by the need to continue aligning the regulations with advances in the U.S. health care delivery system, while retaining important privacy protections for individuals seeking treatment for substance use disorders (SUDs).
LEGISLATIVE UPDATES
House and Senate pass continuing resolution for FY 2020 (H.R. 4378)
Passed Senate 9/26 and House 9/19
Prevents a government shutdown and includes funding for the Indian Health Service and Special Diabetes Program for Indians through November 21, 2019. 

House Subcommittee Hearing on Advance Appropriations  
Hearing 9/25/19
Natural Resources Subcommittee for Indigenous Peoples of the US held a legislative hearing entitled "Advance Appropriations: Protecting Tribal Communities from the Effects of a Government Shutdown" on H.R. 1128 and H.R. 1135. 

Senator Murkowski (R-AK) introduces legislation for Advance Appropriations for the Indian Health Service (S. 2541)
Introduced 9/24
Amends Indian Health Care Improvement Act to authorize advance appropriations for IHS, by providing 2-fiscal years budget authority (companion bill to H.R.1135).  Two other bills for advance appropriations for both IHS and BIA were previously introduced (S. 229 and H.R. 1128). 
Bill text not available yet for S. 2541
NPAIHB Delegates at NCAI Tribal Unity Impact Days and on the Hill
Meetings 9/16-9/18
Spokane Vice Chairman Greg Abrahamson and Cow Creek Chief Health Officer Sharon Stanphill attended NCAI Unity Impact Days and met with 13 Congressional representatives and staff. NPAIHB Delegates advocated for advance appropriations for the Indian Health Service, FY 2020 IHS and HHS appropriations, and SDPI funding . NPAIHB Delegates also brought up area requests, including the Regional Referral Specialty Centers, CHAP expansion, and several bills addressing behavioral health issues and Native veterans. 

WHAT WE'RE READING 
9/26 Senate passes stopgap spending bill, sending it to Trump

9/23 6 Native Leaders on what it would look like if the US kept its promises
Vox

9/23 National Native American Veterans Memorial breaks ground in Washington

9/21 Reform the Indian Health Service to delivery quality healthcare

9/20  New Urban Indian Health Institute report corrects "severely lacking" study from Washington State Patrol on missing Native women and girls

9/11  Nations to Nations: Tribal Leaders on Capitol Hill

9/6  US Native American Agency at crossroads
For more information
  Laura Platero, Director of Government Affairs/Health Policy 
Sarah Sullivan, Health Policy Analyst
(503) 228-4185
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