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Northwest Portland Area Indian Health Board

Legislative and Policy Update

March 13, 2023

Health News & Notes

January Health News & Notes

Take a look at the Behavioral Health edition of the Health News & Notes quarterly journal. This issue features comments from Chairman Nickolaus D. Lewis and information on the upcoming inaugural National Tribal Opioid Summit.

Take a look inside!

Important Dates

Mar. 14-15, 2023

Tribal Leaders Diabetes Committee (TLDC) Meeting

Washington, DC

 

Mar. 15, 2023 (10:00 AM PST)

Indian Health Service (IHS) National Tribal Advisory Committee (NTAC) on Behavioral Health Quarterly Meeting

Virtual

 

Mar. 15, 2023 (12:00 PM PST)

HHS Annual Tribal Budget Consultation Bi-weekly Planning Call

Virtual

Registration Link

 

Mar. 15-16, 2023

CMS TTAG Virtual Face to Face Meeting

Virtual

 

Mar. 16, 2023 (12:00 PM PST)

Direct Service Tribes Advisory Committee (DSTAC) Monthly Meeting

Virtual

 

Mar. 16, 2023 (11:00 AM PST)

Tribal Consultation on OMB Initial Proposals for Revising Statistical Policy Directive for Federal Data on Race and Ethnicity (SPD 15)

— Virtual

Registration Link

 

Mar. 20, 2023 (11:00 AM PST)

HHS Tribal Consultation on New Strategy for Tribes to Access the Strategic National Stockpile

Virtual

Registration Link

 

Mar. 22, 2023 (11:00 AM PST)

National Institutes of Health (NIH) Tribal Advisory Committee

Virtual

 

Mar. 23, 2023 (11:00 AM PST)

Centers for Disease Control (CDC) Tribal Advisory Committee

Virtual

 

Mar. 23, 2023 (11:00AM PST)

SAMHSA Listening Session on National Tribal Behavioral Health Agenda— Virtual

Registration Link

 

Mar. 29, 2023 (12:00 PM PST)

HHS Annual Tribal Budget Consultation Bi-weekly Planning Call

Virtual

Registration Link

 

Apr. 4-6, 2023

Veterans Administration Advisory Committee on Tribal and Indian Affairs (ACTIA)

Cow Creek, OR

 

Apr. 5, 2023 (11:00 AM PST)

Health Resources & Services Administration (HRSA) Office of Intergovernmental & External Affairs (IEA) National Tribal Learning Session: Understanding Historical Trauma and its Impacts on the American Indian/ Alaska Native Workforce

Registration Link

 

Apr. 6, 2023 (6:00 AM PST)

Administration for Children and Families (ACF) Tribal Consultation on Child Support Issues

Hybrid; Atlantic City, NJ

Registration Link

 

Apr. 11-12, 2023

IHS Information Systems Advisory Committee Semi-annual Meeting

Hybrid; Rockville, MD

 

Apr. 12, 2023 (11:30 AM PST)

CMS TTAG Conference Call

Virtual

 

Apr. 18-19, 2023

HHS Annual Tribal Budget Consultation

Washington, DC

 

Apr. 25-27, 2023

Northwest Portland Area Indian Health Board (NPAIHB) Quarterly Board Meeting

Lummi Nation, WA

 

May 1-5, 2023

2023 National Indian Health Board (NIHB) National Tribal Health Conference

Anchorage, AK

 

May 7-11, 2023

Affiliated Tribes of Northwest Indians Midyear Convention

Coeur d’Alene Casino, ID

Registration Link

 

May 10, 2023 (11:30 AM PST)

CMS TTAG Conference Call

Virtual


June 26-29, 2023

2023 Tribal Self-Governance Conference

Tulsa, OK

Registration Link

Visit our FHACT Tracker

Federal Health Agency and Congress Tracker (FHACT) An ongoing list of Dear Tribal Leader Letters, Federal agency actions, and legislation introduced in the 117th Congress related to health.

COVID-19 Funding Tracker

An ongoing tracker of COVID-19 direct and set-aside funding for Tribes. Updated as of Aug. 2, 2021.

Legislative Updates

NPAIHB Chairman Nickolaus Lewis testified before the House Interior Appropriations Subcommittee last week. Chairman Lewis’ testimony focused on Northwest Tribes’ healthcare funding priorities, emphasizing the fentanyl crisis. 

 

Rep. Tom Cole (R-OK) Re-introduces IHS Contract Support Costs Amendment Act. Representatives Cole and Davids (D-KS) introduced H.R. 409 to House on Jan. 20, 2023, which seeks to amend Section 106(a) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5325(a)) to secure existing Tribal contract support cost reimbursements, and for other purposes. The bill was referred to the Committee on Natural Resources.

 

U.S. Senate Committee on Finance releases Mental Health Care Integration draft. Senate Finance Committee Chair Ron Wyden (D-OR), Ranking Member Mike Crapo (R-ID), Senator Cortez Masto (D-Nev.), and Senator John Cornyn (R-TX) released a discussion draft of legislation aimed at creating better care integration of mental and physical health care services, and expanding access to crisis care and follow up services to get Americans the longer-term care they need. This discussion draft on mental health integration is the fourth legislative draft the Finance Committee has released since kicking off its bipartisan mental health initiative.

  • A summary of the provisions is available here, and the full text of the discussion draft here.
  • Other discussion drafts may be released later in 2023. The committee is committed to fully paying for any mental health package with bipartisan, consensus-driven efforts.

Tribal Consultation & Listening Session Updates

HHS Annual Tribal Budget Consultation April 18-19, 2023 with Bi-weekly Planning Calls in March. The Annual Tribal Budget Consultation provides a forum for Tribes to collectively share their views and priorities with HHS officials on national health and human services funding priorities and make recommendations on HHS's FY 2025 budget request. This year's consultation will take place in-person at the Hubert H. Humphrey Building in Washington, D.C. HHS will work with Tribal leaders to improve the consultation process through biweekly planning calls. Tribal leaders are asked to register for one of three calls: Mar. 1, 15, and 29, all taking place at 12:00PM PT (register here). Tribal leaders can meet one-on-one with HHS agencies during the consultation (available in-person only).

  • Refer to Dear Tribal Leader Letter for more information. Note: Registration for the 1:1 sessions with HHS Divisions are separate from the main consultation and must be requested by 3:00PM PT on Friday, Mar. 17th to [email protected].
  • Also, save the date for Region 10 Tribal Consultation Aug. 9-11, 2023 in Anchorage, AK.

 

Office of Management and Budget (OMB) Consultation on Initial Proposals for Revising Statistical Policy Directive 15 – Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity (SPD 15). OMB is reviewing SPD 15 to determine how to improve the quality and usefulness of federal race and ethnicity data. A Federal Interagency Technical Working Group on Race and Ethnicity Standards comprised of federal career officials was convened to facilitate this process. Their initial recommendations on how to improve SPD 15 for racial and ethnicity data collection and use have been submitted to OMB, including on American Indian and Alaska Native categories of identification, and are now open for public comment through the Federal Register. Registration information is provided in this Dear Tribal Leader Letter.

  • OMB is consulting Tribes on the Working Group's initial proposals on Mar. 16 from 11:00AM – 1:00PM PT; register here.
  • Written comments are requested by Apr. 12, 2023, via [email protected].

 

HHS Announces Tribal Consultation on New Strategy for Tribes to Access the Strategic National Stockpile. On January 21, 2021, President Biden issued Executive Order 14001 on a Sustainable Public Health Supply Chain, which directs actions to secure supplies necessary for responding to the COVID-19 pandemic as well as future public health emergencies. In response, a working group led by the HHS Administration for Strategic Preparedness and Response (ASPR) reviewed recommendations received during Tribal Consultation in the fall of 2021 to develop the draft plan (Link EO 14001 pdf). As part of this new round of Tribal consultation (link DTLL), Tribal leaders are invited to a virtual consultation on Mar. 20, 2023, at 11:00AM – 1:00PM PT.

 

SAMHSA Listening Session on National Tribal Behavioral Health Agenda. SAMHSA will be hosting a listening session on Mar. 23, 2023 at 11 AM PST to obtain input on the National Tribal Behavioral Health Agenda. A few objectives of the session include discussing ways to update the priorities and strategies and exploring new ways to leverage the Agenda for improved coordination and collaboration. 

 

HRSA’s Webinar on Understanding Historical Trauma and its AI/AN Workforce Impacts. This national webinar will take place on Apr. 5, 2023 from 11 AM - 12 PM PST. Attendees will hear how historical trauma has impacted the workforce in Indian Country and will receive information on HRSA resources and technical assistance to address workforce impacts in Tribal communities.

 

Administration for Children and Families (ACF) Tribal Consultation on Child Support Issues. The ACF Office of Child Support Enforcement will consult with Tribes on Apr. 6, 2023, from 9:00am to 4:00pm ET on programmatic, regulatory, and legislative priorities. To facilitate the discussion, ACF invites input on discussion questions posed in the Dear Tribal Leader Letter. Tribes have the option of attending in-person in Atlantic City, NJ, or virtually.

Administrative and Regulatory Updates

President Biden Releases Budget in Brief for FY 2024. The Biden Administration’s proposed budget for FY 2024 includes $8.1 billion for the Indian Health Service (IHS) and $250 million in mandatory funding for Special Diabetes Program for Indians (SDPI). The Administration also proposes mandatory funding for all IHS accounts starting in 2025 that would grow automatically each year based on inflation, key operational needs, and existing backlogs in health care services and facilities infrastructure. 


Additionally, the proposal requests reauthorization of SDPI at $250 million in FY 2024, $260 million in FY 2025, and $270 million in FY 2026. NPAIHB will share additional details on the President’s Budget Request once the congressional justification is released.     

 

HHS Secretary Xavier Becerra Issues 90 Day Notice of the End of the COVID-19 Public Health Emergency (PHE). On Feb. 9th, Secretary Becerra announced that the COVID-19 PHE declaration will end on May 11, 2023. The decision, he explains, was reached based on current trends regarding COVID-19 in the United States, which include a 92% decrease in daily reported cases, an 80% decline in deaths, and a nearly 80% decrease in new hospitalizations compared to data from January 2022. HHS will continue to prioritize addressing COVID-19 as it transitions from current flexibilities enabled by the PHE.

 

HHS Releases Consultation Summary on Tribal Input Received for Developing an HHS Tribal Data Sharing Policy. On October 13 and 19, 2022, HHS consulted with Tribal leaders on their recommendations for developing an HHS Tribal Data Sharing Policy in response to the Government Accountability Office's report entitled, "Tribal Epidemiology Centers, HHS Actions Needed to Enhance Data Access." In that report, GAO found that access to Indian Health Service (IHS), Centers for Disease Control and Prevention (CDC), and state and local epidemiological data varied across the twelve Tribal Epidemiology Centers (TECs) serving Tribal communities. HHS’ consultation summary report available here.

Indian Health Service (IHS) Announces Stacey Ecoffey as New Deputy Director for Intergovernmental Affairs. Ms. Ecoffey, an enrolled member of the Oglala Sioux Tribe will be responsible for providing leadership on tribal and urban Indian health activities and will oversee Office of Tribal Self-Governance, Office of Direct Service and Contracting Tribes, and Office of Urban Indian Health Programs. She previously served as the principal advisor for Tribal Affairs at the Office of Intergovernmental and External Affairs within the Immediate office of the Secretary of HHS. We look forward to working with Ms. Ecoffey in her new role as Deputy Director for IHS Intergovernmental Affairs and appreciate her leadership within the Secretary’s Office at HHS.  

IHS Calendar Year 2023 Reimbursement Rates Published. The 2023 IHS MOU Encounter Rate for Medicaid outpatient services is $654. See Federal Register :: Public Inspection: Reimbursement Rates for Calendar Year 2023.

 

IHS Shares Guidance on the Period of Availability for COVID-19 Supplemental Funding Provided in Fiscal Years 2020 and 2021. In response to questions regarding COVID-19 funding availability, IHS released a Dear Tribal Leader Letter dated November 25, 2022. IHS Deputy Director Ben Smith shared guidance on the period of availability and corresponding expenditure timelines for COVID-19 supplemental funding provided to the IHS, tribes, tribal organizations, and urban Indian organizations in FY 2020 and FY 2021.

  • View the Dear Tribal Leader Letter here.

 

CDC Launches a New Tribal Public Health Data Site. The CDC has launched an online Tribal Public Health Data site to assist tribal partners and others with information and tools related to tribal data. The site guides accessing CDC tribal data; information on tribal data issues, tools, technical assistance, and training; and tribal data-related resources from public health partners. This site will continue growing as CDC further engages with tribes and tribal organizations to provide the most needed data-related information.


CMS Issues State Health Official Letter. 'Discussing Unwinding'. CMS released a State Health Official (SHO) letter outlining new requirements in the Consolidated Appropriations Act, 2023, that impact state activities for the Medicaid and CHIP programs to unwind from the COVID-19 public health emergency.

 

CMS Announces First Health Equity Conference. The Centers for Medicare & Medicaid Services (CMS) is pleased to announce its inaugural CMS Health Equity Conference, to be held Jun. 7-8, 2023 at Howard University. The two-day, free conference will convene leaders in health equity from federal agencies, health provider organizations, academia, community-based organizations, and others, both in person and virtually. Conference attendees will have the opportunity to hear from CMS's leadership on recent developments and updates on CMS programs, up-to-date research on health equity, discuss promising practices

and innovative solutions, and collaborate on community engagement efforts.

 

HRSA Provider Relief Funds Reporting Portal Open for Period 4.

The PRF Reporting Portal is open, and Reporting Period 4 is due Mar. 31, 2023.  


Payments Received Period

Deadline to Use Funds

Reporting Time Period

Period 1

4/10/2020 - 6/30/220

6/30/2021

7/1/2021 - 9/30/2021

Period 2

7/1/2020 - 12/31/2020

12/31/2021

1/1/2022 - 3/31/2022

Period 3

1/1/2021 - 6/30/2021

6/30/2022

7/1/2022 - 9/0/2022

Period 4

7/1/2021 - 12/31/2021

12/31/2022

1/1/2023 - 3/1223

SAMHSA Announces Removal of DATA Waiver Requirement to Prescribe Buprenorphine. Clinicians can now prescribe medications for the treatment of opioid use disorder without submitting a Notice of Intent (Waiver) to SAMHSA. 

 

VA Publishes Brochure on Resources for Native American Veterans Experiencing Homelessness. The new brochure was developed as part of the multi-agency Native American Veteran Homelessness Initiative with the IHS that seeks to increase access to care and services for Native veterans experiencing or at-risk of homelessness. The brochure includes 24/7 confidential counselor telephone lines and an overview of the services available through the VA. These include housing, healthcare, case management, employment, and legal support programs. 

 

Free Emergency Care at Any VA or Non-VA Facility for Veterans in Suicidal Crisis. Beginning on Jan. 17, 2023, Native veterans and other veterans may go to any VA or non-VA facility for no-cost emergency acute suicidal crisis care. The VA will provide, pay for, or reimburse eligible emergency suicide care, transportation costs, and follow-up care for up to 30 days of residential care and 90 days of outpatient care, regardless of the facility where such care is received. Veterans need not be enrolled with the VA to be covered under this new benefit.

  • The VA press release with eligibility information and further resources is here.

Tribal Health-related Funding Opportunities

 SAMHSA Announces Grants for the Benefit of Homeless Individuals & Homeless Guidebook Release with Webinar. The Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment (CSAT) FY 2023 Grant for the Benefit of Homeless Individuals Notice of Funding Opportunity has been released with applications due Mar. 21, 2023. The purpose of this program is to provide comprehensive, coordinated, and evidence-based treatment and services for individuals, including youth, and families with substance use disorders (SUDs) or co-occurring mental health conditions and SUDs (CODs) who are experiencing homelessness. Learn more about the NOFO, here.

 

The U.S. Department of Labor (DOL), Veterans’ Employment and Training Service (VETS), announces the availability of approximately $25,000,000 in HVRP grants. On February 28, 2023, The U.S. Department of Labor published a notice of funding, now available for review on Grants.gov. This FOA announces the availability of approximately $25 million in grant funds, with a maximum award limit for an individual award set at $500,000. The purpose of these funds is to conduct programs to provide job training, counseling, placement, and related services to expedite the reintegration of homeless and incarcerated veterans into the labor force. NCHV was instrumental in HVRP's permanent authorization due to the fact that stable employment for veterans is a key component in our fight to end veteran homelessness.

  • Closing Date for Applications: Mar. 30, 2023 no later than 11:59 PM EST

 

ACF Grants for Family Violence Prevention and Services & Domestic Violence Shelter and Supportive Services. Two grants are currently available for Tribes and Tribal organizations to support public education around family, domestic, and dating violence, as well as to provide shelter and supportive services for the victims of these abuses and their dependents. A single Notice of Funding Opportunity announcement details the application requirements for both grants. Applications are due Mar. 31, 2023.

 

IHS Zero Suicide Initiative Coordinating Center Cooperative Agreement. IHS is seeking to build the capacity of existing Zero Suicide Initiative projects through a cooperative agreement that will provide technical assistance in the areas of data collection, reporting, training, resources, and implementation over a five-year period. The $850,000 grant must be used for this work, as well as to facilitate the provision of staffing, logistics, and administrative resources. Applications are due by Apr. 17, 2023, with more information included in the Grant Opportunity announcement. 

 

ACF Human Trafficking Youth Prevention Education Demonstration Project. ACF is funding local educational agencies to develop and implement programs to prevent human trafficking through school-based training and education. Grant activities can include educator and staff training, as well as student-oriented prevention programs. Grantees are also expected to develop and implement a Human Trafficking School Safety Protocol. More information is provided in the Notice of Funding Opportunity. Applications are due Apr. 27, 2023.

 

ACF FY 2023 Tribal Maternal, Infant, and Early Childhood Home Visiting Grant Program. Tribes are encouraged to apply for Development and Implementation grants to conduct community assessments and develop the infrastructure to provide evidence-based maternal, infant, and early childhood home visiting programs. This opportunity is intended for Tribal entities that have no prior experience with implementing such programs (a separate opportunity will be available for entities with past or present programs). The Grant Opportunity announcement states that awards of between $250,000 to $1 million are anticipated. Applications are due May 1, 2023.

Administration for Children and Families (ACF) is now soliciting applications for the Fiscal Year 2023 Tribal Maternal, Infant, and Early Childhood Home Visiting Grant Program: Development and Implementation Grants. Funds will support 63-month cooperative agreements between ACF and federally-recognized Indian tribes (or a consortium of Indian tribes), tribal organizations, or urban Indian organizations to support: conduct community needs and readiness assessments; develop the infrastructure needed for planning and implementation of evidence-based maternal, infant, and early childhood home visiting programs; provide high-quality, evidence-based home visiting services to pregnant women and families with young children aged birth to kindergarten entry; implement performance measurement and CQI activities; and engage in activities to strengthen early childhood systems of support for families with young children.

  • This funding is intended for tribal entities that do not have prior experience with implementing evidence-based home visiting programs and are not currently implementing a program. A separate NOFO (Tribal MIECHV Grant Program: Implementation and Expansion Grants, HHS-2023-ACF-ECD-TH-0241) will be available soon for entities with such prior experience.
  • Applications are due May 1, 2023. More information is available in the NOFO: https://www.grants.gov/web/grants/view-opportunity.html?oppId=345994

For more information:

Laura Platero, Executive Director 

Liz Coronado, Senior Policy Advisor

Candice Jimenez, Health Policy Analyst

Northwest Portland Area Indian Health Board | Website