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Northwest Portland Area Indian Health Board

Legislative and Policy Update

March 2, 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. 2, 2023 (12:00 PM PST)

Indian Health Service: March Tribal and Urban Indian Organizations Call— Virtual

Connection Information


Mar. 8, 2023 (10:30 AM PST)

Tribal Consultation and Urban Confer: IHS Health Information Technology Modernization Preparing for Change

Registration Link

Mar. 8-9, 2023

Indian Health Service (IHS) Tribal Self-Governance Advisory Committee Meeting — Washington, DC


Mar. 8-9, 2023

HRSA Tribal Advisory Committee Meeting — Hybrid; Tahlequah, OK

Mar. 13, 2023 (2:00 PM PST)

NPAIHB Tribal Caucus on HIT Modernization, Access to Federal Medical Supplies and Updating OMBs Race & Ethnicity Statistical Standards


Zoom Link


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


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



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)


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

CMS TTAG Conference Call — Virtual 

Apr. 18-19, 2023

HHS Annual Tribal Budget Consultation — Virtual


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 10, 2023 (11:30 AM PST)

CMS TTAG Conference Call — Virtual 

June 26-29, 2023

2023 Tribal Self-Governance Conference — Tulsa, OK

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

IHS Advance Appropriations Included in 2023 Omnibus Spending Bill. On December 29, 2022, President Biden signed into law the Consolidated Appropriations Act, 2023 (signed P.L. 117-328) – which included a $5.1 billion advance appropriation for the Indian Health Service! This is a historic triumph that required a coordinated effort from tribes, advocacy organizations, the public, members of Congress, and the White House. NIHB coordinated a coalition of tribes, tribal organizations, and other partners to work with Congress and the Administration to include FY 2024 advance appropriations for IHS in the ‘Consolidated Appropriations Act, 2023. Tribal leaders, tribal organizations, Tribal Area Health Directors, Area Indian Health Boards, and non-tribal organization friends of Indian health engaged in an extraordinary advocacy effort. Both parties praised the inclusion of nearly $119 billion for Veterans medical care, a 22 percent increase over FY 2022, not counting a $5 billion infusion for the toxic exposure benefits law enacted over the summer (see PACT Act entry below). The draft bill provides the following:

  • $7 billion for the Indian Health Service for FY 2023, an increase of $327 million above the fiscal year 2022 enacted level.
  • $4.9 billion for Health Services, an increase of $230 million above the fiscal year 2022 enacted level.
  • $959 million for Health Facilities, an increase of $18 million above the fiscal year 2022 enacted level.
  • Fully funds Contract Support Costs and Payments for Tribal Leases.
  • Provides advance appropriations for fiscal year 2024.

House Passes Maternal and Child Home Visiting Reauthorization. The house passed the “Jackie Walorski Maternal and Child Home Visiting Reauthorization Act of 2022” (H.R. 8876) as a part of the 2023 Omnibus bill. The bill reauthorizes the Maternal, Infant, and Early Childhood Home Visiting program for FY 2023 through FY 2027. The bill increases the annual funding level to $800 million in FY 2027 and authorize 6% of total funding for grants to Indian tribes (including tribal consortia), tribal organizations, or urban Indian organizations.

Rep. Tom Cole (R-OK) Re-introduces IHS Contract Support Costs Amendment Act. Representatives Cole and Davids (D-KS) introduce 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 the 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 full text of discussion draft here.
  • Other discussion drafts may be released in early 2023. The committee is committed to fully paying for any mental health package with bipartisan, consensus-driven efforts.

Tribal Consultation & Listening Session Updates

Office of the Assistant Secretary for Health (OASH) Listening Session on Primary Health Care. OASH is seeking Tribal input on ways to improve AI/AN health as part of the HHS Initiative to Strengthen Primary Health Care. The Initiative looks at primary health through a comprehensive lens, and OASH seeks to increase its reach to Tribes and Tribal organizations. A virtual listening session was held Jan. 31.


Indian Health Service (IHS) Tribal Consultation Series on Health Information Technology (HIT) Modernization. IHS is initiating a four-part series of Tribal consultations related to its HIT Modernization Program. The sessions will be staggered each quarter, beginning with "Preparing for Change" on Mar. 8, 2023, at 10:30 AM PST. This first session will provide background on the Program and focus on Tribal feedback on change readiness for electronic health record modernization. The remaining sessions will cover resources, governance, and future planning. The IHS Dear Tribal Leader Letter contains the dates and registration information for all consultations.


Medicare and Medicaid Programs: Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, etc. This proposed rule would place new requirements on Medicare Advantage (MA) organizations, state Medicaid fee-for-service (FFS) programs, state Children's Health Insurance Program (CHIP) FFS programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to improve the electronic exchange of healthcare data and streamline processes related to prior authorization, while continuing CMS' drive toward interoperability in the healthcare market.

  • Written comments may be submitted on this regulation to Follow the “Submit a comment” instructions until Mar. 13, 2023.

HHS Annual Tribal Budget Consultation Coming on 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. As in the past, 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 are separate from the main consultation.


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. The current standards were developed in 1997. 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 11:00 AM – 1:00 PM PST; 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.


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

Indian Health Service (IHS) has approved the rates for inpatient and outpatient medical care provided by the IHS facilities for Calendar Year 2023. The 2023 IHS MOU Rate for Medicaid 2023 dates of service is $654. The official document was published on Monday, Feb. 27 at (Federal Register :: Public Inspection: Reimbursement Rates for Calendar Year 2023).


HHS Secretary Xavier Becerra Issues 90 Day Notice of the End of the COVID-19 Public Health Emergency (PHE). On Feb. 9th, Secretary Becerra provided notice via a Dear Governors Letter 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. The Secretary's announcement goes beyond HHS's prior commitment of at least 60 days' notice to provide 90 days' notice of the PHE's end. HHS will continue to prioritize addressing COVID-19 as it transitions from current flexibilities enabled by the PHE. A factsheet to aid communities in preparing for the transition identifies major healthcare areas that will and will not be affected by the PHE status change. Please see copies of the Dear Governors Letter and factsheet.


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 CMS 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.


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. Tribal leaders participated in the two virtual consultation sessions and had an opportunity to submit written comments. HHS now releases its consultation summary report, here. 


President Issues Memorandum on Uniform Standards for Tribal Consultation. On November 30, 2022, President Biden issued a memorandum for the heads of executive departments and agencies designed to respond to the input received from Tribal Nations regarding tribal consultation, improve and streamline the consultation process for both Tribes and Federal participants, and ensure more consistency in how agencies initiate, provide notice for, conduct, record, and report on tribal consultations. The memorandum states that the standards presented are baseline standards and that agencies are encouraged to build upon them to fulfill the goals and purposes of Executive Order 13175 consistent with their unique missions and engagement with Tribal Nations on agency-specific issues.

  • Read the Presidential Memorandum on Uniform Standards for Tribal Consultation here.


Indian Health Services Announces Fiscal Year 2023 Tribal Management Grants Now Available for Tribes and Tribal Organizations. The Tribal Management Grant Program is designed to enhance and develop health management infrastructure and assist tribes and tribal organizations in assuming all or part of existing IHS programs, functions, services, and activities through agreements under the Indian Self Determination and Education Assistance Act. The program also assists tribes and tribal organizations with existing agreements to further develop and improve their management capability.

  • The Tribal Management Grant Program consists of four project types: Feasibility Study, Planning, Evaluation Study, or Health Management Structure.
  • Applications are due by Mar. 6, 2023, and the earliest anticipated start date is Apr. 20, 2023. For more information about the Tribal Management Grants, please contact Kenneth Coriz at (301) 443-5668 or [email protected].


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 provides guidance on 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 to grow as CDC engages further with tribes and tribal organizations to provide the most needed data-related information.

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, as well as 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 for 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 do not need to be enrolled with the VA to be covered under this new benefit.

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

Health-related Funding Opportunities

NIHB Hear Her Campaign Funding Opportunity on Maternal Health Promotion for American Indian and Alaska Native communities. This funding opportunity is open for those interested in increasing the awareness of key actions to support positive maternal health outcomes while utilizing the Centers for Disease Control and Prevention (CDC) Hear Her campaign materials. NIHB will provide up to 3 sub-awards to Tribes, Tribal organizations, consortium of Tribes, Tribal Epidemiology Centers (TEC) including, Native serving 501©3 and Urban Indian Organizations or other Tribal bodies with public health authority in amounts of up to $20,000 each. Learn more via recorded pre-application webinar, here.

  • To apply for this funding opportunity, submit an application to Elisha Sneddy, Public Health Program Coordinator[email protected]apply here.
  • Completed application is due by 11:59 PM EST on Mar. 2, 2023The project period will run from approximately April 2023 to July 2023.

HRSA Announces Rural Communities Opioid Response Program – Neonatal Abstinence Syndrome. HRSA is funding approximately 40 grant awards to help "reduce the incidence and impact of neonatal abstinence syndrome in rural communities by improving systems of care, family supports, and social determinants of health." Recipients will receive $500,000 per year over a three-year performance period. Tribes and Tribal organizations are eligible to apply. All grant related services must be exclusively provided in HRSA-designated rural areas. The application closes on Mar. 8, 2023.

  • Learn more about the Notice of Funding Opportunity announcement, here.


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 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:

For more information:

Laura Platero, Executive Director 

Liz Coronado, Senior Policy Advisor

Candice Jimenez, Health Policy Analyst

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