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Northwest Portland Area Indian Health Board

Legislative and Policy Update

September 14, 2023

Important Dates

Sep. 14, 2023

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


Sep. 18-21, 2023

Affiliated Tribes of Northwest Indians (ATNI) Annual Convention

Great Wolf Lodge, Centralia, WA

Registration Link

Sep. 19, 2023 (10:00 AM PT)

National Health Service Corps. Program Webinar for Tribal Communities 

Registration Link

Sep. 19-20, 2023

IHS Director’s Workgroup on Improving Purchased/Referred Care

Denver, CO; hybrid

Sep. 19-20, 2023

Tribal Leaders Diabetes Committee (TLDC) Meeting

Washington, DC; hybrid

Sep. 27, 2023 (10:00 AM PT)

Office of Management & Budget Consultation on FY 2025 Budget

Zoom Link

Sep. 28, 2023 (10:00 AM PT)

National Institutes of Health All of Us Research Program Tribal Consultation

Registration Link

Oct. 5, 2023

Tribal & Urban Indian Organizations Call


Oct. 16-19, 2023

NPAIHB Tribal Health Director & Quarterly Board Meeting (QBM)

Fort Hall, ID

Oct. 17, 2023 

MMPC Face-to-Face Meeting 

Washington D.C.; hybrid 

Oct. 18-19, 2023 

CMS Tribal Technical Advisory Group Face-to-Face Meeting 

Washington D.C.; hybrid

Oct. 19, 2023 (12:00 PM PT)

IHS Direct Service Tribes Advisory Committee Monthly Meeting


Oct. 27, 2023 (11:00 AM PT)

IHS Information Systems Advisory Committee Monthly Meeting


Nov. 12-17, 2023 

National Congress of American Indians Annual Convention & Marketplace

New Orleans, LA

Registration Link

2023 National Tribal Opioid Summit

Dear Tribal leaders, Colleagues, and Community –

On behalf of the of the Northwest Portland Area Indian Health Board (NPAIHB), we want to offer our deep appreciation for your participation in the first National Tribal Opioid Summit (NTOS), hosted by the Tulalip Tribes of Washington State. We were over 1,000 Tribal leaders, frontline workers, and federal and state policymakers sharing our knowledge, experiences, and commitment to ending the tribal opioid crisis.


We are now 3 weeks out from the Summit: a Thank You letter and major press releases have been shared from the NPAIHB and the Office of National Drug Control Policy (ONDCP) via the White House. An Executive Summary is now available as a first step to the full Summit Report. You will find all of these materials as well as ongoing resources, available via the National Tribal Opioid Summit Resource Hub.


We look forward to sharing further in the coming weeks the following:

  • A set of policy recommendations to bring to the Affiliated Tribes of the Northwest Indians (ATNI)’s Annual Conference later this month and then to the National Congress of American Indians (NCAI)’s Annual Convention in November;
  • A comprehensive update to the Tribal Opioid Response: National Strategic Agenda based on the feedback, recommendations, and best practices of Tribal leaders, health experts, service providers, and community members;
  • A Summit Report.

Health News & Notes

Summer Edition

Check out the Injury Prevention edition of the Health News & Notes quarterly journal. This issue features comments from Chairman Nickolaus D. Lewis; vehicular and pedestrian safety; and ending the Syphillis endemic in Indian Country.

Read the Publication Here

Legislation & Appropriation Updates

Contract Support Costs (CSC) Litigation Update. Law360 recently released an article by Geoff Strommer and Steve Osborne discussing the current circuit split regarding IHS’ obligation to pay CSC for a tribe’s entire healthcare program, including the portion funded by third party revenues.  

Special Diabetes Program for Indians (SDPI). The Lower Costs, More Transparency Act was introduced last week by the chairs of three House committees—Energy and Commerce, Ways and Means, and Education and the Workforce that includes reauthorizing SDPI, including funding at $170 million for FY 2024 and 2025.  SDPI will expire on Sep. 30 unless Congress passes legislation extending SDPI beyond the end of the month.  Call your delegation today to urge Congressional leadership to reauthorize SDPI before Sep. 30.  NIHB has prepared a sample letter on SDPI renewal here and sample talking points here.

FY 2024 Appropriations. This month’s focus on the Hill will be FY 2024 appropriations bills, the Administration’s supplemental emergency spending requests for Ukraine, disaster aid, and a short-term FY 2024 stopgap continuing resolution to avoid a partial government shutdown on October 1. The Senate aims to pass the first batch of FY 2024 appropriations bills this week and is in the process of teeing up a second spending package for next week. Stopgap funding legislation is still being drafted.  

Tribal Consultation, Listening Session & Written Comment Updates

Office of Management & Budget (OMB) is hosting a virtual tribal consultation on the President’s FY 2025 Budget on Sep. 27, 2023, at 10 AM PT. The consultation aims to share your funding needs for services, programs, and activities serving and benefiting Tribal governments, organizations, and communities. Written comments are due Sep. 29, 2023, to [email protected]

NIH All of Us Research Program Tribal Consultation. NIH will host a virtual tribal consultation on Sep. 28, 2023, from 10-12:00 PM PT on the All of Us Research Program. The Tribal consultation will include an update on NIH’s approach to Tribal engagement, a discussion about integrating data from self-identified AI/AN participants in the program’s data platform, the All of Us Research Hub, and program planning. Written comments are due by Oct. 28, 2023, to [email protected]. 

IHS requests comments on the FY 2016 and 2017 Report to Congress on the Administration of the Indian Health Service (IHS) Tribal Self-Governance Program. The Indian Self Determination and Education Assistance Act at 25 U.S.C. § 5394 (previously codified at 25 U.S.C. § 458aaa-13) requires that, prior to submitting the report to Congress, the IHS must seek your comments and view. Comments are due Sep. 29, 2023 [email protected].  

Administrative and Regulatory Updates

IHS Announces FY 2023 Allocation Decision for $700 million under the Bipartisan Infrastructure Legislation (BIL). In the BIL, IHS was appropriated $700 million each fiscal year 2022-2026 for the Sanitation Facilities Construction Program. During a consultation in April, IHS informed tribal leaders that there was a funding shortfall to fund all 1,369 projects, totaling $4.4 billion in the Sanitation Deficiency System (SDS) as of December 31, 2022. For FY 2023, IHS has announced that the agency will continue to use current SDS data and not limit funding to projects on the SDS list as of 2021. Additionally, IHS will allocate $584 million to Tier 1 construction costs projects, $29 million for Tier 1 design and construction documents, and $70 million for project shortfalls.  

IHS FY 2024 Loan Repayment Program Update. IHS will begin accepting applications on Oct. 1, 2023, for the 2024 Loan Repayment Program for eligible healthcare professionals at The awards will provide up to $50,000 in exchange for a 2-year full-time service obligation.  

Advisory Committee on Immunization Practices (ACIP) Approves RSV Vaccine for InfantsLast month, the CDC ACIP approved an RSV vaccine for infants under eight months born during or entering their first RSV season and infants and children aged 8-19 months at increased risk for severe RSV disease.  

CMS Extends Four Walls Grace Period for an Additional 12 Months. CMS announces an extension for IHS and Tribal facilities enrolled as clinics to continue to claim Medicaid reimbursement for services furnished outside of the “four walls” of the facility.  

Medicaid Unwinding Updates. The Consolidated Appropriations Act 2023 set an end date for the Medicaid continuous enrollment condition to March 31, 2023, which included a fourteen (14) month period for states to comply with Medicaid eligibility determination requirements.  Since unwinding has commenced, there has been a dramatic loss in Medicaid coverage nationwide. The Tribal Self-Governance Advisory Committee is coordinating a Tribal-specific data survey to share with the Centers for Medicare and Medicaid Services to show the impact on Tribes and Tribal health programs. The Survey is available HERE.

FDA Approves Updated COVID-19 Booster Shots. The FDA has approved updated COVID-19 booster shots for Pfizer and Moderna to protect against newer variants.  The CDC ACIP is scheduled to meet on Sep. 12, 2023, to discuss and review COVID-19 vaccine recommendations.


FDA Announces Additional Tools for States and Tribes Interested in Section 804 Importation Program (SIP). The SIP allows authorized programs to import certain prescription drugs from Canada to reduce the cost of covered drug products. For Tribes and states interested in submitting a SIP proposal, the FDA has created Tips for SIP proposals available HERE. You can contact the agency’s Intergovernmental Affairs staff at [email protected] to discuss the SIP program further. 

HRSA Provider Relief Funds Reporting Portal Open for Period 5. 

Just a reminder that the PRF Reporting Portal is open, and Reporting Period 5 is due Sep. 30, 2023.  

Paymenst Received Period

Deadlines to USe Funds

Reporting Time Period

Period 1

4/10/2020 - 6/30/2020


7/1/2021 - 9/30/2021

Periopd 2

7/1/2020 - 12/31/2020


1/1/2022 - 3/31/2022

Period 3

1/1/2021 - 6/30/2021


7/1/2022 - 9/30/2022

Period 4

7/1/2021 - 12/31/2021


1/1/2023 - 3/31/2023

Period 5

1/1/2022 - 6/30/2022


7/1/2023 - 9/30/2023

Tribal Health-related Funding Opportunities

NIHB Climate Ready Tribes Emergency Mitigation Planning Grants – Sep. 29, 2023. The National Indian Health Board (NIHB) provides funding for developing tribal emergency mitigation plans related to extreme weather, coastal erosion, or other impacts of climate change.

IHS released a Dear Tribal Leader Letter announcing that they are accepting applications for the FY 2022 and 2023 Small Ambulatory Program (SAP). The FY 2022 budget includes $25 million, and the FY 2023 budget includes $25 million for a total budget of $50 million available for SAP. Fiscal year 2022 and 2023 SAP projects will be awarded up to $3.5 million, and all 12 IHS Areas that submit an application will have an opportunity to receive an award.  Under the SAP, Tribes or Tribal Organizations that are operating an Indian healthcare facility pursuant to a healthcare services contract or compact may competitively apply for funding for the construction, expansion, or modernization of small ambulatory healthcare facilities.

  • Anticipated Award: Up to $3.5 million. Due date: Nov 10, 2023.
  • If your Tribe or Tribal Organization is interested in participating in the FY 2022 and FY 2023 SAP, please download and complete the application on the DFPC website at

For more information:

Laura Platero, Executive Director 

Karol Dixon, Senior Policy Advisor

Candice Jimenez, Health Policy Analyst

Northwest Portland Area Indian Health Board | Website