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Northwest Portland Area Indian Health Board

Legislative and Policy Update

April 11, 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

Apr. 11, 2023 (12:00 PM PST)

MMPC Monthly Meeting


Apr. 11, 2023 (2:00 PM PST)

NPAIHB Tribal Caucus on Small Ambulatory Program and Sanitation Facilities

Zoom Link


Apr. 11-12, 2023

IHS Information Systems Advisory Committee Semi-annual Meeting

— Hybrid; Rockville, MD


Apr. 12, 2023 (10:30 AM PST)

ACL Tribal Consultation and Listening Session

— Hybrid; Washington D.C.

Zoom Link


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

CMS TTAG Conference Call

— Virtual


Apr. 12, 2023 (12:00 PM PST)

IHS Infrastructure Investment and Jobs Act Funding Tribal Consultation

Zoom Link


Apr. 13, 2023 (12:00 PM PST)

DSTAC Monthly Meeting


Apr. 14, 2023 (10:30 AM PST)

IHS Small Ambulatory Program Tribal Consultation

Zoom Link


Apr. 17, 2023 (10:00 AM PST)

HHS Region 10 Tribal Quarterly Call—Supporting Elders Aging In Community

Registration Link

Apr. 18-19, 2023

HHS Annual Tribal Budget Consultation

— Washington, DC


Apr. 19, 2023 (8:00 AM PST)

Portland Area IHS ISDEAA Training

— Virtual

Zoom Link


Apr. 20-21, 2023

IHS Director’s Advisory Workgroup on Tribal Consultation

— Washington, DC


Apr. 25-27, 2023

Northwest Portland Area Indian Health Board (NPAIHB) Tribal Health Director & Quarterly Board Meeting

— Lummi Nation, WA


Apr. 25-27, 2023

SAMHSA TTAC Joint Meeting

— Hybrid; Rockville, MD


Apr. 26, 2023 (11:00 AM PST)

NIH TAC Monthly Meeting


Apr. 26-27, 2023

IHS Director’s Workgroup on Improving Purchased/Referred Care

— Hybrid; Albuquerque, NM


Apr. 27, 2023 (11:00 AM PST)

CDC/ATSDR TAC Monthly Conference Call


May 1-5, 2023

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

— Anchorage, AK


May 4, 2023 (12:00 PM PST)

IHS May Tribal and Urban Indian Organizations Call


May 7-11, 2023

Affiliated Tribes of Northwest Indians Midyear Convention

— Coeur d’Alene Casino

Registration Link


May 9, 2023 (12:00 PM PST)

MMPC Monthly Meeting


May 10, 2023 (9:00 AM PST)

VA Health Subcommittee Meeting

— Virtual


May 10, 2023 (10:30 AM PST)

IHS Tribal Consultation on Health IT Modernization Resources

Registration Link


May 10, 2023 (11:30 AM PST)

CMS TTAG Conference Call

— Virtual


Jun 4-9, 2023

NCAI Mid-Year Conference

Prior Lake, MN

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.

Legislation & Appropriation Updates

NPAIHB Executive Director Laura Platero testified before the House Natural Resources, Indian and Insular Affairs Subcommittee on challenges and opportunities for improvement in the healthcare delivery system among Northwest Tribal communities.  


President Biden Releases Budget Request 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. IHS program increases in budget request for FY 2024 include: +$181 million for PRC, + $37 million for mental health, +$42 million for alcohol and substance abuse, and + $20 million for CHAP. 

  • Additionally, the President’ Budget Request includes reauthorization of SDPI at $250 million in FY 2024, $260 million in FY 2025, and $270 million in FY 2026


Senate Appropriations Subcommittee on Interior, Environment, and Related Agencies releases outside witness testimony instructions for FY 2024 appropriations. The Indian Health Service budget is within the jurisdiction of the Interior Subcommittee. Testimony is due May 24, 2023

Tribal Consultation, Listening Session & Written Comment Updates

Administration for Community Living (ACL) Tribal Consultation and Listening Session. ACL will be hosting a hybrid tribal consultation and listening session on Apr. 12, 2023 at 10:30 AM PT in Washington D.C. Tribes are invited to testify on a number of issues including, long-term services and supports, providing home and community based services, transportation access, and Title VI funding and services to tribal elders. 


IHS Tribal Consultation on Infrastructure Investment and Jobs Act (IIJA) Funding. IHS will be hosting tribal consultation on Apr. 12, 2023 at 12 PM PST on the spend plan for the second year of funding of the IIJA $700 million (sanitation facilities funding). Written comments are due Apr. 28, 2023 to [email protected]

IHS Tribal Consultation on Small Ambulatory Program. IHS announced tribal consultation on Apr. 14, 2023 at 10:30 AM PST on proposed changes to allow the Area offices to manage the small ambulatory program. The IHS proposes three options to allocate SAP funds to area offices: 1. Allocate funds to the Areas utilizing the Tribal Size Adjustment (TSA) formula; 2. Allocate SAP funding so each Area is awarded at least one SAP project and the remainder distributed using the TSA; or 3. Allocate SAP funding based on the average number of applications received by each Area in the past three SAP solicitations.

HHS Annual Tribal Budget Consultation April 18-19, 2023. 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.  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.
  • Also, save the date for Region 10 Tribal Consultation Aug. 10-11, 2023 in Anchorage, AK.

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).

SAMHSA Listening Session on National Tribal Behavioral Health Agenda. SAMHSA hosted a listening session on Mar. 23, 2023 to obtain input on the National Tribal Behavioral Health Agenda. A few objectives of the session included discussing ways to update the priorities and strategies and exploring new ways to leverage the Agenda for improved coordination and collaboration. 


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.

  • Written comment deadline extended to Apr. 27, 2023 through the Federal Register.


Administration for Children and Families (ACF) Tribal Consultation on Child Support Issues. The ACF Office of Child Support Enforcement hosted consultation with Tribes last week on programmatic, regulatory, and legislative priorities.  ACF invites input on discussion questions posed in the Dear Tribal Leader Letter.

Administrative and Regulatory Updates

White House Releases Inflation Reduction Act Guidebook for Tribes. You can view the “Guidebook to the Inflation Reduction Act’s Clean Energy and Climate Investments in Indian Country” HERE.


FDA Approves Over-the-Counter Narcan. The FDA approved the first nonprescription use Narcan which will increase access to life-saving medication for the treatment of opioid overdose. The timeline of availability and price of this over the counter product is determined by the manufacturer. 


HHS Secretary Xavier Becerra Issues 90 Day Notice of the End of the COVID-19 Public Health Emergency (PHE). On Feb. 9, 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.


New Recommendations for Hepatitis B Screening and Testing. CDC publishes new recommendations and reports for screening and testing for Hep B virus in the Morbidity and Mortality Weekly Report. These new recommendations include using three laboratory test for HBV infection during a lifetime for adults aged 18 and over; expands risk-based testing to include persons incarcerated or formerly incarcerated, persons with a history of sexually transmitted infections or multiple partners, and persons with a history of Hep C virus infection; and providing increased access to testing to anyone who requests HBV testing. 

CDC Releases Final American Indian and Alaska Native (AI/AN) Worker Safety and Health Strategic Plan. This Plan serves as a guide to prevent injuries, illnesses, and fatalities to AI/AN workers. The final AI/AN Worker Safety and Health Strategic Plan is available 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.

New National Indian Health Board Report Released - Health Equity in Indian Country: Rethinking how CMS Approaches Health Equity for American Indian and Alaska Native People

Medicare Prescription Drug Inflation Rebate Program. CMS announces lower coinsurance for individuals with Medicare Part B coverage for certain 27 prescription drugs that will go into effect Apr. 1, 2023.  The list of Part B drugs this rebate applies to is available HERE.


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. As of April 1, 2023, states are no longer required to maintain continuous Medicaid enrollment to receive the temporary FMAP increase. 


CMS Announces First Health Equity Conference. The Centers for Medicare & Medicaid Services (CMS) is hosting an inaugural CMS Health Equity Conference, to be held Jun. 7-8, 2023 at Howard University. The Conference has met in-person capacity, but registration for virtual participation is available. 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.


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 Releases Final Rule on Co-Payment Exemption for Indian Veterans.

This week the VA released the final rule to implement co-payment exemptions for Indian and urban Indian veterans for hospital care or medical services received on or after January 5, 2022.


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. 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.

Tribal Health-related Funding Opportunities

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:


SAMHSA Planning and Developing Infrastructure to Promote the Mental Health of Children, Youth and Families in AI/AN Communities (Circles of Care). The purpose of this program is to provide tribes and tribal organizations with tools and resources to plan and design a family-driven, community-based, and culturally and linguistically competent system of care. There is an anticipated award amount of up to $350,000 per year. 


SAMHSA Tribal Behavioral Health (Native Connections) Grant. The purpose of this program is to prevent and reduce suicidal behavior and substance use/misuse, reduce the impact of trauma, and promote mental health among American Indian/Alaska Native (AI/AN) youth, up to and including age 24, by building a healthy network of systems, services, and partnerships that impact youth. The length of project is up to 5 years and an anticipated award amount of $250,000. 


IHS Releases 2023 Request for Applications on Addressing Dementia in Indian Country: Models of Clinical Care and Support. The Program Award aims to 1) improve recognition, diagnosis, assessment, and management of care for persons living with dementia (PLWD), and 2) improve care and access to dementia caregiver services and supports for Tribes receiving primary health care services from IHS Direct Services.

 Applications are due Jun. 12, 2023 with anticipated project start date of Aug 1, 2023.

For more information:

Laura Platero, Executive Director 

Liz Coronado, Senior Policy Advisor

Candice Jimenez, Health Policy Analyst

Northwest Portland Area Indian Health Board | Website