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Northwest Portland Area Indian Health Board

Legislative and Policy Update

May 16, 2023

Important Dates

May 16, 2023 (10:00 AM PST)

New Hepatitis B Screening Recommendations Webinar

Registration Link

May 17, 2023 (11:00 AM PST)

HHS Office of Civil Rights Tribal Consultation re Reproductive Health

Registration Link


May 17, 2023 (12:00 PM PST)

CMS All Tribes Webinar on Medicare Inflation Rebates and Negotiations

Registration Link

May 17-18, 2023

Direct Service Tribes Advisory Committee (DSTAC) 3rd Quarter Meeting — Richmond, VA

May 22-23, 2023

Washington State Tribal Opioid Fentanyl Summit

— Lummi Nation

May 23, 2023 (1:30 PM PST)

Region 10 Conversation on Equity: Addressing the Maternal Health Crisis

Registration Link


May 24, 2023 (11:00 AM PST)

CMS All Tribes Webinar Re-envisioning Quality Improvement Through a Community-Centered Lens

Registration Link


May 26, 2023 (11:00 AM PST)

ISAC Monthly Meeting

May 31, 2023 (11:00 AM PST)

CMS All Tribes Webinar on Reducing the Risk of Diabetes 

Registration Link

Jun 1-2, 2023

IHS Director’s Advisory Workgroup on Tribal Consultation

Seattle, WA

Jun 2, 2023 (11:00 AM PST)

OMB Virtual Tribal Consultation on IHS Mandatory Funding Proposal 

Registration Link

Jun 4-9, 2023

NCAI Mid-Year Conference

Prior Lake, MN

Jun 7-8, 2023

CMS Health Equity Conference

— Washington D.C.; hybrid 

Conference Link

Jun 13-14, 2023 

IHS Tribal Leaders Diabetes Committee Meeting

— Washington D.C.; hybrid

Jun 14, 2023 (11:30 AM PST)

CMS TTAG Monthly Meeting

Jun 15, 2023 (12:00 PM PST)

DSTAC Monthly Meeting


Jun 23, 2023 (9:00 AM PST)

HRSA IEA Region 10 – Innovative Programs to Develop and Sustain the Health Workforce in Region 10

— Renton, WA; hybrid 

Registration Link

Health News & Notes

Spring Edition

Check out 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 summer youth delegate opportunities.

Read the Publication Here
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

Special Diabetes Program for Indians (SDPI) Reauthorization Act of 2023, H.R. 2547, introduced by Rep. Tom Cole (R-OK-04) and Rep. Raul Ruiz (D-CA-36).  This bill would reauthorize SDPI at $150 million annually for 5 five fiscal years.  SDPI Congressional member sign-on letters are available.  Urge your representative to join the letter!

  • To view the Congressional sign-on letter for the Senate, click here
  • To view the Congressional sign-on letter for the House, click here. 

Assistant Secretary for Indian Health within HHS, H.R. 2535, reintroduced in the 118th Congress by Rep. Stanton (D-AZ) and Rep. Joyce (R-OH).  This bill would elevate the current position of the Director of the Indian Health Service to Assistant Secretary for Indian Health within HHS.  This bill was referred to the House Committee on Natural Resources and then to the Committee on Energy and Commerce.

House Passes “Limit, Save, Grow Act of 2023” 217 to 215 is a debt limit and spending reductions package. This Act returns discretionary spending to FY 2022 levels, including the Indian Health Service, which would be a $327 million cut; expand work requirements for Medicaid, SNAP, and TANF; rescind unused COVID relief funds; and other policy-related amounts.  

President Biden Releases Budget Request for FY 2024. The Biden Administration’s proposed 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 a compulsory budget for all IHS accounts starting in 2025 that would grow each year automatically based on inflation, critical operational needs, and existing backlogs in health care services and facilities infrastructure.  IHS program increases in the 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.  

  • The President’s Budget Request also includes the 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.  

Last week, the Subcommittee held a hearing on the FY 2024 President’s Budget Request, with Director Roselyn Tso testifying on the IHS proposed budget.

Tribal Consultation, Listening Session & Written Comment Updates

Health and Human Services (HHS) Office of Civil Rights (OCR) Tribal Consultation. HHS OCR is hosting tribal consultation on May 17 at 11 AM PST to receive input from Tribes on a proposed rulemaking prohibiting the disclosure or use of protected health information for limited purposes when obtaining, providing, or facilitating reproductive healthcare.   

Office of Management and Budget (OMB) Tribal Consultation on the President’s Mandatory Funding Proposal for the IHS. OMB will conduct a virtual tribal consultation on the President's mandatory funding proposal for the IHS on Jun. 2, 2023, at 11 AM PST.   

Centers for Disease Control and Prevention (CDC) and Agency for Toxic Substances and Disease Registry (ATSDR), Department of Health and Human Services (HHS) Tribal Consultation on CDC’s Rape Prevention and Education (RPE) Program. CDC and ATSDR are hosting this meeting to consult with federally recognized AI/AN tribes to receive input and guidance to inform sexual violence prevention activities and strategies in developing Notices of Funding Opportunities (NOFOs). Tribal consultation will be held on Jul. 12, 2023, from 11 AM to 12:30 PM.

HHS Annual Tribal Budget Consultation.  Last month, HHS hosted the Annual Tribal Budget Consultation for Tribes to 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. 

Administrative and Regulatory Updates

Executive Order 14096, Revitalizing Our Nation’s Commitment to Environmental Justice for All. President Biden issued EO 14096 to advance environmental justice for all “by implementing and enforcing the Nation’s environmental and civil rights laws, preventing pollution, addressing climate change and its effects, and working to clean up legacy pollution that harms human health and the environment.”  The EO establishes the White House Office of Environmental Justice within the Council on Environmental Quality, which oversees the development of policies, programs, and partnerships to advance environmental justice and identify opportunities to collaborate with Tribes, states, and local governments. 

COVID-19 Public Health Emergency (PHE) Ended on May 11, 2023. Below are resources related to the end of the COVID-19 PHE.

IHS Website for Sanitation Facilities Construction Projects.  IHS Division of Sanitation Facilities Construction Projects launched a new website that includes the status of all sanitation facilities projects funded with the Bipartisan Infrastructure Law.   

Administration for Children and Families (ACF) Proposes Eliminating Cost Share for Tribal Child Support Enforcement ProgramsACF has published a notice of proposed rulemaking that would eliminate the non-Federal cost share for Tribal child support enforcement programs, including the 90/10 and 80/20 cost-share rates.  Written comments on this proposed rule are due Jun. 20, 2023.

  • Submit written comments through the Federal eRulemaking Portal HERE using Regulatory Information Number 0970-AC99.


CDC Director Rochelle Walensky Announces her Departure from the Agency. The White House announced that Director Walensky will leave the Agency on June 30.  She has served as agency director for two years and guided the Biden Administration on the COVID-19 response since he took office.  

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 All Tribes Webinar on Reducing the Burden of Illness of Diabetes.  CMS will be hosting an all-tribes listening session on May 31 at 11:00 AM PST focused on improving the accessibility and use of Medicare diabetes prevention and treatment programs and services for AI/ANs. 

Medicare Prescription Drug Inflation Rebate Program. CMS announces lower coinsurance for individuals with Medicare Part B coverage for 27 certain prescription drugs that will go into effect on Apr. 1, 2023.   The list of Part B drugs this rebate applies to is available HERE.  CMS will host an All Tribes webinar on this new Medicare Prescription Drug Inflation Rebate Program and Medicare Drug Price Negotiation Program on May 17 at 12 PM PST.  Registration link for All Tribes Webinar 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.  

Drug Enforcement Agency (DEA) Issues Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription Controlled Substances.  On March 1, the DEA released two proposed rules that would restrict telemedicine prescribing of controlled substances unless there had been a prior in-person medical evaluation.  The DEA received over 30,000 comments from the NPAIHB in response to this proposed rule.  To allow time to review the comments, the DEA will continue the telemedicine flexibilities for prescribing controlled medications authorized under the COVID-19 Public Health Emergency until Nov. 11, 2023.   

HRSA Webinar on New Hepatitis B Screening Recommendations.  On May 16, 2023, at 10:00 AM PT, HRSA will host a webinar to brief clinicians and other healthcare providers on the new recommendations for hepatitis B screening and testing.  

Office of Inspector General (OIG) Compliance Program Guidance Documents. OIG announces modernization of Compliance Program Guidances (CPG) that includes: publishing general CPG on federal fraud and abuse laws, compliance program basics, operating effective compliance programs, and OIG processes and resources for all individuals and entities; publishing industry-specific CPGs for providers, suppliers, and other participants in the healthcare industry or other sectors related to Federal health care programs.  These updated guidances will no longer be available on the Federal Register but on the OIG website.    

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 Adds Chiropractic Services to Covered Medical Benefits. The VA has amended its regulations to add chiropractic services to its medical benefits package, effective May 22, 2023.

VA Released Final Rule on Co-Payment Exemption for Indian Veterans.  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.  

Tribal Health-related Funding Opportunities

HRSA Maternal and Child Health Bureau Funding Opportunities. A suite of HRSA grants currently exists that focus on providing resources to improve maternal health outcomes. Tribes and Tribal organizations are eligible to apply for the following:

  • The Integrated Maternal Health Services initiative fosters the development and demonstration of integrated health services models to improve maternal health outcomes through increased access to comprehensive, quality care. Data health infrastructure is a component of this grant. Applications are due by May 24.

HHS Announces $2.5 Million for Produce Prescription Programs in Indian Country. The U.S. Department of Health and Human Services, through the Indian Health Service agency, is announcing the availability of $2.5 million in funding to support the development of produce prescription programs in Native communities. Produce prescription programs help individuals and families experiencing food insecurity and/or diet‑related health problems more easily obtain fresh fruits and vegetables by receiving a prescription from a health care provider. Eligible applicants include tribes, tribal organizations, and urban Indian healthcare organizations. 

  • Applications are due by Jun. 8, 2023. Approximately 4 to 7 awards will be issued under this program announcement for a performance period of five years.

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 care management for persons living with dementia (PLWD) and 2) improve care and access to dementia caregiver services and support for Tribes receiving primary health care services from IHS Direct Services. 

  • Applications are due Jun. 12, 2023, with an anticipated project start date of Aug 1, 2023. 
  • Learn more about the opportunities here:

ACF Children’s Bureau State-Tribal Partnerships to Implement Best Practices in Indian Child Welfare. This Notice of Funding Opportunity will support nine demonstration sites that promote coordinated efforts among State courts, child welfare agencies, and Tribes to develop and implement best practices related to AI/AN child placements. All three entities must participate in the five-year grant. Partnerships should collaborate on culturally appropriate practices, preventing maltreatment, and improving safety, permanency, and well-being. This can include Indian child welfare codes, legal processes, case management, in-home preservation services, systems changes, and the development of pilot models to test. Applications are due by Jun. 13, 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