Northwest Portland Area Indian Health Board

Legislative and Policy Update

November 19, 2024

Important Dates

November 18-20, 2024 

HHS STAC Meeting 

Washington, DC 

November 20, 2024 

DSTAC 1st Quarter Meeting 

Washington, DC 

December 2, 2024 

NIHB 4th Quarter Board Meeting 

Virtual 

December 3-4, 2024 

TLDC Meeting 

Tucson, AZ 

December 4, 2024 

HRSA Tribal Advisory Council Meeting 

Virtual

December 16-17, 2024 

IHS TSGAC Meeting 

Washington, DC 

January 22-23, 2025

FY 2027 National Tribal Budget Formulation Workgroup Area Report

Virtual

Administrative and Legislative Updates

HHS Region 10 Tribal Issues Tracker: HHS updates the tracker regularly and sends the link out every other month for your review. You can find the most recent version Here. 

CMS Final Rule on Medicaid Four Walls Exception for IHS and Tribally Operated Clinics: On Friday, November 1, 2025, CMS finalized several Indian Country priorities in the Final Rule. The Final Rule:  

• creates a permanent fix that will allow Tribal facilities to bill Medicaid for services provided outside the four walls of a facility without the need for a grace period; 
• creates a separate Medicare Part B add-on payment for high-cost drugs provided by IHS and Tribal hospital outpatient services; 
• commits to working with the CMS TTAG on its priority to allow all tribal clinics to bill Medicare at the Outpatient AIR 

CMS Approved four state section 1115 demonstration amendments that allow Medicaid and Children’s Health Insurance Program (CHIP) coverage of traditional healthcare practices provided by Indian Health Service (IHS) facilities, Tribal facilities, and Urban Indian Organizations. The approval will apply to IHS facilities, Tribal facilities, and Urban Indian Organizations in California, New Mexico, and Oregon, and will apply to only IHS and Tribal facilities in Arizona. 

Administration for Children and Families (ACF): HHS awards $3.7B to the Low Income Home Energy Assistance Program (LIHEAP) to help households lower their home energy costs. LIHEAP is administered by ACF’s Office of Community Services, which releases annual funding to states, tribes, and territories that directly assist households with low incomes struggling to afford their energy bills. 

IHS FY 2025 Joint Venture Construction Program (JVCP): IHS recently announced the opening of a new solicitation for the JVCP. Section 818 of the Indian Health Care Improvement Act authorizes the IHS to establish joint venture projects under which Tribes or Tribal organizations would acquire, construct, or renovate a health care facility and lease it to the IHS, at no cost, for a period of 20 years. The facility may be an inpatient or outpatient facility. Phase I applications are due December 22.

• Please see https://www.ihs.gov/dfpc/programs/#jvcp for additional information, including the full application package. 

Center for Medicare & Medicaid Services Office of Minority Health (CMS OMH): In honor of Native American Heritage Month, the CMS OMH is committed to helping AI/AN community meet their healthcare needs. We encourage you to share the resource links with those you serve. 

• Download the Coverage to Care Roadmap to Better Care (Tribal Version), which explains how to use health coverage to get primary care and preventive services and highlights special protections for American Indians and Alaska Natives under Marketplace, Medicaid, and the Children’s Health Insurance Program (CHIP). 
• Explore the CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities, which outlines six priority areas for how CMS will focus efforts to achieve health equity for rural, tribal, and geographically isolated communities. 
• View a data snapshot, Chronic Condition Prevalence Among Medicare Fee-For-Service Enrollees With COVID-19, to learn about COVID-19 prevalence and hospitalization rates among Medicaid fee-for-service enrollees by race/ethnicity and gender. 
• Read our data snapshot, Ischemic Heart Disease Disparities in Medicare Fee-For-Service Beneficiaries, to find important information about racial and ethnic disparities in coronary artery disease prevalence among Medicare fee-for-service enrollees. 
• Check out the CMS Tribal Technical Advisory Group (TTAG) for information on the Government-to-Government relationship and understanding between CMS and tribes. 
• Visit the American Indian/Alaska Native Heritage Month Lecture Series webpage to view past lectures from the CMS American Indian and Alaska Native Employee Resource Group in honor of Native American Heritage Month. 

Happy Holidays NPAIHB Pets! As we get into the holiday season, we don’t want to forget about our Pet Health. The link below helps us navigate some foods that can be dangerous, and even deadly, to our pets.

• What foods to Avoid? 

HHS Takes Action on the Not Invisible Act Commission’s Findings and Recommendations: 

Today, in its response to the findings and recommendations - PDF of the Not Invisible Act Commission (NIAC), HHS reaffirms its commitment to address the ongoing crises of missing and murdered Indigenous peoples (MMIP) and human trafficking by elevating its social and health care services tied to the prevention, intervention, and healing from violence and trauma. 

Call for Nominations to the CMS Health Equity Advisory Committee – December 12. The Centers for Medicare & Medicaid Services (CMS) requests nominations for members to their newly formed Health Equity Advisory Committee (HEAC). This Committee will advise and make recommendations to CMS on how they can promote quality and access for beneficiaries in all CMS programs, like Medicare and Medicaid. Nominations must be submitted by email to HEAC@cms.hhs.gov with the subject line “HEAC Nomination” by December 12. 

In Honor of Native American Heritage Month: Update Catalogue of Resources from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Office of the Assistant Secretary for Health (OASH).

SAMHSA Resources: 

• SAMHSA Tribal Consultation Session on the Tribal Behavioral Health (TBH) Grant Program Webinar November 21 at 12 PM PST 
• SAMHSA TSLGBTQ Newsletter Sign-Up 
• Native Connections, Tribal Behavioral Health Grant Program Grantee Handbook 
• Native Connections Website 
• PODCAST: Developing Suicide Prevention Policies 
• PODCAST: Ensuring Youth Advisory Group Effectiveness 

OASH Resources: 

• HEAR HER Campaign

This campaign is a collaboration between CDC and the Office of Minority Health in OASH. 

• Food Sovereignty as a Path to Health Equity for Indigenous Communities 

This article highlights some of the work of the Center for Indigenous Innovation and Health Equity (Center for Indigenous Innovation and Health Equity (CIIHE) | Office of Minority Health) on food sovereignty. 

• Food is Medicine 
• Syphilis resources 
• The OASH staff in Region 10 are working to advance efforts in all of these areas. If you have any questions or would like to be included in updates or convenings, please reach out to Renée Bouvion, Regional Health Administrator for OASH at renee.bouvion@hhs.gov. 

Tribal Consultations, Listening Sessions & Written Comments

HHS Traditional Healing Summit 2024: HHS, in coordination with the White House Council on Native American Affairs, is hosting the 2nd Annual Traditional Healing Summit on November 18-19, 2024, in Washington, DC. The Summit will focus on traditional healing practices to address health challenges in Tribal communities. The Summit will highlight successful models of integrated healthcare with traditional healing in prevention, intervention, and treatment methods across behavioral health and primary care. The Summit will be attended by Tribal leaders, traditional health practitioners, and federal policymakers. The goal of the Summit is to further recognize an array of traditional knowledge and practices that contribute to the overall health and well-being of Tribes. View the Summit livestream Here. 

HHS Listening Session on Tribe-Specific Data Disclosures as they relate to the draft HHS Tribal Data Access Policy and draft HHS TEC Data Access Policy. HHS especially invites those who commented on this issues during consultation and those who work directly with Tribal data, whether in Tribal health settings or through epidemiology centers, to participate. The virtual listening session will take place on November 22, 2024, 10:00 AM – 11:30 AM PST.

• Registration here. 

Community Forum on Patient-Centered Contraceptive Care: HHS invites you to a Community Engagement forum with HHS partner Upstream USA, which focuses on working with the healthcare community to expand patient-centered contraceptive access in Region 10.

• Register now at https://zoom.us/webinar/register/WN_DDcknFwfRhqP0T1kr5afdA 

The Social Security Administration in partnership with the Administration for Children and Families has published a request for information (RFI) seeking public input to inform how federal agencies can support broader state and local efforts to improve the outcomes of children in the child welfare system who are eligible for Social Security benefits and Supplemental Security Income (SSI) Payments. Submit comments by December 2, 2024. Refer to Docket No. SSA-2024-0038.

• To submit Online, the link can be found here. 

SAMHSA Tribal Consultation on its Tribal Consultation Policy.  SAMHSA is seeking input from Tribal leaders to modernize its Tribal Consultation Policy. SAMHSA will also align the policy with the reorganization of the agency under the 21st Century Cures Act and the updated HHS Tribal Consultation Policy. Virtual Consultation will be on December 5, 2024, 10:00 AM – 11:30 AM PST. Comments are due: January 6, 2025.

IHS HIT Modernization. On January 18, 2024, the Indian Health Service (IHS) issued a Dear Tribal Leader letter, announcing a series of four Tribal and Urban Consultation sessions set to take place throughout the HIT Modernization 2024 calendar. The first session, slated for February 8th, will provide an overview of the Enterprise Collaboration Group. During this session, the IHS requests feedback on system configuration and change management. Written comments are due 30 days following each session by email to consultation@ihs.gov, SUBJECT LINE: Health IT Modernization. NPAIHB Tribal Caucus scheduled for Monday, November 25, 2:00PM PST. Comments are due: December 7, 2024 

HRSA Tribal Consultation on the Uniform Data System Modernization Initiative (UDS+): HRSA is conducting a virtual consultation on the UDS+. The virtual Tribal Consultation took place on November 13. HRSA encourages all Tribal leaders to help ensure valuable input representing American Indians and Alaska Natives and are encouraged to send written comments to tribalconsultation@hrsa.gov by December 13. 

IHS Invites Updates for Identified Healthcare Facility Needs: Tribal leaders are invited to identify renovation and expansion needs for inclusion in the 2026 IHS and Tribal Health Care Facilities’ Needs Assessment Report to Congress. The report is compiled every five (5) years in close collaboration with the Facilities Appropriation Advisory Board (FAAB) and Facilities Needs Assessment Workgroup. It is not a funding request nor a priority system but an estimate of needs for planning-level use. Comments to be received no later than December 31, 2024.

• DTLL Here. 

Mental Health Services Research (MHSR) 2025: Confronting the Mental Health Crisis with Outcomes that Matter.  Save-the-Date: July 28-31, 2025, Located: Gaithersburg Marriot Washingtonian Center, Maryland. Join the National Institute of Mental Health for its 26th Mental Health Services Research Conference. 

For more information:

Laura Platero, Executive Director 

Candice Jimenez, Chief of Staff

Rebecca Descombes, Health Policy Assistant

Northwest Portland Area Indian Health Board | Website