Northwest Portland Area Indian Health Board

Legislative and Policy Update

Tuesday, September 20, 2022

Important Dates

Sep. 18-22, 2022

ATNI Annual Convention — Tulalip Tribes

Registration Link

Sep. 20-21, 2022

IHS PRC Workgroup Meeting — Albuquerque, NM (hybrid)

Sep. 20-21, 2022 (10:00 AM Pacific)

IHS NTAC on Behavioral Health Q3 Meeting

Zoom Link

Sep. 21, 2022 (10:00 AM Pacific)

TSGAC/ACA/IHCIA Webinar: Medicaid Unwinding

Registration Link

Sep. 22, 2022 (11:00 AM Pacific)

CDC/ATSDR Tribal Advisory Committee Meeting

Zoom Link

Sep. 26. 2022 (12:00 PM Pacific)

DOJ DOI Listening Sessions on Castro-Huerta

Mon. Registration Link

Sep. 26-28, 2022

NIHB National Tribal Health Conference — Washington D.C.

Registration Link

Sep. 27, 2022 (12:00 PM Pacific)

DOJ DOI Listening Session on Castro-Huerta

Tue. Registration Link

Sep. 27, 2022 (9:30 AM Pacific)

CHAP Tribal Advisory Group (TAG) Meeting

Sep. 28, 2022 (11:00 AM Pacific)

NIH Tribal Advisory Committee Monthly Meeting

Zoom Link

Sep.28, 2022 (11:00 AM Pacific)

HHS & Pride Foundation LBGTQ Health Convening

Zoom Link

Sep. 28, 2022 (2:00 PM Pacific)

HRSA Annual Tribal Consultation during the NIHB National Tribal Health Conference — Washington, D.C.

Sep. 29, 2022

Federal/Tribal Coordination Call

Teams Link

Sep. 30, 2022 (12:00 PM Pacific)

ISAC Monthly Meeting

Sep. 30, 2022 (12:00 PM Pacific)

NPAIHB Dancing in the Square: American Indian Day Celebration — Portland, OR

Oct. 6, 2022

IHS Oct. All Tribal and Urban Indian Organization Leaders Call

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.

An ongoing tracker of COVID-19 direct and set-aside funding for Tribes. Updated as of Aug. 2, 2021.

Tribal Consultation Updates

HHS Tribal Consultation on Nondiscrimination in Health Programs and Activities. The Office of Civil Rights hosted a tribal consultation on a notice of proposed rulemaking on implementing Section 1557 of the Affordable Care Act related to Nondiscrimination in Health Programs and Activities. 

• Written comments are due Oct. 3, 2022

OMB Tribal Consultation on FY 2024 President’s Budget. OMB held a virtual consultation this week to seek tribal input on the development of the President’s FY 2024 Budget. Numerous Portland Area Tribal leaders voiced their concerns, recommendations, and requests on the call, including support for advance appropriations, fully funding Purchased/Referred Care, reimbursement of health IT modernization efforts of the Portland Area Tribes, and direct funding for tribal public health infrastructure. Written comments are due Oct. 14, 2022 to tribalconsultation@omb.eop.gov.   

DOJ and DOI Listening Sessions on Castro-Huerta. The Department of Justice and Department of Interior are hosting joint listening sessions on Sep. 26 & 27, 2022 at 12 PM Pacific to discuss the impact of the recent Supreme Court decision in Oklahoma v. Castro-Huerta. 

• Sep. 26 Listening Session Registration Link
• Sep. 27 Listening Session Registration Link

U.S. Department of the Treasury to Hold Tribal Consultation on Treasury’s Strategic Plan. The consultation will be held on Dec. 6, 2022 at 12 PM Pacific. Treasury is accepting written comments until Dec. 31, 2022. Submit written comments to tribal.consult@treasury.gov.

• Register here for the Dec. 6, 2022, 12 PM Pacific consultation
• Dear Tribal Leader Letter on Treasury’s Strategic Plan Consultation
• Summary of the Tribal Consultation relating to Treasury’s FY 2022-2026 Strategic Plan held on Nov. 31, 2021

Health Resources and Services Administration (HRSA) Annual Tribal Consultation. HRSA will be hosting an in-person consultation during the NIHB’s 2022 National Tribal Health Conference on Sep. 28, 2022 at 5:00 PM Eastern. The focus of this consultation will be on physician recruitment, retention, and provider burnout in Indian Country. Written testimony is due Oct. 28, 2022 to aianhealth@hrsa.gov. 

IHS and Veterans Health Administration (VHA) Tribal Consultations. VHA and IHS will host a consultation on the first-ever Draft Annual Operational Plan for fiscal year (FY) 2022 for the VHA-IHS Memorandum of Understanding (MOU). Tribal input will assist in making improvements to operational activities, initiatives, and metrics that align with the mutual goals and objectives of the MOU. Written comments are due Oct. 30, 2022.

• View the Dear Tribal Leader Letter initiating Tribal Consultation on the FY 2022 Draft Annual Operational Plan regarding the VHA-IHS MOU here.
• View the Draft Annual Operational Plan for the FY 2022 VHA-IHS Memorandum of Understanding here.
• View the VHA-IHS MOU, updated in October 2021.

VHA and IHS will host a Tribal consultation on the expansion of VA’s IHS/Tribal Health Program Reimbursement Agreement Program to include PRC and contracted travel. The VA will hold an in-person consultation on Sep. 27, 2022 at 4:30 PM Eastern during the National Tribal Health Conference in Washington D.C. The VA will also host a virtual consultation on Sep. 30, 2022 at 10 AM Pacific. Written comments are due Sep. 30, 2022 to tribalgovernmentconsultation@va.gov.   

• Federal Register Notice Announcing Consultation on Reimbursement Agreement
• Sep. 30, 2022 Virtual Session Access

Administrative and Regulatory Updates

HHS Declares Monkeypox Public Health Emergency. On Aug. 4, 2022, HHS Secretary Becerra declared the ongoing spread of monkeypox virus a public health emergency. IHS has received a limited initial allocation of Monkeypox medical countermeasures, including the JYNNEOS vaccine and oral medication TPOXX. IHS and Tribal health facilities may request these countermeasures through the IHS National Supply Service Center by submitting an IHS-413 form to aaron.wyatt@ihs.gov and cathy.thomas2@ihs.gov. The vaccine started shipping on Aug. 15, 2022. 

• Register for the HHS IEA Weekly Briefing on Monkeypox Here.
• Monkeypox FAQs: Schools and Childcare

IHS Portland Area Office Allocates Funding for Regional Referral Specialty Center. IHS has allocated $500,000 from the available funding to complete planning work necessary to proceed with the project. There are two options for completing the project planning work: 1) either a Portland Area Tribe or Tribal Organization supported by all Portland Area Tribes completes the work under a 638 Agreement or Construction Contract; or 2) IHS completes the work under a federal acquisition contract. IHS will proceed with a federal acquisition if it does not receive a fully supported intent to contract from a Tribe or Tribal Organization by Sep. 30, 2022.

• View the Portland Area Office Regional Referral Specialty Center Planning Notice of Funding Availability (NOFA) here.

IHS Update on Bivalent COVID-19 Booster Vaccines. Everyone age 12 years and older is now eligible for bivalent boosters that targets both the original COVID-19 virus and Omicron variants. In order to receive the booster, you must have completed the primary vaccination series and it has been at least two months since your last COVID-19 vaccine dose. 

• IHS National Pharmacy and Therapeutics Committee Update on Boosters
• CDC Updated Guidance on Boosters

IHS Special Diabetes Program for Indians (SDPI) FY 2023 Grant Application Now Open. The Notice of Funding Opportunity announcement for FY 2023 SDPI grants has been posted and is open to all eligible applicants, including Tribes that have not previously been awarded an SDPI grant. The deadline to apply is Oct. 7, 2022 for SDPI FY 2023 funding. 

• Dear Tribal Leader Letter announcing SDPI FY 2023 Grant Decision Here. 

CMS Proposes Rule to Streamline Eligibility and Enrollment Processes. This CMS rulemaking proposes changes to simplify the processes for eligible individuals to enroll and retain eligibility in Medicaid, the Children's Health Insurance Program (CHIP), and the Basic Health Program. We will schedule a brief NPAIHB Tribal Caucus in October to gather feedback on the proposed rule from Tribal leaders and health directors. Comments are due Nov. 7.

• View the CMS proposed rule “Streamlining the Medicaid, Children's Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes” here.

GAO Makes First Appointments to Newly Created Tribal Advisory Council. On Sep. 15, the U.S. Government Accountability Office (GAO) announced the first appointments to GAO’s newly established Tribal Advisory Council, which will provide the congressional watchdog with insights and recommendations on matters affecting Tribal Nations and their citizens.

• View the GAO Press Release here.

HRSA Provider Relief Funds Reporting Portal Open for Period 3.

Just a reminder that the PRF Reporting Portal opened on July 1, 2022 and will remain open through Sep. 30, 2022 for Reporting Period 3.    

*Grace period ended on Nov. 30, 2021.

U.S. Department of Homeland Security to Establish Tribal Security Advisory Council, Solicits Inaugural Members. The Department of Homeland Security is establishing the Tribal Homeland Security Advisory Council (THSAC). The goal of the THSAC is to provide recommendations on policies, programs, and initiatives that the Department is undertaking that have implications for tribes and Tribal Nations. Applications to join the THSAC will be accepted until Oct. 10, 2022 at 8:59 PM Pacific.

• View Notice of the Establishment of the Tribal Homeland Security Advisory Council; Solicitation of Inaugural Members here.

Litigation Updates

The Ninth Circuit Hears Arguments Regarding Denial of Medicaid Funding for DHAT Services. Washington law allows dental health aide therapists (DHATs) to provide services within the boundaries of a Tribal reservation to persons who are members of a federally recognized Tribe or otherwise eligible for services under IHS criteria. On Sep. 1, 2022, a Ninth Circuit three-judge panel considered an appeal by the Washington State Health Care Authority and the Swinomish Indian Tribal Community seeking to reverse a 2018 Centers for Medicare & Medicaid Services (CMS) decision to deny a Washington State Plan Amendment that authorized Medicaid reimbursement for DHAT services. The State and Swinomish Petitioners argued that CMS decision is contrary to law because it misinterprets the Medicaid free-choice provision, ignores long-standing Indian health and self-determination statutes, and disregards the federal government’s trust and treaty obligations toward American Indian and Alaska Native people.  

• View the Joint Opening Brief of the State of Washington and the Swinomish Indian Tribal Community here.
• View the Answering Brief of Centers for Medicare & Medicaid Services, United States Department of Health and Human Services here.

NPAIHB Joins the Tribal Amicus Brief in Support of the Indian Child Welfare Act (ICWA). The Supreme Court will be hearing oral arguments for Brackeen v. Haaland on Nov. 9, 2022. This case involves challenges to ICWA, which have the potential to dismantle this long-standing law and affect the wellbeing of children, families, and tribes who are currently protected by it.

• Read the Tribal Amicus Brief here.

For more information:

Laura Platero, Executive Director 

Liz Coronado, Senior Policy Advisor

Candice Jimenez, Health Policy Specialist

Northwest Portland Area Indian Health Board | Website