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Northwest Portland Area Indian Health Board

Legislative and Policy Update

December 6, 2023

Important Dates

Dec. 5-6, 2023

IHS Tribal Leaders Diabetes Committee Meeting 

Embassy Suites by Hilton Portland Airport, Portland, OR

or Virtual 

Dec. 5-6, 2023 

IHS Facilities Appropriation Advisory Board Meeting 

Phoenix, AZ; Hybrid

Dec. 6-7, 2023

White House Tribal Nations Summit

Washington, D.C.

Registration Link

Dec. 6, 2023 (11:00 AM PT) 

CDC Grants Governance Board Tribal Listening Session

Zoom Link

Dec. 6, 2023 (11:30 AM PT / 2:30 PM ET)

United States Senate Committee on Indian Affairs Oversight Hearing titled, “Fentanyl in Native Communities: Examining the Federal Response to the Growing Crisis”

Hearing Webpage Link

Dec. 6, 2023 (12:00 PM PT)

CMS All Tribes Webinar: Tribal Protections in Medicaid and CHIP Managed Care Oversight Toolkit

Registration Link

Dec. 7, 2023 (9:00 AM PT)

IHS Behavioral Health Integration Webinar: Reviewing Barriers and Strengths to Integrate Mental Health Services in Primary Care 

Registration Link

Dec. 12, 2023 (9:00 AM PT)

IHS CHAP Tribal Advisory Group Quarterly Meeting


Dec. 13, 2023 (8:00 AM PT) 

IHS Health IT Modernization Summit 

Registration Link

Dec. 13-14, 2023

IHS Tribal Self Governance Advisory Committee Meeting 

Washington, D.C.

Dec. 14, 2023 (9:00 AM PT)

IHS Behavioral Health Integration Webinar: Provider Roles Changing the Way we Practice

Registration Link

Dec. 14, 2023 (10:00 AM PT)

ACF Tribal Advisory Committee Meeting


Dec. 18, 2023 (12:00 PM PT)

Indian Health Service (IHS) Tribal Consultation on Developing a Spend Plan for the Bipartisan Infrastructure Law

Meeting Registration Link

Jan. 9, 2024 (12:00 PM PT)

IHS Tribal Consultation on Definition of Indian Tribe for Tribal Consultation Policy

Registration Link

Jan. 11, 2024 (12:00 PM PT)

IHS Tribal Consultation on Definition of Indian Tribe for Tribal Consultation Policy

Registration Link

Jan. 15, 2023

NPAIHB Tribal Health Directors Meeting

Ilani Casino Resort, WA

Jan. 16-18, 2024

NPAIHB Quarterly Board Meeting 

Ilani Casino Resort, WA

Jan. 17, 2024 (12:30 PM PT)

IHS Tribal Consultation on Definition of Indian Tribe for Tribal Consultation Policy

Registration Link

Jan. 18, 2024 (10:00 AM PT)

IHS Tribal Consultation on Definition of Indian Tribe for Tribal Consultation Policy

Registration Link

Jan. 29-Feb. 1, 2024

ATNI Winter Convention

NPAIHB Governmental Affairs

The NPAIHB is recruiting to fill two open Health Policy positions - Health Policy Specialist and Health Policy Assistant. These are full-time positions with benefits. Please help us recruit for this position by sharing this posting with your contacts and with anyone who may be interested in applying. The recruitment closing date is December 12, 2023.

2023 National Tribal Opioid Summit

Dear Tribal leaders, Colleagues, and Community –

On behalf 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. Together, we were over 1,000 Tribal leaders, frontline workers, and federal and state policymakers sharing our knowledge, our experiences, and our commitment to ending the tribal opioid crisis.


Thank You letter and significant 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 and ongoing resources available via the National Tribal Opioid Summit

Resource Hub


The Draft NTOS Policy Recommendations have been posted on the Resource Hub website.  We request comments, edits and suggestions to [email protected]rg.


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

  • A set of policy recommendations;
  • 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.

Monthly Health News & Notes

November Edition

We've recently created a new monthly version of our Health News & Notes newsletter.

Learn more about our Project updates, relevant resources, community events and more!

Read the Newsletter

To subscribe, contact Communications Manager Kira Rea ([email protected]).

Quarterly Publications

Appropriations and Legislative Updates

Further Continuing Appropriations and Other Extensions Act, 2024 (H.R. 6363)President Biden signed into law H.R. 6363, extending funding at current levels for specific agencies to Jan. 19, 2024, or Feb. 2, 2024.  The Interior, Environment, and Related Agencies bill that includes funding for the Indian Health Service is extended to Feb. 2, 2024.  The Special Diabetes Program for Indians extends to Jan. 19, 2024. 

The Senate Committee on Indian Affairs (SCIA) held an oversight hearing on the fentanyl crisis impacting Native communities on November 8th. SCIA is holding another oversight hearing on Wednesday, December 6th at 11:30 AM PT titled “Fentanyl in Native Communities: Examining the Federal Response to the Growing Crisis” and can be accessed at the hearing webpage link, HERE.

  • The recent SCIA Oversight Hearing held on Nov. 8th titled, “Fentanyl in Native Communities: Native Perspectives on Addressing the Growing Crisis” is available for viewing HERE.

The Senate Confirms Dr. Monica Bertagnolli as the Director of the National Institutes of Health.

House Passes FY 2024 Interior and Environment Appropriations Bill (H.R. 4821). H.R. 4821 includes an increase of $149 million for the Indian Health Service for a total of $7.08 billion in FY 2024 and $5.9 billion in advance appropriations for the IHS in FY 2025.  However, the bill does not include the President’s Budget Request to make Contract Support Costs and 105(l) lease mandatory appropriations.  

Restoring Accountability in the Indian Health Service Act of 2023. Sens. Barrasso (R-WY), Thune (R-SD), Lummis (R-WY), Daines (R-MT), and Rounds (R-SD) have reintroduced the Restoring Accountability in the Indian Health Service Act (S. 3130) to amend the Indian Health Care Improvement Act to improve transparency, oversight, and accountability in the IHS and address recruitment and retention.

IHS Workforce Parity Act of 2023. Sens. Cortez Masto (D-NV) and Mullin (R-OK) introduced S. 3022, titled IHS Workforce Parity Act of 2023, that would amend the Indian Health Care Improvement Act to allow IHS scholarship and loan recipients to fulfill service obligations through half-time clinical practice.  

Bipartisan Primary Care and Health Workforce Act. The Bipartisan Primary Care and Health Workforce Act was introduced and includes $5.8 billion per year over the next three years in mandatory funding for community health centers and $2.2 billion for each fiscal year in discretionary funding, one-time $3 billion capital investment to support construction and renovation at health centers with priority to dental and behavioral health projects, increasing mandatory funding for National Health Service Corps to $950 million per year for FY 2024 through 2026, $300 million for each FY 2024 through 2028 for the Teaching Health Center Graduate Medical Education program.  

Tribal Consultation, Listening Session & Written Comment Updates

Centers for Disease Control and Prevention (CDC) Grants Governance Board Tribal Listening Session.  The CDC is hosting a tribal listening session on Dec. 6, 2023, at 11 AM PT to discuss priorities on the new CDC Grants Governance Board to improve the administration of grants.  

White House Tribal Nations Summit. The White House has announced the Tribal Nations Summit on Dec. 6-7, 2023, in Washington, D.CTribal Leaders will have the opportunity to engage in meaningful conversations with senior Administration officials on implementing key priorities, new policies, and other critical issues facing Tribal Nations.  More details will be forthcoming.

  • Register by Nov. 27, 2023, at 2 PM PT HERE.

IHS Health Information Technology Modernization Virtual Summit. IHS is hosting the Health Information Technology (IT) Modernization Summit on Dec. 13, 2023, from 8 AM - 2 PM PT for Tribal Leaders and Urban Indian Organizations to engage virtually in robust and meaningful conversation on the new enterprise electronic health record solution.

IHS Tribal Consultation on the Definition of Indian TribeThrough Dear Tribal Leader Letter dated November 27, 2023, the IHS has announced tribal consultation on which definition of Indian Tribe should be used in the consultation policy.  The two definitions are the List Act Definition (25 U.S.C. § 5130) or the Indian Self-Determination and Education Assistance Act definition (25 U.S.C. § 5304(e)).  The consultation sessions will occur on the following days and times:

Administrative and Regulatory Updates

White House Releases Playbook to Address Social Determinants of Health.  This Playbook lays out an initial set of structural actions federal agencies are undertaking to break down silos and to support equitable health outcomes by improving the social circumstances of individuals and communities.  To accompany this Playbook, the Department of Health and Human Services also released a Call to Action to Address Health-Related Social Needs and a Medicaid and CHIP Health-Related Social Needs Framework.  

Health and Human Services (HHS) Region 10 Tribal Quarterly Call. HHS Region 10 hosted a quarterly call last week and shared updated resources.

Indian Health Service (IHS) Announces New Electronic Health Record System. IHS has selected General Dynamics Information Technology, Inc. to build, configure, and maintain a new IHS electronic health record system utilizing the Oracle Cerner technology.

CMS Provides Guidance to States on Coverage of Health-Related Social Needs (HRSNs). The CMS guidance provides opportunities available under Medicaid and Children’s Health Insurance Program (CHIP) to cover services and supports that address health-related social needs. 

CMS Releases Tribal Protections in Medicaid and CHIP Managed Care Oversight Toolkit. This new toolkit provides resources for states, managed care plans, and Indian Health Care Providers to maximize the benefits of Medicaid and CHIP managed care for American Indian and Alaska Native enrollees consistent with the statutory and regulatory Indian managed care protections.

CMS Updates on Mandatory Continuous Enrollment for Children in Medicaid and CHIP.  Effective January 1, 2024, states are required to provide 12 months of continuous enrollment for children under 19 in Medicaid and CHIP.  States may terminate eligibility for children under 19 for the following limited circumstances for children who reach age 19, cease to be state residents, request a voluntary termination of eligibility, or who are deceased, or the agency determines that eligibility was erroneously granted.  States are not limited to providing only a 12-month continuous enrollment period for children.  Oregon became the first state to receive approval from CMS to maintain eligibility for children from birth to six.  Washington has a similar request waiting approval by CMS.

Medicaid Unwinding Updates. The Consolidated Appropriations Act, 2023 set an end date for the Medicaid continuous enrollment condition to March 31, 2023, that 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.  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. 

National Institutes of Health (NIH) announces the establishment of the RADx Tribal Data Repository: Data for Indigenous Implementations, Interventions, and Innovations (D4I). After a competitive review, Stanford University, in partnership with the Native BioData Consortium, has been selected to lead this unique NIH-supported effort. The Native BioData Consortium is the first Indigenous-led 501(c)(3) nonprofit research organization and biodata repository within the geographic borders and legal jurisdiction of a Tribal Nation (Cheyenne River Sioux Tribe).

New Health Resources & Services Administration (HRSA) Director of Tribal Affairs, Juliana Blome, Ph.D.  She formerly served as Deputy Director of the Tribal Health Research Office at the National Institutes of Health (NIH), where she worked alongside Dr. David Wilson (Navajo Nation). There, she focused on strengthening collaborations between NIH and American Indian and Alaska Native communities, building partnerships based on trust and transparency, and increasing cultural awareness in research that improves health in Tribal communities.  

The Veterans Affairs (VA) Department Finalizes Rulemaking on the Pilot Program on Graduate Medical Education and Residency.  Effective Dec. 13, 2023, the VA adopts the proposed rule issued on Feb. 4, 2022, as final, with changes, to amend its regulations to include a new pilot program on graduate medical education and residency.  The final rule responds to written comments received, including a number of comments from Tribes and Tribal organizations.  

The U.S. Government Accountability Office (GAO) Releases Report on Indian Health Service Federal Facilities. The Report was released earlier this month that found that many federally operated facilities are not in good condition and their medical equipment is aging.  The GAO made three recommendations to IHS: to assess the extent of medical equipment data problems across IHS areas, implement a plan to correct any problems, and regularly monitor adherence to IHS medical equipment inventory management policy requirements.  

Not Invisible Act Commission Releases Final Report. The Report calls upon the federal government to declare a Decade of Action and Healing to address the crisis of missing, murdered, and trafficked American Indian and Alaska Native people.  A summary of Key Findings and Recommendations can be found on page 11 of the Report.  

Litigation Updates

The Supreme Court Will Hear Contract Support Cost Payments Dispute.

Last week, the Supreme Court agreed to hear the two federal government petitions that have been consolidated into one case.  The petitions request the Court to overturn the orders requiring the IHS to reimburse millions in administrative health care costs to Tribes for third-party income.  

  • SCOTUSblog articles on “Tribal self-governance at center of dispute over federal health care costs” and “Funding for Native healthcare programs”– article links,   one | two.

Tribal Health-related Funding Opportunities

The IHS Division of Facilities, Planning, and Construction is accepting FY 2024 Staff Quarters Project proposals. Deadline to receive project proposals is Feb. 1, 2024.  Email any questions to CAPT Jason Lovett, Director, Division of Health Facilities Engineering, at [email protected].  

For more information:

Laura Platero, Executive Director 

Karol Dixon, Director of Government Affairs/Health Policy

Candice Jimenez, Chief of Staff

Northwest Portland Area Indian Health Board | Website