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Northwest Portland Area Indian Health Board

Legislative and Policy Update

June 14, 2023

Important Dates

Jun 13-15, 2023

Administration for Children & Families Tribal Advisory Committee

— Klamath Tribes, OR

Jun 14, 2023 (11:30 AM PST)

CMS TTAG Monthly Meeting

Jun 15, 2023 (12:00 PM PST)

DSTAC Monthly Meeting


Jun 20-21, 2023

IHS National Tribal Advisory Committee (NTAC) on Behavioral Health Meeting

— Virtual

Jun 21, 2023 (8:30 AM PST)

SAMHSA Tribal Technical Advisory Committee Meeting

— Virtual 

Jun 22, 2023 (9:30 AM PST)

CHAP Tribal Advisory Group (TAG) Meeting

— Virtual 

Jun 22, 2023 (11:00 AM PST)

CDC/ATSDR Tribal Advisory Committee 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

Jun 26, 2023 (10:45 AM CDT)

Veterans Affairs In-Person Roundtable on Draft Reimbursement Agreement Template for Tribal Health Programs at TSGAC

— Tulsa, OK

Jun 26-29, 2023

2023 Tribal Self-Governance Annual Conference

— Tulsa, OK

Jun 27-29, 2023

Our Nations, Our Journeys Indigenous Public Health Conference: Healing from the Opioid Epidemic through Strengths-based Approaches and Data Sovereignty

— Prior Lake, MN

Registration Link

Jun 28-29, 2023

IHS Facilities Appropriations Advisory Board (FAAB) Meeting

— Virtual 

Zoom Link

Jul 19-20, 2023

Region 10 Opioid Summit

— Vancouver, WA

Registration Link

Jul 25-27, 2023

16th Biennial NPAIHB & CRIHB Joint & Quarterly Board Meeting

— Siletz, OR

Jul 25, 2023

MMPC Face-to-Face Meeting

Washington, DC

Jul 26-27, 2023

TTAG Face-to-Face Meeting

— Washington, DC

Introducing our new NPAIHB Senior Policy Advisor

Karol Dixon recently joined the Policy team as a Senior Policy Advisor. Karol is Deg Hit’an Athabascan and an enrolled Tribal member. She has a Master of Public Health from Johns Hopkins University and a Juris Doctor from the University of New Mexico School of Law. Karol brings significant experience working with Medicaid, Medicaid waiver programs and tribal health organizations. Karol has managed health programs from planning and design through implementation and evaluation, including ensuring compliance with federal, state, and nonprofit requirements. She has a personal commitment to health and well-being. When not working, Karol and her family enjoy spending time in the great outdoors, hiking, camping, and traveling throughout the beautiful Pacific Northwest.

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

Fiscal Responsibility Act, H.R. 3746 Passes House and Senate, Signed into Law by President. President Joe Biden signed the debt ceiling bill, a capstone to months of negotiations to address the limit. H.R. 3746 suspends the debt ceiling limit through January 1, 2025, limits FY 2024 nondefense discretionary funds to FY 2023 levels, allows for a 1% growth in FY 2025 and considers only a 1% increase for FY 2026-2029. Additionally, this deal prevents a first-ever default while reducing the budget deficit, safeguards Social Security, Medicare, and Medicaid, and fulfills obligations to veterans. Raising the nation's debt limit, now at $31.4 trillion, will ensure the government can borrow to pay debts already incurred.

  • The legislation includes spending caps on the total amount for non-defense discretionary funding for two years.
  • The Indian Health Service (IHS) falls under non-defense discretionary funding; however, how the caps impact the actual IHS budget has yet to be determined.
  • The bill also includes rescission of some unobligated COVID-19 funding. However, the American Rescue Plan funding for the Indian Health Service (IHS) is protected from these rescissions.
  • The legislation included the budgetary authority to extend advance appropriations for IHS for FY25 and FY26 but limited the advance -
  • Lastly, the deal includes expanding specific work requirements for federal nutrition and cash assistance programs but does not include new work requirements for Medicaid.

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 annuallt for five fiscal years.
  • House SDPI sign-on letters are still accepting signatures!   Urge your representative to join the letter!
  • To view the Congressional sign-on letter for the House, click here. 
  • Special Diabetes Program Reauthorization Act of 2023, S.1855.  On Thursday, June 15, the Senate Health, Education, Labor, and Pensions Committee will hold a business meeting to consider several bills. Among them is legislation introduced on June 7 by Senators Collins (R-ME) and Shaheen (D-NH), the co-chairs of the Senate Diabetes Caucus, which would reauthorize the Special Diabetes Program (S. 1855). The bill would reauthorize the Type 1 Diabetes Research program and the Special Diabetes Program for Indians components at $170 million for FY 2024 and FY 2025.

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.

Urban Indian Health Confer Act, H.R. 630. On June 7, the House Natural Resources Committee’s Subcommittee on Indian and Insular Affairs held a legislative hearing on several tribal bills. One of the measures is the bill reintroduced by full Committee Ranking Member Grijalva which would require agencies of the Department of Health and Human Services to confer with urban Indian organizations regarding health care for American Indians and Alaska Natives who live in urban areas (H.R. 630). The House passed similar legislation in the 117thCongress. The NIHB sent a letter on June 12, 2023 to the House NR Committee expressing concerns with H.R. 630, and Ranking Member Grijalva withdrew the bill from markup.

Tribal Consultation, Listening Session & Written Comment Updates

Health and Human Services (HHS) Office of Civil Rights (OCR) Tribal Consultation. HHS OCR conducted tribal consultation last week to receive input from Tribes on proposed rulemaking prohibiting the disclosure or use of protected health information for limited purposes when obtaining, providing, or facilitating reproductive healthcare.  

National Institutes of Health All of Us Tribal Engagement program hosting Tribal listening sessions. The All of Us Research Program (run by the National Institutes of Health) aims to accelerate health research and medical breakthroughs to enable an era of precision medicine for all. All of Us is committed to ensuring the program reflects the diversity of the United States. All of Us recognizes that American Indian and Alaska Native (AI/AN) individuals are underrepresented in health research and often are not included in sufficient numbers to arrive at scientifically valid conclusions about the population in national research studies.

Office of Management and Budget (OMB) Tribal Consultation on the President’s Mandatory Funding Proposal for the IHS. OMB held a virtual tribal consultation on the President's mandatory funding proposal for the IHS on Jun. 2, 2023, at 11:00 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 11:00 AM to 12:30 PM.

Administrative and Regulatory Updates

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

Administration for Children and Families (ACF) Proposes to Eliminate Cost Share for Tribal Child Support Enforcement Programs. ACF 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.

IHS Requesting Priorities on Health Professionals for the Scholarship Program and Loan Repayment ProgramIHS invites feedback on a “Priority Categories” list for inclusion in the Scholarship Program and Loan Repayment Program for FY 2024-2025.  Health profession priorities are due Aug. 1, 2023, to Jeremy Sheehan at [email protected].   

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.


IHS Requesting Priorities on Health Professionals for the Scholarship Program and Loan Repayment Program. IHS invites feedback on a list of “Priority Categories” for inclusion in the Scholarship Program and Loan Repayment Program for FY 2024-2025.  Health profession priorities are due Aug. 1, 2023 to Jeremy Sheehan at [email protected].   


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


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.

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 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 SubstancesOn 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.   

Office of Inspector General for Health and Human Services issues Consumer AlertFraud Schemes Targeting Native American Communities in Behavioral Health Treatment Centers. A summary of the May 16 Alert is below, and the total Alert can be found here. The Alert identifies two types of fraudulent schemes targeting some of the most vulnerable members of Native American communities:

  1. A scheme involving phony sober living homes for addiction treatment and support, where the scammers pretend to be healthcare providers offering fake services and treatments while stealing the personal and medical identities of vulnerable community members;
  2. A scheme involving the recruitment of patients by employees of behavioral health outpatient treatment centers, who often work for fraudulent healthcare providers, and seek to induce patients to undergo an intake process with a licensed Behavioral Health Professional specializing in substance abuse counseling, then fraudulently billing Medicaid for services that do not align with the actual time spent. 

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

Upcoming HRSA Grant Application Deadlines in July:

SAMHSA releases notice of funding opportunity for 988 Tribal Response Cooperative Agreement Support. The opportunity provides financial resources to improve response to 988 contacts (calls, chats, and texts) originating in Tribal communities and/or activated by American Indians/Alaska Natives. This program aims to: (1) ensure access to culturally competent, trained 988 crisis center support 988 Lifeline centers; (2) improve integration and support of 988 crisis centers, Tribal nations, and Tribal organizations to ensure follow-up care; and (3) facilitate collaborations with Tribal/state/territory health providers, UIOs, and first responders in a manner which respects Tribal sovereignty.

  • Eligible entities, Award and Application Information: Federally recognized Indian Tribes, tribal organizations, and Urban Indian Organizations. Anticipated Award: $2,000,000 annually/3 years total. Due date: Jul. 18.

For more information:

Laura Platero, Executive Director 

Karol Dixon, Senior Policy Advisor

Candice Jimenez, Health Policy Analyst

Northwest Portland Area Indian Health Board | Website