MicrosoftTeams-image _19_.png

Northwest Portland Area Indian Health Board

Legislative and Policy Update

November 1, 2023

Important Dates

Nov. 2, 2023 (12:00 PM PT) 

IHS November Tribal and Urban Indian Organizations Call

Nov. 8, 2023 (10:30 AM PT)

IHS Tribal Consultation: Health Information Technology Modernization The Path Forward

Registration Link

Nov. 9, 2023 (11:00 AM PT)

SAMHSA Tribal Consultation on Tribal Opioid Response Grant

Zoom Link 

Nov. 9, 2023 (1:00 PM PT)

SAMHSA Tribal Listening Session on Behavioral Health and Substance Use Disorder Resources for Native Americans

Zoom Link

Nov. 12-17, 2023

National Congress of American Indians Annual Convention & Marketplace

New Orleans, LA

Registration Link

Nov. 13, 2023

SAMHSA Tribal Listening Session on the Use of High-Dose Buprenorphine for the Tx of OUD

Registration Link

Nov. 28, 2023 (8:00 AM PT)

Save the New Date!

Portland Area Office FY 2026 Budget Formulation Meeting


Nov. 28-29, 2023 - to be confirmed

HHS Secretary’s Tribal Advisory Committee (STAC) Meeting

Washington, D.C.


Nov. 30, 2023 (10:00 AM PT)

IHS NTAC Quarterly Meeting



Dec. 5-6, 2023

IHS Tribal Leaders Diabetes Committee Meeting 

Embassy Suites by Hilton Portland Airport, Portland, OR

or Virtual


Dec. 6-7, 2023

Direct Service Tribes Advisory Committee National Meeting

Dec. 13, 2023 (8:00 AM PT) 

IHS Health IT Modernization Summit 

Registration Link

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]g.


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.

Quarterly Health News & Notes

Autumn Edition

Check out the Chronic Disease edition of the Health News & Notes quarterly journal. This issue features comments from Chairman Nickolaus Lewis, the 2023-2024 Youth Delegates, the vaping epidemic, and more!

Read the Publication Here

Appropriations and Legislative Updates

House Republicans Elected Rep. Mike Johnson (R-LA-4) as the new Speaker of the House last week.  With his recent election, the House is back to business on FY 2024 appropriations.  Rep. Johnson pledged to pass the remaining FY 2024 spending bills quickly.  Rep. Johnson is also working on Republican consensus to pass another stopgap continuing resolution to fund the government through January 15 or April 15. 

Continuing Appropriations Act, 2024. Congress passed the Continuing Appropriations Act, which funds the federal government through Nov. 17, 2023, and averted a government shutdown for now.  The Act included a temporary extension for the Special Diabetes Program for Indians (SDPI), which will expire after the Nov. 17 deadline.

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

Substance Abuse and Mental Health Services Administration (SAMHSA) Virtual Tribal Consultation on the Tribal Opioid Response Grant Program.  SAMHSA will hold a virtual tribal consultation on the Tribal Opioid Response grant program on Nov. 9, 2023, at 11 AM PT.  

SAMHSA Virtual Tribal Listening Session on the Behavioral Health and Substance Use Disorder Resources for Native Americans. SAMHSA will be hosting a second virtual tribal listening session on Nov. 9 at 1 PM PT on the Behavioral Health and Substance Use Disorder Resources for Native Americans grant program that was authorized under Section 1201 of the Consolidated Appropriations Act, 2023.  

SAMHSA Virtual Tribal Listening Session on the Use of High-Dose Buprenorphine for the Treatment of Opioid Use Disorder.  SAMHSA will be hosting a virtual tribal listening session on Nov. 13 at 11:30 AM PT to hear from providers treating OUD in Tribal clinical settings about the need for, effectiveness and safety of, barriers to, and practical experience with higher dose (24mg+) buprenorphin.  

IHS Portland Area Office (PAO) Budget Formulation Tribal Consultation. IHS Portland Area Office (PAO) FY 2026 Budget Formulation Meeting. Please save the date for the IHS PAO FY 2026 Budget Formulation meeting on Nov. 28, 2023, from 

8-12:30 PM PT

  • Location information, a Zoom link, and meeting materials will be forthcoming.

Office of Minority Health (OMH) Listening Session on Healthy People 2030.  OMH hosted a listening session last week to discuss a notice of funding opportunity entitled “Healthy People 2030 Leading Health Indicators Initiative.”  Written comments were accepted until Oct. 31, 2023, to [email protected].  

HHS Tribal Consultation on Section 504 of the Rehabilitation Act Proposed Rulemaking. HHS Office for Civil Rights hosted a virtual tribal consultation last week on proposed rulemaking implementing Section 504 of the Rehabilitation Act, which prohibits discrimination based on disability in programs and activities that receive Federal financial assistance.  Written comments are due Nov. 13, 2023, through the Federal Rulemaking Portal.  

Administration of Community Living (ACL) Tribal Consultation on the Older Americans Act (OAA).  ACL hosted a tribal consultation last week to review proposed changes to the OAA implementing regulations to incorporate a new subpart on Adult Protective Services published in the federal register on Sep. 12, 2023.  

IHS Tribal Consultation on Designating North Dakota and South Dakota as Purchased/Referred Care Delivery Areas (PRCDA). IHS hosted two tribal consultations to discuss the agency’s plans to study PRC implications and the feasibility of creating statewide PRCDAs in North Dakota and South Dakota.  Written comments will be accepted until Nov. 15, 2023.  

Administrative and Regulatory Updates

HHS and Drug Enforcement Agency (DEA) Issues Second 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 continued the telemedicine flexibilities for prescribing controlled medications authorized under the COVID-19 Public Health Emergency until Nov. 11, 2023.  The DEA and HHS have issued a second temporary extension through Dec. 31, 2024.     

IHS Shares Resources to Address Opioid Epidemic. The IHS has gathered resources and tools to address the opioid crisis, including fentanyl test strips education; screening, brief intervention, and referral to treatment; Naloxone training toolkit; and syringe service resources.  The resources and tools are available at

IHS Released Updated Information on Seasonal Vaccines. See Dear Tribal Leader Letter dated September 22, 2023, with updated information on Influenza, Respiratory Syncytial Virus (RSV), and COVID-19 vaccines.

IHS FY 2024 Loan Repayment Program Update. IHS will begin accepting applications on Oct. 1, 2023, for the 2024 Loan Repayment Program for eligible healthcare professionals at  The awards will provide up to $50,000 total in exchange for a 2-year full-time service obligation.  

ACF Announces Proposed Reallotment of FY 2022 Funds for the Low-Income Home Energy Assistance Program (LIHEAP). ACF has announced a preliminary determination that funds from FY 2022 LIHEAP are available for reallotment to states, territories, tribes, and tribal organizations that received FY 2023 direct LIHEAP grants.  This preliminary redistribution of funds from FY 2022 does not include funds appropriated under the American Rescue Plan Act of 2022, P.L. 117-2.  

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 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 for approval by CMS.

CMS Releases Updated Guidance on Medicare Provider Enrollment for Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs). CMS has released a provider enrollment Frequently Asked Questions (FAQs) addressing details on Medicare enrollment of MFTs and MHCs. The Consolidated Appropriations Act of 2023 expanded Medicare Part B coverage to include reimbursement for behavioral health services furnished by MFTs and MHCs starting in 2024.  

CMS Extends Four Walls Grace Period for an Additional 12 Months. CMS announces an extension for IHS and Tribal facilities enrolled as clinics to continue to claim Medicaid reimbursement for services furnished outside of the “four walls” of the facility.  


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

Tribal Health-related Funding Opportunities

IHS released a Dear Tribal Leader Letter to announce that they are accepting applications for the FY 2022 and 2023 Small Ambulatory Program (SAP). The FY 2022 budget includes $25 million, and the FY 2023 budget includes $25 million for a total budget of $50 million available for SAP. Fiscal year 2022 and 2023 SAP projects will be awarded up to $3.5 million, and all 12 IHS Areas that submit an application will have an opportunity to receive an award.  Under the SAP, Tribes or Tribal Organizations that are operating an Indian healthcare facility pursuant to a healthcare services contract or compact may competitively apply for funding for the construction, expansion, or modernization of small ambulatory healthcare facilities.

  • Anticipated Award: Up to $3.5 million. Due date: Nov 10, 2023.
  • If your Tribe or Tribal Organization is interested in participating in the FY 2022 and FY 2023 SAP, please download and complete the application on the DFPC website at

John Hopkins Center for American Indian Health Scholarship. Financial support for American Indian and Alaska Native scholars, health leaders, health professionals, and paraprofessionals serving tribal communities who are interested in attending the Johns Hopkins Center for American Indian Health Summer or Winter Institute courses at the Johns Hopkins School of Public Health. Eligible applicants are American Indian and Alaska Native scholars with a Bachelor’s degree and a minimum grade point average of 2.75. 

  • The application due date is Nov. 17, 2023.  

The IHS Division of Diabetes Treatment and Prevention has a new 2024 funding opportunity for federally recognized tribes, tribal organizations, urban Indian organizations, and/or federal healthcare facilities that currently do not have a 2023 Special Diabetes Program for Indians grant. The 2024 Special Diabetes Program for Indians 2.0 (SDPI-2) will be a 4-year program to address diabetes treatment and prevention efforts in American Indian and Alaska Native communities, and applications are due by Nov. 29, 2023.

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