Northwest Portland Area Indian Health Board

Legislative and Policy Update

Wednesday, September 28, 2022

Important Dates

Sep. 26-28, 2022

NIHB National Tribal Health Conference — Washington D.C.

Registration Link

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 (11:00 AM Pacific)

Federal/Tribal Coordination Call

Teams Link

Sep. 30, 2022 (10:00 AM Pacific)

VA Consultation on IHS/THP Reimbursement Agreement

Virtual 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. 5, 2022 (8:00 AM Pacific)

IHS Director’s Advisory Workgroup on Tribal Consultation

Oct. 6, 2022 (12:00 PM Pacific)

IHS Oct. All Tribal and Urban Leaders Call

Oct. 11, 2022 (12:00 PM Pacific)

MMPC Monthly Meeting

Oct. 12-13, 2022

ACF TAC Triannual Meeting — Jamestown S’Klallam Tribe

Oct. 13, 2022 (11:00 AM Pacific)

CMS All Tribes Consultation on Measuring Health Disparities

Registration Link

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.

Legislative Updates

2023 Continuing Resolution Unveiled (H.R. 6833). On Monday, Sep. 26, 2022, Congress unveiled their stop-gap funding measure for FY 2023 to avert a government shutdown on Oct. 1, 2022. The Senate narrowly advanced the continuing resolution through a procedural vote on Sep. 27, 2022. The bill extends funding through Dec. 16, 2022 and includes an additional $17.9 million for the Indian Health Service for staffing and operations of new facilities, extension of HRSA’s Maternal, Infant, and Early Childhood Home Visiting, and an additional $1 billion for ACF’s Low Income Home Energy Assistance Program (LIHEAP). More Congressional action on this bill is expected this week. 

Senate Finance Committee Releases Bipartisan Mental Health Workforce Discussion Draft. Last week, the Senate Finance Committee released another round of legislative language for their Bipartisan Mental Health Bill. This round focused on bolstering the behavioral health workforce, including expanding Medicare Part B coverage to include mid-level behavioral health providers and requiring Medicaid to produce new guidance to states on increasing mental health workforce. 

• Read the Proposed Provisions Here

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 [email protected].   

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 [email protected]. 

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 - 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 [email protected].   

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

CMS All Tribes Consultation Webinar on Measuring Health Disparities in Medicaid and CHIP. CMS will be hosting a virtual tribal consultation webinar on Oct. 13, 2022 at 11 AM Pacific to gather input from the Tribal community on CMS’ proposed approach to measuring health disparities to advance health equity.

•  Registration Link for Oct. 13 Consultation Webinar

Administrative and Regulatory Updates

Northwest Tribal Leaders Attend Swearing in of New Indian Health Service (IHS) Director, Roselyn Tso. IHS Director Tso was formally sworn in by Secretary Becerra on Tuesday, Sep. 27, 2022.  Last week, the U.S. Senate confirmed the nomination of Ms. Tso as Director of the IHS. Ms. Tso is an enrolled member of the Navajo Nation and began her career with the IHS in 1984. She previously served as the Navajo Area Director. President Biden nominated Ms. Tso this past March after the advocacy of Tribal Leaders calling for a permanent IHS Director. 

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, 2022.

• 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.

For more information:

Laura Platero, Executive Director 

Liz Coronado, Senior Policy Advisor

Candice Jimenez, Health Policy Specialist

Northwest Portland Area Indian Health Board | Website