NPAIHB Legislative and Policy Update

Friday, November 19, 2021

Important Dates

Nov. 30, 2021 (1:00 PM Pacific)

IHS AZ PRCDA Tribal Consultation Session

Zoom Link


Dec. 1, 2021 (11:30 AM Pacific)

TTAG Conference Call


Dec. 2, 2021 (7:00 AM Pacific)

FAAB Meeting


Dec. 6, 2021 (11:00 AM Pacific)

MMPC Monthly Meeting


Dec. 8, 2021 (1:00 PM Pacific)

IHS AZ PRCDA Tribal Consultation Session

Registration Link


Dec. 14, 2021 (9:00 AM Pacific)

NIHB Health IT Summit

Registration Link


Dec. 16, 2021 (12:00 PM Pacific)

VA Listening Session on PRC

Adobe Link

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 Updates

President Biden signs infrastructure bill into law! (H.R.3684). Passed in the House on November 5, 2021, the infrastructure bill, also known as the Infrastructure Investment and Jobs Act became public law this week. Key provisions of the Act include $3.5 billion one-time funding for the Indian Health Service (IHS) sanitation facilities construction program including:

  • $700 million each year for FY 2022 to FY 2026, to remain available until expended;
  • Up to $2.2 billion for projects that exceed economical unit cost that are available until expended;
  • No more than 3% for salaries, expenses, and administration;
  • 0.5% for the Office of Inspector General to provide oversight of the program;
  • Provides an additional $2 billion to Tribal Broadband Connectivity Program

The House Passes the $1.75 Trillion Build Back Better Act. This package includes funding for universal pre-K, Medicare expansion, renewable energy credits, affordable housing, and a year extension of the Child Tax Credits. It also includes an additional $2.3 billion for tribal health programs. The Act will now go to the Senate that will likely include revisions. Senate Majority Leader Chuck Schumer has aimed to pass the Build Back Better Act by Christmas.  

White House Tribal Nations Summit Summary

Earlier this week, November 15 and 16, Tribal leaders from across the nation met with the Biden-Harris administration and federal agency leaders to discuss priorities and challenges from across Indian Country. On day 1, the White House released the White House Tribal Nations Summit Progress Report and related Fact Sheet to outline the historic contributions of the Biden-Harris Administration to support tribal communities. Some of the major highlights from the week, included the following:

We share our gratitude with our Northwest Tribal leaders who supported and shared in this event with other Tribal leaders! If you were unable to attend or would like to revisit any portion of the summit, please see the full agenda, day 1 and day 2 live streams.

Tribal Consultation Updates

Interior Consultation on Boarding Schools Initiative. The U.S. Department of the Interior announced 3 consultation sessions to seek input on the implementation of the Indian Boarding School Initiative announced this past June. Written input will be accepted until Dec. 23, 2021 to consultation@bia.gov. Consultation schedule is provided below:

  • Session 1: Nov. 17, 2021 at 10 AM - 2 PM Pacific; Registration Link
  • Session 2: Nov. 18, 2021 at 10 AM - 2 PM Pacific; Registration Link
  • Session 3: Nov. 23, 2021 at 10 AM - 2 PM Pacific; Registration Link
  • On a related note, this week the National Native American Boarding School Healing Coalition (NABS) is holding a ‘Boarding School Healing Virtual Summit: Healing in a Time of Truth and Justice’ on November 19 and 20, 2021. Learn more, here and register.


Updated Indian Health Service (IHS) Tribal Consultation Sessions on Designating Arizona as a Purchased/Referred Care Delivery Area (PRCDA). On Aug. 20, 2021, IHS announced tribal consultation on the multi-year feasibility study results for designating the entire state of Arizona as a Purchased/Referred Care Delivery Area. Tribal consultation sessions have been rescheduled.  

  • 1st Session: Nov. 30, 2021 1 PM Pacific Zoom Link
  • 2nd Session: Dec. 8, 2021 1 PM Pacific Zoom Link


Administration for Children and Families (ACF) Tribal Consultation(s) on Tribal Consultation Policy and Office of Head Start (OHS). ACF held their annual tribal consultation and Office of Head Start consultation on November 4 and 15, respectively. ACF sought tribal leader input on the ACF Tribal Consultation Policy, self-governance and improving cultural adaptations that come from Tribal input for ACF portions of the Family First Prevention Services Act.                      

Administrative and Regulatory Updates

HHS Strategic Plan. HHS published their draft Strategic Plan for FY 2022-2026 on the Federal Register. The five broad goals of HHS include: Protect and Strengthen Equitable Access to High Quality and Affordable Healthcare; Safeguard and Improve National and Global Health Conditions and Outcomes; Strengthen Well-Being, Equity, and Economic Resilience; Restore Trust and Accelerate Advancements in Science and Research for All, and Advance Strategic Management to Build Trust, Transparency, and Accountability.


SUNSET Final Rule Withdraw Proposal. HHS released a proposed rule to withdraw or repeal the Securing Updated and Necessary Statutory Evaluations Timely (SUNSET final rule). The SUNSET final rule’s effective date was delayed until Mar. 22, 2022 after a lawsuit was filed this past spring. The SUNSET Rule would have required HHS and its agencies to review all of their regulations within a certain time period or otherwise the regulations would sunset.     

  • Written comments are due Dec. 29, 2021 through the Federal eRulemaking Portal


New Federal Strategy for Overdose Prevention. HHS announced a new overdose prevention strategy that includes: primary prevention, harm reduction, evidence-based treatment and recovery support. Earlier this year, the CDC determined that the rate of rural overdose deaths from 1999 to 2019 rose from 4.0 to 19.6 per 100,000 people. In 2019, rates in rural counties were higher than in urban counties in California, Connecticut, North Carolina, Vermont, and Virginia.


CMS COVID-19 Vaccination Requirement. This month CMS issued a new emergency rule imposing COVID-19 vaccination requirements on 21 participating Medicare and Medicaid providers and suppliers.  Employees must receive at least the first dose of COVID-19 vaccine by Dec. 5, 2021, and be fully vaccinated by Jan. 4, 2022. Boosters are not required at this time. For more information, see the following resources:


Open Enrollment for Health Insurance Begins November 1. Plans and pricing are already available for preview and consumers may use the Federal Health Insurance Marketplace or one of 18 state-based websites

IHS announced $46.4 million to fund behavioral health programs that serve American Indians and Alaska Natives. The funding opportunities will support addressing suicide, domestic violence, and substance abuse, and supporting an integrative approach to the delivery of behavioral health services. Applications are due by February 2, 2022. Major funding highlights include:

  • Substance Abuse Prevention, Treatment, and Aftercare ($14 million)
  • Suicide Prevention, Intervention, and Postvention ($14 million)
  • Domestic Violence Prevention ($7.9 million)
  • Behavioral Health Integration Initiative ($6 million)
  • Forensic Healthcare ($2.5 million)
  • Zero Suicide Initiative ($2 million)


IHS announced $9.34 million in funding opportunities to support tribal self-governance and urban Indian health. The announcement covered the availability of the Fiscal Year 2022 Tribal Self-Governance Planning and Negotiation Cooperative Agreement funding opportunities for $840,000, which are administered by the IHS Office of Tribal Self-Governance. These annual awards support tribes and tribal organizations with the planning and preparation necessary to assume responsibility for providing health care to their tribal members through the Tribal Self-Governance Program.

  • The Planning Cooperative Agreement assists Tribes for a one-year period, not to exceed $120,000 each with up to 5 planning agreements awarded; these awards assist Tribes in the planning phase of self-governance.
  • The Negotiation Cooperative Agreement assists Tribes for a one-year period, not to exceed $48,000 each with up to 5 negotiation agreements awarded; these awards assist Tribes in defraying the costs related to preparing for and conduction self-governance program negotiations.
  • The Urban Indian Health Programs 4-in-1 Grant Program funding opportunity assists eligible urban Indian organizations that are currently administering a contract or receiving a grant.
  • The application deadline for the cooperative agreement funding opportunities is February 10, 2022.


IHS Special Diabetes Program for Indians (SDPI) Funding Update.  The IHS has released a Dear Tribal Leader Letter announcing updates of SDPI funding for FY 2022 and 2023. A mandatory sequester will reduce SDPI funding level for FY 2022 to $147 million each year through FY 2023. The current SDPI grant cycle will be extended for 1 more year through FY 2022. If you have any questions on your SDPI funding, please contact Ms. Carmen Hardin, Acting Director, Division of Diabetes Treatment and Prevention by telephone at (844) 447-3387.  


The Biden Administration announced new investments to support COVID-19 response and recovery efforts as COVID-19 Health Equity Task Force Submits Final Report.

  • Funding at $210 Million will serve to build preparedness in Tribal communities, support school nurses in the Bureau of Indian Education, and expand the Public Health Workforce in the Indian Health Service and across Indigenous communities.
  • The COVID-19 Health Equity Task Force held their AI/AN stakeholder briefing virtually last week. The recording and brief recommendations can be accessed here.


Portland Area Office Health Care Facilities Construction Green Infrastructure Project. The Portland Area Office is accepting proposals for green infrastructure projects through Dec. 31, 2021. 


The Department of Veterans Affairs (VA) - Veterans Health Administration (VHA) announces invitation to Tribal leaders for two listening sessions. The listening sessions will cover the VA’s Indian Health Service/Tribal Health Program (IHS/THP) Reimbursement Agreement Program (RAP) and implementation of Public Law 116-311, Proper and Reimbursed Care for Native Veterans Act.

  • Session 1 on Purchase Referred Care: Thursday, Dec. 16th at 12:00 PM – 1:30 PM (Pacific); Participant Link (to be updated) via Adobe Connect.
  • Session 2 on Updated Reimbursement Agreement Template: Thursday, Jan. 13th at 11:30 AM – 1:30 PM (Pacific); Participant Link (to be updated) via Adobe Connect.
  • Written comments may be submitted to tribalgovernmentconsultation@va.gov before February 13, 2022.


The U.S. Department of Veterans Affairs (VA) Veterans Health Administration (VHA) and the U.S. Department of Health and Human Services Indian Health Service (IHS) signed a new memorandum of understanding (MOU), announced on October 21, 2021. The MOU aims to improve the health status of American Indian and Alaska Native (AI/AN) Veterans through coordination and partnership between the VHA and IHS to leverage and share resources and investments in support of each organization’s mutual goals.


Office of Minority Health Center for Indigenous Innovation and Health Equity (CIIHE). Through legislation enacted in 2020, OMH was directed to develop the CIIHE to focus on health research, policy, and innovation to address health disparities among American Indian/Alaska Native and Native Hawaiian and Pacific Islander populations. OMH is seeking nominations for a delegate and an alternate from each IHS area to serve on the CIIHE Tribal Advisory Committee. Nominations are due Jan 7, 2022.


Office of Assistant Secretary for Public and Indian Housing, Department of Housing and Urban Development (HUD) announces intent to establish a Tribal Intergovernmental Advisory Committee (TIAC). This notice announces HUD's intention to form the Department's first standing Tribal advisory committee and provides a pathway for American Indian and Alaska Native housing priorities to be established alongside peer learning and capacity building among Tribes and non-Tribal entities and federal agencies.

  • Comments on the proposed structure of the TIAC are due on or before: Jan 14, 2022 via electronic submission through the Federal eRulemaking Portal at www.regulations.gov; refer to agency/docket number: FR-6289-N-01. 

For more information Laura Platero, Executive Director

Lisa L. Griggs, Executive and Program Ops Assistant | Candice Jimenez, Health Policy Specialist | Liz Coronado, Health Policy Specialist

Northwest Portland Area Indian Health Board npaihb.org