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Contact: Janee Andrews at [email protected]

The call for health equity rang loud on Capitol Hill during the

2022 National Tribal Health Conference

WASHINGTON, DC – October 5, 2022 – The National Indian Health Board's (NIHB) 39th Annual National Tribal Health Conference (NTHC) – THE POWER OF IDENTITY: A PATH TO TRIBAL HEALTH EQUITY came to its close last week where the call for health equity rang loud on Capitol Hill. Leadership from NIHB Chairman William Smith and CEO, Stacy A. Bohlen provided for an energized and informative conference.

During the Opening Plenary Session, Jon Blum, Principal Deputy Administrator from the Centers for Medicare and Medicaid Services (CMS) committed to raising the standard for health care in Indian Country by working to expand coverage, provide resources, increase behavioral health services, and improve maternal health care. He also spoke about the importance of it partnering with Indian Country and other agencies. To do so Blum asked all to:

1. Hold CMS accountable and responsive to build forward engagement.

2. Help CMS define what healthcare equity means by providing feedback and input.

3. Educate and prepare Indian Country for the end of the Public Health Emergency (PHE) and the need to be redetermined for Medicaid/Medicaid expansion eligibility.

The White House Council on Native American Affairs (WHCNAA) heard Indian Country’s call for health equity and worked with Congress to establish the Tribal Broadband Connectivity Program among other action items. Anthony Morgan Rodman, Executive Director WHCNAA acknowledged the concerns about American Rescue Plan Act (ARPA) funds and the Tribes that are cautious about spending funds they cannot pay back like sanctions. 

The council is co-chaired by U.S. Department of the Interior (DOI) Secretary Deb Haaland, who provided a video message for conference attendees. 

Bryan Newland, DOI Assistant Secretary focused on health equity and how the power of AI/AN identity, “Indian Country became a leader in the United States for how to come together and respond to a public health crisis,” that is how American Indian/Alaska Native (AI/AN) people are, united. He touched on climate change jeopardizing treaty rights and how our lands and waters are directly related to our health. “Because of where we live, we often feel the impacts of climate change first.” Newland also reminded attendees there is not a single person in Indian Country who has not been affected by Indian Boarding Schools. The power is in our identity.

An update from Dr. Rose Weahkee, Acting Director, Intergovernmental Affairs, Indian Health Service (IHS), reported the President's fiscal year (FY) 2023 Budget proposed the first fully funded IHS and how the agency would like to see a mandatory budget process moving forward. Roselyn Tso, confirmed Director of IHS partook in the IHS Listening Session and was formally sworn in the following day by U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra.

With IHS funding of concern, Rachel Joseph, Former Chairwoman, Lone Pine Shoshone Paiute Tribe called on Tribal leaders, organizations, and Urban Indian Organizations to take steps to define and advance health equity in Indian Country. The National Tribal Budget Formulation Workgroup (NTBFWG) stressed that equity in funding has always been a core issue in terms of Indian health care. Full funding and mandatory funding are necessary for Tribal health equity but are not the only component; understanding social determinants of health is also needed.

Secretary Denis McDonough was on hand to provide the U.S. Department of Veterans Affairs (VA) Update. The VA is implementing a model of health care which will support traditional methods of healing and culturally competent care and have reimbursement sites, purchased referred care agreements, and expand partnerships. Additionally, McDonough offered, “I know it’s been a long wait on implementation of legislation to exempt AI/ANs from copays at the VA. I make this commitment to you, the VA is implementing this law this calendar year and AI/AN veterans will be exempt from copays before we see 2023.”

Health equity extends to opioids litigation, settlement issues, and Tribal participation. Geoffrey Strommer, Partner, Hobbs, Straus, Dean & Walker, LLP reported there are currently 3000 cases nationally that involved litigation against opioid manufacturers. There is $600 million headed to Indian Country to help deal with this issue through settlements. All Tribes are eligible to receive settlement payments, but settlements are dependent on Tribal participation thresholds. Strommer called upon Indian Country to join the settlement now to receive funds sooner. Comments on the structure of the formula that determines how much a Tribe would receive are due by November 10, 2022. Submit comments and inquiries to Geoff Strommer at [email protected].

While western medicine has its benefits, Tribal communities have always practiced traditional methods of care. Donald Warne MD, MPH, Provost Fellow and Co-Director, Center for Indigenous Health, Johns Hopkins University asked conference attendees for help advancing maternal health equity through policy and system solutions, which are linked to funding and sustainability. AI/ANs did not have hospitals and relied on Indigenous doulas and ceremonies. The next step for training programs with traditional ways is to remove administration burdens.

The Community Health Aid Program (CHAP) is more than just a health initiative. It does not just bring more providers into the community but allows those providers to offer care incorporating language and Tribal practices. The CHAP model is an AI/AN traditional model of care but carries concerns of sustainability challenges beyond FY 2023. There needs to be continued consultation that is meaningful to facilitate a strong partnership.  

Further discussions surrounding the vision for the next 50 years closed out the conference. Kitcki Carroll, Executive Director, United South and Eastern Tribes, Inc. (USET) reminded attendees why we have conferences like this. “There has never been a moment the United States has honored its trust responsibilities. Indian Country is not a special interest, these obligations are due to us,” said Carroll. Topics laid out a vision for the next 50 years that include key concepts that need to be kept at the forefront; Principles of Self-Governance, Quiet Crisis Report – 2003 and Broken Promises in 2018, health care funding, and policy reform. Bohlen proclaimed, “Our lawmakers need to understand that Indian health isn’t Indian health, it’s American health. It’s as American as it gets. Congress needs to help us make our future by funding us appropriately.”

NIHB understands it cannot do it alone and hosted its annual Outstanding Service Awards at the 2022 NIHB Heroes in Health Awards Gala at the Museum of the American Indian hosted by Olympic Gold Medalist Billy Mills. The 50th anniversary was celebrated with commemorative Pendleton blankets that were gifted by NIHB Board Members. Their and award-winners service and selfless work have resulted in major contributions to improving AI/AN health. The gala honored and recognized outstanding individuals, programs, and organizations with celebratory messages from across Indian Country. Read more about the awards gala here.

The 39th Annual National Tribal Health Conference – THE POWER OF IDENTITY: A PATH TO HEATH EQUITY, concluded with an invite to NIHB’s conference in May 2023 in Alaska. Details will be forthcoming.

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About the National Indian Health Board

Founded in 1972, NIHB is a 501(c) 3 not-for-profit, charitable organization providing health care advocacy services, facilitating Tribal budget consultation, and providing timely information, and other services to all Tribal governments. NIHB also conducts research and provides policy analysis, program assessment and development, national and regional meeting planning, training, technical assistance, program, and project management. NIHB presents the Tribal perspective while monitoring, reporting on, and responding to federal legislation and regulations. It also serves as a conduit to open opportunities for the advancement of American Indian and Alaska Native health care with other national and international organizations, foundations corporations, and others in its quest to build support for, and advance, Indian health care issues.