The National Indian Health Board (NIHB) held its Second Quarter Board of Directors Meeting in Washington, DC on June 21 and 22, 2023. During this meeting, the Board received updates from NIHB staff on progress in the areas of policy, advocacy, programs and organizational operations. Board Members and NIHB Member Organization staff provided updates from their Areas to highlight priority issues that should be brought to the national level. Since the last Board Meeting, NIHB has moved into its new headquarters office at 50 F Street NW in Washington, DC, advanced the International Indigenous Determinants of Health, and held its largest National Tribal Health Conference to date, amongst other accomplishments.

The Board had the opportunity to meet with Dr. Karina Walters (Choctaw Nation), Director of the Tribal Health Research Office at the National Institutes of Health. As Dr. Walters is newly appointed to this position, she provided an introduction to the office, its core values, and goals. Dr. Walters emphasized the need for a syndemic approach for health in Indian Country, and the priority to prepare for pandemics and climate change. The Board welcomed Dr. Miriam Delphin-Rittmon, Assistant Secretary for Mental Health and Substance Abuse with the Substance Abuse and Mental Health Services Administration. Dr. Delphin-Rittmon shared about the Tribal Opioid Response Grant program and updates to the Tribal Behavioral Health Agenda. 

The Board met with Elizabeth Molle-Carr, (Sault Ste. Marie Chippewa), Tribal Advisor to the Director, Office of Management and Budget (OMB). The Board discussed the debt ceiling negotiations and how the OMB can provide education on the Federal Advisory Committee Act (FACA) in relation to Tribal Advisory Committees as well as carry over funding for grants.

The Board welcomed Roselyn Tso (Navajo Nation), Director of the Indian Health Service (IHS). Ms. Tso provided updates on staffing for the Indian Health Service, the IHS workplan, and progress on the recommendations from the Government Accountability Office (GAO), Office of the Inspector General (OIG), and the White House. She shared that working with the Veterans’ Administration (VA) continues to be a priority for IHS, they have launched a new VA/IHS map to help veterans gain better access to care. The NIHB Board expressed concerns about public health data, particularly in regard to the current syphilis outbreak in the Great Plains Area. Additional IHS senior staff attended the meeting, including Mitchell Thornbrugh (Muscogee Creek), Chief Information Officer and Director for the Office of Information Technology. Mr. Thornbrugh provided an update on the health information technology project to replace the current electronic health record system.

On Friday, June 23, the Board visited the White House to meet with Senior Policy Advisor for Native Affairs at the Domestic Policy Council, Elizabeth Reese (Pueblo of Nambe). During this time, they discussed the renewal of Tribal Behavioral Health Agenda, data access to address the current syphilis outbreak, and the Federal Advisory Committee Act (FACA). Later that day on Capitol Hill, Board Members had the chance to discuss the expansion of Tribal self-governance at the US Department of Health and Human Services (HHS), renewal of the Special Diabetes Program for Indians, increased funding for the Indian Health Service and providing direct resources to Indian Country for improving Tribal Maternal Health outcomes. Lastly, they met with Congressman Tracey Mann (R-KS), a member of the House Agriculture Committee, to discuss Tribal nutrition priorities for the 2023 Farm Bill and other legislative priorities.

The NIHB Board passed six resolutions during this meeting: 

NIHB Resolution 23-03 Calling on Direct Access to Federal Block Grant Funding for Tribal Nations

This resolution calls on the federal government to either establish a Tribal nation block grant program to administer the same granted federal authority for every federal block grant provided to state or local governments. Block grants are distributed by formula, allow greater flexibility in the use of funds, and have fewer administrative conditions than categorical grants, however, Tribal Nations are not eligible to receive this funding and state and local governments often fail to pass on or utilize the funding for the benefit of American Indians and Alaska Natives.

NIHB Resolution 23-04 in Support for Indigenous Determinants of Health and National Plan for Tribal Health

This resolution calls on the United States government to carry out the actions in the World Health Organization (WHO) adopted Resolution A76/A/CONF./1 “The Health of Indigenous Peoples as necessary steps for member states to take to advance health equity for Indigenous Peoples. It also urges U.S. Department of Health and Human Services to recognize and adopt an appropriate framework for Tribal Determinants of Health, in consultation with American Indian and Alaska Native Tribes. Lastly, it encourages the United States government to develop and implement a national plan for Tribal health, in consultation with Tribes, and supported by sufficient funding to achieve health equity and ensure the health and wellness of American Indians and Alaska Natives.

NIHB Resolution 23-05 in Support for Standard Coverage of Oral Health Care Services under Medicaid

This resolution calls on Congress to create a federal minimum dental benefit under Medicaid, including preventative services, restorative services, dentures and emergency care.

NIHB Resolution 23-06 in Support for Updating the National Tribal Behavioral Health Agenda

This resolution calls for a review and update of the Tribal Behavioral Health Agenda (TBHA), which was first published in 2016. Over six years have passed since the publication of the TBHA, during which AI/AN communities have experienced the COVID-19 pandemic and increasing rates of behavioral health disparities, especially related to substance misuse, overdose deaths, and suicide. NIHB seeks to partner with the Substance Abuse and Mental Health Services Administration (SAMHSA) to update the document in a collaborative manner that incorporates Tribal leaders, SAMHSA, the Indian Health Service and other key partners.

NIHB Resolution 23-07 Supporting Federal Legislation Requiring Removal of Debts

This resolution seeks to remedy when Indian Health Service (IHS) beneficiaries inaccurately receive bills for Purchased Referred Care (PRC), which either the patients pay out-of-pocket to avoid adverse impact on credit, or they go unpaid and subsequently to collections. The resolution supports legislation similar to the Protecting Veterans Credit Act of 2017 that would provide a mechanism to require credit reporting agencies to remove information on the credit reports of IHS beneficiaries that relates to debts or collections activity for bills that should have been paid by the IHS. It also urges the IHS to implement Section 222 of the Indian Health Care Improvement Act (IHCIA) to establish an accessible, transparent process for IHS beneficiaries to obtain reimbursement for PRC bills that IHS should have, but did not, pay in a timely manner.

NIHB Resolution 23-08 in Support for Fair and Proportional Facilities Support Account Resources for Tribal Health Programs

This resolution supports fair and proportionate Facilities Support Account (FSA) funding for all Indian Health Service (IHS) Areas regardless of the absence of IHS facilities. It calls on IHS and Congress to address this issue immediately with new and additional funding to protect current Area FSA budgets.

The Board of Directors will be present at the upcoming National Tribal Opioid Summit August 22-24 in Tulalip, Washington (Click here for more information). The next quarterly Board Meeting will be held virtually Monday, November 6.

Please address any questions to Jennifer Speight at [email protected].