The National Indian Health Board (NIHB) is committed to advocating on behalf of all Tribal Governments and American Indian/Alaska Natives while: promoting healthy practices; preventing diseases and injuries; providing basic resources and infrastructure to Tribes; and researching and developing Tribal, local, state, and national health policy. To view all our public health resources, please visit www.nihb.org/public_health/public_health.php. | |
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COVID-19 Public Health Emergency to End on May 11, 2023
The U.S. Department of Health and Human Services (HHS) has extended the COVID-19 public health emergency (PHE) for 90 days to May 11, 2023; this is expected to be the final renewal. HHS based this decision on the most recent COVID-19 trends.
What will not be affected:
- Access to COVID-19 vaccines and treatments, such as Paxlovid and Lagevrio.
- Medicaid will continue to cover COVID-19 vaccinations without a co-pay or cost-sharing through September 30, 2024. After that, coverage will vary by state.
- Medicare telehealth flexibilities will not be affected. This is a win for Tribal communities in rural areas or those who struggle to access care.
What will be affected:
- Medicaid Continuous Enrollment Provision. People no longer eligible for Medicaid may lose coverage as early as April.
- Medicare and Medicaid waivers and flexibilities for healthcare providers will end.
- Medicare beneficiaries enrolled in Part B will lose access to free over-the-counter (OTC) COVID-19 tests.
Although HHS is expected to announce the end of the PHE classification for COVID-19 on May 11, COVID-19 infections will not disappear overnight. We must work together to prevent the spread of COVID-19 in our communities and support interventions to keep our people healthy. Consider getting a booster to protect yourself and your loved ones against Omicron variants and to reduce your risk of severe illness, hospitalization, and death.
The National Indian Health Board will continue to monitor the status of major health policies when the public health emergency ends. As new information is provided, we will provide updates.
You can read more about the HHS plan for ending the COVID-19 Public Health Emergency here.
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SAMHSA 2021 National Survey of Drug Use and Health (NSDUH)—Key Findings for Indian Country
The Substance Abuse and Mental Health Services Administration (SAMHSA) has released its 2021 National Survey of Drug Use and Health (NSUDH). NSDUH is an annual survey that provides self-reported, nationally representative data on substance use, treatment, and mental health issues and services among those aged 12 or older.
In 2021, American Indians and Alaska Natives reported the highest use of tobacco products, nicotine vaping, and marijuana. They were more likely to have used illicit drugs in the past year than any other group. They were also more likely to have a diagnosed substance use disorder and mental illness and to need substance use treatment.
Rates of opioid misuse and suicidal thoughts and behaviors were comparable, with no statistically significant differences compared to other groups.
As Tribal communities continue to gather data to provide effective behavioral health services, it is essential to note that the 2021 NSDUH survey results apply only to 2021 and cannot be compared to earlier years.
Click here to read more about the survey’s findings, limitations, and potential implications for Tribal communities.
Click here to read more about NIHB’s ongoing work in substance use and suicide prevention.
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FDA Issues Refuse to Accept Letter for Applications for Approximately 17 million E-Liquid Products
To date, the U.S. Food and Drug Administration (FDA) has made determinations on more than 99% of the nearly 26 million deemed products for which applications were submitted, including authorizing 23 new e-cigarette products and devices, and issuing refuse to accept (RTA) letters, refuse to file letters or marketing denial orders for millions of products. This includes determination on applications for nearly 6.7 million products received by the Sept. 9, 2020, deadline, more than 18 million products received after the Sept. 9 deadline, and applications for almost 1 million non-tobacco nicotine products submitted by May 14, 2022, by the new federal law passed in April 2022. Under a federal court order, manufacturers of new tobacco products on the market as of the deeming rule’s effective date (Aug. 8, 2016) were required to submit premarket review applications by Sept. 9, 2020.
On Feb. 21, 2023, FDA issued an RTA letter to one applicant notifying a company that their Premarket Tobacco Product Applications (PMTAs), associated with approximately 17 million individual tobacco products, do not meet the acceptance requirements outlined in FDA’s regulations. The applications were for a grouped submission of e-liquids in varying sizes, nicotine strengths, and flavor combinations. Each was treated as a product application according to existing premarket review processes.
During the acceptance phase of application review, FDA reviews applications to ensure they meet a minimum threshold for acceptability for FDA scientific review. If the required contents for acceptance are included, the FDA will accept the application. This company was issued an RTA letter because the company’s applications for these products lacked the required Environmental Assessments. The company may submit a new application for these products at any time; however, the products may not be marketed unless the FDA reviews the applications and determines that the marketing of the products is appropriate for the protection of public health.
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Coronavirus (COVID-19) Update: FDA Authorized Bivalent Pfizer-BioNTech COVID-19 Vaccine as Booster Dose for Certain Children Six Months through Four Years of Age
On March 14, 2023, the U.S. Food and Drug Administration (FDA) amended the emergency use authorization (EUA) of the Pfizer-BioNTech COVID-19 Vaccine, Bivalent for children six months through four years of age. Children who completed their three-dose primary series with the monovalent Pfizer-BioNTech COVID-19 Vaccine more than two months ago are now eligible for the single booster dose of the Pfizer-BioNTech COVID-19 Vaccine, Bivalent. Read more. Vaccination is critical to protecting our community and loved ones from getting the SARS-COV-2 virus. Getting vaccinated is an Act of Love.
Related Information:
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Funding and Opportunities | |
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New Funding Opportunity: Utilizing Social Media to Increase COVID-19 Vaccine Confidence Across Indian Country
The National Indian Health Board (NIHB) is offering a funding opportunity for Tribal governments, Tribal health departments, and Tribal health care facilities/health systems seeking to provide community-level support for combatting COVID-19 vaccine hesitancy through direct support through the development of regionally and culturally specific vaccine hesitancy material.
NIHB will fund up to 12 Tribal governments, Tribal health departments, and/or Tribal health care facilities/health systems in amounts up to $40,000 each. Subwardees can use these funds to develop vaccine hesitancy materials and communication efforts. Examples of activities can include (but are not limited to); supporting graphic designers, pre- and post-meetings to gain community feedback, printing costs, and community events.
NIHB hosted an optional pre-application webinar on Friday, March 10th, at 2:00 pm Eastern Time. Join the webinar here. To apply for this funding opportunity, submit an application to Darby Galligher, Public Health Policy and Programs Coordinator, [email protected] no later than March 24, 2023 at 11:59 PM EDT..
Application Deadline: March 24, 2023
Apply for funding here.
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New ACF Funding Opportunities Available!
The Administration for Children and Families (ACF) is now soliciting applications for the Fiscal Year 2023 Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Grant Program: Development and Implementation (DIG) and Implementation and Expansion (IEG) Grants!
Funds under both Notices of Funding Opportunity (NOFOs) will support the implementation of high-quality, culturally grounded, evidence-based home visiting services to American Indian and Alaska Native (AIAN) families and children; implementation of performance measurement and continuous quality improvement systems; development of early childhood systems; and participation in research and evaluation activities to build evidence around home visiting, particularly in tribal communities.
Tribal MIECHV Development and Implementation Grants are intended for tribal entities that do not have prior experience with implementing evidence-based home visiting programs and are not currently implementing a program. Applications are due May 1, 2023. More information is available here.
There is an upcoming webinar to provide technical assistance to potential applicants. For Tribes who have never had a home visiting grant (applications due May 1), March 16, 3-4:30 pm Eastern Time (ET). New applicants will join via this Zoom link.
Tribal MIECHV Implementation and Expansion Grants are intended for tribal entities with an established implementation history. They are currently implementing evidence-based home visiting services to AIAN families and children (including current Tribal MIECHV grantees). Applications are due May 31, 2023. More information is available here.
There is an upcoming webinar to provide technical assistance to potential applicants. For Tribes with home visiting grant/s (applications due May 30), March 30, 3-4:30 pm ET. Applicants with prior home visiting grants will join via this Zoom link.
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Tribal Epidemiology Centers Request Access to Epidemiological Data
On March 4, 2023, the Government Accountability Office (GAO) published a report providing recommendations for how the U.S Department of Health and Human Services (HHS) can clarify how public health data will be made available, as required by law, to Tribal Epidemiology Centers (TECs) and create procedures to do so. Among the 12 TECs, public health entities serving American Indian and Alaska Native (AI/AN) communities across the U.S., access to epidemiological data varies. Federal law authorizes TECs' access to data from HHS to monitor the spread of infectious diseases, such as COVID-19, and conduct other analyses supporting public health decision-making in AI/AN communities.
To improve engagement with Tribes and Tribal organizations, the Centers for Disease Control and Prevention (CDC) has launched a new website on Tribal Public Health Data. The website provides information about CDC Tribal health data, issues, tools, technical assistance, training, and Tribal data-related resources. The website includes a CDC Public Health Data set list and a form for Tribal members to request data.
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Local Food Purchase Assistance Cooperative Agreement Plan
The Local Food Purchase Assistance Cooperative Agreement Program (LFPA) uses non-competitive cooperative agreements to provide up to $900 million of American Rescue Plan (ARP) and Commodity Credit Corporation (CCC) funding for state, Tribal, and territorial governments to purchase foods produced within the state or within 400 miles of the delivery destination to help support local, regional and underserved producers. This program aims to maintain and improve food and agricultural supply chain resiliency. The cooperative agreements allow the states, Tribes, and territories to procure and distribute local and regional foods and beverages that are healthy, nutritious, unique to their geographic areas, and meet the population's needs. The food will serve feeding programs, including food banks, schools, and organizations that reach underserved communities. In addition to increasing local food consumption, the funds will help build and expand economic opportunities for local and underserved producers.
The performance period will be up to two years from the time of award to accommodate two harvest seasons.
Learn more about the Large Food Purchase Assistance Cooperative Agreement Plan more here.
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Medicaid Unwinding Toolkit for Tribal Enrollment Assisters
At the onset of the COVID-19 public health emergency, many flexibilities were implemented in the Medicaid program, including continuous enrollees coverage without the normal annual renewal process. Enrollees retained coverage regardless of a change in circumstance that would have otherwise deemed them ineligible for Medicaid coverage. This continuous enrollment requirement ends on March 31, 2023, before the end of the PHE. States will soon begin to engage in normal eligibility determination processes. We will see a drop in enrollment as conditions start to disenroll those who no longer qualify for Medicaid. Some states may have already started this process but will need to wait until April 1 to terminate coverage for any individual.
The National Indian Health Board (NIHB), in collaboration with the Indian Health Service (IHS), created the Medicaid Unwinding Toolkit for Tribal Enrollment Assisters to familiarize Tribal health facility staff with this “Medicaid Unwinding” process. Millions of individuals could lose healthcare coverage; American Indians and Alaska Natives (AI/ANs) are no exception. NIHB estimates that as many as 236,000 AI/ANs could lose their coverage due to Medicaid unwinding. Tribally operated healthcare facilities must understand how to prevent as many patients as possible from falling off Medicaid coverage and assist those who need to change healthcare coverage plans due to changes in their circumstances, financially or otherwise. The toolkit provides (1) a summary of Medicaid unwinding guidance, (2) recommendations on how to prevent an eligibility redetermination crisis, (3) a summary of Medicaid telehealth flexibilities, (4) information on the impact of the unwinding on Tribal communities, (5) FAQs, and (6) customizable graphics for outreach and education purposes.
Learn more about Medicaid Unwinding here.
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No Cost Mental Health Services for 2SLGBTQ+ Persons (Ages 15+)
Access to mental health services that affirm our Indigenous and 2SLGBTQ+ identities is Indigiqueer Joy. The Paths (Re)Membered Project offers NO COST mental health services to Two-Spirit and Indigiqueer 2SLGBTQ+ persons aged 15 years and older. Services are currently offered in limited states (AL, AR, AZ, CA, CO, DC, DE, GA, ID, IN, KS, KY, MD, ME, MN, MO, NC, ND, NH, NJ, NM, OH, OK, OR, PA, TN, TX, UT, VA, WA, WV, & WI). They are working hard to expand availability to other states.
Please note that this is not a mental health crisis line, and submissions of this form are NOT monitored 24/7. It may take up to 5 business days to receive a response. If you are experiencing a mental health crisis, please dial 988 to reach the Suicide & Crisis Lifeline or text NATIVE to 741741 to chat with the Crisis Text Line.
Please complete this form to connect virtually with an affirming mental health professional.
If you have any questions about these services, email [email protected].
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CDC Launches Website to Help Consumers Find Free Covid-19 Testing Sites
The Increasing Community Access to Testing (ICATT) program provides no-cost testing sites to Tribes and other communities greatly affected by the COVID-19 pandemic. ICATT sites are a partnership between the federal government, state and local jurisdictions, and a federal testing contractor.
The ICATT program provides testing resources for people experiencing symptoms related to COVID-19 or has been exposed to someone with COVID-19. People without health insurance must not pay for COVID-19 testing at ICATT locations. The tests are billed to third-party payers, such as Medicare, Medicaid, and private health insurers to increase program sustainability.
For more information about the CDC Testing Locator website, click here.
For more information about the ICATT program, click here.
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2023 Maternal Health Tribal Learning Community Series
Please join the National Indian Health Board (NIHB) for the 2023 Maternal Health Tribal Learning Community Series. The first session in the series was on March 21 (a recording will be available soon). The series will address topics such as:
- Sovereignty from First Breath
- Cultural Competency and Responsive Healthcare Practices
- Mental Health and Well-Being: Reconnecting Indigenous Lifeways
- Advancing Health Equity: Strengthening Community Engagement
Addressing maternal and child health disparities in Indian Country requires collective action, as American Indian and Alaska Native communities are experiencing alarming and disproportionately high rates of maternal health inequities.
Join us to learn together about maternal health work in Indian Country. Share your knowledge at the Tribal and community levels to inform maternal mortality prevention efforts going forward. Engage with other leaders in the field of maternal and child health.
Tuesday, March 21
Tuesday, April 25
Tuesday, May 23
Tuesday, June 27
2:00 PM - 3:30 PM Eastern Time
We invite community members, Tribal leaders, Tribal healthcare and public health professionals, and anyone interested in learning more about Indigenous maternal health to join! Questions about the series may be directed to Elisha Sneddy, Project Coordinator, at [email protected]
Register for the 2023 Maternal Health Tribal Learning Community here.
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Virtual Webinar for Birthing People, Families, and Community Members: The Power of Prenatal Care During Pregnancy
The Inter Tribal Council of Arizona, Inc. Maternal Health Innovation Program is hosting a maternal health virtual webinar on Standardized Prenatal & Postpartum Care at Whiteriver Indian Hospital Birthing Center by D Laura Close, DNP, FNP-BC, on Wednesday, March 29, 2023, from 10 am-11:30 am MST. The webinar is for maternal healthcare professionals, paraprofessionals, and program staff serving community members in Tribal communities across Arizona. In this virtual webinar, they will review the medical practices and patient experiences at the Whiteriver Birthing Center. They will discuss a standardized approach to prenatal and postpartum care, including a screening checklist implemented to evaluate the risk of pre-eclampsia in pregnancy. This webinar is free to attend. Registration is required at the link below.
March 29, 2023, from 10:00 - 11:30 am Mountain Standard Time
Register and join the webinar here.
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Tribal Accreditation Learning Community (TALC)
Friday, March 31, 2023, 3:00 PM ET
Performance Improvement (PI) is essential to building public health capacity in Indian Country. These formal activities contribute to how Tribal public health departments plan, monitor, and improve their activities and programs. As a result, departments can support department efficiency with evidence and use these efforts to strengthen their organization and systems.
Join the National Indian Health Board’s (NIHB) Tribal Accreditation Learning Community (TALC) for a presentation and discussion on the Pillars of PI. TALC is a free webinar series held each month. It is designed for sharing and learning about public health performance improvement, system improvement, and accreditation in Tribal communities.
Register to attend this month's TALC here.
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Save the Date for the National Tribal Opioid Summit
Join NIHB as we partner with the Northwest Portland Area Indian Health Board’s National Tribal Opioid Summit, to be held August 22-24, 2023, at the Tulalip Resort in Tulalip, Washington.
The summit will provide an unprecedented opportunity of national scope for Tribal nations and communities to share stories, build strength, and collaborate to address the opioid crisis. This inaugural summit will provide dedicated space to addressing the fentanyl crisis with a Tribally driven agenda.
August 22 - 24, 2023
More information to come!
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