The National Indian Health Board is a dedicated advocate in Congress on behalf of all Tribal Governments and American Indians/Alaska Natives. Each weekly issue contains a listing of current events on Capitol Hill, information on passed and upcoming legislation, Indian health policy analysis, and action items. To view all of our legislative resources, please visit www.nihb.org/legislative/washington_report.php.
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This Week: Articles and Action Items
- Senate Starts Work for this Year on Indian Health Bills
- Meet Your Members: Arizona
- Congressional Spotlight: Tribal Health Data Improvement Act of 2021
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ACTION ITEM: Watch Senate Hearing on Tribal Health Data Improvement Act and Urge the Senate Committee on Indian Affairs to Advance The Legislation
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Senate Starts Work for This Year on Indian Health Bills
On March 23, 2022 at 2:30 PM ET, the Senate Committee on Indian Affairs (SCIA) will hold a legislative hearing on several Indian bills including one Indian health-related bill. Senator Tina Smith (D-MN) introduced S. 1397 Tribal Health Data Improvement Act of 2021 that is on the hearing schedule. Senators Murkowski (R-AK), Cortez-Masto (D-NV), Daines (R-MT), Tester (D-MT), Cramer (R-ND), and Warren (R-MA) are co-sponsors. The National Indian Health Board's Resolution No. 21-05 calls for Congress to enact legislation to improve and strengthen data sharing across federal agencies, Tribes, and Tribal Epidemiology Centers. Other bills included on the hearing schedule are S.3168, S.3308, S.3443, S.3773, and S.3789.
Marvin Figueroa Department of Health and Human Services Director of Intergovernmental and External Affairs is scheduled to be the federal witness on this bill. He is the Secretary of Health and Human Services' Principal Advisor on strengthening intergovernmental relationships with state, local, territorial, and Tribal governments.
The House companion bill is H.R. 3841, introduced by Representative Markwayne Mullin, was passed by the House of Representatives on June 23, 2021. It is pending before the Senate Committee on Indian Affairs.
WHY THIS MATTERS TO TRIBES?
Tribal public health programs and Tribal Epidemiology Centers are sometimes denied access to important public health data held by the States or local public health authorities. This bill would increase Tribal access to important public health data. The data would help enable the Indian Health Service and Tribes to, among other things, make informed decisions about where COVID-19 outbreaks are occurring, trends in disease and vaccination rates, and where Tribal public health efforts need to be focused or improved.
More specifically, this bill would expand Tribal access to public health care data and public health surveillance programs. It would require the Department of Health and Human Services establish a strategy for providing data access to Indian Tribes and Tribal epidemiology centers. In addition, the bill would make available all requested data related to health care and public health surveillance programs and activities to the Indian Health Service, Tribes, Tribal organizations, and Tribal epidemiology centers.
Tribes and other friends of Indian health can urge the Senate Committee on Indian Affairs to support and advance the Tribal Health Data Improvement Act of 2021 by phone or email at testimony@indian.senate.gov. The Senate Committee on Indian Affairs generally accepts testimony, including a letter of support, for up to two weeks after the hearing (or by April 6, 2022). You can watch the hearing here.
Legislative Hearing to receive testimony on S. 1397, S. 3168, S. 3308, S. 3443, S. 3773 & S. 3789
March 23 | 2:30 PM E.T
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Senator Kyrsten Sinema (D-AZ)
Senator Sinema was first elected to the U.S Senate in 2018 and is serving her first term. Her top issues include veterans' affairs, job creation, public and affordable education.
Committees
Tribal Advocacy
Senator Sinema sponsored S.112 a bill to require the Secretary of Health and Human Services to award additional funding through the Sanitation Facilities Construction Program of the Indian Health Service. It is related to S.1895, the Indian Health Service Sanitation Facilities Construction Improvement Act that Senator Sinema also co-sponsored and was passed as part of the Infrastructure Investment and Jobs Act.
Senator Sinema co-sponsored S.789 Repealing Existing Substandard Provisions Encouraging Conciliation with Tribes Act (RESPECT) that repeals certain provisions related to the treatment of Indians, including provisions on hostile tribes, alcohol, work requirements, penalties for truancy, and placement of youth in reform school without the consent of a parent or guardian.
She also co-sponsored S.3623 the Violence Against Women Act Reauthorization Act which reaffirms Tribal authority to seek justice for native victims for certain violence crimes committed by non-Indians. This bill was included in the Omnibus appropriations bill H.R. 2471 Consolidated Appropriations Act 2022 which was signed into law on Tuesday, March 15, 2022.
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Representative Greg Stanton (D-AZ-09)
Representative Stanton represents Arizona's 9th congressional district - the most urban district in the state of Arizona. He is currently serving his second term and is seeking re-election in the 2022 Congressional election. His top issue areas include focusing on infrastructure, immigration reform, and economic growth rooted in innovation and trade.
Committees
Tribal Advocacy
Representative Stanton sponsored H.R 6406 Stronger Engagement for Indian Health Needs Act of 2022 that would elevate the Indian Health Service (IHS) Director to an Assistant Secretary for Indian Health within the Department of Health and Human Services (HHS). It would align the authorities of the new Assistant Secretary with that of other Assistant Secretaries within the HHS.
He co-sponsored H.R 1667 Dr. Lorna Breen Health Care Provider Act. The bill provides for the Secretary of HHS to, among other things, establish a program to award grants to Indian Tribes or Tribal organizations to support the training of health care students, residents, or health care professionals in evidence-based or evidence-informed strategies to address mental and substance use disorders and improve mental health and resiliency among health care professionals. The bill was signed by the President and became law on March 18, 2022.
Additionally, he co-sponsored H.R 1620 the Violence Against Women Act Reauthorization Act.
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Representative Ruben Gallego (D-AZ-7)
Representative Gallego represents Arizona's 7th congressional district and is currently serving his fourth term. He is seeking re-election in the 2022 Congressional elections. Representative Gallego advocates for U.S national security, veterans' affairs, natural resources, and tribal affairs where Gallego oversaw the House passage of the Carcieri fix and championed investment in broadband and other infrastructure needs in Indian Country.
Committees
Tribal Advocacy
Representative Gallego sponsored H.R 6372 Tribal Medical Supplies Stockpile Act. The bill would ensure facilities of the Indian Health Service (IHS), facilities operated by an Indian Tribe, Tribal organization, or inter-Tribal consortium, and facilities operated by an urban Indian organization receive items from the strategic national stockpile and qualified pandemic or epidemic products directly from the Department of Health and Human Services.
His co-sponsored tribal healthcare legislation includes H.R 5549 Indian Health Service Advance Appropriations Act which provides for advance appropriations for the Indian Health Service and H.R 5567 Indian Programs Advance Appropriations Act which provides advance appropriations for the Bureau of Indian Affairs, Bureau of Indian Education, and for IHS.
In addition, Representative Gallego co-sponsored H.R 5444 Truth and Healing Commission on Indian Boarding School Policies Act of 2021 introduced by Representative Sharice Davids (D-KS-03) on September 30, 2021. Read NIHB's Resolution no. 22-01 Boarding School Healing Resolution here that was passed on February 24, 2022.
He also sponsored H.R 3496 Urban Indian Health Providers Improvement Act which expands the authority of the IHS to make funds available for urban Indian organizations to renovate, construct, or expand urban Indian health facilities.
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Tribal Health Data Improvement Act of 2021
On April 27, 2021, Senator Tina Smith (D-MN) introduced S.1397 the Tribal Health Data Improvement Act of 2021. This bill will be featured in the legislative hearing held by the Senate Committee on Indian Affairs on Wednesday, March 23, 2022, at 2:30 p.m. ET. On June 24, 2021, Representative Markwayne Mullin (R-OK-2) introduced the House companion bill H.R. 3841. Representative Tom O’Halleran (D-AZ-1) co-sponsored the bill.
Both bills are intended to improve Tribal access to important public health data and information – a key priority for Tribal nations and the National Indian Health Board (NIHB) that is reflected throughout the NIHB Legislative and Policy Agenda and in Resolution No. 21-05. Data helps Tribal health officials determine trends in health care improvements or disparities, where the health care services are having positive impacts, or where resources are most needed. Without data, Congress, Tribal leaders, and health department officials may lack the information necessary to make informed decisions on resources and priorities.
Data has been critical in implementing and reauthorizing the Special Diabetes Program for Indians as well as increasing Medicaid and Medicare participation and reimbursement. For example, the NIHB Legislative and Policy Agenda highlighted data on Medicaid and Medicare reimbursements contained in a 2019 Government Accountability Office Report.
That Report found the number of American Indian and Alaska Native (AI/AN) people with Medicaid coverage increased from 1,458,746 in 2012 to 1,793,339 in 2018. This increase of 334,593 AI/AN enrollees is a 23 percent increase over 2012. In 2018, 34 percent of all AI/AN people had Medicaid coverage compared to 30 percent in 2012. This information can be useful in assisting Congress, the Administration, Tribal leaders, and health officials when evaluating the effectiveness of and need for improved enrollment programs.
The NIHB Legislative and Policy Agenda also stressed the need for data and data access improvement for important initiatives such as (1) a study to determine strategies for mandatory funding for Indian health care, (2) approaches to best capture and incorporate American Indian and Alaska Native data accurately and respectfully for the national HIV/AIDS strategy plan, and (3) for behavioral health activities.
Most notably, the NIHB Legislative and Policy Agenda recommended that the Centers for Disease Control and Prevention work with states, Indian Health Service, and other stakeholders to ensure that complete and accurate data is captured and shared with Tribes to effectively respond and recover from COVID-19 and other similar public health emergencies. This legislation is an important step in achieving this priority.
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NIHB Joins Home Visiting Coalition Supporting Tribal MIECHV Programs
The MIECHV program currently includes a set-aside for Tribal MIECHV programs of $12 million. The Home Visiting Coalition recommends doubling the tribal set‐aside within MIECHV from three to six percent to reach more families in AI/AN communities. The current MIECHV funding is set to expire on September 30, 2022. It is crucial that MIECHV be reauthorized before it expires to avoid any lapse in programming. A five‐year reauthorization will provide stability and security to the field, further preventing any disruptions to the program
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Register for the National Tribal Public Health Summit 2022
This year’s summit theme is Tribal Health is Public Health and will feature dynamic national speakers, interactive workshops and roundtable discussions, a welcome reception, a fitness event, as well as the presentation of the Native Public Health Innovation Awards.
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