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UPCOMING EVENTS
May 29 - 30, 2019
Rapid City, SD
June 6, 2019
Call in: 800-857-5577
Passcode: 6703929
July 15 - 16, 2019
Washington, DC
August 6 - 9, 2019
Oklahoma City, OK
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Community Health Aide Program (CHAP) TAG Vacancies
In February 2018, with the announcement of CHAP expansion to Tribes beyond Alaska, IHS created a CHAP Tribal Advisory Group.
Information on CHAP and CHAP TAG, including
vacant
positions, is available on the CHAP
website
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Join the National Partnership for Dental Therapy!
Click
HERE for more information!
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Stay Current: Health Alerts from the CDC!
Don't wait for the emergency to arrive before signing up for emergency alerts from the Centers for Disease Control & Prevention!
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House Appropriations Committee Passes FY 2020 Interior Bill, Includes Significant Increases for Indian Health Service
On Wednesday May 22, 2019, on a 30-22 party-line vote, the House Appropriations Committee, chaired by Congresswoman Nita Lowey (D-NY), passed a $37.3 billion Interior-EPA spending package that included top-line and line item increases to the Indian Health Service (IHS) budget. The FY 2020 Interior-EPA bill boosts spending overall by 4%, and increases the IHS budget by $537 million overall, to a total of $6.3 billion.
Tribes, NIHB, and national Tribal and urban Indian organizations have long advocated for advance appropriations for IHS in order to protect the agency from dangerous lapses in funding brought on by government shutdowns, and to establish parity between IHS and the Veteran's Health Administration, which has received advance appropriations for almost a decade. During the most recent 35 day shutdown, IHS, Tribes, and urban Indian clinics faced significant budget constraints leading to staff departures, clinic closings, and significant barriers in access to care. The FY 2020 Interior-EPA Committee Report included the following language regarding advance appropriations for IHS:
Advance Appropriations
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In 2018, the Government Accounting Office (GAO) identified considerations for Congress when considering whether to advance appropriate funds to IHS, including whether IHS has the processes in place to develop and manage an advance appropriation. The Committee directs IHS to examine its existing processes and determine what changes are needed to develop and manage an advance appropriation and report to the Committee within 180 days of enactment of this Act on the processes needed and whether additional Congressional authority is required in order to develop the processes.
NIHB continues to advocate for advance appropriations for IHS, and is working in a bipartisan fashion to help ensure passage of legislation in both the House and Senate providing advance appropriations for the agency.
Below is a summary of a few significant line item increases for IHS that were included in the committee report for the bill:
Hospitals and Clinics: increased to $2.42 billion overall including
- $12.9 million for domestic violence prevention (+ $4 million over 2019 level)
- $6.4 million for Tribal Epidemiology Centers (+ $2 million over 2019 level)
- $58 million for accreditation emergencies (equal to 2019 level)
The bill includes important new spending items that Indian Country has long advocated for, and were introduced in the FY 2020 President's Budget. These include:
- $25 million for HIV/AIDS and Hepatitis C prevention and treatment
- $20 million for a national community health aide program (CHAP)
- $25 million for modernization of electronic health records
Notably, the legislation includes $53 million to help address growing concerns with 105(l) leases, which provide supplemental funds to cover clinic and hospital operational costs for Village Built Clinics and "638" Tribal clinics. This is $17 million above the 2019 enacted level. Tribes have advocated for 105(l) leases to be a separate line item, and the committee report includes language directing the IHS to examine whether such an approach would be preferred, in a manner similar to contract support costs. Committee report language requires IHS to report back to Congress within 90 days of bill passage on their determination. It is important for Tribes to remain apprised of this process and request consultation with IHS as they consider separating funding for 105(l) leases into a distinct line item.
Other important increases include $125.3 million for Mental Health (+ $20 million); $280 million for Alcohol and Substance Abuse (+ $34.4 million); $81 million for urban Indian health (+ $29.6 million); $90.6 million for Indian Health Professions (+ $33.2 million); and $304.2 million for Health Care Facilities Construction (+ $60.8 million)
Another major victory in the bill was the rejection of proposed cuts to the Community Health Representatives (CHR) and Health Education line items that were outlined in the FY 2020 President's Budget. While the President's Budget proposed slashing CHR funding by nearly $40 million and zeroing out Health Education, the House bill instead gives a slight $25,000 boost to CHR funding, to a total of $62.9 million. The bill also includes a $101,000 increase to Health Education, to a total of $20.6 million.
The bill now advances to the full House floor for a vote. While these increases are significant, top-line spending numbers are still subject to change. Because Congress has yet to pass a budget resolution that would raise budget caps and establish top-line spending limits for FY 2020 and beyond, it is far from certain that these spending numbers will remain the same moving forward. The Senate has not yet begun formal work on any FY 2020 appropriations package, primarily because of ongoing negotiations between party leaders from both the House and Senate on a budget deal. Congressional leaders are eager to strike a budget deal that raises spending caps in order to avoid across the board budget cuts under sequestration, which would trigger in FY 2020 if Congress fails to pass a deal.
NIHB continues to monitor the appropriations process and will provide regular updates as legislation moves through Congress.
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In This Issue:
TOP STORY
CAPITOL HILL UPDATES
FEDERAL ADMINISTRATION AND STATE GOVERNMENT UPDATES
UPCOMING EVENTS, CALLS, AND WEBINARS
GRANTS AND RESOURCES
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Congressman Tom O'Halleran Introduces SDPI Reauthorization Bill, Including Funding Increase to $200 million!
On Friday, May 10, 2019, Congressman Tom O'Halleran (D-AZ) introduced legislation that would reauthorize the Special Diabetes Program for Indians (SDPI) for a period of five years while increasing annual funding for the program to $200 million.
Long-term reauthorization for SDPI including an increase in funding has been a top priority for Indian Country, and NIHB is proud to have partnered with organizations such as
American Diabetes Association, the Endocrine Society, JDRF, and the National Council of Urban Indian Health to advocate for its introduction. The bipartisan bill is currently co-sponsored by Representative Diane DeGette (D-CO); Rep. Markwayne Mullin (R-OK); Rep. Tom Cole (R-OK); Rep. Deb Haaland (D-NM); and Rep. Tom Reed (R-NY).
As a result of these advocacy efforts,
376 of the 435 members of the House of Representatives - or 86 percent of all members - signed on to a letter to House leadership requesting reauthorization of SDPI. It is unprecedented for any legislation to receive such bipartisan support, and its occurrence speaks to the incredible success of SDPI and the hard work and continued advocacy of Tribes, Tribal organizations, and urban Indian organizations.
For more information about Rep. O'Halleran's bill,
click here
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Senator Elizabeth Warren (D-MA) and Representative Elijah Cummings (D-MD) Reintroduce CARE Act to Address Opioid Crisis
Earlier this month, Senator Elizabeth Warren and Representative Elijah Cummings reintroduced the Comprehensive Addiction Resources Emergency (CARE) Act, which provides $100 billion in federal funding over a ten year period to combat the opioid epidemic, including over $800 million per year in direct funding to Tribal governments and organizations for substance and opioid use disorder prevention and treatment.
The bill currently has 9 co-sponsors in the Senate and 91 co-sponsors in the House. The legislation provides by far the most direct funding to Indian Country including
- $670 million in direct grants to Tribal governments for substance use prevention and treatment;
- $7.5 million in funding to Tribes and Tribal Epidemiology Centers for surveillance and data collection on drug overdoses;
- $50 million to Tribal colleges and universities and other Tribal partners to train a new generation of Native health leaders to address workforce shortages for substance use disorder treatment;
- $100 million in funding to Tribal and urban Indian organizations;
- $500 million in funding for naloxone to Tribes, Tribal organizations, urban Indian organizations, first responders, and other public health agencies to help save lives and reduce overdose fatalities.
NIHB was proud to provide significant suggestions and recommendations to ensure the bill comprehensively meets the needs of Indian Country in the wake of the national opioid crisis, and will continue to monitor and advocate for its passage.
To access more information about the legislation,
click here
To access a fact sheet on the bills direct funding to Indian Country,
click here
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FEDERAL ADMINISTRATION AND STATE GOVERNMENT UPDATES
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HHS Establishes and Seeks Member Nominations for Interdepartmental Substance Use Disorders Coordinating Committee
On May 14, Adm. Brett P. Giroir, M.D., announced that HHS created a new Coordinating Committee tasked with identifying areas for improved coordination related to substance use disorder (SUD) research, services, supports and prevention activities across all relevant federal agencies. This committee, which was authorized by the SUPPORT for Patients and Communities Act, is led by HHS and the Office of National Drug Control Policy (ONDCP). The committee will include representatives across many federal departments, including Education, Housing and Urban Development, Veterans Affairs, and more. The HHS secretary will also appoint Committee members from outside the government, including:
- Individuals who have received treatment for a diagnosis of SUD;
- Directors of state substance use agencies;
- Representatives of leading research, advocacy or service organizations for adults with SUDs;
- Physicians, licensed mental health professionals, advance practice registered nurses, or physician assistants with experience in treating individuals with SUDs;
- SUD treatment professionals who provide treatment services at certified opioid treatment programs;
- SUD treatment professionals who have research or clinical experience in working with racial and ethnic minority populations; and more.
Details regarding the nomination process are available
here.
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UPCOMING EVENTS, CALLS, AND WEBINARS
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CMS ITU Trainings
Don't miss the National Indian Health Board's (NIHB) presentation at the Centers for Medicare and Medicaid Services' (CMS), Indian Health Service (IHS), Tribal Health Programs, and Urban Indian Programs (CMS I/T/U) regional training sessions! CMS is committed to helping the I/T/U facilities to maximize their ability to access third party resources. To meet this objective, CMS, in partnership with the States, the Department of Veteran Affairs, the Social Security Administration, the DHHS Office of the Inspector General, IHS and NIHB provide training to patient benefits advocates on the programs and benefits available through Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and the Health Insurance Marketplace.
The target audience for CMS ITU Trainings includes:
- Business Office staff
- Benefits Coordinators
- Patient Registration staff
- Medical Records staff
- Purchased/Referred Care staff
Upcoming Regional Trainings:
May 30-31, 2019
Holiday Inn Express
2422 Ridgeway Ave NW
Bemidji, MN 56601
June 4-6, 2019
Courtyard Marriott Sacramento Cal Expo
1782 Tribute Road
Sacramento, CA 95815
June 10, 2019
Davenport Grand Hotel
333 West Spokane Falls Boulevard
Spokane, WA 99201
For more information, and to register, click here
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ACL announces Funding Opportunity for Tribal LTSS Resource Center
The Administration for Community Living (ACL) is proposing to aware a new cooperative agreement to find a National Resource Center of AI/AN and Native Hawaiian LTSS, (NRCAIANNHLTSS). This center will address the unmet need of Tribal-specific and culturally appropriate LTSS information and guidance to
Tribes. The outcomes of this project will be to:
- Create a network of navigators that will assist Tribes in development of appropriate LTSS in response to identified, tribally-specific needs; and
- Based on documented best practices, the Center will develop a practical and hands-on toolkit for Tribes to assist in implementing LTSS in their individual Tribal communities.
The Resource Center will target its services to the 270 tribes that receive Title VI grants, however it will also have publicly-available resources that are accessible to all Tribes and organizations that work with the AI/AN and Hawaiian populations. The Resource Center will focus on improving the lives of those served by ACL by supporting the development of Tribal-specific LTSS that assist older adults and people with disabilities while also empowering tribes to develop programs that are integrated into their unique culture.
Applications are due July 5, 2019. Click
here for more details.
Funding Opportunity Number: HHS-2019-ACL-AOA-IELT-0349
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Technologies to Enhance Independence and Community Living for People with Cognitive Impairments
The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), within the Administration for Community Living (ACL), announced a new funding opportunity on May 16, 2019. The project that NIDILRR is funding is called the "Rehabilitation Engineering Research Centers (RERCs) Program: RERC on Technologies to Enhance Independence and Community Living for People with Cognitive Impairments", whose goal is to improve the effectiveness of services authorized under the Rehabilitation Act by conducting research and developing innovative technologies that solve rehabilitation problems or remove environmental barriers.
Federally-Recognized Tribal Governments, Native American Tribal organizations, and Nonprofits with a 501(c)(3) status are among the eligible applicants.
Applications are due July 15, 2019. Click
HERE for more details.
Funding Opportunity Number: HHS-2019-ACL-NIDILRR-REGE-0343
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IHS Letter Announces Competitive Grant Opportunity: FY 2019 Small Ambulatory Program
On April 23, 2019, the Indian Health Service issued a Dear Tribal Leader Letter (DTLL) to inform Tribes of the opportunity to apply for the 2019 Small Ambulatory Program (SAP). The SAP is a competitive grant awards program for Tribes and/or Tribal organizations operating a healthcare facility program under either Title 1 or Title 5 of the Indian Self Determination Act (ISDEAA), to construct, expand, or modernize their ambulatory health care facilities.
The IHS FY 2019 budget includes $15 million for SAP and grant recipients may receive up to $2 million in funding. The deadline for submitting SAP applications is Friday, June 28, 2019. However, IHS requires that applications include an approval by their IHS Area office, and encourages that complete applications are submitted to their area by Friday, May 31, 2019.
To apply for this grant:
- Read the DTLL Announcement here.
- View the application criteria here.
- View the Online Application Kit here.
- Download the Application Kit as PDF here.
IHS Small Ambulatory Program's contact Information:
LCDR Omobogie Amadasu, SAP Manager, IHS
Phone: (301) 443-4751
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CDC Funding Opportunities
Public Health Approach to Asthma Control Through Evidence-Based Interventions
NOFO Number: CDC-RFA-EH19-1902
Link: https://www.grants.gov/web/grants/view-opportunity.html?oppId=314360
Description: The purpose of the award is to improve the reach, quality, effectiveness, and sustainability of asthma control services and to reduce asthma morbidity, mortality and disparities by implementing evidence-based strategies across multiple sectors.
Deadline: May 31, 2019
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HRSA Funding Opportunity: Rural Communities Opioid Response Program-Medication-Assisted Treatment Expansion
NOFO Number: HRSA-19-102
Deadline: June 10, 2019
The Health Resources and Services Administration's (HRSA) Federal Office of Rural Health Policy (FORHP) released a Notice of Funding Opportunity (NOFO) yesterday for the Rural Communities Opioid Response Program-Medication-Assisted Treatment Expansion (RCORP-MAT Expansion). HRSA plans to invest approximately $8 million in rural communities as part of this funding opportunity.
Successful RCORP-MAT Expansion award recipients will receive up to $725,000 for a three-year period of performance to establish or expand medication-assisted treatment (MAT) in eligible hospitals, health clinics, or tribal organizations located in high-risk rural communities.
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HRSA Funding Opportunity: Medical Student Education Program
NOFO Number: CDC-RFA-DP19-1903
Deadline: June 14, 2019
Funding for medical schools in Mississippi, Alabama, Kentucky, Oklahoma, Utah, Arkansas, Missouri, and Indiana.
The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year 2019 Medical Student Education (MSE) Program. The application cycle closes on June 14, 2019.
The purpose of this program is to provide grants to public institutions to expand or support graduate education for medical students preparing to become physicians in states with the highest* projected primary care provider shortages in 2025. Students are prepared and encouraged to choose residencies and careers in primary care that serve tribal communities, rural communities, and/or medically underserved communities after they graduate.
HRSA expects approximately $23,750,000 to be available in fiscal years 2019 - 2022 to fund up to five grants among eligible medical schools.
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Resources Available to Tribes on Health Issues
The following resources are now available to Tribes on issues related to health and wellness:
HRSA Grant Application Webinars
The Health Resources and Services Administration (HRSA) has created a series of
FREE
Grants Education and Technical Assistance Webinars for Tribes, Tribal Organizations, Indian Health, Tribal and Urban Indian Health Programs.
Topics include
the federal grant application process, how to write better grant proposals and evaluation plans for your projects, strategies for successful grant management, and more.
Please find below links to all the recorded sessions.
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Apr 11, 2018
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Federal Grants Application Process: The Basics
Where to Find Funding Opportunities, Grants Resources & Technical Assistance
Recording and slides available here
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May 9, 2018
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Writing a Competitive Grant Application / HRSA Review Criteria
Recording and slides available here.
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Jun 13, 2018
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Applying for a HRSA Grant: A Grantee and a Reviewer's Perspectives /
The Benefits of Becoming a Reviewer
Recording and slides available here.
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Jul 11, 2018
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Writing a Successful Evaluation Plan for Your Grant Application
Recording and slides available here.
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Aug 8, 2018
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Preparing a Budget for your Grant Proposal
Part 1: Building a Budget
recording and slides available
here
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Part 2: HRSA Budget 101 / Tips & Resources
recording and slides available
here
.
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Sept 12, 2018
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Effective Grants Management/Administration & Reporting
Recording and slides available here.
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CMS
announced the five-year Maternal Opioid Misuse (MOM) model to help state Medicaid programs improve clinical care and social services for pregnant and postpartum women with opioid use disorder and their children.
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