January 14, 2020 |  Issue 20-1   Missed Last Week's Washington Report? Click Here to Visit our Archives!

January 23 - 24, 2020
Washington, DC

Secretary's Tribal Advisory Committee Meeting
February 6 - 7, 2020
Washington, DC

February 11 - 12, 2020
Washington, DC

February 11 - 12, 2020
Washington, DC

February 13 - 14, 2020
Washington, DC

February 25 - 26, 2020
Washington, DC

Tribal Leaders Diabetes Committee Meeting
March 11-12, 2020
Washington, DC

March 17 - 19, 2020
Omaha, Nebraska
Register for the Summit HERE

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 .

Join the National Partnership for Dental Therapy!
Click HERE for more information!

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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Top Story
FY 2021 President's Budget to be Released February 10; House Interior Appropriations Subcommittee to hold Tribal Witness Hearings February 11 and 12
Last week, the Trump Administration announced that it will be releasing its FY 2021 Budget Request on Monday, February 10, 2020. This will mark the first time under this administration that officials are able to craft and release the President's Budget with the certainty of spending levels for the current fiscal year. This is because President Trump signed the full fiscal year (FY) 2020 spending package just before the holidays. In previous years, release of the President's Budget was delayed due to federal government shutdowns, or were released while the government was operating under a continuing resolution (CR). 

NIHB will conduct and share an analysis of the President's Budget request for the Indian Health Service (IHS) and Tribal health programs outside of IHS upon its release.

Congressional appropriators have also begun scheduling hearings on next year's budget, including the House Interior Appropriations Subcommittee which will be holding its annual American Indian and Alaska Native (AI/AN) Public Witness Hearings on February 10 and 11, 2020. The public witness hearings provide an opportunity for AI/AN Tribal leaders and representatives to communicate spending priorities for the IHS budget, which is funded under Interior Appropriations. The Subcommittee is accepting requests to testify through Thursday, January 16. 

For more information and to submit a request to testify, click here
Did you know? The latest population estimates for American Indians and Alaska Natives in US counties
US Census 5-year American Community Survey estimates for 2018 were released on December 19, 2019. The 5-year survey pools data from 2014, 2015, 2016, 2017, and 2018 annual surveys to create estimates that are useful for smaller populations and smaller geographies, e.g., counties. The 3,126 included counties have a combined AI/AN alone and in combination (multiple races) population of 
5.6 million. This total includes AI/ANs born in foreign counties. The US total without foreign born is  5.3 million.

The 5-year estimates and Margin of Error
The US Census urges users to understand and utilize the margin of error (MOE) whenever their estimates are based on surveys, but the MOE is not always available for smaller geographies or smaller population groups; including AI/ANs. Fortunately, the 5-year survey estimates do include census calculated MOEs at the 90% confidence level for counties. What does this mean? If for example, we look at Tulsa County, Oklahoma's estimated population of 69,935 and its MOE of 798 we can say we are 90% confident that the actual population is within 69,137 and 70, 833. That is, if multiple surveys were conducted over and over again the estimates would be within this range. The MOE is a measure of sampling error. Non-sampling error should also be considered for many survey responses if we have doubts about whether or not the answer to questions are valid (do they measure what we think they measure) and are they reliable (do they yield the same response over time).
These county estimates are a valuable input for health care planners and grant writers who need accurate data to estimate need and the potential for meeting that need for health care services for American Indians and Alaska Natives. While most health programs know how many current patients consider them their medical home, many are asking how many future patients are in their surrounding area that could potentially be served by culturally competent Indian health programs.
Michigan Medicaid Work Requirements to Begin in January 1, 2020
Michigan's Medicaid work requirements went into effect on January 1. The work requirements will apply to people ages 19-62 years old and enrolled in the Healthy Michigan Plan. Unless an exemption applies, beneficiaries will be required to report work or activities beginning February 2020. In October 2018, NIHB and NCUIH submitted comments to CMS voicing concerns about the lack of an AI/AN exemption. NIHB urges AI/ANs who live in Michigan to check to see if they meet one of the existing exemption criteria. Michigan's Medicaid recipients have until January 31, 2020 to file for an exemption from work requirements.  The form is located here
Affordable Care Act Update
Last week, Democratic lawmakers from 20 states and Washington D.C. formed a coalition to seek expedited review of the Affordable Care Act (ACA) by the U.S. Supreme Court. California Attorney General Xavier Becerra, the coalition leader, is concerned about the Fifth Circuit Court's decision to declare the ACA's individual mandate unconstitutional will have a serious impact on states, local governments, providers, and patients. The coalition aims to get a hearing and decision by summer, but this timeline is ambitious for the Supreme Court.
On December 19, 2019, NIHB wrote about the Fifth Circuit's decision, and will continue to provide updates as they are available.
Medicare Card Reminder
The Centers for Medicare and Medicaid Services announced that beginning January 1, new Medicare Cards must be used by hospitals and clinics. This is because if a facility does not use the new Medicare Beneficiary Identifier (MBI), their claim will be automatically rejected. In order to ensure that claims are paid, it is critically important that Medicare beneficiaries are aware of this change. CMS also provides information on what to do if a beneficiary does not have a card yet or fails to bring it to an appointment.
Registration Open for National Indian Health Board's 11th Annual National Tribal Public Health Summit!
March 17-19, 2020
Chi Health Center, Omaha, NE

The National Indian Health Board invites you to submit a proposalfor the National Tribal Public Health Summit (TPHS). TPHS is a premiere Indian public health event that attracts over 500 Tribal public health professionals, elected leaders, advocates, researchers, and community-based service providers. This year's Summit will feature dynamic national speakers, interactive workshops and roundtable discussions, a welcome reception, a morning fitness event, as well as the presentation of the 2020 Native Public Health Innovation awards.
This year's tracks are:
  • Health Promotion and Disease Prevention
  • Public Health Policy, Infrastructure, Workforce and Systems
  • Substance Misuse, Opioids, and Behavioral Health
  • Environmental Health and Climate Change
  • Traditional Public Health Practice
Click here   to register for the Summit by February 14, 2020 for Early Bird Rates!
February 19-21: Sixth International Meeting on Indigenous Women's Health
The American College of Obstetricians and Gynecologists (ACOG) and the Society of Obstetricians and Gynecologists of Canada (SOGC) will host the 6th International Meeting on Indigenous Women's Health, February 19-21, 2020, in Albuquerque, New Mexico. The conference will focus on innovative clinical care models and community-based approaches to health for women and their families in First Nations, Inuit, Metis, American Indian and Alaska Native and other Indigenous communities. During the meeting, participants will strengthen their knowledge about prevalent health 
challenges  facing Indigenous women and acquire practical skills. Topics include: rural maternity safety, trauma-informed care, maternal substance use and cultural safety. Optional hands-on sessions are available for clinical skills building and safety planning.

The preliminary program is available here.
CMS Outreach Materials
National Indian Health Board (NIHB) and Centers for Medicare and Medicaid Services (CMS) developed PSAs to use in Indian Country that depicts the best ways to use the outreach and education materials that CMS has created for Tribal communities.

This video demonstrates tips for using CMS Tribal outreach materials at an information booth at a health fair or community pow-wow.

This video  demonstrates tips for using CMS Tribal outreach materials in a patient home visit with a community health educator like a Community Health Representative, Public Health Nurse or a Community Health Care Provider.
If you have any questions, please email Kristen Bitsuie at kbitsuie@nihb.org .
CMS ITU Trainings and Webinars
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:
CMS ITU Training - San Diego, CA
February 5-6, 2020
Four Points by Sheraton
8110 Aero Drive
San Diego, CA 92123
CMS ITU Training - Denver, CO
March 18-19, 2020
Embassy Suites by Hilton
Denver Tech Center North
7525 East Hampden Avenue
Denver, CO 80231
CMS ITU Training - Galllup, NM (Navajo)
March 24-25. 2020
Navajo Tribal Utility Authority
Fort Defiance, AZ
Click here to register and for more information.
Udall Foundation Announces Next Round of Applications for 
Native American Congressional Internship Program
Application Deadline: January 31, 2020

This program for Native American and Alaska Native undergraduate (juniors/seniors), graduate, and law students offers a unique opportunity to gain professional leadership experience in Washington, D.C. Udall Foundation's fully-funded, ten-week summer internship in Washington, D.C., offers distinctive opportunities for Native American and Alaska Native students who are interested in learning more about the Federal legislative process while gaining an insider's view of the government's unique trust relationship with Tribes. Interns work in congressional and agency offices where they have opportunities to research legislative issues important to Tribal communities, hone their legal research and writing skills, and network with public and Tribal officials and Tribal advocacy groups.
The Foundation seeks candidates who demonstrate academic excellence, leadership qualities, and an interest in working with Native American issues and policy. Interns are provided round-trip airfare, lodging, per diem, and an educational stipend. Download the application from the Udall Foundation website and submit it by the January 31  deadline.
IHS 2020-2021 Scholarship Program Now Open!
Application Deadline: February 28, 2020, 7:00 PM Eastern

The Indian Health Service (IHS) Scholarship Program is now accepting applications for scholarship support for the 2020-2021 academic year.

Pre Nursing, Pre Medicine, Pre Dentistry, Nursing BS, Nurse Anesthetist MS, Nurse Midwife MS, Physician Assistant MS, Clinical Social Work MS, Nurse Practitioner MS, DNP, Clinical Psychology D, Counseling Psychology D, Dentistry D, Optometry D, Pharmacy D, Physician (Allopathy/Osteopathy), Physical Therapy D, Podiatry D.

For specific eligibility requirements with degree programs, please view the IHS Scholarship Comparison Chart.

HRSA Funding Opportunity: Rural Health Care Coordination Program
Application Deadline: March 12, 2020

HRSA is accepting applications for fiscal year (FY) 2020 Rural Health Care Coordination Program. The purpose of this program is to support rural health consortiums aiming to improve access and quality of care through application of care coordination strategies with the focus areas of collaboration, leadership and workforce, improved outcomes, and sustainability in rural communities.

The FY 2020 President's Budget does not request funding for this program. This notice is a contingency action taken to ensure that, should funds become available for this purpose, HRSA can process applications and award funds in a timely manner. You should note that this program may be cancelled prior to award.

The Health Resources and Services Administration (HRSA) is the primary federal agency for improving access to health care services for people who are uninsured, isolated, or medically vulnerable.  

Click here to view the funding opportunities in Grants.gov .
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