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July 15, 2020

July 22-23, 2020

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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Top Story
InteriorReportHouse Appropriations Committee Releases FY 2021 Report with Line Item Totals for IHS Budget
On Tuesday July 7, the House Appropriations Subcommittee for Interior, Environment, and Related Agencies released its Fiscal Year (FY) 2021 spending bill, proposing to fund Indian Health Service (IHS) at just under $6.5 billion, an increase of $445 million overall above the FY 2020 enacted budget.

In addition to this amount,  the House bill would provide a  separate  $1.5 billion specifically as emergency infrastructure funding to construct and renovate IHS Facilities . As outlined in the bill text, use of the $1.5 billion in emergency IHS Facilities funds would first require the agency to submit a comprehensive spending plan to Congress for approval. This plan would need to identify the cost of each project, and identify each specific project by Tribe. The bill outlines a few more stipulations on use of emergency infrastructure funds as well. 

For FY 2021, the House bill proposes $101 million for 105(l) lease costs,  matching the request in the President's Budget but $37 million below the recommendation put forth by the Tribes through the   National Tribal Budget Formulation WorkgroupImportantly,  the House bill proposes an indefinite appropriation for 105(l) lease contracts - a longstanding Tribal priority that was also included in the President's FY 2021 Budget request for IHS.  The House bill authorizes an indefinite appropriation for 105(l) lease costs for two years - through September 30, 2022. 

NIHB continues to strongly advocate for important Indian health programs funded under the Labor-HHS budget by agencies such as CDC and the Substance Abuse and Mental Health Services Administration (SAMHSA). Under CDC, the spending package  increases funding for the successful Good Health and Wellness in Indian Country Program (GHWIC) to $23 million for FY 2021.  In addition,   the LHHS bill proposes a  new baseline $150 million Tribal set-aside in CDC funding for public health infrastructure and program development.

The bill also  maintains the $15 million set-aside for placements of National Health Service Corps (NHSC)  officers at IHS, Tribal and urban Indian facilities , and the $50 million Tribal set-aside under SAMHSA for the Tribal Opioid Response grants.

The LHHS Committee Report is set to be released later this week, and will outline totals for important Tribal programs like the AI/AN Suicide Prevention Initiative under SAMHSA, and the SAMHSA Tribal Behavioral Health Grants.

The full House Appropriations Committee is set to markup the Interior bill tomorrow, Friday July 10 at 9:00 AM Eastern and will be livecasted  HERE . The Interior Subcommittee had marked up and favorably referred the bill to full committee earlier this week.

Although the Senate had initially planned on beginning appropriations markups before the July 4th holiday, that timeline slipped due to unrelated negotiations on bills to address police brutality and the ongoing COVID-19 pandemic. The Senate is now on recess until Monday July 20. As soon as the Senate returns, efforts will rapidly resume on another COVID-19 relief package before both chambers depart for the month-long August recess, further delaying bicameral action on FY 2021 appropriations likely into September.

With the delayed appropriations timeline and focus on the November election as that date draws closer, the likelihood of yet another continuing resolution cannot be ruled out.

For a copy of bill text,  click here.
For a copy of the Committee Report,  click here.

For any questions on FY 2021 appropriations, please contact NIHB Director of Congressional Relations, Shervin Aazami, at  saazami@nihb.org
In This Issue:

UrgentNeedsNIHB Submits Testimony to House Energy & Commerce Committee on Urgent Needs of Tribal Communities
On Wednesday July 8, the House Energy & Commerce Committee held a full committee hearing titled, "Addressing Urgent Needs of Our Tribal Communities". While the hearing's scope was general in nature, the Committee spent its time asking witnesses about issues related to the COVID-19 pandemic, health inequities, and funding and infrastructure deficiencies of the Indian Health Service (IHS). In response, NIHB submitted written testimony to the Comittee for the record providing Tribal health policy recommendations including:
  • Authorize advance appropriations for the IHS and the Bureau of Indian Affairs (BIA);
  • Pass the Special Diabetes Program for Indians (SDPI) Reauthorization of 2019;
  • Make significant investments in water and sanitation development across IHS and Tribal
  • facilities;
  • Provide direct funding to I/T/U facilities for broadband, telehealth, electronic health
  • records and health information technology (IT) infrastructure development;
  • Fix the "four walls" Medicaid billing restriction and extension of 100% FMAP to urban Indian organizations
  • Authorize Indian Health Care Providers (IHCPs) to receive Medicaid reimbursement for
  • all medical services authorized under the Indian Health Care Improvement Act (IHCIA)
  • Enact Certain Sections of the Bipartisan CONNECT to Health Act

To read NIHB's full written testimony, click here. 

For questions regarding NIHB's advocacy, please contact Director of Congressional Relations Shervin Aazami at saazami@nihb.org
DataLetterBipartisan Group of Lawmakers Address Concerns of Tribal Access to Federal COVID-19 Data
On July 2, US Representatives Frank Pallone Jr. (D-N.J.), chair of the House Energy and Commerce Committee, Raúl M. Grijalva (D-Ariz.), chair of the House Natural Resources Committee, and Ruben Gallego (D-Ariz.), chair of the House Natural Resources Subcommittee for Indigenous Peoples, US Senators Tom Udall (D-N.M.), vice chairman on the Senate Committee on Indian Affairs, and Patty Murray (D-Wash.), ranking member of the Senate Health, Education, Labor and Pensions Committee, and called on the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) to clarify their policies and practices regarding Tribal epidemiology centers' (TECs) access to disease surveillance data, including data necessary to inform Native communities' response to the coronavirus disease of 2019 (COVID-19) pandemic.

An excerpt from the letter reads, "Many Tribal leaders and Members of Congress are deeply concerned this trend is continuing with COVID-19, particularly because more than one-third of American Indians and Alaska Natives are at high-risk of serious COVID-19 complications due to underlying health factors[...]limitations on TEC access to national public health surveillance systems are hampering efforts by Tribes and Urban Indian Organizations to understand and respond to the full impacts of COVID-19 on their communities."

To read the full letter, click here.

NIHB will continue to monitor Congress's work on addressing public health surveillance challenges for Tribes and will advocate for greater access to resources and data.

For questions regarding NIHB's advocacy, please contact Director of Congressional Relations Shervin Aazami at saazami@nihb.org.

HITAC2020 Meeting Notice from the Health Information Technology Advisory Committee
On June 29, 2020 the Department of Health and Human Services released a
notice of a meeting of their Health Information Technology Advisory Committee. The committee is primarily responsible for identifying priorities for guidelines and recommendations to the National Coordinator for Health Information Technology. Specific topics covered during these meetings include interoperability, privacy, security and patient access. The remaining meetings for 2020 will be held on September 9, 2020, October 21, 2020 and November 10, 2020. These meetings are open to the public and each meeting has an oral public comment period. For more information on these meetings please follow this link
ProcessingAppealThe Office of Medicare Hearings and Appeals Case Processing Manual
On July 1, 2020 the Department of Health and Human Services released a notice on the Office of Medicare Hearings and Appeals Case Processing Manual that was published in March 2020. The Office of Medicare Hearings and Appeals oversees the Administrative Law Judge hearing program for Medicare claims nationwide. The Office is responsible for all Medicaid entities to have specific forums to address disagreements with Medicare coverage and payment determinations made by Medicaid contractors. The manual itself covers topics like the standard day to day procedures for carrying out adjudicative functions, regulations and directives of the Office of Medicare Hearings and Appeals.
ExecutiveReportExecutive Order on Promoting the Rule of Law Through Improved Agency Guidance Documents
On July 2, 2020 the Department of Health and Human Services (HHS) published a notice on the Rule of Law Through Improved Agency Guidance Documents. This notice was previously an executive order that the president issued on October 9, 2019 and makes it a requirement for all federal agencies to create an on-line guidance portal. This notice serves to inform the public that HHS has reviewed the guidance documents and has made them available on this website.
FCCProgramThe Federal Communications Commission (FCC) Approves Thirteenth Set of Applications for the COVID-19 Telehealth Program
On July 1, 2020 the FCC released its thirteenth set of applications for their telehealth program adding an additional 70 funding applications. This set provides both urban and rural areas a total of $31.63 million in funding for telehealth services during the COVID-19 pandemic. During the course of this program, the FCC has released a total of $189.27 million in funding for the COVID-19 telehealth program with 514 applications in 46 states.
FCCFundingThe Federal Communications Commission (FCC) Increases Funding in Rural Health Care Program for 2020
On June 30, 2020 the FCC Communications Commission's Wireline Competition Bureau released an announcement that directed the Rural Health Care Program of the FCC to release $197.98 million in unused funds from previous years to help rural health care providers during these times. This extra funding comes from the programs increased annual funding cap that was adjusted due to inflation back in 2018. The total overall funding for eligible healthcare providers will be $802.74 million for 2020.
DTLLDear Tribal Leader Letter from the Indian Health Service (IHS)
On July 2, 2020 the IHS released a Dear Tribal Leader letter on initiating Tribal consultation on the use of $30 million in funding from the Special Diabetes Program for Indians (SDPI). This funding is an offset from previous year funds due to an accumulation of prior SDPI grants. Due to an added sixth year to the current grant cycle for SDPI, a new plan is needed for FY 2020 offset funds. Both offset funds and carry over funds could be used for different purposes. These purposes could include "new grant funding for $10 million per year for 3 years for eligible entities that do not currently have a SDPI grant, or one open to all eligible entities to apply to address diabetes related risk factors." This letter concludes with an invitation for all Tribal leaders to provide feedback to IHS on how this $30 million might be spent. The deadline to comment is August 28, 2020.
Please see below for call information to the  IHS' All Tribes Call on Thursday, July 16th at 4:00 PM Eastern . This call is intended to update Tribes on the Coronavirus Disease 2019 (COVID-19). Tribal Leaders will have an opportunity to provide comments and ask questions to federal officials. IHS has also scheduled a COVID-19 call for the following week at the same time-call info is the same for both calls.

Date:   Thursday, July 16th
Time:  4 :00 PM - 5:30 PM (Eastern)
Conference Call:   800-857-5577 | Participant Passcode:  6703929
Webinar Adobe Connect:   https://ihs.cosocloud.com/r4k6jib09mj/ | Participant Password:  ihs123
The target audience for CMS ITU Trainings includes:
  • Business Office staff
  • Benefits Coordinators
  • Patient Registration staff
  • Medical Records staff
  • Purchased/Referred Care staff
Upcoming  virtual training - Navajo Area
 July 7 - 16, 2020
For information and to register, click here
DTFundingFunding Opportunity: Dental Therapy in Indian Country
Applications due Monday, July 20, 2020 at 11:59 PM ET
The National Indian Health Board (NIHB) is pleased to announce it is accepting applications for three funding opportunities related to dental therapy in Indian Country. These announcements are part of NIHB's Tribal Oral Health Initiative.
  • Tribal Colleges/Universities to conduct activities to develop dental therapy education programs
  • Tribes and Tribal Organizations to conduct activities to implement dental therapy in health settings
  • Tribes and Tribal Organizations to conduct outreach and education activities in support of dental therapy
Completed applications should be submitted to Brett Weber at bweber@nihb.org and should reference the grant code in the subject line. Read more and download the applications here.  
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