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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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Top Story
VaccineLetterNIHB Sends Letter to Congressional Appropriators Urging Dedicated Funding to Indian Country for COVID-19 Vaccines
On July 30, 2020, NIHB joined by the National Congress of American Indians and National Council of Urban Indian Health submitted a letter to House and Senate appropriators urging them to ensure a minimum 5% statutory set-aside in funding for COVID-19 vaccine distribution for the Indian Health Service, Tribal Nations, and urban Indian organizations in this next COVID-19 pandemic relief package. In the letter, the organizations recommend a minimum 5% direct, statutory set-aside in funds for the entire I/T/U system for COVID-19 vaccine distribution. NIHB will continue to advocate that Indian Country receive the vaccine, will have funds sufficient to acquire and distribute it and the full faith and confidence of the United States Government will ensure distribution to this nation's first citizens will be reliable, swift and early.

Read the full letter here. 
CAPITOL HILL UPDATES
FMAPNIHB Leads Efforts for Joint Letter to Congress Opposing Policy Changes to Medicaid FMAP
On Tuesday July 27, the National Indian Health Board (NIHB) sent joint a letter to Congress firmly opposing any policy that would undo decades of precedent in federal Medicaid policy towards Tribal Nations by extending 100% Federal Medical Assistance Percentage (FMAP) to States for Medicaid services rendered by providers outside the Indian health system to American Indians/Alaska Natives. This policy would seek to stabilize state Medicaid programs at the direct expense of the Indian health system, and runs contrary to federal trust and treaty obligations.
NIHB was joined by Tribal Nations, National Congress of American Indians, National Council of Urban Indian Health, and multiple regional Tribal organizations in this important advocacy. NIHB encourages all Tribal Nations and organizations to join us in showing that Indian Country is uniformly opposed to this provision by sending similar letters. 

Please find this template letter on NIHB's Tribal COVID-19 Resource Center. 

Read the joint letter here.
RuizLetterRepresenative Ruiz sends Letter to Congressional Leadership Urging Maintenance of Funding for the Indian Health Service
On Wednesday, July 29 Representative Raul Ruiz (D-CA) sent a letter to Speaker Pelosi, House Minority Leader McCarthy, Senator Majority Leader McConnell, and Senate Minority Leader Schumer urging them to maintain the $1 billion appropriation intially proposed in the House-passed HEROES Act (H.R. 6800) for the Indian Health Service (IHS), Tribal Health Programs, and Urban Indian Organization (UIO) health prgroms (I/T/U) to help them recover significant COVID-19 related losses in revenue. 

As Congressional leadership begins negotiations on what is assumed to be the final COVID-19 relief package, advocacy remains strong to make sure Indian Country does not remain behind in the final version of the funding. In the CARES Act, $100 billion in provider relief funds helped hospitals truggling with the loss of revenue from the
cancellation or delay of non-COVID-related procedures; and the Department of
Health and Human Services (HHS) provided $500 million to IHS for distribution
to I/T/U programs. While this funding was desperately needed by tribal health programs, it falls short of the actual need in Indian Country. 

The National Indian Health Board will continue to advocate for the inclusion of $1 billion in funding to the I/T/U progarms. 
FEDERAL ADMINISTRATION AND STATE GOVERNMENT UPDATES
BenefitManagersPresident Issues Executive Order 13939 to Lower Drug Prices and Tighten Rules on Pharmacy Benefit Managers
On July 24, 2020 the Executive Office of the President issued an Executive Order (EO) titled, "Lowering Prices for Patients by Eliminating Kickbacks for Middlemen". The President wants to restrict the ability Pharmacy Benefit Managers (PBMs) have to profit from the rates they negotiate with drug manufacturers, by removing a safe harbor that allows PBMs to collect rebates. The Administration believes that once the safe harbor is eliminated, the savings will be passed on to Medicare Part D beneficiaries.
In the EO, the President directs the Secretary of Health and Human Services (HHS) to create rulemaking affecting section 1128(b) of the Social Security Act, and to confirm that such rulemaking would not cause Medicare Part D premiums to increase.
NIHB monitors and responds to federal rulemaking through its Policy Center. If HHS introduces a rule following the E.O., NIHB will discuss potential comments through its MMPC Regulations workgroup. To read the full E.O., click here.
TaskForcePresidential Task Force on Protecting Native American Children in the Indian Health Service System Releases Report
On July 23, the Presidential Task Force on Protecting Native American Children in the Indian Health Service System, commissioned to investigate systemic and institutional breakdowns at the Indian Health Service (IHS), released a report with their findings and recommendations. The Task Force report complements ongoing work by the HHS Office of Inspector General, examining the sufficiency and implementation of IHS patient protection policies and procedures. T he Task Force traveled around Indian Country, meeting with IHS staff, Tribal officials, and key contractors to discuss opportunities for combating child abuse through telehealth for emergency services, specialist consultations, and patient care for children, and cultural education and related training for IHS providers. 
UPCOMING EVENTS, CALLS, AND WEBINARS
Please see below for call information to the  IHS' All Tribes Call on Thursday, August 6th 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, August 6th
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
FEMAFEMA Webinar for Individual Assistance Program and Policy Guide, Thursday, August 6, 2020
The Individual Assistance Program and Policy Guide (IAPPG) Version 1.1 has been updated and is being released for public comment. IAPPG is a comprehensive policy guide for all Federal Emergency Management Agency (FEMA) Individual Assistance programs. 
FEMA released the current draft version for a 45-day public comment period. The draft guide and accompanying comments matrix are available on the FEMA website at: Individual Assistance Program and Policy Guide. FEMA will accept public comments submitted between July 8 and August 24, 2020. FEMA requests that all comments be submitted using the comments matrix provided. Any comments received before the close of the public comment period will be reviewed and considered for the final version of the guide to be released by the end of 2020.
If you have questions or suggestions about the Version 1.1 of the IAPPG, please email FEMA-IA-publiccomment@fema.dhs.gov.

FEMA is offering a webinar for tribal governments to provide an overview of the draft IAPPG and an opportunity to capture comments and answer questions.
The webinar will review major updates to the IAPPG, to include:
  • Clarification of assistance for applicants residing in non-traditional housing;
  • Delegation of Authority for Rental Assistance Rate Increases;
  • Authorization and eligibility criteria for Critical Needs Assistance; and
  • Incorporation of changes made by the Disaster Recovery Reform Act of 2018:
  • Separate financial assistance maximum award amounts for Housing Assistance and Other Needs Assistance;
  • Specific disaster-damaged accessibility items covered under Home Repair or Personal Property Assistance are not limited to a financial maximum award;
  • Increase of the Group Flood Insurance Policy premium; and
  • Waiver authority for debts.
If you have any questions, please contact FEMA Office of External Affairs, Congressional and Intergovernmental Affairs Division: Tribal Affairs (202) 646-3444 or at FEMA-Tribal@fema.dhs.gov

Thursday, August 6th, 2020
2:00 to 3:00 p.m. ET
Join the webinar| Password: IAPPG
GRANTS & RESOURCES
FCCFCC 2.5 GHz Rural Tribal Window
Applications due Monday, August 3, 2020 at 6:00 PM ET

In light of the COVID-19 pandemic, there is a greater need for high-speed internet connections as communities turn to telemedicine. The Federal Communications Commission (FCC) 2.5 GHz Rural Tribal Window is unique opportunity for Tribes in rural areas to directly access unassigned spectrum over their Tribal lands, subject to buildout requirements. Read more here.
HardshipMedicare Eligible Hospitals: Hardship Exception Application
Application Deadline: Sept. 1, 2020

The Centers for Medicare and Medicaid Services (CMS) opened the hardship exception application submission period for Medicare's Eligible Hospital (EH) Hardship Exception to avoid the 2021 payment adjustment. EHs that utilized 2014 Certified Resource and Patient Management System (RPMS) Electronic Health Record (EHR) and were unable to demonstrate Promoting Interoperability (formerly known as Meaningful Use) in CY 2019 may need to apply for a hardship. Read the full memo here.

The deadline to apply for an EH Hardship Exceptions is Tuesday, September 1, 2020. Please note: This deadline has been extended from the original date of July 1, 2020 due to COVID-19. Direct all inquiries to Drew Morgan andrew.morgan@cms.hhs.gov related to hardship exceptions. For IHS Specific questions related to the hardship exception, please direct all inquiries to IHS's Promoting Interoperability Team at promotinginteroperabilityteam@ihs.gov.
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