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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.

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Top Story
CDCReportCDC Releases Study Showing American Indians and Alaska Natives are Disproportionately Affected by COVID-19
The Centers for Disease Control and Prevention (CDC) released a new study
 that specifically examines how COVID-19 is affecting American Indians and Alaska Natives (AI/AN). CDC found that in 23 selected states, the cumulative incidence of laboratory-confirmed COVID-19 cases among AI/AN was 3.5 times that of non-Hispanic whites. An early release of the Morbidity and Mortality Weekly Report (MMWR) issued by the Centers for Disease Control and Prevention (CDC) examines COVID-19 among American Indians and Alaska Natives (AI/ANs). Limited data are available to quantify the disparity in COVID-19 incidence, severity, and outcomes among AI/AN persons compared with those among other racial/ethnic groups. 
The agency has provided more than $200 million in COVID-19 funding to Indian Country, which supports Tribes and Tribal organizations in carrying out COVID-19 preparedness and response activities, including surveillance, epidemiology, laboratory capacity, infection control, and mitigation.
"American Indian and Alaska Native people have suffered a disproportionate burden of COVID-19 illness during the pandemic," said CDC Director Robert R. Redfield, M.D. "This funding approach will broaden access to COVID-19 resources across tribal communities." 
This CDC funding to date exceeds the $165 million directed by Congress through the Coronavirus Preparedness and Response Supplemental Appropriation Act, 2020, and the Coronavirus Aid, Relief, and Economic Security Act or the CARES Act. Specific funding programs provided through the CDC include: 
To read the full MMWR release, please click here.
To read the National Indian Health Board's library of correspondence with the CDC and other federal agencies, click here.  
CAPITOL HILL UPDATES
CDCReportCDC Releases Study Showing American Indians and Alaska Natives are Disproportionately Affected by COVID-19
The Centers for Disease Control and Prevention (CDC) released a new study
 that specifically examines how COVID-19 is affecting American Indians and Alaska Natives (AI/AN). CDC found that in 23 selected states, the cumulative incidence of laboratory-confirmed COVID-19 cases among AI/AN was 3.5 times that of non-Hispanic whites. An early release of the Morbidity and Mortality Weekly Report (MMWR) issued by the Centers for Disease Control and Prevention (CDC) examines COVID-19 among American Indians and Alaska Natives (AI/ANs). Limited data are available to quantify the disparity in COVID-19 incidence, severity, and outcomes among AI/AN persons compared with those among other racial/ethnic groups. 
The agency has provided more than $200 million in COVID-19 funding to Indian Country, which supports Tribes and Tribal organizations in carrying out COVID-19 preparedness and response activities, including surveillance, epidemiology, laboratory capacity, infection control, and mitigation.
"American Indian and Alaska Native people have suffered a disproportionate burden of COVID-19 illness during the pandemic," said CDC Director Robert R. Redfield, M.D. "This funding approach will broaden access to COVID-19 resources across tribal communities." 
This CDC funding to date exceeds the $165 million directed by Congress through the Coronavirus Preparedness and Response Supplemental Appropriation Act, 2020, and the Coronavirus Aid, Relief, and Economic Security Act or the CARES Act. Specific funding programs provided through the CDC include: 
To read the full MMWR release, please click here.
To read the National Indian Health Board's library of correspondence with the CDC and other federal agencies, click here.  
FEDERAL ADMINISTRATION AND STATE GOVERNMENT UPDATES
VaccineTrialsNIH Issues Dear Tribal Leader Letter Regarding Vaccine Trials
On August 18, the Indian Health Services (IHS) released a Dear Tribal Leader Letter (DTLL) informing Tribal leaders of several updates. Specifically, the letter details HHS Secretary Alex Azar's trip to the Alaska Native Medical Center to assess COVID-19 testing and best practices that are being done there. There was also an announcement of a partnership with Moderna, Inc. to distribute 100 million doses of the company's COVID-19 vaccine. This distribution is part of "Operation Warp Speed", one of the Trump Administration's goals begin delivering vaccines to the American people by the end of 2020. This DTLL also noted that additional funding from the Provider Relief Fund is available for eligible providers equal to two percent of their total patient care revenue. The deadline to apply for Provider Relief Funding is August 28, 2020.
Other updates included in the letter describe IHS's request for nominations to the Secretary's Tribal Advisory Committee  (STAC)  and upcoming Tribal Consultation sessions with the Presidential Task Force on Missing and Murdered American Indians and Alaska Natives. Nominations for STAC are due September 11, 2020 and comments for the Presidential Task Force consultation sessions are due by September 30, 2020. IHS also reminds AI/ANs that August is National Immunization Awareness Month and the importance of protecting the immune system, as well as new guidance on COVID-19 hospitalization and death demographics from the CDC.
RehabPaymentProspective Payment Rate Update from CMS on Inpatient Rehabilitation Facilities
On August 10, 2020 CMS released a final rule on updating the prospective payment rate of Inpatient Rehabilitation Facilities (IRF) for 2021. Specifically, this rule applies a 5 percent cap on wage index decreases in relation to FY 2020 and incorporates the classification and weighting factors for the IRF. This rule also changes the IRF requirements for coverage in order for the post-admission physician evaluation requirements to be removed and instead allow a non-physician practitioner to conduct in-person meetings in inpatient rehabilitation. This rule is effective October 1, 2020
RetireeSubsidyRequest for Comment from CMS on the Retiree Drug Subsidy Application
On August 10, 2020 CMS released a notice on a comment request for the Retiree Drug Subsidy Application, Payment Request and Instructions. This notice is a reinstatement of a currently approved collection that enables subpart R plan sponsors to receive 28 percent subsidy for allowable drug costs. This notice also asks for comments on the "Manufacturer Submission of Average Sales Price Data for Medicare Part B Drugs and Biologicals", which requires the price of Part B drugs and biologicals be based on manufacturer's average sales price data. The final comment request detailed in this notice concerns the "Consumer Experience Survey Data Collection" that surveys customer's satisfaction with Qualified Health Plans. Comments on the application are due September 9, 2020.
OutpatientPaymentCMS Medicare Hospital Outpatient Prospective Payment System Proposed Rule
On August 12, 2020 CMS released a proposed rule on a revision to the Medicare hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ASC) for 2021. This rule breaks down payment rate factors for Medicare services from the OPPS and those paid under the ASC system. The rule also updates the requirement for Hospital Outpatient Quality Reporting and its Quality Reporting program. The rule also establishes an Overall Hospital Quality Star Rating starting with year 2021 and adds new service categories for the Outpatient Department Prior Authorization Process.
CMSQuarterlyCMS Quarterly List on Manual Instructions
On August 12, 2020 CMS and HHS published a notice on CMS's quarterly list on manual instructions, specific regulations and other notices relating to the Medicare and Medicaid Programs within CMS. These instructions and regulations intend to equip Medicare and Medicaid beneficiaries, health providers and the public with pertinent information and to continue communication with regional CMS offices, state agencies, the public and state governments. This specific notice only details the updates that have taken place within the last 3 month period.  
IHSAwardIHS Notice of Award
On August 13, 2020 IHS released a notice of an award of a "single-source unsolicited grant to Johns Hopkins University in Baltimore, Maryland." This award intends to collect, develop and distribute specific information on COVID-19 to American Indian and Alaska Native communities (AI/AN) and is intended to provide "recommendations on healthcare in a culturally sensitive way." The Johns Hopkins Bloomberg School of Public Health Center for American Indian Health intends to work in partnership with AI/AN communities in the wake of COVID-19 to improve health status through research, training and education. The total amount of the award is $127,644 for the period of performance from April 24 till August 24, 2021.
UPCOMING EVENTS, CALLS, AND WEBINARS
HRSAConsultationHealth Resources & Services Administration (HRSA) Tribal Consultation on the CARES Act Provider Relief Fund
Purpose: HRSA is conducting this rapid Tribal consultationto seek input and Tribal recommendations on the allocations of CARES Act Provider Relief Fund, announced by the U.S. Department of Health and Human Services on April 22, 2020.  Please save the date. 
 
Date: Monday, August 31, 2020
Time: 3:00 p.m. - 4:00 p.m. (Eastern)
Call in Information:
Dial-in Number:  888-566-7684
Participant passcode: 7562556
 
AGENDA  
 
3:00- 3: 15 PM Welcome
  • Opening Prayer
  • Opening Comments and Welcome - Tom Engels, Administrator, Health Resources and Services Administration
  • Update - Elizabeth "Betsy" Wieand, Lead Policy Advisor, Health Resources and Services Administration
 
3:15 - 3:55 PM Open Discussion with Tribal Leaders
3:55 PM  - Closing
4:00 PM - and Adjourn call
Please see below for call information to the IHS' All Tribes Call on Thursday, August 27th 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 27th
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
GRANTS & RESOURCES
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.
FCCFCC 2.5 GHz Rural Tribal Window
DEADLINE EXTENDED! Applications Now due Wednesday, September 2, 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.
DentalTherapyAlaska Dental Therapy Education Program Receives Accreditation
The Commission on Dental Accreditation (CODA) has awarded accreditation to the Alaska Dental Therapy Education Program. The program, operated by Iisaġvik College with support from the Alaska Native Tribal Health Consortium, is the first dental therapy education program to receive CODA accreditation in the country.

National Indian Health Board (NIHB) Chief Executive Officer Stacy A. Bohlen said, "NIHB is pleased that the Alaska Dental Therapy Education Program has received accreditation from the Commission on Dental Accreditation. This program has for years educated Native oral health providers who are building paths to accessing oral health care and providing high quality care in their own Tribal communities. Accreditation validates the groundbreaking and life changing success this program continues to provide. Through NIHB's Tribal Oral Health Initiative and the National Partnership for Dental Therapy, we will continue our work to support Tribes across the country that are bringing or want to bring dental therapy to their communities. NIHB sends our sincere congratulations to the faculty, staff, and students whose work made today possible."

Dental therapists have worked under the Community Health Aide Program (CHAP) in Alaska since 2004. As IHS expands CHAP to Tribes outside Alaska, the newly accredited education program will continue to train dental therapists to work in IHS, Tribal, and other settings in the 13 states with dental therapy laws. Several of these states require that dental therapists graduate from accredited programs. This accreditation award for the Alaska program brings these communities one step closer to equitable oral health access
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