February 4, 2020 |  Issue 20-4   Missed Last Week's Washington Report? Click Here to Visit our Archives!

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

February 11 - 12, 2020
Arlington, VA

February 11 - 12, 2020
Washington, DC

February 13 - 14, 2020
Arlington, VA

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!

Follow NIHB on Twitter and Instagram
Top Story
NIHB to Testify before House Interior Appropriations Subcommittee on FY 2021 Indian Health Service Budget
On Tuesday, February 11, 2020, National Indian Health Board (NIHB) Chair and Great Plains Area Representative, Victoria Kitcheyan, will be testifying before the House Appropriations Subcommittee on Interior, Environment, and Related Agencies, to discuss Tribal priorities for the Fiscal Year (FY) 2021 Indian Health Service (IHS) budget.

Chairwoman Kitcheyan is testifying as part of the Interior Subcommittee's annual American Indian and Alaska Native Public Witness hearings. She will be testifying at 9:40am Eastern on Tuesday, February 11, 2020. NIHB's testimony reflects the priorities and recommendations of the National Tribal Budget Formulation Workgroup for the FY 2021 IHS Budget. Some of the priorities discussed in NIHB's testimony include but are not limited to:
  • Establishing a full, needs-based budget for IHS funded under mandatory appropriations
  • Securing advance appropriations for IHS and other critical Indian programs
  • Ensuring Congress enacts an indefinite appropriation and distinct line item for 105(l) lease expenditures
  • Securing meaningful funding increases for all line items in the IHS budget, including the newly established Electronic Health Records (EHR) line item
To watch a live recording of the hearing, click here
To access a copy of NIHB's written testimony for the record, click here
In This Issue:


Congress Must Hear from Indian Country NOW on 5-Year Renewal of the Special Diabetes Program for Indians
The National Indian Health Board (NIHB), National Congress of American Indians (NCAI), and National Council of Urban Indian Health (NCUIH) are working closely together to ensure that Congress passes a 5-year renewal of the Special Diabetes Program for Indians (SDPI) before it expires on May 22, 2020. But lawmakers NEED to hear directly from Tribes, Tribal organizations, and urban Indian organizations urging them to swiftly pass a 5-year reauthorization NOW!

SDPI is one of the most successful public health programs ever implemented. Because of SDPI, rates of End Stage Renal Disease among American Indians and Alaska Natives fell by 54% from 1996 to 2013. Meanwhile, rates of diabetic eye disease fell by 50%. Not only does SDPI improve and save lives, it also saves millions of taxpayer dollars. A 2019 federal report found that SDPI is responsible for saving Medicare $52 million per year! These results are unmatched, and speak directly to the value and success of SDPI. Congress must achieve 5-year renewal of SDPI now!

If Congress fails to pass 5-year renewal of SDPI, our People's health will be placed in grave danger. Our communities will lose medical and public health providers. Our facilities will be forced to cut vital diabetes care services. Our youth and adult health education programs would close down. And most importantly, our People's lives will be lost.

In December 2019, key members of Congress including Chairman Pallone (D-NJ) and Ranking Member Walden (R-OR) of the House Energy and Commerce Committee, along with Chairman Alexander (R-TN) of the Senate Health, Education, Labor, and Pensions Committee, announced a bipartisan, bicameral agreement that would fund SDPI, community health centers, teaching medical centers, and other critical health programs for five years!

Congress almost passed 5-year renewal of these programs under the fiscal year 2020 spending package but special interests got in the way. A 5-year renewal would be the longest stretch of guaranteed funding in over a decade. It is long past due for Congress to do its job and pass 5-year renewal of SDPI.

Contact your Member of Congress TODAY to demand that they put our health first and swiftly pass 5-year renewal of SDPI and other critical health programs NOW!
  • Click here for talking points on SDPI
  • Click here for a sample template letter to send to your Representative
  • Click here for a sample template letter to send to your Senators
Your Representative's contact information can be found  here , and your Senators' information can be found  here .

The clock is ticking!
Congress must hear from YOU about SDPI Renewal NOW!
Trump CMS Proposes Policy that would End Automatic Re-Enrollment in ACA Exchange Health Plans
CMS is requesting comments on whether to discontinue the reenrollment process so that enrollees receiving tax subsidies covering their entire plan premium would instead be automatically signed up without subsidies or with reduced subsidies. Under the current system, existing customers who do not take any action during the open enrollment period are automatically renewed in the same plan. With the proposed rule, CMS is encouraging those who receive subsidies covering more than their entire premium to return to the exchange to update their financial information.
In the final payment rule for 2020, CMS agreed that automatic reenrollment reduces insurer administrative expenses, makes enrollment more convenient for consumers, and is consistent with broader industry practices. Requiring active enrollment as soon as 2021 could require additional resources to increase system capacity, so that users would be able to apply by the December 15 exchange deadline.
CMS says that should it implement this change, it would "conduct consumer outreach and education alerting consumers to the new process." This outreach could include fact sheets, email or mail outreach depending on preference, and education among issuers, agents, brokers, Navigators, and other assisters. The comment deadline is March 2, 2020 for this rule.
HHS Releases Annual Federal Poverty Guidelines
The U.S. Department of Health & Human Services released new guidelines used to determine financial eligibility for federal benefits programs. The poverty guidelines differ from the poverty thresholds (issued by the U.S. Census Bureau) in that the guidelines are used to administer certain programs to eligible recipients, whereas the poverty thresholds are used to calculate the number of people in poverty. Programs using the guidelines include the Children's Health Insurance Program, parts of Medicaid, Medicare - Prescription Drug Coverage (subsidized portion only), and the Supplemental Nutrition Assistance Program (SNAP).
Trump Administration Seeks to Revise Federal Grants Guidance to Reflect New Priorities
On January 22, the Office of Management and Budget proposed changes to the guidance for grants, cooperative agreements, and other types of federal financial assistance to support the President's Management Agenda . All recipients of federal grant awards, including Tribes and Tribal organizations, could be impacted. For agreements with Indian Tribes, the provisions of the Indian Self-Determination and Education and Assistance Act (ISDEAA) will govern.

The proposed changes are an update to the Uniform Guidance located in Title 2 of the Code of Federal Regulations (2 CFR 200). The proposal reflects some of the priorities of the 2019 Grant Reporting Efficiency and Agreements Transparency Act, which President Trump signed into law on December 30 and requires agencies to use government wide data standards in their information collection from grant recipients. The Act allows the White House Office of Management and Budget Director to permit exceptions on data reporting standards for federal awards granted to Indian Tribes and Tribal organizations consistent with the Indian Self-Determination and Education Assistance Act, only after the Director publishes a list of exceptions and submits the list to the Senate Committee on Homeland Security and Governmental Affairs and the House Committee on Oversight and Reform. Comments on the Guidance are due March 23, 2020.
Federal Communications Commission Announces Rural Tribal Priority Window to Strengthen Broadband on Tribal Lands
On Monday, February 3, the Federal Communications Commission opened the Rural Tribal Priority Window for tribes that will allow them to access available fallow spectrum located on rural tribal lands. During this six-month window, which will remain open until August 3, qualifying tribal applicants may apply for one or more vacant channels of 2.5 GHz band spectrum.
If a tribe obtains a 2.5 GHz spectrum license, it may effectively use its available spectrum by constructing and developing its own wireless broadband network. A qualifying tribe also may obtain the license and lease its spectrum to third parties, such as internet service providers.
Spectrum, in the context of the telecommunications industry, refers to invisible radio frequencies over which wireless electromagnetic signals can travel to convey information across a telecommunication network. Radio waves or spectra can carry analog or digital information from one point to another as long as telecommunications networks that transmit such information using radio frequencies are in place and operating.
More info can be found here.
Medicaid Coverage Among American Indians and Alaska Natives in 2018
215,000 American Indians and Alaska Natives who are both under 139% of the federal poverty level and between 19 and 65 remain uninsured according to recently released estimates of the US Census and it's annual 1 year American Community Survey. About half of the remaining uninsured are located in a small number of states.

Only 14 states remain who have not yet expanded Medicaid.  About 103,000 American Indians and Alaska Natives who are between 19 and 65 remain uninsured in these non-expansion states. Oklahoma and South Dakota have about 50% of all the remaining uninsured (49,000), with 33,000 in Oklahoma and 15,800 in South Dakota.  

Oklahoma faces a ballot measure to adopt Medicaid expansion with 300,000 certified signatures and the Governor has indicated he will soon have a plan to adopt a version of Medicaid expansion that will include a work requirement and other restrictions on eligibility and services. 
Medicare Card Reminder
For those enrolled in Medicare, the Centers for Medicare  and Medicaid S ervices (CMS) announced that beginning January 1 st  2020, new Medicare Cards must be presented when receiving services from Tribal hospitals and clinics. If the hospitals and clinics do not receive the new Medicare Beneficiary Identifier (MBI), from those that are enrolled into Medicare, their claim will be automatically rejected.  In order to ensure that claims are paid, it is critically important that Tribal Medicare beneficiaries are aware of this change. 
In the event that an enrolled beneficiary does not have a card yet, or fails to bring it to the appointment, CMS also provides additional i nformation   on how to obtain the new Medicare card.

Early Bird Registration Still 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!
IHS Monthly All Tribal and Urban Indian Organization Leaders Call
Date: Thursday, February 6, 2020
Time: 3:30 PM - 4:30 PM (Eastern)
Call-in: 800-857-5577 | Passcode: 6703929
Webinar Adobe Connect:  https://ihs.cosocloud.com/r4k6jib09mj/
Password: ihs123
Contact Info: Jennifer Reeder , IHS Public Affairs 
Register for the February 12 MIPS Value Pathways Webinar

The Centers for Medicare & Medicaid Services (CMS) is hosting a webinar on
Wednesday, February 12 at 2:30 p.m. ET to provide an overview of the MIPS Value Pathways (also referred to as MVPs) participation framework, which was outlined in the
2020 Quality Payment Program Final Rule . CMS is committed to co-developing the MIPS Value Pathways with stakeholders and the public, and will be using this webinar to answer questions from organizations interested in providing input on MVPs.
During the webinar, CMS subject matter experts will:
  • Recap the MIPS Value Pathways framework
  • Discuss the goals of the MVPs and benefits for clinicians
  • Obtain feedback and answer questions as time allows
Please note that this webinar will only cover existing information about the MIPS Value Pathways, as found within the 2020 Final Rule, MVPs webpage , and accompanying materials such as the MVPs fact sheet and illustrative diagrams . No new information about the MVPs will be presented during this time.
Webinar Details
Title: MIPS Value Pathways Webinar
Date: Wednesday, February 12, 2020
Time: 2:30 - 3:30 p.m. ET
Please note: The audio portion of this webinar will be broadcast through the web. You can listen to the presentation through your computer speakers. CMS will open the phone line for the feedback portion. If you cannot hear audio through your computer speakers, please contact  CMSQualityTeam@ketchum.com
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:
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.

Two New Videos - Public Service Announcements (PSA)
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 .
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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