February 21, 2020 |  Issue 20-6  Missed Last Week's Washington Report? Click Here to Visit our Archives!
 UPCOMING EVENTS 

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

April 8-9, 2020
Washington, DC

April 27-May 1, 2020
Mahnomen, MN

May 4-5, 2020
Richmond, VA

May 11-15, 2020
Location TBD


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
@NIHB1
 
Top Story
NIHBtestify
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.
CAPITOL HILL UPDATES
SDPI
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!
FEDERAL ADMINISTRATION AND STATE GOVERNMENT UPDATES
TRUMPCMSFederal Appeals Court Rules Against Medicaid Work Requirements
On Friday, February 14, 2020, a Federal Appeals Court panel unanimously ruled to halt Medicaid work requirements in Arkansas. Arkansas was the first state to implement work requirements for Medicaid beneficiaries, although the Centers for Medicare and Medicaid Services (CMS) has approved similar demonstrations in several other states. The court ruled that imposing work requirements does not further the objective of the Medicaid program. According to Healthcare Dive, 18,000 Arkansas residents lost Medicaid coverage before work requirements were put on hold.This number accounts for one quarter of total Medicaid beneficiaries in the state. 
 
Although there are no federally recognized Tribes in Arkansas, this is an important state to watch, as it may set precedent for other states with larger AI/AN populations.  NIHB continues to monitor the status of Medicaid work requirements and its impact on Indian Country.

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.
grantguidance
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.
employercoverage
Did You Know?: Two-Thirds of AI/ANs do not have employer-sponsored health insurance
According to the American Community Survey's 2018 estimates, 67 percent of all Americans have employer-sponsored health insurance.  Conversely, 67.9% of the patients of Indian Health Programs who are American Indians and Alaska Natives (AI/AN) do not have employer-sponsored coverage.  There are 53% of AI/ANs who have neither access to IHS programs, or employer coverage.  In all, over 3 million of the 5.3 million AI/ANs in the nation do not have employer-sponsored coverage-while the remaining 2 million do have employer paid health insurance.
NIHB UPDATES
TPHS
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 March 8, 2020.
UPCOMING EVENTS, CALLS, AND WEBINARS
CMSSS
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 - 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.

HOW TO USE CMS TRIBAL OUTREACH MATERIALS
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 .
GRANTS & RESOURCES
scholarship
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.

ELIGIBLE DEGREE PROGRAMS FOR IHS Scholarship 2020-2021:
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.

HRSAfundingrural
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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