March 11, 2020 |  Issue 20-8  Missed Last Week's Washington Report? Click Here to Visit our Archives!

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
AzarLetterNIHB Sends Letter to Secretary Azar Outlining Indian Country's Position on $40 million Tribal and urban Indian Set-Aside Funding for COVID-19 Response
On March 6, President Trump signed into law H.R. 6074 which enacts a funding package to  provide billions of dollars to spearhead medical research and vaccine development, provide relief to local businesses impacted by the coronavirus, and bolster preparedness and response efforts for state, local, Tribal, and urban Indian health entities. (For a summary of the bill,  click here .)

As NIHB reported last week, H.R. 6074 includes $40 million in direct set-aside funding for Tribes, Tribal organizations, and urban Indian organizations. 

On Thursday March 5, NIHB held an All-Tribes call with more than 200 Tribal leaders and health officials to receive guidance on how Indian Country wants the set-aside funds to be distributed. With that guidance, the National Indian Health Board sent a letter to HHS Secretary Alex Azar outlining Indian Country's recommendations for the $40 million set-aside funding in response to COVID-19 including: 

  • Authorize an interagency transfer of the $40 million in set-aside funds for Tribes, Tribal organizations, and urban Indian organizations from the Centers for Disease Control and Prevention (CDC) to the Indian Health Service (IHS) for dissemination
  • Triple the set-aside funds for Tribes, Tribal organizations, and urban Indian organizations to $120 million
  • Provide additional funds to cover related Tribal and urban Indian expenses for COVID-19 outside of strictly clinical care
  • Minimize deployments of Commission Corps officers stationed at IHS, Tribal and urban Indian sites and deem all IHS Commission Corps officers as mission critical
  • Clarify the process by which Tribes, Tribal organizations, and urban Indian organizations can receive reimbursements authorized under H.R. 6074. 

NIHB has also created a template letter for Tribes and Tribal organizations to utilize if they would like to voice their positions to Secretary Azar as well. To download the letter, click here. 
In This Issue:

NIHB Sends Letter to Secretary Azar Outlining Indian Country's Position on $40 million Tribal and urban Indian Set-Aside Funding for COVID-19 Response

SenateLetterBipartisan Group of Senators Urge Vice President Pence to Ensure Coronavirus Resources for Tribes and Urban Native Communities
On March 5, Senator Tom Udall (D-NM), Vice Chairman of Senate Committee on Indian Affairs, led a bipartisan group of 27 senators in writing to Vice President Pence request the administration to meaningfully engage with Native communities and Tribal leaders on their response to the novel coronavirus (COVID-19).

In their letter to the Vice President, the senators wrote, " The U.S. government has specific trust and treaty responsibilities to provide American Indians and Alaska Natives (AI/ANs) with comprehensive quality healthcare. While the IHS serves as the primary agency charged with provision of AI/AN healthcare, all federal healthcare-related programs and initiatives - including the COVID-19 response - share equally in the requirement to fulfill these trust and treaty obligations," the senators continued.

DidYouKnowDid you know? COVID-19 planning and response: Many American Indians and Alaska Natives (AI/ANs) need to take special precautions due to age (60 or older) or medical conditions 
The Centers for Disease Control and Prevention (CDC) has advised those 60 and older and those with underlying medical conditions to take special precautions with daily activities and travel. How many American Indians and Alaska Natives (AI/ANs) are 60 years old and older?   How many have underlying medical conditions that warrant heightened attention and response to COVID-19?
It is well known that the life expectancy of AI/ANs is less than the all races population, however the AI/AN population 60 and older is still sizable, and in some states, approaches the all-races percentage of the population.
The 2018 American Community Survey estimates 827,000 AI/ANs are 60 year old and older. Four states have over 50,000: California (107,000), Oklahoma (76,000), Arizona (57,000) and Texas (51,000). The percentage of the AI/AN population 60 and older is 15.5% nationally compared to 19% for all races. The variation in the percentage of adults age 60 and older between states with Indian Tribes ranges from 9% in North Dakota and South Dakota to over 17% in Oregon, Wisconsin, and Michigan.
There is no way to estimate the number of AI/ANs with underlying conditions that would make them at risk for COVID-19. It is reasonable to expect the AI/AN population to be at higher risk since the AI/AN population has higher rates of disability, eligibility for Medicare due to disability, and higher rates of asthma.

AlternateSettingsCOVID-19 Guidance on the Providing Services in Alternate Settings for Medicaid and the Children's Healthcare Improvement Program
Medicaid and CHIP's Disaster Preparedness Toolkit for State Medicaid Agencies contains guidance on what healthcare providers can do in response to a public health crisis, such as COVID-19. Only after the president has declared a disaster or emergency as well as the HHS Secretary, certain Medicare, Medicaid and Children's Health Insurance Program requirements can be waived to ensure that sufficient health care items and services are accessible to individuals enrolled in Social Security Act programs during the emergency. Specifically, certain guidance allows facilities to provide services in alternative settings such as a temporary shelter, when a provider's facility is inaccessible. More on this can be found on the 1135 Waiver form.

  PovertyGuildelinesFederal Poverty Guidance Released by HHS
HHS has released the 2020 Federal Poverty Guidelines (attached as a PDF and also available here) - also known as the Federal Poverty Level. The Federal Poverty Level (FPL) numbers are used by state Medicaid offices to determine who is eligible for benefits such as Medicaid, CHIP, and the Health Insurance Marketplace. In addition health care coverage benefits, FPL is also used for administering Tribal programs such as the Low Income Home Energy Assistance Program (LIHEAP), Head Start, General Assistance, SNAP, TANF, food distribution commodities and some services for elders.   Tribes and IHS facilities can request new 2020 Medicaid eligibility charts from their state Medicaid offices and access it online at their state's Medicaid website.
Information for individuals eligible for both Medicare and Medicaid is available at this link,
About the FPL 2020:
This year's guidelines reflect a 1.8% increase that comes from inflation measured by the Consumer Price Index (CPI).
2020 Poverty Guidelines for the 48 Contiguous States &  Washington D.C.
  • 1 Person Family/Household .................... $12,760
  • 2 Person Family/ Household .................... $17,240
  • 3 Person Family/ Household .................... $21,720
  • 4 Person Family/ Household .................... $26,200
  • 5 Person Family/ Household .................... $30,680
  • 6 Person Family/ Household .................... $35,160
  • 7 Person Family/ Household .................... $39,640
  • 8 Person Family/ Household .................... $44,120
For Families/Households of 8 or more, add $4,480 for each additional person
Additional information for Tribes: This is a great time for Enrollment Assisters to conduct education and outreach in Tribal communities about Medicaid, CHIP and the Health Insurance Marketplace. Often Tribal members are too discouraged to re-apply for health coverage if they have been previously denied for being over income. Although individuals assume they will always be denied, that is not the case.  
It is possible that Tribal members  previously denied for coverage are now eligible due to: increase of the FPL; a change in income level (e.g., employed, unemployed, or salary change); or an increase to their household size (additional children, marriage, etc.). In addition to increasing access to health care coverage for Tribal members, the insurance reimbursement paid to IHS and Tribes for American Indian and Alaska Native (AI/AN) patients also keeps healthcare dollars in Tribal communities.
The Administration on Aging (AOA) and Administration for Community Living (ACL) just released a Title VI (Older Americans Act) Transportation Quick Guide. The Guide contains resources on Part A/B funding that can be used for transportation services and related expenses. To view the Guide, click here
NIHBStatementNIHB Postpones Tribal Public Health Summit Due to COVID-19 Concerns
Due to growing concerns around the spread of the COVID-19 virus, the Board of Directors and CEO of the National Indian Health Board (NIHB) announce that the 2020 National Tribal Public Health Summit, currently scheduled to take place March 17-20, 2020 in Omaha, Nebraska, is being postponed to a later time during 2020. At the heart of NIHB's work is our commitment to improving the health care and public health systems of all federally recognized Tribes. This sacred charge guides our decisions, including the decision to postpone the Tribal Public Health Summit to a date (to be determined) later this year.

In addition to this outreach, NIHB also will refocus its work on ensuring Tribal Communities and citizens are informed about COVID-19 and its impacts in Indian Country. We also will continue our advocacy efforts to bring resources to address COVID-19 in Tribal Communities, respecting Tribal sovereignty.

NIHB will be sending out more updates regarding the National Tribal Public Health Summit, including what to expect if you are currently registered as an attendee, exhibitor, vendor, or are a sponsor. For up to date information on the Summit and COVID-19, please see NIHB's website,

To read NIHB's full statement, click here.
NIHB Coronavirus Survey
NIHB is asking for Tribes' assistance in assessing the coronavirus prevention and response capacity in Indian Country. We are asking for this information because NIHB has the opportunity to share information on Tribal needs and advocate for resources with both the Congress and Administration.

To ensure that these efforts have the best possible impact, NIHB is gathering key information from as many Tribes as possible to create a comprehensive profile of what is needed. We ask that you please consider the questions at the link below and share any information you can with NIHB. This survey should take about 5-10 minutes to complete. You can access the survey here.
IHS COVID-19 All Tribes CAll
Please see below for call information to the  IHS' All Tribes Call on Thursday, March 12th at 3:30 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:   Thursdays, March 12th & March 19th, 2020
Time:   3:30 PM - 4:30 PM (Eastern)
Conference Call:   800-857-5577 | Participant Passcode:  6703929
Webinar Adobe Connect: | Participant Password:  ihs123
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.

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 .
Rural Communities Opioid Response Program Notice of Funding Opportunity
Application Deadline: April 24, 2020

HRSA recently released the Rural Communities Opioid Response Program (RCORP) notice of funding opportunity (HRSA-20-031). HRSA plans to award approximately 89 grants to rural communities as part of this funding opportunity. Applications are due by Friday, April 24, in
Successful RCORP-Implementation award recipients will receive $1 million for a three-year period of performance to enhance and expand substance use disorder (SUD), including opioid use disorder (OUD), service delivery in high-risk rural communities. They will implement a set of core SUD/OUD prevention, treatment, and recovery activities that align with HHS' Five-Point Strategy to Combat the Opioid Crisis.
910 Pennsylvania Avenue, SE
Washington, DC 20003
Main Phone: 202-507-4070
Fax: 202-507-4071
Thank you for visiting the Washington Report!