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Top Takeaways
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NIHB Board Members met with the White House and Congress: learn more about NIHB’s second advocacy day.
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NIHB Submits Written Comments on the President’s IHS Mandatory Proposal: read NIHB’s comments and next steps.
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Indian Health Service and Department of Veterans Affairs Hosts Listening Session: VA plans to reimburse healthcare services to AI/AN Veterans.
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Submit Comments on the Older Americans Act: learn more about the Administration for Community Living’s Tribal Title VI for Elder Programs.
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In this Letter:
📰 News
📝 Dear Tribal Leader Letters
📣Announcements
📒Upcoming Tribal Advisory Committees & Tribal Consultations
💵 Notice of Funding Opportunities
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NIHB Submits Written Comments on the President’s IHS Mandatory Proposal
On June 30, the NIHB submitted written comments to the Office of Management and Budget (OMB) in response to its May 2, 2023, Dear Tribal Leader Letter seeking input on the President’s legislative proposal for IHS mandatory funding.
NIHB’s comments focus on the cultural, historical, and geographic underpinnings that make each federally recognized Tribe and their relationship with the United States critical to the development and advancement of a legislative proposal for mandatory IHS funding. NIHB encourages the Administration to accelerate policy development through investments in strategic missions and partnerships, address historical injustice to build consensus, and demonstrate IHS capacity to implement and project budgets. Another important recommendation of NIHB is to immediately move Contract Support Costs and Section 105(l) Lease Agreements to mandatory spending. There is no reason to wait on these accounts and recognizing these authorities for what they are in the budget and appropriations process is good governance that will provide clarity and efficiency for all those involved.
As part of developing this mandatory proposal, NIHB encourages the Administration to review in detail all the collaborative policy developed by Tribal advisory committees and through Tribal consultation. Empowering Tribes works. Listening to Tribes works. Government-to-government collaboration works. Read NIHB’s full comments here.
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Centers for Medicare & Medicaid Services Four Walls Grace Period Extension
On July 30th, Director of the Center for Medicaid and CHIP Services Dan Tsai announced that the Centers for Medicare & Medicaid Services (CMS) would again extend a grace period to permit Indian Health Service and Tribal facilities to receive Medicaid reimbursements for services provided outside of the “four walls” of their facilities. This new grace period will end in February 2025. CMS’s current interpretation of the clinic benefit regulations provided in 42 C.F.R. § 440.90 prohibits Medicaid reimbursements for “clinic services” provided outside of the “four walls” of facilities. Without the allowances made during this grace period, the CMS interpretation of 42 C.F.R. § 440.90 would prevent access to care, including home visits, telehealth, and other necessary outpatient services. Moving forward with actions beyond extending the grace period, CMS plans to publish an Informational Bulletin and to further discuss this matter at the upcoming CMS Tribal Technical Advisory Group Meeting on July 26th – 27th.
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The Indian Health Service (IHS) and Department of Veterans Affairs (VA) Hosts Listening Session at 2023 Tribal Self-Governance Conference
On June 26, the IHS and VA hosted a listening session in Tulsa, OK during the 2023 Self-Governance Conference. The listening session focused on the VA/IHS draft reimbursement agreement for the lower 48 states. The VA/IHS Reimbursement Agreement Program is a means for the VA to reimburse IHS, Tribal Health Providers, and Urban Indian Organizations (UIOs) for healthcare services provided to eligible AI/AN veterans.
Councilman Nicklaus Lewis (Lummi Nation), NIHB Vice Chairperson and Portland Area Representative, moderated the panel, which included Hilary Peabody, Deputy Assistant Undersecretary of Health for Integrated Veterans Care, Ben Smith, Deputy Director of IHS, and Kara Hawthorne, manager of VA-Native Reimbursement Agreement Program. The discussion focused on the current draft of the agreement, which came out of a virtual consultation session on September 30, 2022. During the session, Tribal leaders expressed concerns around reimbursement for purchased and referred care (PRC), pharmacy funding formularies, and travel costs.
The VA is still accepting written comments on the draft agreement through July 20, 2023. Those may be submitted to tribalgovernmentconsultation@va.gov. For additional information regarding this effort, please see this Dear Tribal Leader Letter or contact Kara Hawthorne at tribal.agreements@va.gov. The current draft agreement can be found here.
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Dear Tribal Leader Letters
View all of IHS' Tribal Leader Letters Here
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June 30 Letter: IHS announces $419M in funding recission impacts under the Fiscal Responsibility Act
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June 29 Letter: Opportunity for Tribal and Urban Indian organization sites to collaborate in planning for new IHS electronic health record solution
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June 21 Letter: Announcement of Mr. DuWayne Begay’s appointment as Director of Navajo Area IHS
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June 20 Letter: The IHS Director writes to announce the appointment of Mr. Joe Amiotte to serve as the Director of the Great Plains Area Indian Health Service
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Announcements
Submit Comments on the Older Americans Act, Tribal Title VI for Elder Programs
The Older Americans Act’s Tribal Title VI creates the only federally funded grants for the long-term care of Elders and disabled adults in Tribal communities to support meal, caregiving, preventative health, and home care services, among others. For the first time in 35 years, the Administration for Community Living (ACL) has proposed changes to this legislation which are accessible here. Comments on this change will be accepted through August 15, 2023, and instructions to do so are available here.
Nominations for the VA Advisory Committee on Tribal and Indian Affairs
The Veterans Administration released a solicitation for nominations for appointment to the Advisory Committee on Tribal and Indian Affairs. The Advisory Committee provides advice and guidance to the Secretary of Veterans Affairs relating to Native American Veterans and Tribal organizations. Nominations can be sent to tribalgovernmentconsultation@va.gov and must be received by the VA by August 1, 2023, at 5:00 PM EST.
Upcoming Tribal Health Equity Data Symposium on September 26 and 27
National Indian Health Board will host the Tribal Health Equity Data Symposium on September 26 – 27, 2023 in Washington, D.C. The symposium will explore what needs to change in data law, policy, systems, and practices in order to better support health equity for American Indians and Alaska Natives. Themes covered will include data access, measuring health equity, race/ethnicity standards, and culturally centered data reporting and communication. The Call for Proposals is open now until July 16; proposals may be submitted by email to Rochelle Ruffer at rruffer@nihb.org. For more information on the symposium and NIHB’s health equity work, please see nihb.org/health-equity.
Upcoming Deadline to File PACT Act Claim is August 8, 2023
The PACT Act is a law that allows Veterans exposed to toxic substances such as burn pits or Agent Orange to receive expanded Veterans Affairs health care benefits. To receive backdated benefits from August 10, 2022, the deadline to file a claim is August 8, 2023. Learn more on the Veterans Affairs Website.
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Upcoming Tribal Advisory Committees & Tribal Consultations
The Department of Health and Human Services (HHS) Annual Regional Tribal Consultations Summer 2023: Each of the 10 HHS regions will again be hosting consultations with regional Tribes to discuss programmatic issues and Tribal priorities. Each session will include one-on-one opportunities with regional leadership. The remaining consultation dates are:
July 11-12 | Region 5 | New Buffalo, MI
July 19 | Region 3 | Virtual
August 1-2 | Region 8 | Denver, CO
August 10-11 | Region 10 | Anchorage, AK
August 22-24 | Region 6 | Dallas, TX
August 30-31 | Region 4 | Choctaw, MS
Direct Service Tribal Advisory Committee (DSTAC) Monthly Call
Date: July 20, 2023
Time: 3:00 – 4:00 PM ET
Join ZoomGov Meeting
Centers for Medicare and Medicaid Services (CMS) Tribal Technical Advisory Group Meeting (TTAG)
Date: July 26-27, 2023
Location: Washington, DC
National Institute of Health All of Us Update for Data Access and Use
Announcement Link
Date: September 28, 2023
Time: 1:00-3:00 PM ET
Meeting Registration Link
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Notices of Funding
Health Resources and Services Administration (HRSA) Substance Use Disorder Treatment and Recovery Loan Repayment (STAR LRP) Program – Providers and Site Opportunities
Award Amount: Up to $250,000 in educational loan repayment
Application Deadline: July 13, 2023, 7:30 PM ET
Description: Eligible substance use disorder treatment clinicians and community health workers can apply to receive up to $250,000 in educational loan repayment from HRSA in exchange for working full-time for six years at an approved facility. Eligible treatment facilities for substance use disorder can be approved for clinicians and community health workers in HRSA's STAR LRP eligible sites/facilities.
SAMHSA Support for 988 Tribal Response Cooperative Agreements | Click Link
Application Deadline: July 18, 2023
Description: This funding opportunity will provide resources to improve the response to 988 contacts by AI/ANs or in Tribal communities by improving the integration and support of 988 crisis centers with access to culturally competent in a manner that respects Tribal sovereignty.
HRSA Pediatric Specialty Loan Repayment Program | Click Link
Award Amount: up to $100,000 in loan repayment for eligible health professionals
Application Deadline: July 20, 2023, 7:30 PM ET
Description: The Administration is investing $15 million to recruit and retain pediatricians through a loan repayment program of up to $100,000 for eligible health professionals (pediatric medical subspecialty, pediatric surgical specialty, or child and adolescent behavioral health care) in exchange for a three-year, full-time service commitment at an approved facility in an underserved area. Those interested can attend an application webinar or Q&A session.
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