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NIHB is Hiring!

We are seeking qualified candidates for the following open positions based in Washington DC:

Accounting Associate

Public Health Policy & Programs Director

Posted: June 2, 2016

Tribal Exemption from Employer Mandate

The Tribal Employment and Jobs Protection Act (H.R. 3080) was considered in a Full Committee Markup of the U.S. House of Representatives House Ways and Means Committee:
H.R. 3080 was reported favorably by the Committee on a vote of 24 (yes) - 13 (no)

This legislation, introduced by Representative Kristi Noem (R-SD), seeks to exempt Tribes and Tribal employers from the employer mandate under the Patient Protection and Affordable Care Act (ACA). It would prevent fines that Tribal employers would incur under the employer mandate and ensure that the U.S. federal government lives up to its trust responsibility to federally recognized Tribes.

As the House Ways and Means Committee Chairman Kevin Brady (R-TX) said today in his opening statement, "Congresswoman Noem's legislation brings relief from Obamacare's employer mandate to Tribally owned businesses...by advancing these bills today, we can demonstrate that we are serious about addressing major challenges in child welfare and health care."

The legislation will now move to be considered by the full House of Representatives. NIHB will continue to monitor and provide updates on this important legislation. If you have questions or feedback regarding this issue, please contact Mr. Devin Delrow, NIHB Director of Federal Relations, at (202)-507-4070 or [email protected].



Posted: June 2, 2016

Indian Health Service Seeking Tribal Consultation on the Catastrophic Health Emergency Fund (CHEF) Proposed Rule

Yesterday, the Indian Health Service (IHS) released a Dear Tribal Leader Letter to provide an update on the proposed rule for the Catastrophic Health Emergency Fund (CHEF). Several Tribes and Tribal Organizations, including the National Indian Health Board (NIHB), submitted comments and expressed concerns about the provisions and requested Tribal consultation before finalizing the rule. In response, IHS is listening to Tribes and will not move forward with the proposed rule until Tribal consultation has taken place, which will include two telephone consultation sessions and an in-person consultation session at the National Congress of American Indians (NCAI) Convention scheduled for October 9-14, in Phoenix, Arizona...

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Posted: June 1, 2016

Indian Health Service Seeking Tribal Consultation on Draft Policy to Expand Community Health Aide Program

Today the Indian Health Service (IHS) released a Dear Tribal Leader letter requesting Tribal Consultation on a draft policy statement detailing the planned national expansion of the Community Health Aide Program (CHAP, including the creation of a national certification board.

The national expansion of the CHAP would mean an increase in paraprofessionals and workers providing services for health education, communicable disease control, maternal and child health, dental health, behavioral health, family planning, and environmental health. Community health aide is an encompassing term that includes behavioral health aides, nursing aides, and dental health aides. Many Tribal communities are likely familiar with a community health aide program already in place: the IHS Community Health Representative (CHR) program. The CHR deploys trained and medically guided health care workers that provide medical services, including health education, case management, patient transport, and patient advocacy.

Tribal communities in Alaska also benefit from the Dental Health Aide Therapist (DHAT) program, which brings dental education and routine dental services to rural Alaska Native communities. DHATs provide dental services to 40,000 Alaska Native people since 2004. Many rural Alaskan Native villages also have Community Health Aides (CHA). CHAs serve as a primary provider for many individuals, providing emergency first aid, patient examinations and follow-ups in conjunction with the treating physician, and carrying out treatment recommendations, education and instruction, and conducting preventive health programs. Behavioral Health Aides (BHA) work within Tribal communities to address behavioral health needs, including substance abuse and mental health problems. BHAs address these needs by serving as counselors, health educators, and advocates.

With a low access to care in many Tribal communities and tremendous success in existing programs, the Indian Health Service is committed to expanding the Community Health Aide Program. In the draft policy statement Mary Smith, Principal Deputy Director of the IHS, states, "Not only do CHAPs contribute to the overall health care team, but the additional advanced training they receive often leads to improved health and quality of life for the communities they serve. CHAPs are proven partners in health, and the IHS is committed to seeing them expand outside of the State of Alaska."

In the coming weeks, NIHB will be reaching out to Tribes and Tribal organizations for their input on what they would like to see in the policy. Based on this input, NIHB will create a template comment and briefing memo for Tribes to use in submitting their own comments. If you would like a copy of these materials or more information, please contact NIHB’s Director of Federal Relations, Devin Delrow at 202-507-4072 or [email protected].

Comments are due to IHS on Friday, July 29, 2016.

Comments may be submitted to [email protected], with the subject IHS Expansion of Community Health Aide Program Draft Policy Statement Consultation.

Mail your comments to:
Alec Thundercloud, M.D.
Director, Office of Clinical and Preventive Service
Indian Health Service
5600 Fishers Lane Mail Stop: 08N34-A
Rockville, MD 20857
ATTN: IHS Expansion of Community Health Aide Program Draft Policy Statement Consultation



Posted: May 6, 2016

Tax Season is Over – It’s Time for a PTC Check-up

While you may be tempted to forget all about your taxes and your premium tax credit once you’ve filed your tax return, don’t give in to that temptation.

When you applied for assistance to help pay the premiums for 2016 health coverage through the Marketplace, the Marketplace estimated the amount of your premium tax credit. Advance payments are based on an estimate of the premium tax credit that you will claim on your federal income tax return. You may be receiving the benefit of monthly advance payments to lower what you pay out-of-pocket for your monthly premiums. Doing a PTC check-up now will help you avoid large differences between the advance credit payments made on your behalf and the amount of the premium tax credit you are allowed when you file your tax return next year...

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Posted: May 5, 2016

OUTREACH NEEDED: Congressional Sign-on Letter for Zika Funding to Tribal Communities

Dear Tribal Leaders, Tribal members and Advocates:

We encourage you to contact your Representatives to urge them to sign onto a letter requesting that Tribes be included in any supplemental funding for Zika virus mitigation. The closing date for the letter is Wednesday, May 11, 2016.

The incidence of the Zika virus is reaching high levels in certain areas close to the United States. The Zika virus is spread by the Aedes mosquito and has been found recently in areas of Central America, the Caribbean, and South America. Zika in pregnant women is thought to be associated with microcephaly in infants which is a sign that the baby is born with a smaller brain which can result in medical programs and impaired development. The Centers for Disease Control and Prevention (CDC) estimates that Zika inflected mosquitos could reach the lower part of the United States in 2016, and there are efforts underway to ensure that communities in the United States can accurately respond to the disease...

READ MORE



Posted: April 25, 2016

Treasury Consultation Call with Tribes on the ACA Employer Mandate - May 13, 2016

On Friday, May 13, 2016 at 3:00PM EDT the U.S. Department of Treasury will be holding a Tribal consultation conference call on the Affordable Care Act Employer Shared Responsibility Provisions. The purpose of the consultation call is to engage Tribal leaders and their representatives in government-to-government consultation on the application of the employer shared responsibility provisions of the ACA to Tribal employees.

Date: Friday, May 13, 2016
Time: 3:00PM EDT
Call-In Number: 888-390-0682
Passcode: 6432

For more information on the ACA Employer Mandate or the Tribal consultation call with Treasury, please feel free to contact Devin Delrow, NIHB Director of Federal Relations at [email protected] or 202-507-4072.



Posted: April 25, 2016

The 2014 SDPI Report to Congress is Now Available!

The 2014 Report to Congress highlights the Special Diabetes Program for Indians (SDPI) ongoing and outstanding accomplishments in improving the quality of diabetes care and health outcomes for American Indian and Alaska Native (AI/AN) people. The report is published by the Indian Health Service and is available on the Division of Diabetes Treatment and Prevention website...

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Posted: April 18, 2016

IHS Releases Draft Contract Support Costs Policy - Initiates 60-Day Tribal Consultation

The Indian Health Service Principal Deputy Director issued a letter to Tribal leaders on April 11 to open a 60-day Tribal Consultation with Tribes and Tribal Organizations to consult on the IHS Contract Support Costs (CSC) Policy...

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Posted: April 18, 2016

Help Support Enactment of Zika Virus Funding and Request Direct Funding to Tribes

The incidence of the Zika virus reaching high levels in certain areas close to the United States. The Zika virus is spread by the Aedes mosquito and has been found recently in areas of Central America, the Caribbean, and South America. Zika in pregnant women is thought to be associated with microcephaly in infants which is a sign that the baby is born with a smaller brain which can result in medical programs and impaired development. CDC estimates that Zika inflected mosquitos could reach the lower part of the United States in 2016, and there are efforts underway to ensure that communities in the United States can accurately respond to the disease...

Read More



Posted: March 30, 2016

Disease Prevention and Control Highlighted in CDC Hearing

Last week, the Director of the Centers for Disease Control and Prevention (CDC), Dr. Thomas Frieden, appeared before the House Appropriations Subcommittee on Labor, Health and Human Services (HHS), Education, and Related Agencies. This subcommittee provides annual funding for most HHS agencies (besides the Indian Health Service).

During the hearing, Subcommittee Chairman Tom Cole (R-OK), asked Dr. Frieden what the CDC is doing to support issues on a wide range of public health issues in Indian Country such as suicide, motor vehicle accidents, cancer, HIV and others. Dr. Frieden noted that CDC is proposing in its FY 2017 budget to strengthen capacity through the Tribal Epidemiology Centers and hopes to build on traditional practices that are healthy. He also discussed ways that CDC can support families and communities. In response, Chairman Cole said that CDC often works "directly with state and local health departments, and quite often Tribes do seem left out of that equation by states. So having federal involvement to make sure there is some equity in those communities ... I think is very important."...

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Posted: March 22, 2016

NIHB testifies before House Interior Appropriations Subcommittee

On Thursday, March 17, National Indian Health Board Secretary Lisa Elgin presented testimony to the House Appropriations Subcommittee on Interior, Environment and Related Agencies on the FY 2017 Indian Health Service Budget (IHS). The testimony was delivered as part of the subcommittee's American Indian and Alaska Native public witness hearings which heard testimony from over 70 representatives from across Indian Country.

Ms. Elgin delivered the recommendations of the Tribal Budget Formulation Workgroup for full funding of IHS at $30 billion, with a FY 2017 recommendation of $6.2 billion. She reiterated the Workgroup's top priorities of Purchased/Referred Care; Hospitals & Clinics; Alcohol & Substance Abuse Services; Mental Health; and Dental Services...

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Posted: March 22, 2016

IHS implementing new regulation to cap payment rates at a "Medicare-Like rate"

On Friday, March 18, 2016, the Indian Health Service (IHS) announced that it will be implementing a new regulation that gives IHS, Tribal, and Urban Indian health programs (I/T/Us) the ability to cap payment rates at a "Medicare-Like rate" to physician and other non-hospital providers and suppliers who provide services through the Purchase and Referred Care (PRC formally CHS) program. The final “Medicare-Like rate” rule can be accessed here.

The new rule says that I/T/Us can negotiate with certain Indian health care providers, who provide services through Purchased and Referred Care (PRC), for payment at Medicare-like rates. This is good news because for years, IHS and Tribal healthcare programs paid higher payment rates than private health insurers and other Federal programs, such as Medicare and the Veterans Health Administration. The proposed rule is an opt-in and not a requirement, which gives I/Ts more flexibility. This is in recognition of Tribal sovereignty and self-determination as Tribes have the right to negotiate with providers and determine how best to meet the needs of their community when providing health care. This flexibility means that in some individual cases, it is better for I/Ts to be able to negotiate higher rates than what Medicare provides. However the ability to negotiate higher rates for Tribally-operated facilities must be a reasonable pricing arrangement and in the best interest of the I/T.

IHS recognizes that this rule will have significant Tribal implications so in order to ensure that all concerns are taken into account, it will be implemented as a final rule with another 60 days for the public to provide comment on the rule. In addition, IHS will be conducting outreach and education to PRC administrators and participating providers and suppliers. NIHB will be discussing the new rule during its next Medicare, Medicaid, and Health Care Reform Policy Committee (MMPC) Monthly Call this upcoming Wednesday, March 23, 2016 at 2 PM EST. We encourage you to attend and participate.

For more information or if you have any questions, please feel free to reach out to NIHB’s Director of Federal Relations, Devin Delrow at [email protected].



Posted: March 10, 2016

NIHB Sponsors Native Youth to Provide Remarks on Children's Mental Health in Indian Country

WASHINGTON, DC - On Tuesday, March 8, 2016, the National Indian Health Board (NIHB) was pleased to sponsor the participation of Wiyaka Little Spotted Horse in a Congressional Briefing on Native Children's Mental Health. The briefing was hosted by the American Academy of Pediatrics and co-hosted by NIHB, the American Academy of Child and Adolescent Psychiatry; the Center for Native American Youth; and the School-Based Health Alliance...

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Posted: February 26, 2016

CMS Issues 100 Percent Federal Medical Assistance Percentage (FMAP) Policy Update

On February 26, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a letter to states and Tribes providing guidance about an update to CMS policy regarding the circumstances in which 100 percent federal funding would be available for services furnished to Medicaid-eligible American Indians and Alaska Natives (AI/AN) through facilities operated by the Indian Health Service (IHS) or Tribes under the Indian Self-Determination and Education Assistance Act, P.L. 93-638. Through this letter, CMS is re-interpreting its payment policy with respect to services “received through” an IHS/Tribal facility, and is expanding the scope and nature of services that qualify for this matching rate. CMS will be holding an All Tribes’ Call to walk through the policy and provide time for questions and answers. NIHB will provide the call-in information as soon as it is available.

Dear State Health Official Letter (PDF)



Posted: February 10, 2016

President Releases FY 2017 Budget Request to Congress - Proposes $5.2 billion for IHS

On February 9, 2016, the President Released his FY 2017 Budget Request to Congress. This yearly process kicks off the annual budget process in Congress. Republican leaders in Congress have noted that this proposal will be considered "dead on arrival," as they consider many of the proposals contained in the budget to be too progressive. However, funding for Tribal programs, and especially Tribal health, continue to garner bipartisan support in Congress and the National Indian Health Board (NIHB) will advocate that many of the important policy and funding proposals that are specifically targeted to benefit Indian Country will remain in the final FY 2017 enacted budget...

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Posted: February 5, 2016

NIHB Participates in Senate Committee on Indian Affairs Hearing and Listening Session

Committee Chairman Calls Unacceptable Indian Health Care in the Great Plains "Malpractice"

The Senate Committee on Indian Affairs (SCIA) held an oversight hearing yesterday on "Re-examining the Substandard Quality of Indian Health Care in the Great Plains." Immediately following the oversight hearing, SCIA held a listening session on "Putting Patients First: Addressing Indian Country's Critical Concerns Regarding the Indian Health Service (IHS)." During the oversight hearing, there were ten U.S. Senators in attendance. The oversight hearing consisted of three panels before the SCIA designed to address all of the issues that plague the Indian health care system.

NIHB attended this hearing and participated in the listening session, calling IHS to account, but also calling on Congress to enact solutions that will ensure meaningful changes for Indian health. You can read the whole statement of NIHB's Board of Directors Member, Charles Headdress here....

Read Full Story



Posted: January 28, 2016

National Indian Health Board Calls for Indian Health Service Accountability and Creation of an Oversight Task Force

Washington, DC. In response to a health care delivery crisis among Tribes in the Great Plains, the National Indian Health Board’s Board of Directors unanimously approved resolutions to investigate, evaluate and offer reform strategies to the Indian Health Service (IHS). This move came in response to the reports by Members of the Omaha, Winnebago and Rosebud Sioux Tribe Tribal Councils attending the Board meeting, held January 20 and 21, 2016.

These tragedies include the preventable deaths of at least five Tribal members under the care of trained medical professionals at the IHS-operated hospitals in the Great Plains Area. The Centers for Medicare & Medicaid Services (CMS) rescinded its accreditation of the Winnebago-Omaha IHS hospital in July 2015, limiting the chronically under-funded hospital’s ability to bill for essential services. In November 2015, CMS notified the IHS that they would rescind the Rosebud Indian Hospital’s CMS accreditation, because they determined the hospital was not in compliance with regulatory requirements, and patient care was being severely impeded. IHS since submitted a satisfactory corrective Action Plan for the Rosebud Hospital, but the emergency room remains closed. Reports from across Indian Country confirm that poor quality of care at IHS facilities that prompted these CMS findings is not limited to the Great Plains Area. Several at the board meeting also shared their stories of how IHS care has negatively impacted them or their loved ones...

Read More (PDF)



Posted: January 26, 2016

Washington State Senator John McCoy calls for Washington State to adopt legislation allowing Tribes to hire dental therapists.

John McCoy - The Seattle Times

THE year I started legislative efforts to bring basic dental-care services to native communities, more than 1,800 Indian children were born in Washington state.

That was 2006. Ten years later, the data show us that at least 75 percent of these children already will have experienced tooth decay and many more have experienced pain or had infections.

Generations of native children before have faced the same barriers to oral health care. For too many, their introduction to oral hygiene was waiting in line to have teeth pulled if a dentist happened to be visiting the reservation...

Read Full Article



Posted: January 25, 2016

RESCHEDULED: Senate Hearing on Quality of Care issues in the Great Plains - Input Requested

The Senate Committee on Indian Affairs will hold a hearing titled: "Reexamining the Substandard Quality of Indian Health Care in the Great Plains." Due to blizzard conditions in Washington, DC the hearing has been postponed to Wednesday, February 3, 2016 at 2:15PM EST...

More Information



Posted: January 11, 2016

How Obamacare Will Cost Native American Tribes Millions of Dollars

The Daily Signal

Native American tribes are pushing back against a provision of Obamacare mandating that tribal governments provide health insurance to their employees. Tribal leaders say it’s a "misinterpretation" of the law that will cost millions of dollars.

When Congress passed the Affordable Care Act in 2009, lawmakers exempted Native Americans from the individual mandate, shielding them from having to pay a fine for not having insurance. Native Americans could, however, purchase health insurance on the federal exchange, HealthCare.gov, and have access to substantial tax credits, driving down the cost of their plans...

Read full article at dailysignal.com



Posted: January 6, 2016

Essential Community Provider (ECP) Petition Action Needed by January 8th

CMS has released an Essential Community Provider (ECP) Petition to collect more complete data from providers who qualify as an ECP and wish to appear on CMS's ECP list for the 2017 benefit year.

Indian health care providers (IHCPs) need to take action by 11:59 p.m. ET on January 8, 2016, to revise an existing entry or obtain placement on the list of ECPs maintained by the federal Department of Health and Human Services (HHS ECP List) for benefit year 2017.

The ECP petition form is a web-based questionnaire that is available here. Please note if you are on the 2016 benefit year ECP list you still must update your information for the 2017 benefit year.

Qualified Health Plan (QHP) Issuers are required to include within their network, Essential Community Providers (ECPs) that serve their community members. Under the Affordable Care Act (ACA), QHP issuers are required to contract with at least 30 percent of the available ECPs in their service area.

HHS ECP Petition



Posted: January 4, 2016

Must read: This story about a grassroots movement to improve access to dental & why the American Dental Association is fighting it.

Dental health for the poor is a big problem in Washington state. Some see dental therapists — licensed professionals who can perform simple procedures — as a route to less expensive care. But the powerful state dentists association has thwarted efforts to allow the therapists...

Read more at seattletimes.com



Posted: January 4, 2016

Swinomish become first tribe in the Lower 48 to use dental therapists to address oral health crisis in Indian Country

SWINOMISH, Washington – Leading the effort to address the oral health crisis in Indian Country, the Swinomish Indian Tribal Community on Monday became the first tribe in the Lower 48 states to employ a dental therapist to provide basic oral health services.

There are too few dentists in Indian Country," said Brian Cladoosby, Chairman of the Swinomish Indian Tribal Community. “We cannot stand by any longer and allow Native people to continue to suffer tooth decay at a rate three times the national average. We have developed a tribal approach to solve a tribal issue. This solution will help our people immediately address their oral health needs in ways that have not been possible until today.”

Read more at swinomish.org



Posted: December 17, 2015

Congress Unveils FY 2016 Omnibus Spending Agreement

On December 16, 2015, the House and Senate Appropriations Committees unveiled their final FY 2016 spending bill (H.R. 2029). The bipartisan agreement is expected to pass Congress by the weekend in order to avoid a government shutdown. The large spending bill will provide $1.15 trillion in discretionary appropriations to keep the federal government funded through September 30, 2016. This legislation contains annual discretionary appropriations for the Indian Health Service (IHS), Bureau of Indian Affairs (BIA) and the Bureau of Indian Education (BIE) and other federal programs at the Department of Health and Human Services (HHS) for Indian Health. Many of the health-related programs are unfortunately flat-funded or have nominal increases for FY 2016...

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Posted: November 20, 2015

Cherokee Nation Public Health Director Highlights Public Health Needs of Indian Country on Capitol Hill

WASHINGTON, DC - On November 18, 2015, the Congressional Public Health Caucus and the Coalition for Health Funding organized a briefing entitled "Public Health 101- Opportunity Lost: Struggles to Meet Health Demands in an Era of Austerity." The National Indian Health Board (NIHB) was also a co-host of this event. During the briefing, panelists discussed how federal funding cuts have impacted health outcomes across the country. Among the panelists was Lisa Pivec, Senior Director of Public Health at the Cherokee Nation, who highlighted public health needs in Indian Country. NIHB was pleased to sponsor her participation in this event. Other panelists included Sandy Eskin, Pew Charitable Trusts; Jessica Hayes, Illinois Alcohol and Other Drug Abuse Professional Certification Association; Dr. Clarence Lam, The Johns Hopkins Bloomberg School of Public Health; and Dr. Benjamin Margolis, University of Michigan Medical School...

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Posted: November 17, 2015

It's Native American ACA Week of Action!!

The National Indian Health Board (NIHB) will participate in several events this week in recognition of the Native American Affordable Care Act (ACA) week of Action. This week all American Indians and Alaska Natives (AI/ANs) are encouraged to learn more about the health insurance options available under the Affordable Care Act. Many IHS, Tribal and urban Indian clinics will also be hosting outreach, education and enrollment events. Make sure to tell your family, friends and community members about the Affordable Care Act so that everyone is afforded the opportunity to improve their health...

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Posted: November 17, 2015

NIHB and Other Tribal Organizations Send Letter to the American Dental Association Supporting DHATs

On Friday, November 12, the National Indian Health Board, Northwest Portland Area Health Board, Affiliated Tribes of Northwest Indians and the National Congress of American Indians sent a letter to the American Dental Association (ADA) in response to a recent blog post by the Washington State Dental Association (WSDA). A few weeks ago, WSDA added a post to their website that that took aim at the Swinomish Dental Health Aide Therapist (DHAT) project and generally at Indian Country's ability to act as sovereign nations with respect to providers on Tribal lands.

The WSDA post claimed that Tribes do not know how to access the dental industry and assumed that dental care provided by a DHAT is not of a highest standard. The Tribal organization letter disputed these claims by noting that, "Tribes will not accept anything less than a single, high standard of care for our citizens." The letter also emphasized the strong track record of DHATs in the United States and elsewhere around the world. You can view the whole letter and the original blog post here.



Posted: November 13, 2015

Discussion on Affordable Care Act Outreach and Education in Indian Country
Monday, November 16, 2015 | 2:00 PM – 3:00 PM Eastern Time

Please join Secretary Sylvia Burwell from the U.S. Department of Health and Human Services and Raina Thiele from the White House Office of Intergovernmental Affairs for a discussion on Affordable Care Act outreach and education in Indian Country. There will also be sharing from tribal and urban Indian communities on successful outreach and enrollment events across the country.

We anticipate time for questions about best practices to enroll your community in Insurance options.

DATE: November, 16 2015
TIME: 2:00 PM ET – 3:00 PM EST
Call: 888-945-5896
CODE: 5582547



Posted: November 13, 2015

Public Health 101 Congressional Briefing to Feature Cherokee Nation

On November 18, 2015, Congressional Public Health Caucus will sponsor a Congressional Briefing entitled "Public Health 101: Opportunity Lost: Struggles to Meet Health Demands in an Era of Austerity." The National Indian Health Board is a Co-Host of the briefing, along with other partner organizations including the Coalition for Health Funding.

The event will feature five panelists including Lisa Pivec the, Senior Director of Public Health at the Cherokee Nation. Ms. Pivec will discuss the role of public health in Indian Country and unique challenges that Tribes experience as they navigate jurisdictional competition and strive to find resources for public health programs.

When: November 18, 2015, 12:00PM- 1:30PM EST
Where: 2168 Rayburn House Office Building
RSVP: [email protected]
(Lunch will be provided)

For more information on the briefing click here.



Posted: November 9, 2015

Coming-up This Week:

The week of November 9th is Women’s Week of Action.

  • Wednesday, November 11 is Veterans Day – help us use this an opportunity to highlight how the ACA helps veterans and military families.
  • On Thursday, November 12, we expect release the first weekly Enrollment Snapshot.
  • On Thursday and Friday, November 12-13, Kevin Counihan will travel to Richmond, Virginia to meet with stakeholders and raise awareness around Open Enrollment.
  • MARK YOUR CALENDAR!! Looking ahead to the week of November 15, we’ll mark Native American Week of Action and Rural Health Week of Action.


Posted: November 5, 2015

Diabetes Awareness Month: A Time to Celebrate Successes!

November is American Diabetes Month! In an effort to raise awareness of this disease and its negative impacts on Indian Country the National Indian Health Board will be sharing Local Impact Stories and Diabetes Prevention Resources throughout the month to highlight the successes of one of the most comprehensive and effective diabetes treatment and prevention program in the U.S. - the Special Diabetes Program for Indians. Today, we release three (3) new stories on the "Diabetes in Indian Country" website and a digital story created by Native youth on her experience with Type 1 diabetes:

Please read, watch and share widely using #DiabetesAwarenessMonthSDPI! Have you or a loved one been affected by diabetes or the SDPI? Share your story with policymakers and key stakeholders here.



Posted: November 5, 2015

Bipartisan Budget Act Passes Congress, Work Moves to Appropriations Committee

On Monday, November 2, President Obama signed the Bipartisan Budget Act of 2015 into law. As NIHB reported last week, the deal would add an extra $80 billion to the federal discretionary budget in FYs 2016-2017. In FY 2016, non-defense discretionary spending (the funding that Congress appropriates every year) will see a $25 million increase beyond what is originally established.

Work now moves to the House and Senate Appropriations Committees to craft a final appropriation for FY 2016. Congress must pass FY 2016 by December 11 when the current continuing resolution funding the government expires. IHS currently has $4.8 billion in both House and Senate draft Appropriations bills. Also contained in the draft appropriations bills is important language for Tribal behavioral health, Tribal Epidemiology Centers and Definition of Indian in the Affordable Care Act.

If you have any questions on the Bipartisan Budget Act or FY 2016 appropriations, please contact NIHB's Director of Congressional Relations, Caitrin Shuy, at [email protected] or (202) 507-4085.



Posted: October 30, 2015

Open Enrollment 3 (OE3) National Tribal Day of Action Rally Call!

Please join representatives from the Department of Health and Human Services (HHS) and the Indian Health Service (IHS) for an Open Enrollment Kick-Off Call. The Open Enrollment period for the Health Insurance Marketplace begins November 1, 2015 and ends January 31, 2016. Please join Mr. McSwain, Principal Deputy Director, IHS, Mary Smith, Deputy Director, IHS, and Geoffrey Roth, External Affairs, Office of Intergovernmental and External Affairs, HHS, for a call to discuss important topics related to Open Enrollment and the Affordable Care Act for American Indians and Alaska Natives.

When: Monday, November 2nd at 12:00pm ET

Call In: 1-800-369-1837
Participant passcode: 7616818

For additional information about the Affordable Care Act and AI/AN please visit: www.healthcare.gov/tribal or www.ihs.gov/aca



Posted: October 30, 2015

Consumers will continue to find affordable options in the Health Insurance Marketplace in 2016

A new report detailing affordability and plan choice in the Health Insurance Marketplace finds that with applicable tax credits, more than 7 in 10 current Marketplace enrollees could find plans for $75 a month in premiums or less, and almost 8 in 10 could find plans for $100 a month in premiums or less.

Consumers who return to the Marketplace to comparison shop could save money. According to today’s report, more than 8 in 10 returning Marketplace consumers could save an average of about $50 per month and $610 annually in premiums before tax credits for the same level of coverage by returning to shop. If all consumers switched from their current plan to the lowest-cost premium plan in the same metal level, the total savings - to consumers and taxpayers (in premiums and tax credits) - would be $4.5 billion. In 2015, about one-third of consumers who reenrolled in a Marketplace plan switched to a new plan.

In addition, nearly 9 out of 10 returning consumers will be able to choose from 3 or more issuers for 2016 coverage. And on average, consumers can choose from plans sold by 5 issuers for 2016 coverage, just as they could for 2015 coverage. Previous research shows that price competition typically intensifying with three or more competitors in a market.

Read the full press release here.

The report can be found here.

Questions or Concerns? Contact [email protected].



Posted: October 22, 2015

HHS awards $2.2 billion in grants for HIV/AIDS care and medications

Health and Human Services Secretary Sylvia M. Burwell announced today that more than $2.2 billion in Ryan White HIV/AIDS Program grants was awarded in fiscal year (FY) 2015 to cities, states and local community-based organizations. This funding supports a coordinated and comprehensive system of care to ensure that more than half a million people living with and affected by HIV in the United States continue to have access to critical HIV health care, support services, and essential medications...

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Posted: October 16, 2015

The Prevention and Public Health Fund (PPHF)

The Prevention and Public Health Fund (PPHF) is a program of the Centers for Disease Control and Prevention. Although, it has been funding important public health activities in Indian Country, it is often targeted for elimination by some in Congress. NIHB helped provide background and information to some members of the Senate and make sure that they were aware how important this funding stream is to Indian Country, The Senate Democratic Caucus recently released a letter that was signed by nine senators that details the importance of the Public Health Prevention Fund (PPHF) to Indian Country.

Click here to read the letter.



Posted: October 16, 2015

10 million people expected to have Marketplace coverage at end of 2016

U.S. Health and Human Services (HHS) Secretary Sylvia M. Burwell announced today that she expects 10 million individuals to be enrolled in coverage through the Health Insurance Marketplaces and paying their premiums – so-called effectuated coverage – at the close of 2016. As part of that goal, HHS believes more than 1 out of every 4 uninsured Marketplace-eligible consumers will select plans during Open Enrollment.

Today, the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) released a demographic analysis of the uninsured individuals who are likely eligible for Marketplace coverage, along with its methodology for estimating the number of individuals it expects to have effectuated Marketplace coverage at the end of 2016. According to the reports, nearly 8 in 10 of the approximately 10.5 million uninsured individuals likely to be eligible for qualified health plans (or the “QHP-eligible uninsured”) may be eligible for financial help through the Marketplaces...

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Posted: October 15, 2015

HHS Awards More Than $240 Million to Expand the Primary Care Workforce

Health and Human Services (HHS) Secretary Sylvia Burwell today announced more than $240 million – including about $176 million in Affordable Care Act funding – to support the National Health Service Corps (NHSC) and NURSE Corps scholarship and loan repayment programs to increase access to primary health care in the communities that need it most.

"The most critical step in connecting people to quality health care is a primary care provider," said Secretary Burwell. "These awards provide financial support directly to health professionals, including physicians, registered nurses, and physician assistants, to help individuals -- particularly the 17.6 million uninsured who have recently gained coverage -- find the primary care services they need."...

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Posted: October 5, 2015

Congress Likely to Pass Short-term Funding Extension for FY 2016

With the surprise resignation of House Speaker John Boehner (R-OH) last week, it is expected that Congress will pass a short-term funding measure, known as a "continuing resolution" or "CR," to keep the federal government funded until December 11, 2015. Many conservative Members of Congress have argued for the stopgap measure to exclude funding for Planned Parenthood after a series of videos was released that allegedly show the organization illegally profiting from the sale of tissue from aborted fetuses. However, as of the time of this writing, it looks like efforts to derail the funding measure over the issue will not be successful. Congress is expected to clear the CR sometime on Wednesday, September 30, just hours before the end of the fiscal year.

If Congress does pass the CR, Congress must finalize the rest of FY 2016 appropriations by December 11. Many in Congress, on both sides of the aisle, are calling for a compromise that can raise the "caps" on spending set forth in the Budget Control Act of 2011. Without an agreement on higher spending levels, there could be the risk of devastating across-the-board sequestration cuts. Legislation has been introduced in both the House and the Senate to exempt Tribes from sequestration. You can click here to learn more about these bills.



Posted: September 1, 2015

Fishing, Cooking And A Yup'ik Upbringing Made Alaska's Health Commissioner

From npr.org
Valerie Davidson, Alaska's health and social services commissioner, drives her 1983 Chevy truck to pick up salmon for a dinner party for 50 people.
Annie Fiedt/Alaskan Public Media

In less than 24 hours, Valerie Davidson has 50 people coming to her house for dinner.

She had planned to catch and cook enough salmon for the main course. But early in the morning, Alaska opened the Kuskokwim River to commercial fishing, which means subsistence fishermen like her can't fish on it.

So Davidson and I are in her bright orange 1983 Chevy pickup stalking the "free fish" container where state biologists deposit their test catches after conducting studies after each high tide.

We have been here for an hour, but Davidson is patient and persistent. It's the same approach she used as Alaska's health and social services commissioner while working to expand Medicaid in the state...

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Posted: July 15, 2015

Historic White House Tribal Youth Gathering

On Thursday, July 9, the White House hosted the first White House Tribal Youth Gathering for over 1,000 Native Youth representing 230 Tribes from 42 states. Native youth leaders from across Indian Country engaged Cabinet officials, non-federal partners and an audience favorite - First Lady Michelle Obama. The First Lady assured everyone of the Administration's faith in today's Native youth by saying, "I know that you may have moments in your lives when you're filled with doubts, or you feel weighed down by history or stifled by your circumstances - every single one of your lives is precious and sacred, and each of you was put on this earth for a reason... you definitely have a President and a First Lady who have your back."

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Posted: July 10, 2015

Director Named for the Midwest Area Tribal Health Board

The Great Lakes Inter-Tribal Epidemiology Center (GLITEC), a program of Great Lakes Inter-Tribal Council, Inc. (GLITC), is pleased to announce that Kara Schurman has been selected as the Director of the Midwest Area Tribal Health Board (MATHB). Though the new area wide Health Board was launched through the efforts of the Midwest Alliance of Sovereign Tribes (MAST) about two years ago, a Health Board Director and administrative home was needed. Bemidji Area Tribal leaders have long recognized that other Indian Health Service Areas across the country have benefitted from their Health Boards in numerous ways to address long standing health issues...

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Posted: July 2, 2015

Using Innovative Models to Address Oral Health Needs in Indian Country

Today, the Swinomish Indian Tribal Community announced steps it will be taking to bring an innovative mid-level dental provider model to its Nation.

National Indian Health Board Executive Director Stacy Bohlen applauded the Tribe's actions and shared, "Indian Country suffers from a severe shortage of dental care providers with many Tribal citizens going without regular and preventive care. Given these barriers to access, it is no surprise that American Indian and Alaska Native communities experience higher rates of disease than many segments of the general population. Today, Swinomish Indian Tribal Community took action to address the situation. We congratulate them on these steps, and we congratulate their Tribal citizens on what promises to be better oral health for all."

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Posted: July 2, 2015

IHS Releases Dear Tribal Leader Letter Detailing Changes on SDPI Funding Distribution

On June 29, 2015, the Acting Director of the Indian Health Service (IHS), Mr. Robert McSwain, issued a Dear Tribal Leader Letter (DTLL) and an Urban Indian Organization Leader Letter (UIOLL) regarding the Special Diabetes Program for Indians (SDPI) FY 2016 funding distribution and formula.

SDPI is now entering its 19th year of providing diabetes treatment and prevention to hundreds of programs across Indian Country. After conducting a nationwide Tribal Consultation period March 19-April 20, 2015, and meeting with the Tribal Leaders Diabetes Committee (TLDC) in May, the IHS Acting Director has made the following decisions for SDPI FY 2016...

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Posted: July 2, 2015

Senate Committee on Indian Affairs Holds Hearing on Youth Suicide

On Wednesday, June 24, 2015, the Senate Committee on Indian Affairs held a hearing entitled "Demanding an End to Native Youth Suicides." The Committee was seeking information and answers on how Congress might be able to act in order to end the prevalence of youth suicide in Indian Country. During this hearing, the Committee heard from representatives from Indian Country and the Indian Health Service (IHS). The witnesses included: Acting Director for the Indian Health Service (IHS) Robert McSwain, Oglala Sioux Tribe Councilman Collins "C.J." Clifford, Red Lake Band of Chippewa Indians Chairman Darrell G. Seki, Sr., and Stanford Professor Dr. Teresa D. LaFromboise. The National Indian Health Board also submitted testimony...

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Posted: June 24, 2015

MSPI/DVPI Dear Tribal Leader Letter Released

Acting Indian Health Service Director Robert McSwain writes to Tribes to provide an update on how the IHS will move forward with Methamphetamine and Suicide Prevention Initiative (MSPI) and the Domestic Violence Prevention Initiative (DVPI) programs over the next five years.

Read Dear Tribal Leader Letter (PDF)



Posted: June 10, 2015

CDC Newsletter summary

CDC’s latest addition to its Public Health Practice Stories from the Field describes how pharmacists on the Yakama Nation Reservation in Washington are helping improve the health of patients with diabetes. The pharmacists help patients manage their diabetes and stay current on lab tests and health checks, thus easing the workload of overburdened primary care providers. Patients who are enrolled in the program are more than twice as likely to have their glucose, blood pressure, and cholesterol under control as nonenrolled patients. Read Pharmacists Help Improve Health of Yakama Indians Living with Diabetes to find out how Yakama achieved this success.

Public Health Practice Stories from the Field is a collection of stories showcasing success and innovation in public health practice by state, tribal, local, and territorial (STLT) health agencies. The stories are featured on the STLT Gateway, a web portal for STLT health professionals created by CDC’s Office for State, Tribal, Local and Territorial Support. You might also be interested in these other stories promoting heart health: Clinic Takes Team Approach to Controlling Hypertension in Ellsworth, Wisconsin, Public Health and Primary Care Partner in South Carolina to Address Cardiovascular Health, Schenectady County Program Lowers Sodium in Menu Items for Seniors, and Sodium Reduction Campaign Encourages Healthy Choices Among Consumers.



Posted - June 4, 2015

Dental Health Aide Therapist Program Recognized with Award from the Indian Health Service

WASHINGTON, DC--June 3, 2015--On May 29, 2015, the Alaska Native Tribal Health Consortium (ANTHC) Dental Health Aide Therapist (DHAT) Program was recognized with the Indian Health Service (IHS) Director's award for 2014 for its innovative public health and clinical strategies to provide quality dental care to Alaska Native communities.

The IHS Director's Award recognizes individuals or teams whose service significantly advances the Indian Health Service's mission and goals. The Dental Health Aide Therapist Program received an award for its "innovation, perseverance and leadership in improving access to safe and culturally competent dental care and addressing the significant oral health disparities across the Indian Health Service Areas."...

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Posted - June 4, 2015

NIHB Board Member Andy Joseph, Jr. Honored with Prestigious Director's Award from the Indian Health Service

WASHINGTON, DC--June 3, 2015--On May 29, 2015, the Indian Health Service (IHS) Acting Director Robert McSwain presented long-time National Indian Health Board (NIHB) Board Member Andy Joseph, Jr. with the 2014 IHS Director's Special Recognition Award for his significant contributions and unwavering leadership to advancing the health agenda in Indian Country.

"I am deeply honored and grateful to receive this award from the Indian Health Service. Through my many years and work on the Northwest Portland Area Indian Health Board, and the National Indian Health Board, I have witnessed many struggles in Indian health but also many victories. The work that Tribal health professionals do across the country is needed to keep our Peoples healthy and strong, and I'm thankful that the work is recognized," said Mr. Joseph, who is in his fifth term on the Confederated Tribes of Colville Tribal Council representing the Nespelem District...

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Posted - May 6, 2015

A Toolkit: Five Fast Facts about the ACA for Native Youth

The National Indian Health Board (NIHB) and the Centers for Medicare and Medicaid Services' (CMS) Division of Tribal Affairs joined forces to create Affordable Care Act (ACA) educational materials specifically for the Native youth population. The materials, highlighting the Fast Five Facts that Native youth need to know about the ACA, include three Public Service Announcements (PSAs), a poster and brochure. All materials are available for immediate download at NIHB's Tribal Health Reform Resource Center website. Tribes, Tribal organizations, I/T/Us, and other ACA stakeholders are encouraged to use the materials in their communities to help educate and empower youth, so that they in turn, can share information about the ACA with their families.

The Five Fast Facts that Native youth need to know about the Affordable Care Act are:
  1. They can be added to or kept on their parent or guardian's health insurance until they turn 26 years old.
  2. They will be covered for prevention screenings for STDs, HIV, pregnancy, depression and diabetes.
  3. Their additional coverage will allow them to receive services outside of the Indian Health Service.
  4. Medicaid may be an additional option for health coverage.
  5. Their parents can file an exemption from the tax penalty for them.

For more information, contact Francys Crevier, NIHB Tribal Health Care Reform Education and Outreach Program Coordinator, at 202-507-4082 or [email protected].



Posted - April 23, 2015

National Indian Health Board (NIHB) Elevates Native Health Issues at the Department of Health and Human Services

House Labor HHS Appropriations Subcommittee Holds Hearing on American Indian/Alaska Native Priorities

WASHINGTON DC - On April 23, 2015, the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies held a Budget Hearing on Programs Serving Native Americans. This subcommittee is responsible for allocating annual funding for agencies of the Department of Health and Human Services (HHS) (with the exception of the Indian Health Service (IHS) which receives funding from the Interior and Environment Appropriations Subocmmittee) and the Departments of Education, Labor and related agencies. The hearing represented a historic opportunity for Tribal advocates to describe challenges that Indian Country faces when it comes to accessing federal programs at HHS and other federal agencies...

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Posted - April 21, 2015

Funding Opportunity: Navigator Grants

Last week, the Department of Health and Human Services (HHS) announced a funding opportunity for organizations and individuals to operate as Navigators in Federally-facilitated Marketplaces (FFMs), including State Partnership Marketplaces (SPMs). As they have done over the past two years, and as they are doing now, Navigators will assist consumers in various ways, including providing information about available coverage options through the Marketplace during open enrollment.

Navigators have been an important resource for the millions of Americans who enrolled in coverage over the past two years. This funding announcement ensures this important work will continue over the next three years in states with a FFM, including during Marketplace open enrollment periods. Applications are due on June 15, 2015. For more information about the grant opportunity click here.



Posted - April 16, 2015

Special Diabetes Program for Indians Two Year Renewal Clears Congress

Last night, the U.S. Senate passed a two (2) year renewal of the Special Diabetes Program for Indians (SDPI). The renewal was contained in a larger bill called: "H.R. 2 - The Medicare Access and CHIP Reauthorization Act of 2015." The measure was passed the Senate by a bipartisan vote of 92-8. This follows action by the U.S. House of Representatives on March 26, 2015, which also passed the legislation by a bipartisan vote. President Obama is expected to sign the legislation into law...

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Posted - April 15, 2015

HHS announces $1 million in new grant programs to help improve sharing of health information

Projects to help long-term and behavioral health care providers

National Coordinator for Health Information Technology Karen B. DeSalvo, M.D., M.P.H., M.Sc., announced today the availability of $1 million in grant funds to support community projects for the Community Interoperability Health Information Exchange (HIE) Program. The funding will help support and enable the flow of health information at the community level, leading to better care and better health.

Read more about this announcement



Posted - March 20, 2015

NIHB would like to thank the following sponsors who gave so generously to make the 2015 Tribal Public Health Summit the largest to date

California Rural Indian Health Board
Centene Corporation
The Pew Children's Dental Campaign


Posted - February 26, 2015

Special Enrollment Period for Tax Season

The Centers for Medicare & Medicaid Services (CMS) recently announced a special enrollment period (SEP) for individuals and families who did not have health coverage in 2014 and are subject to the fee or "shared responsibility payment" when they file their 2014 taxes in states which use the Federally-facilitated Marketplaces (FFM). Between March 15th and April 30th, those individuals and families who were unaware or did not understand the implications of this new requirement, can enroll in 2015 health insurance coverage through the FFM.

Enrolled members of federal recognized Tribes, including shareholders of Alaska Native Claims Settlement Act (ANCSA) Corporations, are eligible for enrollment on a monthly basis and do not need to wait for the SEP. Others eligible for services from an Indian Health Care Provider (Indian Health Service (IHS), Tribal or Urban Indian program) can enroll in this SEP.

This year's tax season is the first time individuals and families will be asked to provide basic information regarding their health coverage on their tax returns. However, those individuals who are members of federally recognized Tribes and shareholders of ANCSA corporations, as well as those who are eligible for services through an Indian health care provider, including IHS, can receive an exemption for 2014. There are two ways to apply for an exemption: by submitting an application through the Health Insurance Marketplace or claiming an exemption on the 8965 Tax Form.

Failure to claim an exemption and not having health coverage in 2014 will result in a fee - $95 per adult or 1 percent of their income, whichever is greater - when they file their taxes this year. The fee increases to $325 per adult or 2% of income for 2015.



Posted - February 10, 2015

Dr. Yvette Roubideaux Named Senior Advisor to Secretary Burwell

This morning, HHS Secretary Burwell announced that Acting IHS Director Yvette Roubideaux, MD, MPH, will immediately begin serving as Senior Advisor to Secretary Burwell on American Indians and Alaska Natives. Robert McSwain will serve as Acting Director of IHS, effective immediately. The move comes as a result of Appropriations Act rules limiting the time that a nominee may serve in an “Acting” position. The Administration will resubmit Dr. Roubideaux’s nomination to serve as IHS Director.

To read the announcement from Secretary Burwell, CLICK HERE (PDF).



Posted - February 10, 2015

Tribal Leaders Visit Capitol Hill in Support of SDPI

Tribal leaders took to Capitol Hill on February 3, 2015 to provide outreach and education to Congress on the Special Diabetes Program for Indians (SDPI). Over 15 individuals participated in visits to 9 Congressional offices. The group met with members of both the House of Representatives and the Senate and included representatives from Cowlitz Indian Tribe; Cow Creek Band of Umpqua Tribe of Indians; Navajo Nation; Sault Ste Marie Tribe of Chippewa Indians; Pueblo of Zuni; Astariwi Band of Pit River Indians; the Santa Ynez Band of Chumash Indians; and the Tohono O'Odham Nation.

SDPI will expire on September 30, 2015, unless Congress acts. The legislation that typically serves as the legislative vehicle for SDPI, the Sustainable Growth Rate Fix (aka the "Doc Fix"), which governs the rates physicians are paid by Medicare, expires on March 31 2015. It is still unclear if Congress will find a way to pay for the overall bill which is estimated to cost over $150 billion. If there needs to be another short-term patch for the Doc Fix Tribes are asking that SDPI be included in that reauthorization.

Please visit www.nihb.org/sdpi for more information on how you can be involved in SDPI renewal for 2015!



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