RAPID CITY, SD - Today, the National Indian Health Board (NIHB) and Great Plains Tribal Chairmen's Health Board (GPTCHB) met in a historic joint meeting to discuss Health Systems Improvement for American Indians and Alaska Natives (AI/ANs). The meeting was called after a series of reports by the Centers for Medicare and Medicaid Services (CMS) found that certain facilities in the Great Plains Area of the Indian Health Service (IHS) are providing substandard care and failing to live up to the federal trust responsibility for health. Specific topics covered included how to increase the number of Native physicians in the workforce, ways to restructure the IHS in the Great Plains Area, increasing funding to the IHS, moving from direct service models to self-governance models of healthcare and ways to leverage existing relationships and federal Tribal advisory committees like the Secretary's Tribal Advisory Committee to get additional federal resources to Tribes...
On July 29th, the Indian Health Service (IHS) released several 'Dear Tribal Leader Letters' updating Tribes on several Tribal consultation opportunities regarding recent policy proposals put forth by IHS.
First, IHS has extended the consultation period for its Tribal Premium Sponsorship Draft Circular. Tribal Premium Sponsorship occurs when a Tribe pays health insurance premiums on behalf of its IHS eligible members. By enrolling members in health insurance, it increases third party revenue to the IHS/Tribal facility which allows them to extend the services that they provide. Tribes have until October 31, 2016 to provide comment on this draft circular. In addition, an in-person Tribal consultation opportunity will be available at NIHB’s National Tribal Health Conference on September 19, 2016...
On July 12, 2016, the National Indian Health Board (NIHB) testified on behalf of all 567 federally recognized Tribes in a hearing held by the U.S. House of Representatives Natural Resource Committee's Subcommittee on Indian, Insular, and Alaska Native Affairs. The legislative hearing was held on H.R. 5406, the "Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare (HEALTTH) Act", recently proposed by Representative Kristi Noem (R-SD). The HEALTTH Act is just one of several recent pieces of legislation that aim to address the longstanding, systemic issues within the IHS that have led to crisis situations - especially, in the Great Plains Service Area. In the last year, several hospitals in this region have lost, (or received threats of revocation) their ability to bill Centers for Medicare and Medicaid Services (CMS) due to the failure of federally run sites to comply with basic safety and regulatory procedures...
On June 1, 2016, IHS initiated tribal consultation through a Dear Tribal Leader Letter and a draft policy statement titled, "Creating a National Indian Health Service Community Health Aide Program." A national Community Health Aide Program (CHAP) would increase access to quality health care for American Indians and Alaska Natives through the expansion of community health aides at facilities operated by tribes and the Indian Health Service (IHS), including administrative requirements, such as the creation of a national certification board. To assist tribes with developing thoughtful comments, the National Indian Health Board (NIHB), in partnership with the Northwest Portland Area Indian Health Board (NPAIHB) developed a Briefing Paper to provide some background information on the CHAP program and some preliminary ideas on what to include in any comments that tribes might submit. On July 7, NIHB and NPAIHB held a tribal-only call to solicit initial feedback on IHS’ proposal and answer any questions.
On July 15, NIHB will provide tribes with another opportunity to learn more about the CHAP program and its success in Alaska through a webinar from 2 p.m. to 3 p.m. eastern. The purpose of the webinar will be to provide a more comprehensive overview of the CHAP program and answer any remaining questions that tribes might have.
For more information on joining the webinar, please contact Sarah Freeman at [email protected]
FOR IMMEDIATE RELEASE: During the Senate Committee on Indian Affairs (SCIA) oversight field hearing on Friday, June 17, in Rapid City, South Dakota, the National Indian Health Board (NIHB) put forth 17 recommendations for improvement of the Indian health system. The hearing, "Improving Accountability and Quality of Care at the Indian Health Service Through S. 2953", focused on legislation proposed by U.S. Senator John Barrasso (R-WY), chairman of the Committee, and Senator John Thune (R-SD), titled the Indian Health Service Accountability Act of 2016...
The National Indian Health Board and the Northwest Portland Area Indian Health Board (NPAIHB) will be hosting a Tribal Only call on the Creation of a National Indian Health Service Community Health Aide Program (CHAP) on Thursday, July 7, 2016 at 4:00PM ET to discuss the proposed comments and provide input on the creation of a national Indian Health Service Community Health Aide Program (CHAP). Comments on the Creation of a National Indian Health Service CHAP are due to IHS no later than July 29, 2016. NIHB and NPAIHB will work collaboratively to develop a template Tribal comment letter to assist Tribes in making their own comments. NIHB and NPAIHB have created a briefing paper on CHAP for Tribes. Please contact Devin Delrow ([email protected]) for call-in information.
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].
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...
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
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...
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...
Date: Friday, May 13, 2016
Time: 3:00PM EDT
Call-In Number: 888-390-0682
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.
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...
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...
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...
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."...
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...
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].
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...
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.
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...
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....
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...
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...
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...
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...
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.
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...
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.”
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...
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...
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...
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.
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
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.
The week of November 9th is Women’s Week of Action.
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:
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.
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
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].
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...
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.
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...
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."...
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.
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...
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."
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...
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."
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...
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...
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.
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.
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."...
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...
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:
For more information, contact Francys Crevier, NIHB Tribal Health Care Reform Education and Outreach Program Coordinator, at 202-507-4082 or [email protected].
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...
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.
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...
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.
|California Rural Indian Health Board|
|The Pew Children's Dental Campaign|
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.
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).
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!
Today, the Corporation for National and Community Service (CNCS) released two new Notices of Funding Availability in the Senior Corps Foster Grandparent (FGP) and Senior Companion (SCP) programs. These competitions are open to federally-recognized Indian Tribes, including current tribal grantees. With these notices, CNCS intends to fund successful applicants that increase the impact of national service in Native American and Alaska native communities not currently served by FGP or SCP grantees.
For more information, please click here.
WASHINGTON, D.C. - On Wednesday, January 28, the Senate Committee on Indian Affairs held its first hearing during the 114th Congress to gain an overview of American Indian and Alaska Native priority issues. National Indian Health Board (NIHB) Executive Director Stacy A. Bohlen (Sault Ste. Marie Chippewa) testified before the Senate Committee on Indian Affairs in an oversight hearing to explore "Indian Country Priorities for the 114th Congress."
The Centers for Medicare and Medicaid Services (CMS), the California Rural Indian Health Board (CRIHB) and the National Indian Health Board (NIHB) will be presenting a Data Symposium at the National Museum of the of the American Indian in Washington, D.C. on Thursday, February 19th, 2015. The Data Symposium will feature the latest data on key priorities in the delivery of healthcare services across Indian Country.
Tribal leaders, representatives, and their staff are invited to attend the daylong event that follows the Tribal Technical Advisory Group (TTAG) Face-to-Face meeting the day before. Notable topics for the Symposium include updates on the changes in American Indian and Alaska Native Medicaid enrollment and payment, IHS updates on the diabetes and Medicare payments, CMS information on Medicare payment adjustments, federal and state marketplace and qualified health plan enrollment, and more.
The National Indian Health Board highly encourages Tribal leaders and staff to attend this rare event. For more information, please contact Devin Delrow at [email protected].
The Department of Health and Human Services (HHS), Office of Minority Health (OMH), is seeking nominations of qualified candidates to be considered for appointment as a member of the Advisory Committee on Minority Health (hereafter referred to as the ''Committee or ACMH'')
The current and impending vacancies on the ACMH impact the representation for the health interests of American Indians and Alaska Natives and Asian Americans, Native Hawaiians, and other Pacific Islanders. OMH is particularly seeking nominations for individuals who can represent the health interests of these racial and ethnic minority groups.
According to new data published in today's MMWR, American Indian and Alaska Native (AI/AN) populations experienced higher rates of new infections than non-Hispanic white (NHW) populations in 14 of 26 reportable infectious diseases during 2007-2011. Although incidence rates of some infectious diseases have declined in AI/AN populations, disparities between groups remain.
CDC analyzed data from the National Notifiable Diseases Surveillance System that collects reports on nationally notifiable diseases in the United States and its territories. Interventions are needed to reduce disparities in chlamydia, gonorrhea, West Nile virus, spotted fever rickettsiosis, and other infections among AI/AN and NHW populations.
On Wednesday, January 14, Congressman Don Young (R-AK) introduced H.R. 395 which would provide for Advance Appropriations for the Indian Health Service (IHS). Tribes and Tribal organizations have been supporting this change in the way IHS is funded in order to achieve better stability in how our health care is funded.
Advanced appropriations would mean Tribal and IHS facilities would know their funding levels one year in advance, but the funds would not be drawn down until the year in which it was spent. Congress uses a similar funding procedure for the Veterans' Health Administration. Advance appropriations would allow Indian health programs to effectively and efficiently manage budgets, coordinate care, and improve health quality outcomes for American Indians and Alaska Natives.
But in order to see this legislation enacted, we will need help from you! NIHB and its partners are encouraging Tribes to pass resolutions and send letters to Congress in support of this important issue in order to demonstrate widespread support in Indian Country. We are also encouraging you to share your story on how funding delays have impacted health care delivery at your Tribe. Click here to learn more.
Note: This call is off the record and not for press purposes. Please dial in 5-10 minutes early to avoid any delays in joining the call.
On November 26th, the Centers for Medicare and Medicaid Services, (CMS) issued a proposed rule, "Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2016," that announced a number of new benefits for American Indians and Alaska Natives (AI/AN). In the proposed rule, CMS is establishing a requirement for Qualified Health Plan (QHP) issuers to prepare a summary of Benefits and Coverage for each plan variation that they offered.
This is beneficial to AI/ANs who will be better able to compare plans and fully understand the type of coverage that is available to them. In addition the proposed rule will also urge QHPs to offer contracts to all Indian health care providers in their network and to include all the special terms and conditions under Federal law pertaining to Indian Health Care Providers, otherwise referred to as the "Indian Addendum." These proposed changes are a direct result of NIHB's advocacy efforts in these areas. NIHB applauds CMS for making these proposed changes but will continue to advocate that the inclusion of the "Indian Addendum" be a mandatory requirement.
Comments are due on December 22, 2014. NIHB and the Tribal Technical Advisory Group to CMS (TTAG) are in the process of constructing comments for this proposed rule. For more information or a copy of NIHB's comments, please contact Devin Delrow at 202-507-4072 or at [email protected].
On Saturday, December 13, the U.S. Senate cleared an omnibus appropriations package that will keep the majority of the federal government (including the Indian Health Service) funded through September 30, 2015. The final vote on the legislation was 56-40. In the Senate, 31 Democrats and 24 Republicans, majorities for both parties, supported it.Specifically, the provisions for Indian Health Service Include:
On December 11, Congress passed S. 1474 which repeals Section 910 of the Violence Against Women Act (VAWA). This provision prohibited Alaska Tribes from exercising Special Domestic Violence Jurisdiction over non-Indian domestic violence offenders. This action is a major victory for Alaska Native Tribes.
Last year, the Indian Law and Order Commission, a bipartisan advisory board, called the Alaska exemption "unconscionable".
Last night, Congress unveiled a $1.1 trillion spending bill that will keep most of the federal government funded through September 30, 2015. The Department of Homeland Security has funding only until February 27, 2015 so that action might be taken by the Republican Congress early next year to counter the President's recent actions on immigration.
The Indian Health Service (IHS) will receive a total of $4.6 billion in FY 2015. This is $208 million above the FY 2014 level. Within this, $4.2 billion is provided for services and $460.2 million for facilities...
On Friday, December 5, 2014, Department of Health and Human Services released a proposed rule on a Medicare Like Rate for non-hospital services. This proposed rule would amend Indian Health Service (IHS) Purchased and Referred Care (PRC), (formerly known as the Contract Health Services) regulations to apply Medicare payment methodologies to all physician and other health care professional services and non-hospital-based services. (IHS referrals currently use a Medicare Like Rate for hospital-based services.)
Specifically, it proposes that the health programs operated by IHS, Tribe, Tribal organization, or urban Indian organization (collectively, I/T/U programs) will pay the lowest of the amount provided for under the applicable Medicare fee schedule, prospective payment system, or Medicare waiver; the amount negotiated by a repricing agent, if available; or the usual and customary billing rate...
The second round of buying health insurance on the Affordable Care Act exchanges has started. Health officials say Native Americans may have much to gain by buying insurance there.
On Tuesday, November 4, the United States voters chose to make a change in who controls the US Senate and the margin by which the House of Representatives is controlled. In the Senate, Republicans gained several seats; they will now control the body by a 53 to 46 margin (In Louisiana, candidates will have a runoff election on December 6). In the House of Representatives, Republicans netted a gain of 13 seats; the breakdown of that Chamber is 244-184 with a few races still undecided. Click here for a full tally of election results by State and Congressional District.
Congress will return this week and begin considering the top leadership and committee positions for next Congress. They will also be looking at emergency funding for the Ebola crisis and continuing behind-the-scenes work on the FY 2015 spending package.
A path forward on FY 2015 Appropriations is still not clear. Many in Congressional Leadership on both sides of the aisle are arguing that FY 2015 appropriations should be completed in a single "omnibus" appropriations bill by December 11. This is the day when the current continuing resolution (CR) will expire. Others, however, are calling for Congress to put off this decision until January or early February and enact another CR. Still others, have said that Congress may choose to enact a full-year CR which would keep FY 2015 spending at FY 2014 levels.
Passing full-year appropriations would be more beneficial for the IHS/ Tribal and Urban health programs because they would be able to operate with knowledge of their budget for the remainder of the fiscal year. An omnibus would also ensure that current spending priorities are funded at needed amounts. One example of this is in Contract Support Costs (CSC) where IHS had to cut $25.1 million at the end of the year from other programs in order to fill unmet CSC need.
If you have any questions about the FY 2015 Budget, please contact NIHB's Director of Congressional Relations, Caitrin Shuy, at [email protected] or (202) 507-4085.
On November 7, 2014, the United States Supreme Court agreed to hear the case, King v. Burwell, a case that could determine whether the Affordable Care Act (ACA) remains in its current form. The case centers on the question of whether premium tax credits should only be available in state-based marketplaces, and not federally-facilitated marketplace. Currently, they are available in both. This past July, the D.C. Circuit Court of Appeals had ruled that the tax credits only applied to state- based exchanges and not federally-facilitated marketplace. However, the D.C. Circuit agreed to rehear the same case en banc (reviewed by the entire panel of judges who sit on the D.C. Circuit) in December. It surprised many when the Supreme Court agreed to hear this case before the D.C. Circuit could issue a new opinion.
The ACA provides a federal tax credit to low and middle income Americans to offset the cost of insurance policies purchased through the marketplace. The marketplaces advance an individual's eligible tax credit dollars directly to health insurance providers as a means of reducing the upfront cost of plans to consumers. The ACA gives primary responsibility for establishing the marketplaces to individual states. If a state does not create its own marketplace, the federal government, through the Department of Health and Human Services (HHS), establishes and operates the marketplace within the state. The Supreme Court will now hear the issue to determine whether this is authorized under the law.
King v. Burwell does not threaten the Indian Health Care Improvement Act but it may mean significant changes to the other parts of the ACA, especially the premium tax credit. Given the fact that nearly 5 million people have already received subsidies through the federally-facilitated marketplace, the Court will likely defer to Congress to fix the error. Since the Court won't likely hear the case until sometime in the spring, there is time to strategize how we can best ensure the Indian-specific provisions are protected.
NIHB will keep you updated as this case develops. For further information or if you have any questions, please contact Devin Delrow at [email protected] or (202) 507-4072.
Please click here to view.
If you have any questions please contact NIHB's Director of Congressional Relations, Caitrin Shuy, at [email protected] or (202) 507-4085.
President Obama, the White House Office of Intergovernmental Affairs and the White House Domestic Policy Council cordially invitee you to join him and senior members of his Administration for the 2014 White House Tribal Nations Conference. The goal of this year's Conference is to bolster the meaningful discussion between Tribal leadership and the Administration, and further strengthen the Nation-to-Nation relationship between the United States and American Indian and Alaska Native Tribes.
The Conference will be held on Wednesday, December 3, 2014, at the Capital Hilton located at 1001 16th St NW, Washington, D.C. from 8:30 a.m. to 4:00 p.m. Supplementary programming will take place the afternoon of December 2nd (please click here for a draft agenda and FAQ).
One representative from each Federally recognized Tribe is invited to attend this event. Please RSVP here: http://www.whitehouse.gov/webform/rsvp-2014-white-house-tribal-nations-conference by 10 p.m. EST on Wednesday, November 12th, 2014.
Centers for Disease Control and Prevention (CDC) continues to provide current information on the Ebola outbreak. The latest update (October 27, 2014), "Interim U.S. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure" is listed on the website.
The healthcare workers who take care of the patients with Ebola are not only helping those with the disease but also protecting the United States by helping to fight the outbreak at the source...
The Affordable Care Act is working for millions of Americans who are able to access quality health coverage at a price they can afford, in large part because of the efforts of in-person assisters in local communities across the nation. People shopping for and enrolling in coverage through the Health Insurance Marketplace can get local help in a number of ways, including through Navigators.
Health and Human Services Secretary Sylvia M. Burwell today announced $60 million in Navigator grant awards to 90 organizations in states with federally-facilitated and state partnership Marketplaces. These awards support preparation and outreach activities in year two of Marketplace enrollment and build on lessons learned from last year...
It’s hard work trying to get people to sign up for health insurance when their care is mostly free to them. Andrea Thomas is working to get Alaska Natives in Sitka, Alaska, to do just that. She’s the outreach and enrollment manager at SouthEast Alaska Regional Health Consortium (SEARHC), and it’s her job to sign people up for health insurance coverage through exchanges created as a result of the Affordable Care Act...
The Centers for Disease Control and Prevention (CDC) have announced the next face-to-face meeting of the Tribal Advisory Committee (TAC). The meeting will be hosted by the Tribes of the Bemidji Area and will be held August 12-14, 2014 at the Grand Traverse Resort and Spa by Traverse City, Michigan. The CDC will be sending out a Dear Tribal Leader Letter soon. This is a good opportunity to consult with Tribal leaders about challenges and successes with health and public health systems and programming, funding, access to information and data, and other related topical areas in order to funnel this information to the official Area TAC representative. As the agenda has not been published yet, it is not known what portions of the meeting will be closed and what will be open, however, attendance is encouraged and a wonderful opportunity to provide live testimony and to listen to the testimony of others.
After a few months on the job, Maniilaq Association CEO Tim Schuerch said the organization is more financially stable now than it was when he started.
However, delays in federal funding are causing headaches when it comes to running the facilities and hiring healthcare workers.
Last week Schuerch took Maniilaq's plight to the House Natural Resources Subcommittee on Indian and Alaska Native Affairs, chaired by Congressman Don Young, to urge them to pass a bill that would provide Indian Health Service funding in advance...
The Substance Abuse and Mental Health Services Administration has released a Dear Tribal Leader letter within the past month soliciting feedback on the latest revisions to their Tribal Consultation Policy (TCP). The policy can be read here, http://beta.samhsa.gov/sites/default/files/tribal-consultation.pdf. SAMHSA is requesting that all feedback on the revised policy be submitted via e-mail to [email protected] by August 29, 2014.
Today, the United States Patent and Trademark Office has canceled six federal trademark registrations for the name of the Washington Redsk*ns. As grounds for cancellation the Patent and Trademark Office ruled that the name is "disparaging to Native Americans" and cannot be trademarked under federal law that prohibits the protection of offensive or disparaging language. The plaintiff's lead counsel said in a press release that they "presented a wide variety of evidence - including dictionary definitions and other reference works, newspaper clippings, movie clips, scholarly articles, expert linguist testimony, and evidence of the historic opposition by Native American groups - to demonstrate that the word 'redsk*n' is an ethnic slur." The defendants in this case will most likely appeal the ruling and the trademark protection will continue through the appeals process.
For additional information see the links below:
WASHINGTON, DC- June 12, 2014- Yesterday Congresswoman Betty McCollum (D-MN) and Congressman Tom Cole (R-OK), co-chairs of the Congressional Native American Caucus, introduced H.R. 4843, the "Native Contract and Rate Expenditure (CARE) Act." The bill would extend the Medicare-Like Rate cap on payments made by Purchased/Referred Care (PRC) (formerly Contract Health Services) programs at the Indian Health Service (IHS) and Tribal levels to all Medicare participating providers and suppliers. The National Indian Health Board (NIHB) worked closely with Congresswoman McCollum and Congressman Cole's offices to assist in the development of this legislation and is very pleased to see the bill introduced. The introduction of this legislation is an essential first step in allowing IHS and Tribal health facilities spend precious PRC resources most effectively and efficiently...
The Indian Health Care Improvement Act, as reauthorized by the Affordable Care Act, required the Secretary of the Department of Health and Human Services to conduct a study and report to the Congress on the feasibility of establishing a Navajo Nation Medicaid Agency. A copy of the report was submitted to Congress by the Centers for Medicare & Medicaid Services. The report was prepared in consultation with the Navajo Nation.
CLICK HERE to access the report.
IHS Acting Director Dr. Yvette Roubideaux wrote to Tribal Leaders on May 9, 2014 to provide an update on the Special Diabetes Program for Indians (SDPI). The letter notes that that the SDPI program has been renewed by Congress for 1 year and that the Tribal Leaders Diabetes Committee (TLDC) recommended that IHS continue the same funding distribution in FY 2015. The TLDC also recommended that IHS continue discussions on recommendations for any future extension that might be for multiple years, and encouraged IHS to request a waiver to allow for a continuation application rather than a competitive application.
View Letter (PDF)
On May 12, 2014, IHS Acting Director Dr. Yvette Roubideaux wrote to Tribal Leaders to provide an update on Contract Support Costs (CSC). The letter addresses: 1) the Indian Health Service’s (IHS) progress on resolving past CSC claims; 2) consultation activities on a long-term solution for CSC as requested by Congress; 3) CSC appropriations and payments in fiscal year (FY) 2014; and 4) CSC in the FY 2015 President’s Budget Request.
View Letter (PDF)
BILLINGS, Mont.--April 3, 2014--During its full day of free Affordable Care Act training for Tribes, today in Billings, MT, the National Indian Health Board (NIHB) launched a media campaign featuring American Indian elders. The launch was marked by the national debut of a public service announcement (PSA) for American Indian and Alaska Native elders highlighting how the Affordable Care Act (ACA) improves the health care for Native elders.
Today the President released the FY 2015 Budget request to Congress. This officially kicks off the appropriation season. In the coming months, Congress will use this request as a baseline as it develops the FY 2015 budget.
Overall, the FY 2015 budget request totals $3.901 trillion and would increase taxes on the wealthy (by formalizing the “Buffet Rule”), cut the size and pay of the military and expand social programs. Most of the proposal will not be enacted by Congress, but will still serve as a benchmark as FY 2015 spending is finalized. You may also find this infographic from the Washington Post interesting:
For the Indian Health Service the President requested $6 billion, and increase of $228 million or 4 percent over FY 2014. The budget fully funds contract support costs and provides increases for Purchased/referred care (aka contract health service) for medial inflation (5%); and clinical services. The budget also restores the cuts that were made to the Indian Health professions; tribal management and self-governance accounts in the FY 2014 operating plan in order to fully fund contract support costs.
The Administration has released a brief (attached) today but more details will be shared in the coming days. Please stay tuned for a more detailed analysis from NIHB. You can view the whole Health and Human Services Department brief here: http://www.hhs.gov/budget/#brief
On February 18, 2014, the Indian Health Service released its FY 2014 operating plan. As you may recall, on January 17, 2014, Congress passed an appropriations bill to fund the Federal government for the remainder of Fiscal Year 2014 (FY 2014). The law removed caps on Contract Support Costs (CSC) and created a way for the Indian Health Service (IHS) and Bureau of Indian Affairs (BIA) to fully fund CSC in 2014. Given the parameters of the legislative language, the “way” to fully fund CSC was by moving money from other IHS and BIA line items into CSC.
Today, IHS released their FY 2014 operating plan which details the funding for each spending account for the remainder of the fiscal year. The plan funds Contract Support Costs and made reductions in other areas from FY 2013. Accounts receiving those reductions for FY 2014 include Self-governance ($1 million), Tribal Management ($1 million) and Indian Health Professions ($5 million).
IHS Budget Review FY2012-2014: Click Here (PDF)
IHS Budget FY2014: Click Here (PDF)
BIA Budget FY2014: Click Here (PDF)
Please contact Caitrin Shuy at [email protected] with any questions on the FY 2014 budget.
Comment period for the Health Resources and Services Administration (HRSA) Tribal Consultation Policy has been extended for an additional 30 days through Monday, July 28, 2014 (the original comment period was set to end June 27, 2014).
HRSA has asked for input regarding the current HRSA Tribal Consultation Policy. HRSA policy requires review of the consultation policy every two years, and revision to the policy if necessary. HRSA is seeking Tribal input and asks for comments no later than Monday, July 28, 2014.
Please continue to send comments to the dedicated mailbox: [email protected]
On May 20, 2014, HHS published a new proposed rule (click here to see an easy to read pdf) that would provide eligible professionals, eligible hospitals, and critical access hospitals more flexibility in how they use certified electronic health record (EHR) technology (CEHRT) to meet meaningful use. The proposed rule, from the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), would let providers use the 2011 Edition CEHRT or a combination of 2011 and 2014 Edition CEHRT for the EHR reporting period in 2014 for the Medicare and Medicaid EHR Incentive Programs.
The proposed rule also includes a provision that would formalize CMS and ONC’s previously stated intention to extend Stage 2 through 2016 and begin Stage 3 in 2017.
To submit comments please visit:
Comments are due July 21, 2014, 11:59pm EST.
Representatives of seven Montana and Wyoming reservations testified to the critical state of health care services and injustices suffered by their members during a U.S. Senate Indian Affairs Committee hearing in Billings, Montana, on May 27. The Indian Health Service regional office in Billings, Montana, serves approximately 80,000 tribal members from Montana and Wyoming.
"All too often, tribal members complain of ailments but get sent home from the Indian Health Service with cough medicine or pain killers. Later we learn the situation is much more serious, like cancer," testified A.T. "Rusty" Stafne, chairman of the Assiniboine and Sioux Tribes of northeast Montana’s Fort Peck Indian Reservation, reported the Associated Press...
Read full article at Indian Country Media Network
CDC is announcing a series of six funding opportunity announcements (FOAs) dedicated to one or more of the leading risk factors for the major causes of death and disability in the United States: tobacco use, poor nutrition, and physical inactivity.
Of particular note is DP14-1421PPHF14: A Comprehensive Approach to Good Health and Wellness in Indian Country. This 5-year, $14 million/year initiative aims to prevent heart disease, diabetes, stroke, and associated risk factors in American Indian tribes and Alaskan Native villages through a holistic approach to population health and wellness. The initiative will support efforts by American Indian tribes and Alaskan Native villages to implement a variety of effective community-chosen and culturally adapted policies, systems, and environmental changes. These changes will aim to reduce commercial tobacco use and exposure, improve nutrition and physical activity, increase support for breastfeeding, increase health literacy, and strengthen team-based care and community-clinical links. Funds will support approximately 12 American Indian tribes and Alaskan Native villages directly and approximately 12 Tribal Organizations (one of each in each of 12 IHS administrative areas) to provide leadership, technical assistance, training, and resources to American Indian tribes and Alaskan Native villages within their IHS Administrative Areas.
Click here to view the FOA:
Indian Health Service recently released a Dear Tribal Leader Letter that was calling for comments from Tribal leaders regarding potential future funding for the Methamphetamine and Suicide Prevention Initiative and the Domestic Violence Prevention Initiative. The comment period closes on March 27, 2014. This is an important opportunity for Leaders to support two critical programs in our communities… Read More
Today is the National Tribal Day of Action for Affordable Care Act Enrollment. Over 65 events are being hosted in tribal communities across the nation and President Obama wants to ensure that every American Indian and Alaska Native has the information they need to take advantage of new health care options available under the health care law...
Read full article at
Get Covered on Today's National Tribal Day of Action for ACA Enrollment
Today is the National Tribal Day of Action for the Affordable Care Act Enrollment. This is a prime opportunity for American Indians and Alaska Natives (AI/AN) to enroll in the Health Insurance Marketplace at www.healthcare.gov.
The open enrollment deadline set for March 31, 2014 is quickly approaching. And, even though members of federally recognized Tribes have a special monthly enrollment status, it is important for AI/AN individuals and families to learn about their insurance options. Whether it's purchasing insurance through the Marketplace or qualifying for Medicaid, knowing that you have quality coverage will provide peace of mind.
Times and Dates: 8:00 a.m.-5:00 p.m., February 18, 2014 (TAC Meeting); 8:00 a.m.-5:00 p.m., February 19, 2014 (10th Biannual Tribal Consultation Session)
Location: TAC Meeting and Tribal Consultation Session to be held at CDC Headquarters, 1600 Clifton Road NE., Global Communications Center, Auditorium B3, Atlanta, Georgia 30333
Status: The meetings are being hosted by CDC/ATSDR and are open to the public.
Topics and Format: The TAC and CDC leaders will discuss the following public health issue topics identified by Tribal leaders: Native specimens, behavioral risk factors, and disease-specific topics. There will also be a listening session with the CDC Director/ ATSDR Administrator and a roundtable discussion with CDC and ATSDR leadership.
Written Testimony: Tribal Leaders are encouraged to submit written testimony by 12:00 a.m., EST on January 24, 2014, to April R. Taylor, Public Health Analyst for the Tribal Support Unit, or CAPT Craig Wilkins, Acting Director for the Tribal Support Unit, CDC/OSTLTS, via mail to 4770 Buford Highway NE., MS E-70, Atlanta, Georgia 30341 or email to [email protected]
Registration Required: All attendees must pre-register by January 29th.
Learn More: Registration forms, agendas, and hotel information can be found on the CDC/ATSDR Tribal Support website at www.cdc.gov/tribal/meetings.html.
The CDC/ATSDR is seeking nominations to fill open positions on the Tribal Advisory Committee (TAC). Out of 16 seats, there are 11 seats open (Aberdeen, Albuquerque, Billings, California, Nashville, Phoenix, Portland, and 4 At-large seats). Nominations for the TAC will be accepted until January 17, 2014.
For more information on the TAC and instructions on how to submit a nomination please follow the links below:
For additional assistance, questions, or concerns, please contact CAPT Craig Wilkins, Acting Director, Tribal Support Unit at [email protected] or (404) 498-2208.
On December 5, the National Indian Health Board (NIHB) will host a Special Diabetes Program Indians (SDPI) briefing on Capitol Hill in Washington, D.C from 10:00 – 11:15 AM in 2218 Rayburn House Office Building. The SDPI is making a tremendous difference in the health of American Indians/Alaska Natives (AI/ANs), who are burdened disproportionately with type 2 diabetes at a rate of 2.8 times the national average.
As SDPI is set to expire in September 2014, the program must be renewed this year to ensure that critical programs around the country can continue. This is your opportunity to hear directly from SDPI grant program directors and other SDPI stakeholders on specifically how SDPI funding is changing the diabetes landscape for AI/ANs and how SDPI is saving lives, lowering medical expenditures and demonstrating a real return on the federal investment. To view the SDPI briefing invitation, CLICK HERE (PDF).
To RSVP for the SDPI briefing, please contact Jeremy Marshall, NIHB Senior Legislative Associate, at [email protected] or at (202) 507-4078.
This Thanksgiving, as with every year since 1970, Native Americans and supporters of indigenous peoples throughout Canada, Mexico and the U.S. will march on Plymouth Rock in Massachusetts to protest the turkey jubilee and reappropriate the holiday as National Day of Mourning (NDOM)...
76 Senators have signed the Special Diabetes Program for Indians (SDPI) Senate support letter this year, translating into over 75% of the U.S. Senate supporting this critical program. This is an increase from last year’s total of 72 Senate signatures. To view the SDPI Senate support letter (with signatures), CLICK HERE (PDF)
October 24, 2013, Fairbanks, Alaska – Governor Sean Parnell today presented the 2013 Shirley Demientieff Award to H. Sally Smith at the Alaska Federation of Natives (AFN) Convention in Fairbanks. The award, presented each year at AFN, is given by the governor for advocacy on behalf of Alaska Native women and children.
To read more, click here.
Click here to view the letter (PDF).
336 U.S. House of Representatives Members have signed the Special Diabetes Program for Indians (SDPI) support letter, translating into over 75% of House Members signing on in support of SDPI. This is an increase from last year’s total of 268 House Member signatures. Please note that the House SDPI Support Letter contains 335 signatures. Rep. Pete Sessions (R-TX-32) provided his own support letter.
To view the House SDPI Support Letter (with House Member signatures), CLICK HERE (PDF).
Please note that the House SDPI support letter contains 335 actual signatures. Rep. Pete Sessions (R-TX-32) provided his own support letter, bringing the total to 336. While a final copy of the U.S. Senate SDPI support letter has not been provided by the Senate Diabetes Caucus at this time, we can confirm that 76 Senators have signed the Senate SDPI support letter. The Senate SDPI support letter (with signatures) will be posted on the NIHB homepage once its released.
For more information, contact Jeremy Marshall (NIHB Senior Legislative Associate) at [email protected] or at (202) 507-4078. Stay tuned to the SDPI Resource Center website at www.nihb.org/sdpi for regular updates on the SDPI renewal campaign and how you can become involved.
On October 16, 2013, Senator Mark Begich (D-AK) with Senator Max Baucus (D-MT), Senator Brian Schatz (D-HI), and Senator Tom Udall (D-NM) introduced a bill (S.1575) that would streamline the Definition of Indian in the Affordable Care Act. This is an important first step in ensuring that all American Indians and Alaska Natives (AI/ANs) receive the benefits and protections intended for them in the Affordable Care Act (ACA)...
Yesterday (October 3, 2013), the House of Representatives approved for House Floor consideration several measures which would end the government shutdown for select agencies. Among these was a resolution offered by Chairman of the Interior Appropriations Subcommittee Mike Simpson (R-ID) to continue funding for several programs critical to Indian Country. The “American Indian and Alaska Native, Health, Education, and Safety Act” (H.J.Res.80), would fund the Indian Health Service (IHS), The Bureau of Indian Affairs (BIA), and the Bureau of Indian Education (BIE) until December 15, 2013. This bill would provide funding for these programs at FY 2013 funding levels, and still maintain sequestration cuts. In addition to this bill there were also measures approved for consideration that would fund nutrition assistance for low-income women and children (H.J.Res.75) Impact Aid, (H.J.Res.83) and Head Start (H.J.Res.84)...
CROW AGENCY — American Indian tribes have more than access to national parks on the line with the government shutdown, as federal funding has been cut off for crucial services including foster care payments, nutrition programs and financial assistance for the needy.
For the 13,000 members of southeast Montana's Crow Tribe, the budget impasse had immediate and far-reaching effects: Tribal leaders furloughed more than 300 workers Wednesday, citing the shutdown and earlier federal budget cuts...
No roads link the tiny town of Fort Yukon, Alaska, to the rest of the United States, but that doesn't mean the federal government shutdown won't reach the nearly 600 inhabitants, mostly members of the Alaska Native population, who still fish and hunt for subsistence.
Ed Alexander, 36, is second chief of the Gwichyaa Zhee band of Gwich'in Indians who reside there, and he spent most of Tuesday online trying to determine what exactly the shutdown's impact will be. The timing is terrible for Alaska Native villages, he said, hurting students who have not yet received scholarship money they need for faraway universities and creating unemployment — the government is a core employer — just as people are preparing for an interior Alaska winter...
The U.S. government has officially shutdown as of 12a.m. on October 1 due to Congress’s failure to pass a continuing resolution, or “CR,” to fund the government. Late last night, the House of Representatives sent back a version of the CR to the Senate which delayed the individual mandate in the Affordable Care Act and eliminated health premium subsidies for members of Congress, their staff and the president, his cabinet and political appointees. However, the Senate immediately rejected this proposal. The House then voted to go into a “conference” with the Senate to work out a final CR. However, Senate Majority Leader Harry Reid refused noting, “We will not go to conference with a gun to our head." Both chambers are in session today, but a path forward is unclear.
What does this mean for Indian health?...
In June 2012 the U.S. Supreme Court ruled in Salazar v. Ramah Navajo Chapter that the federal government must pay for the full contract support costs (CSC) incurred by tribes while providing healthcare and other governmental services for their tribal citizens through Indian Self-Determination Act contract agreements.
In opposition to that ruling, the White House shared with Congress late this summer a continuing resolution budget proposal that would allow the federal government to forgo paying millions of dollars worth of CSC to tribes...
WASHINGTON, DC—August 7, 2013—According to a recent report by the Centers for Medicare and Medicaid Services (CMS), the National Indian Health Board’s (NIHB) Regional Extension Center contributed to producing $47 million in CMS Electronic Health Records (EHR) incentive payments to Indian Country...
In June, Indian Health Service Director Yvette Roubideaux sent a “Dear Tribal Leader” letter with an update on the Special Diabetes Program for Indians (SDPI). In April of this year, the Tribal Leaders Diabetes Committee (TLDC) recommended that the national funding distribution for the SDPI remain the same for FY 2014. IHS Director Roubideaux concurred with this recommendation provided by the TLDC.
The Letter also provides an update on efforts to address the $3 million sequestration cut to SDPI funding in FY 2013. IHS has worked hard to find ways within current SDPI funding levels to address the $3 million reduction and has announced that SDPI grant amounts will not be reduced due to sequestration in FY 2013. SDPI programs established in Indian Country will continue to receive the necessary resources and funding to fight diabetes in Tribal communities.
To view a copy of the “Dear Tribal Leader” letter, CLICK HERE
It’s an old American story: malign policies hatched in Washington leading to pain and death in Indian country. It was true in the 19th century. It is true now, at a time when Congress, heedless of its solemn treaty obligations to Indian tribes, is allowing the across-the-board budget cuts known as the sequester to threaten the health, safety and education of Indians across the nation...
Re “Broken Promises,” by Byron L. Dorgan (Op-Ed, July 11):
The National Indian Health Board, an advocacy group serving the 566 federally recognized tribes, calls on Congress to acknowledge the harm that health care cuts are having on tribal communities and to exempt the Indian Health Service, a federal agency, from further reductions...
At Pine Ridge Indian Reservation, one of the poorest parts of the United States, the budget cuts known as sequestration have slashed millions of federal dollars in funding.
By ANNIE LOWREY
New York Times
PINE RIDGE, S.D. — The Red Cloud-Bissonette family needs a new trailer. Frank, who is disabled, and Norma, his wife, are members of the Oglala Sioux Tribe who live on the sprawling grasslands of the Pine Ridge Indian Reservation. Despite their constant efforts to patch the seams of one of their trailers that was hauled here in 1988, rot and mold continue to climb up the walls.
The family has punched a hole in the ceiling for a chimney for their wood stove, a necessity given the harshness of the winters but a fire hazard in the dry climate...
The Youth Summit will take place at the NIHB 30th Annual Consumer Conference (ACC) in Traverse City Michigan on August 23-26, 2013. This year’s Summit focuses on creating Digital stories related to Diabetes and Cancer in your community. We encourage all Native Youth to apply and tell us why you would like to be a part of this year’s Summit.
To find out more information on the 2013 3rd Annual NIHB Native Youth Summit, please click here and see Digital Stories produced at last year’s Summit.
Native Health Summit
The 2013 National Indian Health Board’s Native Youth Summit of the 30th Annual Consumer Conference will bring together youth throughout Indian Country to focus on health care issues in their communities. This year we will offer full workshops on two critical health care issues in Indian Country: Cancer and Diabetes. With support from the Mayo Clinic’s Spirit of Eagles Program and the American Diabetes Association, these two issues will be the focus of Digital Story-telling workshops and productions. The Digital Stories will be featured at the end of the track during a Native Youth Film Festival held on Monday, August 26th following the Annual Consumer Conference Opening Reception!
For further questions regarding the Summit please call 202-507-4081.
This week, the House Diabetes Caucus released a Dear Colleague letter to support the renewal of the Special Diabetes Program and the Special Diabetes Program for Indians (SDP/SDPI). Both of these programs expire at the end of next fiscal year - September 30, 2014. You can read the Senate letter here and the House letter here.
SDPI is a critical investment to prevent and treat Type 2 diabetes in the American Indian/Alaska Native Communities. This program is saving lives and saving taxpayer dollars. If this program is not renewed, Tribes across Indian Country will not only lose funds but will continue to suffer from Type 2 diabetes at alarming rates.
Please contact your representatives and urge them to sign onto this letter. The deadline to sign on is July 31, 2013.
Last year's letter had signatures from 268 House members and 72 Senators and was instrumental in the renewal of SDPI. Please help us make this year's letter an even bigger a success!
By BYRON L. DORGAN
WASHINGTON — WHEN I retired in 2011 after serving 30 years in Congress, there was one set of issues I knew I could not leave behind. I donated $1 million of unused campaign funds to create the Center for Native American Youth at the Aspen Institute, because our country has left a trail of broken promises to American Indians.
As chairman of the Senate Committee on Indian Affairs, I once toured a school near an Indian reservation where I encountered a teacher who told me that when she asked a young Indian student what she wanted for Christmas, she said she wanted the electricity turned on in her house so she could study at night...
In 2012 the Annual Consumer Conference in Denver, Colorado featured the 2nd Annual Native Youth Summit. This track brought together Native Youth from around Indian Country to develop digital stories focused on health and wellness in their communities. These stories created by the youth over a two day Digital Story workshop dealt with topics ranging from Obesity to Suicide to Stress and Cultural Identity.
Washington, DC – Today, the National Indian Health Board (NIHB) was joined by the National Congress of American Indians (NCAI) requesting that the administration appoint one of the four candidates it proposed for Surgeon General of the United States. The candidates include foremost leaders in the field of Indian Health: Lori Arviso-Alvord, MD (Navajo), Donald Warne, MD, MPH (Oglala Lakota), Charles Grim, DDS (Cherokee) and Rear Admiral Craig Vanderwagon. The NIHB announced its support for the four candidates at the close of the National Indian Health Board’s National Annual Tribal Public Health Summit June 19, which was held on the Seminole Nation, in Florida...
On Wednesday, June 26, the Secretary of the Department of Health and Human Services (HHS) issued a final rule that provides a hardship waiver that will prevent American Indians/Alaska Natives (AI/ANs) from receiving a tax penalty if they fail to retain minimum essential coverage under the Affordable Care Act.
The National Indian Health Board (NIHB) applauds HHS’s decision to move forward with this waiver and appreciates the Secretary responding to the comments of the Tribes and Tribal advocates to address definition of Indian issue. Yet, there are many other benefits included in the ACA specific to AI/ANs that need to be addressed in order for all AI/ANs to be afforded the opportunities provided for in the Act.
On June 19th, the National Indian Health Board (NIHB) launched the Special Diabetes Program for Indians (SDPI) renewal campaign. As SDPI will expire on September 30th, 2014, NIHB asks you to help Congress understand the impact of SDPI in your communities by inviting your Member of Congress to visit your SDPI program in August during the Congressional recess. NIHB has created the “Schedule, Host, Organize, and Witness” (S.H.O.W.) SDPI Grantee Site Visit Toolkit, a step-by-step guide on how to host a site visit with your Member of Congress...Read More (PDF)
See a video and hear comments of those that attended the ceremony at
On March 1, the Office of Management and Budget (OMB) released its Report to the Congress on the Sequestration for Fiscal Year (FY) 2013. The Report provides calculations of the amounts and percentages by which various federal agency budgetary resources are required to be reduced over the seven months remaining in the fiscal year and a listing of the reductions required for each non-exempt budget account.
As a result of the Congress’s failure to enact legislation to stop the sequester, President Obama was required by law to issue a sequestration order on March 1 canceling $85 billion in budgetary resources across the federal government for FY 2013. As noted in the Report, the Indian Health Service (IHS) discretionary lines – IHS services and facilities – are subject to a 5% cut, which translates into a cut of $195 million for services and a $22 million reduction for facilities in FY 2013. The IHS mandatory account for the Special Diabetes Program for Indians (SDPI) is subject to a 2% cut of $3 million.
For a copy of the OMB March 1 Report, CLICK HERE
This morning, the U.S. House of Representatives has begun consideration of S. 47, the Violence Against Women Act (VAWA) legislation that was passed by a strong bipartisan Senate majority earlier this month. Today, the House is expected to vote first on the House VAWA substitute bill, which aims to give non-Indian perpetrators the ability to take their cases from Tribal court to federal court at any point in the legal process if they assert that their Constitutional rights are being violated by a Tribal court. If the vote on the House VAWA substitute fails, the House will then hold a vote on S. 47, which includes more favorable Tribal jurisdiction provisions. S. 47 appropriately addresses the high incidence of domestic and sexual abuse of American Indian women by giving the necessary authority to Tribal police and courts to prosecute non-Indian perpetrators.
We respectfully ask you to contact your House Members this morning and urge them to vote “No” on the VAWA House substitute and vote “Yes” on S. 47. For more information, attached is a VAWA Action Alert (PDF) that provides information on how to contact your House Members and a copy of S. 47 (PDF).
On February 28, the House of Representatives voted in support of S. 47, a renewal of the Violence Against Women Act (VAWA). The legislation passed on a vote of 286 to 138, with 199 Democrats joining 87 Republicans in support of the reauthorization of the landmark 1994 law, which assists victims of domestic and sexual violence. The successful measure passed the Senate last month with 78 votes — including those of every woman, all Democrats and just over half of Republicans. The approved VAWA measure includes a key provision that will allow Tribal courts to prosecute non-Native perpetrators accused of assaulting Indian women on Tribal lands. The measure is now on its way to the desk of President Obama to be signed into law.
The alternative unveiled by the House last week immediately came under sharp criticism from Democrats and women’s and human rights groups for failing to include protections in the Senate bill for gay, bisexual or transgender victims of domestic abuse. The House bill eliminated “sexual orientation” and “gender identity” from a list of “populations” that face barriers to receiving victim services — and also stripped certain provisions regarding American Indian women on reservations. With House Republicans divided, House leadership agreed that it would allow a vote on the Senate bill if the House version could not attract sufficient votes. It failed on a vote of 257 to 166. Sixty Republicans joined 197 Democrats in opposition; 164 Republicans and 2 Democrats voted for it.
Brought to you by Indian Health Service’s TeleBehavioral Health Center for Excellence and the University of New Mexico’s Center for Rural and Community Behavioral
Presented by Snehal Bhatt, MD and Joanna Katzman, MD, MSPH
This 15-session course will address:
- Pain Management within a primary care setting.
- Risk Management with pain patients.
- Assessing aberrant behavior in pain patients.
- Diagnosing and managing Opioid Addiction within a primary care setting.
- Practical assessment and intervention.
Sessions will occur weekly on Mondays
As in previous years, HHS will continue to work with you to improve the consultation process. The Department understands the importance of hearing from tribes on national crosscutting issues, regional perspectives, as well as tribal-specific concerns. The consultation session will provide a forum for tribes to collectively share their views and priorities with HHS officials on national health and human services funding priorities and recommendations for the Department’s FY 2015 budget request. We hope the consultation will provide a venue for a two-way conversation between tribal leaders and HHS officials on program issues and concerns that will lead to recommended actions. The schedule for this year’s consultation is as follows...
On January 23, in an effort to improve mental health services for young people and prevent youth suicides, U.S. Senators Jack Reed (D-RI) and Lisa Murkowski (R-AK) introduced the Garrett Lee Smith Memorial Act Reauthorization bill. The Reauthorization will help improve access to counseling for at-risk teens and promote the development of statewide suicide early intervention and prevention strategies. It will also increase federal funding for competitive grants to help States, colleges, universities, and Tribes improve mental and behavioral health counseling services...
On January 22, U.S. Senate Judiciary Committee Chairman Patrick Leahy (D-VT) and Sen. Michael Crapo (R-ID) introduced S. 47, a bipartisan bill that would reauthorize the landmark Violence Against Women Act (VAWA) in the new 113th Congress. On the same day, Rep. Gwen Moore (D-WI) and Rep. John Conyers (D-MI) introduced H.R. 11, a House companion bill identical to the bipartisan Senate bill S. 47...
On January 23, the House of Representatives passed debt legislation that would suspend the country’s debt limit through May 18. House Members voted 285-144 to pass H.R. 335, with 86 Democrats supporting the measure and 33 Republicans opposing it.
H.R. 335 automatically increases the current $16.4 trillion ceiling to accommodate additional debt accumulated before May 18. Without action, the federal government would reach its borrowing ceiling as early as mid-February. H.R. 335 would also tie Congressional pay to passage of a budget plan by suspending salaries of House or Senate Members if either chamber does not adopt a budget resolution by April 15.
Senate Majority Leader Harry Reid (D-NV) said that the Senate will pass H.R. 335 and the White House has indicated that it will not block the measure. The timing of the Senate vote to pass the measure has not been determined. Stay tuned to www.nihb.org for updates as they develop.
Today the Centers for Medicare & Medicaid Services (CMS) issued a solicitation for applications for Connecting Kids to Coverage Outreach and Enrollment Grants This solicitation seeks applications for Connecting Kids to Coverage Outreach and Enrollment (Cycle III) grant funding, provided under the Section 2113 of the Social Security Act, as amended by section 10203(d)(2)(E)(i) of the Patient Protection and Affordable Care Act (ACA) (Pub. L. 111-148).
A total of $32 million is available for grants to states, local governments, community-based and non-profit organizations. Indian health care providers and tribal entities also are eligible to apply for grants under this FOA. In addition, the Center for Medicare & Medicaid Services (CMS) will be announcing a separate FOA exclusively for Indian health care providers and tribal entities, under which $4 million will be made available for outreach and enrollment grants. Cycle III grants will support outreach strategies similar to those conducted in previous grant cycles, and also will fund activities designed to help families understand new application procedures and health coverage opportunities, including Medicaid, CHIP and insurance affordability programs under the ACA.
All grant applications must be submitted electronically through www.grants.gov and are due on February 21, 2013. Applications received through www.grants.gov until 3:00 p.m. Eastern Standard Time on February 21, 2013, will be considered "on time."
Teleconferences for Applicants:
The Centers for Medicare & Medicaid Services (CMS) will hold at least two applicant teleconferences to provide an opportunity to ask questions about this solicitation. The first teleconference will take place on January 16, 2013, from 2 p.m. to 3 pm eastern time. The dates, times, and call information for this and future teleconferences will be posted on the Insure Kids Now website at www.insurekidsnow.gov/
Click here to see the full announcement
Congratulations! As one of the final acts of the 112th Congress, the U.S. House of Representatives and U.S. Senate approved H.R. 8 – American Taxpayer Relief Act of 2012 – a bipartisan bill that included a one-year renewal of the Special Diabetes Program for Indians (SDPI) at the current funding level of $150 million. The reauthorization of the SDPI is a significant accomplishment in the current challenging political and fiscal environment in Congress. The measure is expected to be signed by the President shortly.
This victory is due to your tremendous dedication in spending countless hours connecting with Congress. The renewal of the SDPI was a top legislative priority of the National Indian Health Board (NIHB) and for the past year, we focused much of our efforts, with your help, on demonstrating to Congress that SDPI is an urgent priority that must be renewed. With this extension, SDPI programs can continue through September 2014 to make a real difference in the lives of people in Tribal communities who fight diabetes on a daily basis.
In the coming days, NIHB will be releasing information on how you can thank your Members of Congress for their support of SDPI renewal. In the meantime, NIHB thanks each of you for your great outreach efforts to Congress. Lastly, for more information about the details of the fiscal deal package, please see the fact sheet issued by the White House.
View the Tax Agreement Fact Sheet (PDF)
Early this morning, by a vote of 89-8, the Senate passed legislation - H.R. 8 - American Taxpayer Relief Act of 2012 - that not only neutralizes the across-the-board tax increases and spending cuts scheduled to take effect at midnight but also includes a one-year extension for the Special Diabetes Program for Indians (SDPI) at the current funding level of $150 million. The renewal would extend SDPI through September 2014. The one-year renewal of SDPI will continue to provide Indian County with the necessary resources to continue to make significant advances in diabetes education, treatment, and prevention in Tribal communities.Other key highlights of this legislation include:
The House of Representatives convened at Noon today and will hopefully pass the legislative package so it can be sent to President Obama and signed into law.
NIHB continues to monitor the situation and will provide updates as they develop. For more information on SDPI, please visit the SDPI Resource Center at www.nihb.org/sdpi
To view the text of H.R. 8, CLICK HERE
19 states, including the District of Columbia, have announced their intent to establish a state exchange before last Friday’s deadline, December 14, 2012.
To view which states are establishing a state exchange, visit NIHB’s Tribal Reform Resource Website at www.nihb.org/tribalhealthreform.
The National Indian Health Board is pleased to announce our new initiative GO the EXTRA MILE, the result of our Executive Director Stacy A. Bohlen signing the CEO Pledge. The CEO Pledge is part of a national campaign to encourage Executive Directors to commit to supporting and fostering a physically-active workplace. NIHB’s GO the EXTRA MILE initiative achieves these goals by creating a workplace that supports physical activity for every member of its staff. Through the GO THE EXTRA MILE with NIHB initiative, staff is required to walk at least one mile each day for a year. We will aggregate these miles and “virtually” walk to each of the 12 Indian Health Service Areas, either to an Area Indian Health Board or to a Tribal Partner in Areas that do not have a Board.
To view the letter from our Executive Director, Stacy A. Bohlen about the CEO Pledge and the GO the EXTRA MILE, CLICK HERE.
On November 1, 2012, the first day of both American Indian Heritage Month and Diabetes Awareness month, NIHB will launch its GO THE EXTRA MILE initiative, and we invite you to join us on this year-long journey. The kickoff walk will take place at 8 AM in front of the National Museum of American Indians in Washington, D.C. NIHB wants to begin this journey by walking the first mile together!
To see Kickoff Walk flyer CLICK HERE.
We invite you to join NIHB by signing the CEO pledge and participating in the November 1st launch. You will have access to the NIHB Go The Extra Mile website (available on November 1st), which will include a toolkit, electronic mapping for your journey, and access to information like “Hot Health Tips” from our partner, the Association of American Indian Physicians.
For additional information about the GO the EXTRA MILE, CEO Pledge, and the kickoff walk, please contact Liz Heintzman at [email protected] and/or 202-507-4072. CLICK HERE to view the GO the EXTRA MILE proposal and CLICK HERE to view NIHB’s virtual walking plan.
The National Indian Health Board (NIHB) is producing several fact papers about the post-election 2012 and the health reform implications, focusing specifically on how they pertain to Indian Country.
For an update about the health exchanges and the approaching deadline for states to announce their decision to implement a state exchange, click here (PDF).
To view a state by state comparison of governors’ decisions on implementing state exchanges, click here (PDF).
For an update about the general post-presidential and congressional election results, click here (PDF).
Stay tuned for more NIHB Special Analysis Series fact sheets.
On October 26th, National Indian Health Board (NIHB) Chairperson Cathy Abramson (Board Member, Treasurer, Sault Ste. Marie Tribe of Chippewa Indians) provided remarks and chaired the Health Subcommittee meeting at the 69th Annual National Congress of American Indians (NCAI) Convention & Marketplace in Sacramento, California. The focus of NIHB Chairperson Abramson’s remarks was to provide an update on NIHB’s efforts to secure the Special Diabetes Program for Indians (SDPI) reauthorized by Congress and the importance of protecting Indian programs from sequestration...
On September 14, 2012, the Office of Management and Budget (OMB) issued its Sequestration report. As noted in the report, many of the federal health programs and services provided to and accessed by American Indians and Alaska Natives will experience significant cuts if sequestration goes into effect in 2013. In particular, the Indian Health Service’s discretionary accounts for services and facilities will be subject to an 8.2% across-the-board cut, which is quite different from what many originally understood and reported, and the IHS mandatory account of the Special Diabetes Program for Indians is subject to a 2% cut. The report notes that the 2% limit, as provided for the Indian Health Service’s services and facilities accounts under the Balanced Budget and Emergency Deficit Control Act of 1985, applies “only for a discretionary cap sequestration and such accounts are fully sequestrable under a Joint Committee sequestration.” This means that nearly the entire Indian Health Service’s budget is subject to an 8.2% cut, and the total estimated automatic cut to the IHS budget is $356 million in Fiscal Year 2013.
August 24, 2012
On August 22, the National Indian Health Board submitted an official statement to the Senate Finance Committee in response to the August 8th Field Hearing at Crow Agency, MT, titled: Healing in Indian Country: Ensuring Access to Quality Health Care. The purpose of the Field Hearing was to address accessing quality health care in Indian Country. In addition to the tribal testimony provided at the Field Hearing, the statement highlights two additional recommendations: Special Diabetes Program for Indians (SDPI) reauthorization and protection of the Indian Health Service budget through any cuts enacted through the sequestration process next January. The SDPI statement will be posted on the Senate Finance Committee website in the coming months as it becomes a part of the official record.
To continue positioning yourselves as a trusted advisor, it is important for you to announce this milestone to your stakeholders as soon as possible. Your timely communication reinforces your connection to the federal agencies that make these impactful determinations.
To quickly push out the announcement, utilize the attached template email and below tweets.
Stage 2 Final Rule released on CMS website:
CMS announces new Stage 2 meaningful use rule for #EHRs.
Read more (PDF).
ONC Final Rule released Standards & Certification Criteria (Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition; Revisions to the Permanent Certification Program for Health Information Technology): ONC announces new Stage 2 meaningful use rule for #EHRs. Read more (PDF).
On Wednesday, November 14th - World Diabetes Day - please join NIHB and Tribal communities from across the country in asking your Senators and Representatives to support renewal of the Special Diabetes Program for Indians (SDPI) this year! Congress will be back in session and we need to make sure that they renew SDPI!
On October 16, the National Indian Health Board (NIHB) submitted a letter to the U.S. Department of Veterans Affairs (VA) and the Indian Health Service (IHS) recommending that Tribes receive the Medicaid All-Inclusive Reimbursement Rate rather than the Medicare Fee Schedule Reimbursement Rate. The Medicaid All-Inclusive Rate provides a fairer level of reimbursement that more adequately addresses the costs of providing services in small, often rural locations; assuring the availability of needed programs.
Earlier this year, Alaska Tribal Health programs executed reimbursement agreements with the VA under which the Medicaid All-Inclusive Rate would be paid for both inpatient and outpatient services. When Tribes outside of Alaska sought to negotiate a similar arrangement, VA indicated to Tribes that all reimbursement for Indian health outpatient services provided outside Alaska would be limited to the Medicare Fee Schedule Reimbursement Rate. In Tribal consultation sessions with VA, Tribes have objected this change in policy by VA.
This issue will play a critical role in allowing American Indians and Alaska Natives access to quality health care, especially as Tribes enter into negotiations with the VA on terms and conditions for reimbursement rates for direct services.
The Centers for Medicare & Medicaid Services (CMS) is pleased to share their draft for a revised American Indian and Alaska Native (AI/AN) Strategic Plan for CMS for the period 2013‐2018.
This is the third AI/AN Strategic Plan for CMS that the Tribal Technical Advisory Group (TTAG) has prepared. The previous plans were issued in 2004 and 2009. It is urgent that the plan is updated because there has been legislation that has resulted in policy and regulatory changes since the last plan was issued, which will significantly impact AI/ANs’ access to health care and the Indian health care delivery system. These changes include the American Recovery and Reinvestment Act of 2009 (ARRA) and the Patient Protection and Affordable Care Act (ACA) in 2010, which also permanently authorized the Indian Health Care Improvement Act (IHCIA).
The draft plan has goals, objectives, tasks, and budgets organized around the five themes of Tribal consultation, Policy Development, Long Term Care, Outreach and Enrollment, and Data. The Plan requests significant increases in CMS funding for AI/AN initiatives over the 5‐year period.
In addition to providing a roadmap for CMS, the plan is informative and useful, particularly Appendix B, which provides an updated summary of the "Legal Basis for Special CMS Provisions for American Indians and Alaska Natives."
The TTAG would like to hear from you about this plan before we finalize this draft and send it to CMS. Please send your comments to Elizabeth Heintzman via email [email protected] no later than October 30, 2012. Our intention is to complete the plan with your input by the end of the year.
A Word version of the Plan is available HERE, in which you can use to make red edits of your recommendations.
Also, visit the TTAG website HERE.
Washington, DC September 17, 2012 – The National Indian Health Board has completed Milestone 1 for Meaningful Use of Electronic Health Records as mandated by the Office of the National Coordinator for Health Information Technology.
August 23, 2012
Today, Health and Human Services (HHS) Secretary Kathleen Sebelius announced the next steps in the Obama administration’s work to help doctors and hospitals use electronic health records.
“The changes we’re announcing today will lead to more coordination of patient care, reduced medical errors, elimination of duplicate screenings and tests and greater patient engagement in their own care,” Secretary Sebelius said.
The final agenda for the IHS Tribal Consultation Summit being held in Denver, CO on August 7-8, 2012, can be located on the IHS Director’s Blog. Click here to for the final agenda.
Also posted on the Director’s Blog were several new Dear Tribal Leader (DTL) letters providing updates on consultation activities that the DTL letters have initiated a few new consultations. IHS has also developed a summary of all consultation activities initiated since June 2009 with brief updates on their status and outcomes. Click here to view those updates.
Please note that if the letter does not state a deadline for comments, then IHS requests comments be submitted within 60 days from the date of the letter. Comments are should be addressed to Dr. Yvette Roubideaux at IHS Headquarters in Rockville, MD, or by email to [email protected].
The Centers for Disease Control and Prevention’s (CDC) Office for State, Tribal, Local and Territorial Support is pleased to inform you about the upcoming CDC Orientation for New Health Officials, October 15–17, 2012. The orientation will be held at CDC’s headquarters in Atlanta, Georgia.
July 3, 2012
The Special Diabetes Program for Indians (SDPI) is set to expire September 2013 unless Congress takes action to renew the program. And, as in past renewal campaigns, it is critical for Congress to renew the program as soon as possible to avoid disruption in programs and staff. That means we must all work together – in this difficult budget and political climate – to convince Congress to RENEW SDPI THIS YEAR. And it will take all of us working together and sharing information.
That is why NIHB has created a new resource to share information and new tools to make it easy for you and your communities to get involved. Today, we are happy to announce the launch of our new NIHB SDPI Resource Center! Click Here to visit this new site and to start using this valuable tool.
This website will contain up to date information on the status of the renewal campaign in Congress; materials created by grantees and tribes that showcase successes and personal stories, state specific information, and a new tool – a Congressional Tracker – that will give you current information on your Member of Congress relevant to the SDPI renewal campaign.
June 28, 2012
In today’s landmark decision of National Federation of Independent Business et al. vs. Sebelius, the Supreme Court upheld the Affordable Care Act (ACA) and affirms the permanent reauthorization of the Indian Health Care Improvement Act (IHCIA) included in the ACA. Now, with this important Supreme Court decision regarding the ACA with it permanent reauthorization of the IHCIA, the Indian health care system can begin a new chapter in the delivery of quality health care to American Indians and Alaska Natives. NIHB will continue to fight to protect the ACA and the continuous improvement of health care for American Indians and Alaska Natives...
On Monday, June 18th the U.S. Supreme Court ruled that the government must fully reimburse the Ramah Navajo Chapter and other Native American tribes for millions of dollars they spent on federal programs. The federal government had agreed to pay contract support costs to tribes that entered into agreements to manage federal programs, but Congress capped the amount of money earmarked for that reimbursement. The tribes sued, and the 10th U.S. Circuit Court of Appeals in Denver and said the money must be fully reimbursed. “Consistent with longstanding principles of government contracting law, we hold that the government must pay each tribe’s contract support costs in full,” Justice Sonia Sotomayor wrote for the majority. The U.S. Congress has long been keen to the funding issues that plague tribes, but it has never taken legislation actions for an appropriation solution. The high court now states that the executive branch must now make up the difference.
Attached below are both the April 18, 2012 Oral Argument transcript and the June 18, 2012 Decision of the Court.
On May 16th, the Department of Health and Human Services (HHS) issued guidance documents to advance the implementation of Insurance Exchange under the Affordable Care Act. One of these documents addressed the federally facilitated exchange. If a state decides not to operate an exchange, HHS will operate a federally facilitated exchange (FFE) in that state. This guidance describes how HHS will consult with stakeholders to implement a federally facilitated exchange, how states can collaborate with HHS through a state partnership exchange to implement certain functions of this exchange, and key policies for the exchange. Through the work of the MMPC, NIHB submitted comments regarding the FFE to the Center for Consumer Information and Insurance Oversight (CCIIO) at Centers for Medicare & Medicaid Services (CMS) on Monday, June 18th.
Click here to read the comments.
On April 4, the National Indian Health Board (NIHB) submitted comments to the Indian Health Service (IHS) and the Department of Veterans Affairs (VA) regarding the agencies’ draft agreement for reimbursement for direct health care services.
Click here to read the comments
With 449 Tribes and Tribal organizations from across the nation, the National Indian Health Board (NIHB) filed an amicus brief to protect the permanent reauthorization of the Indian Health Care Improvement Act (IHCIA) and other Indian-specific provisions included in the ACA in the Affordable Care Act (ACA) case in the United States Supreme Court...
On February 3, 2012, a Tribal and State Health Collaborative Roundtable was hosted by ASTHO, the National Indian Health Board, the Northwest Portland Area Indian Health Board, and the Centers for Disease Control at the Marriott Century Center in Atlanta, GA. The meeting began with dinner at 6pm on Thursday, February 2nd and ended at 3pm on Friday, February 3rd. The purpose of this meeting was to assemble state and tribal health leaders to identify opportunities to improve state health and Medicaid agencies’ collaboration with tribal health leaders and to discuss pertinent issues in regard to public health programming, federal funding, and strategic relationships. Preliminary steps were taken to develop an action plan for on-going work among states, tribes, CDC and Center for Medicare and Medicaid. Based on discussions and work at this meeting, a primer will be developed to promote enhanced communication between new State Health Officers and Tribal Leaders and enhance collective understanding of their roles and responsibilities.
NIHB participated in the ASTHO Community Benefits Consensus Statement Meeting on February 6, 2012. The purpose of this meeting was to convene stakeholders to create a consensus statement to inform the Internal Revenue Service (IRS) and non-profit hospitals on specific state and local public health expertise and inputs for community health needs assessments. NIHB attended the meeting on behalf of all federally recognized Tribes who may be running 501(c)(3) hospitals in Indian Country to ensure that AI/AN input was provided.Meeting objectives included:
NIHB has since sent out information on the pending policy changes to Tribal leaders and health organizations potentially impacted. Please contact Paul Allis, Senior Public Health Manager at [email protected] for any questions or comments. The deadline for comments included in the draft consensus statement are due to ASTHO on February 9, 2012.
On January 11th, the Department of Health and Human Services released a “Dear Tribal Leader Letter” inviting Tribes to the 14th Annual U.S. Department of Health and Human Services (HHS) Tribal Budget Consultation (ATBC) which will take place from March 7- 9, 2012, in the Great Hall of the Hubert H. Humphrey Building at 200 Independence Avenue, SW, Washington, DC as well as to its 2012 Annual Regional Tribal Consultations held across the country.
The National Indian Health Board has submitted comments to the Indian Health Service (IHS) in response to a November 9th “Dear Tribal Leader Letter” regarding the Federal Advisory Committee Act (FACA) and IHS Advisory Groups.
Click here to read NIHB’s comments.
Click here to read the “Dear Tribal Leader Letter”
Although Fiscal Year (FY) 2012 officially began on October 1st, Congress has yet to pass nine of the twelve appropriations bills for this year. This includes the Interior, Environment, and Related Agencies Appropriations bill, which contains funding for the Indian Health Service (IHS)...
On November 21st, the Joint Select Committee on Deficit Reduction aka Supercommittee officially admitted defeat in the quest to find $1.2 trillion in federal deficit reduction over the next 10 years.
Click here for more information on what this means for federal spending and the Indian Health Service.
On November 14th, the Supreme Court announced announced that it will hear arguments regarding the constitutionality of various provisions of the Patient Protection and Affordable Care Act (ACA), including the controversial individual mandate, this March.
Click here for an NIHB update.
The National Congress of American Indians (NCAI), the National Indian Health Board (NIHB), and the National Council of Urban Indian Health (NCUIH) have been jointly awarded a grant from the Indian Health Service (IHS) to collaborate on the National Indian Health Education and Outreach initiative.
Through this partnership, our organizations are working together to develop the necessary tools and resources to assist Tribal nations and their communities in making more informed decisions about their new health care options under the Patient Protection and Affordable Care Act (ACA).
In order to have a better understanding of what resources and tools Tribal nations and their communities might need regarding health care delivery and options, we are encouraging Tribal leaders, American Indian and Alaska Native community members, Tribal employers, and health directors to complete a survey on the ACA.
The National Indian Health Board commented on six proposed federal rules related to the implementation of the Affordable Care Act on October 31st. Five of the proposed rules were issued by the Centers for Medicare and Medicaid Services (CMS), regarding eligibility for federal health coverage and the establishment of new state-run health insurance exchanges (online marketplaces where consumers can compare pricing and services to choose the best health insurance option for themselves and their families):
In 2010, the Department of Health and Human Services (HHS) created a Secretary’s Tribal Advisory Committee (STAC) and has successfully been meeting for nearly a year. The STAC was one of the first Cabinet Level Tribal Advisory Committee to any Secretary in the Administration...
On October 26th, 2011, the United States Government Accountability Office (GAO) released a report entitled, "Indian Health Service: Continued Efforts Needed to Help Strengthen Response to Sexual Assaults and Domestic Violence."...
On October 22, 2011, NIHB Board Member and Alaska Area Representative, H. Sally Smith, testified at a Senate Committee on Indian Affairs Oversight Field Hearing at the Dena’ina Civic and Convention Center in Anchorage, Alaska. Entitled, “H.O.P.E. for the Future: Helping Our People Engage to Protect Our Youth,” the hearing centered on root causes of the youth suicide epidemic currently plaguing Indian Country and featured witnesses from the federal government, as well as Alaska Native witnesses. Ms. Smith’s testimony on behalf of NIHB focused on adverse childhood experiences (ACEs) as a major cause of suicide and called for greater funding for the Indian Health Service, mental health studies, and suicide prevention grant programs.
On September 27th, seven senators from the Senate Committee on Indian Affairs sent a letter to HHS Secretary Sebelius and IHS Director, Dr. Yvette Roubideaux, urging the Secretary and other top administration officials to act quickly to improve health care delivery to American Indians and Alaska Natives. The Senators pointed to a U.S. Government Accountability Office (GAO) report issued September 23rd that highlights billing and other problems in the IHS system that make it difficult for American Indians and Alaska Natives to receive care from health providers and makes it difficult for health care providers offering the services to get reimbursed.
The senators requested that IHS submit a comprehensive corrective action plan to address each of the problems and recommendations made in the GAO report, including a timeline for (1) corrective actions, (2) a date when each action will be commenced, (3) a date when each action is expected to be completed, and (4) identifiable goals that will lead to completion of each corrective action.
To view the letter, please visit: http://bingaman.senate.gov/policy/gao_ihs.pdf
The report is available at http://www.gao.gov/new.items/d11767.pdf
Purpose of the Study: The Patient Protection and Affordable Care Act requires GAO to study the adequacy of federal funding for IHS’s CHS program. To examine program funding needs, IHS collects data on unfunded services—services for which funding was not available—from the federal and tribal CHS programs. GAO examined (1) the extent to which IHS ensures the data it collects on unfunded services are accurate to determine a reliable estimate of CHS program need, (2) the extent to which federal and tribal CHS programs report having funds available to pay for contract health services, and (3) the experiences of external providers in obtaining payment from the CHS program. GAO surveyed 66 federal and 177 tribal CHS programs and spoke to IHS officials and 23 providers.
What GAO Recommends: GAO recommends that HHS direct IHS to ensure unfunded services data are accurately recorded, CHS program funds management is improved, and provider communication is enhanced. HHS noted how IHS would address the recommendations; describing the proposed new method to estimate need. IHS’s steps will address some recommendations, but immediate steps are needed to improve the collection of unfunded services data to determine program need.
Since the 1970s, the rate of childhood obesity in our country has tripled, and today a third of American children are overweight or obese. This dramatic rise threatens to have far‑reaching, long-term effects on our children's health, livelihoods, and futures. Without major changes, a third of children born in the year 2000 will develop Type 2 diabetes during their lifetimes, and many others will face obesity‑related problems like heart disease, high blood pressure, cancer, and asthma...Read Full Article
The President’s Plan for Economic Growth and Deficit Reduction lives up to a simple idea: as a Nation, we can live within our means while still making the investments we need to prosper – from a jobs bill that is needed right now to long-term investments in education, innovation, and infrastructure. It follows a balanced approach: asking everyone to do their part, so no one has to bear a disproportionate share of the burden. And it says that everyone – including millionaires and billionaires – must pay their fair share. Pursuing a balanced approach to deficit reduction is critical to being able to keep our promises made to all Americans...Read Full Article
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