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Washington Report

An NIHB Publication

The Washington Report is an e-newsletter produced by the National Indian Health Board. Each issue contains a listing of current events on Capitol Hill, information on passed and upcoming legislation, Indian health policy analysis and action items.

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Legislative Action Alerts are only sent to your inbox when legislation relevant to Indian health is introduced, debated, or voted upon. These timely alerts will provide background information and a pathway for you to get involved in the issue at hand.

Legislative

Located on Capitol Hill, the National Indian Health Board is a dedicated advocate in Congress on behalf of all Tribal Governments and American Indians/Alaska Natives. We maintain a presence in the halls of Congress, working with representatives from across the country to achieve quality, lasting health care for tribal members.

In our efforts to secure quality health care we track legislation and regulations, lead discussions on health care reform, provide recommendations and analysis of the Indian Health Service budget and educate members of Congress on the federal trust responsibility for health. We also endeavor to ensure Tribes, Tribal members, and advocates have accurate and up-to-date information related to Congressional action on Tribal healthcare issues...

2020 Legislative and Policy Agenda (PDF)


What's New?

Posted December 24, 2020

Congress Passes Several Significant Native Veteran's Health Bills

Before Congress recessed for the holiday, it passed several significant Native veteran's health bills – the Native American Veterans PACT Act, the Veterans Affairs Tribal Advisory Committee Act and the PRC for Native Veterans Act – that impact the delivery, access, and coordination of healthcare for American Indian and Alaska Native veterans who receive care from both the Indian Health Service (IHS) and Veterans Administration (VA).

Read the full release



December 22, 2020

Congress Seals Massive Spending/Stimulus Deal

After months of impasse in negotiations, and at the 11th hour, Congress clinched a bipartisan and bicameral deal on a roughly $900 billion COVID-19 pandemic stimulus bill. The package is attached to a massive $1.4 trillion Fiscal Year (FY) 2021 omnibus appropriations package - which includes all twelve appropriations bills including the Interior, Environment, and Related Agencies bill that funds the Indian Health Service (IHS). Alongside the stimulus and appropriations package is the surprise billing package provides the federal cost savings to pay for a 3-year extension of the Special Diabetes Program for Indians (SDPI).

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Posted December 8, 2020

NIHB, NCAI and NCUIH Send Joint Letter to Congressional Leaders Urging passage of Native Veterans Bills

The National Indian Health Board, alongside the National Congress of American Indians (NCAI) and the National Council of Urban Indian Health (NCUIH) sent a letter to Congressional leadership on December 4, 2020. The letter urges passage of Native Veterans bills including legislation to establish a Tribal Advisory Committee to the Secretary of Veterans Affairs (VA) and legislation to eliminate copays for Native Veterans, and to ensure the VA is fully reimbursing the Indian Health Service (IHS) and Tribes for services authorized under Purchased/Referred Care.

Read the full letter.



Posted December 8, 2020

NIHB, NCAI and NCUIH Send Joint Letter to Congressional Leaders on COVID-19 Relief for Indian Country

The National Indian Health Board, alongside the National Congress of American Indians (NCAI) and the National Council of Urban Indian Health (NCUIH) sent a letter to Congressional leadership on December 4, 2020. The letter urges Congress to include direct health relief funding to Tribes, including for vaccine distribution, COVID-19 testing and contact tracing, third-party reimbursement shortfall relief, and other provisions.

Read the full letter.



Posted November 16, 2020

NIHB Leads Efforts on Joint Letter to Indian Health Service Regarding Expanding Tribal Self-Determination and Self-Governance Authority for Special Diabetes Program for Indians

On Friday, November 13, NIHB was joined by ten Tribes and Tribal organizations in a letter submitted to Indian Health Service (IHS) Director Weahkee and members of Congress outlining the Tribes' final and official position on a legislative amendment to the Special Diabetes Program for Indians (SDPI) to permit Tribes and Tribal organizations to receive SDPI awards through Title I self-determination contracts or Title V self-governance compacts.

Read the full letter



November 10, 2020

Senate Releases All Twelve Appropriations Bills for Fiscal Year 2021

Earlier today, Tuesday, November 10, 2020, the Senate Appropriations Committee released all twelve appropriations bills for Fiscal Year (FY) 2021. Release of the spending bills follows months of gridlock on FY 2021 appropriations, forcing Congress to pass a continuing resolution (CR) keeping the federal government open through December 11, 2020.

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Posted November 10, 2020

NIHB sends letter to USCCR Regarding Withholding of COVID-19 Report

The National Indian Health Board (NIHB) has submitted a letter to the United States Commission on Civil Rights (USCCR) to express concern about their recent decision to not release a report that detailed COVID-19’s impact on Indian Country. In the letter we expressed our belief that this report contains information that would be vital for helping Tribal leaders respond to the pandemic, through both direct action and advocacy for policy changes. We are deeply disappointed in this decision and the lack of justification provided for it. We hope that the USCCR reverses this decision and releases their report.

Read the full letter



Posted November 3, 2020

NIHB Briefs Stakeholders on the Importance of the Special Diabetes Program for Indians

On Tuesday, October 27 the National Indian Health Board (NIHB), along with the Endocrine Society and the Juvenile Diabetes Research Foundation (JDRF), hosted a virtual briefing to educate Congressional staff about the Special Diabetes Program for Indians (SDPI) and the Special Diabetes Program (SDP) and its importance of extending both programs before the continuing resolution expires on December 11, 2020. Together, all three organizations are advocating for a long-term reauthorization of 5 year and $150 million per program per year.

Earlier in October, the Indian Health Service (IHS) announced the release of their 2020 Special Diabetes Program for Indians (SDPI) Report to Congress, Changing the Course of Diabetes: Charting Remarkable Progress. This new report highlights SDPI's ongoing and outstanding contributions to improvements in diabetes care and health outcomes for American Indian and Alaska Native (AI/AN) people. In the report, Ann Bullock, Director of the IHS Division of Diabetes states, "These improvements have huge implications for quality of life and health care costs. Sustained efforts in diabetes prevention and treatment are critical to ensuring continued advances in the health of AI/AN people. The SDPI has been, and continues to be, key to this remarkable progress." A recording of the virtual briefing may be viewed here.



Posted October 22, 2020

NIHB joined by partner organizations in letter to IHS regarding National Tribal Budget Formulation Workgroup

On Tuesday. October 13, 2020, National Indian Health Board (NIHB) submitted a letter to Indian Health Service (IHS) Director Michael D. Weahkee outlining NIHB’s strong concerns with loss of NIHB’s funding to support the critical work of the National Tribal Budget Formulation Workgroup (TBFWG). For decades, NIHB has been entrusted by Tribal Nations to help facilitate the national convening of the TBFWG and in drafting and publishing an annual budget book detailing the priorities and recommendations of Tribes across Indian Country towards a fully funded and operational Indian health system. NIHB was joined by Alaska Native Health Board, Albuquerque Area Indian Health Board, Association of American Indian Physicians, California Rural Indian Health Board, Northwest Portland Area Indian Health Board, Rocky Mountain Tribal Leaders Council, Southern Plains Tribal Health Board and United South & Eastern Tribes, Inc. as signatories on this letter.

Read the letter



September 30, 2020

Congress Sends Short-Term FY 2021 Continuing Resolution to President's Desk

Earlier today, Wednesday, September 30, 2020, the U.S. Senate passed the short-term continuing resolution (CR) that cleared the U.S. House of Representatives last week. The final vote was 84-10.

As NIHB reported, this CR, filed under H.R. 8319, would flat fund the federal government at FY 2020 enacted levels through December 11, 2020. It would also extend the Special Diabetes Program for Indians (SDPI) through December 11 - equaling the fifth short-term extension of the program in just the past year. The President is set to sign the CR before midnight, when the next fiscal year officially begins.

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September 21, 2020

House Introduces Short-Term Continuing Resolution for Fiscal Year 2021

Earlier today, Monday, September 21, 2020, the House of Representatives released a short-term continuing resolution (CR) for Fiscal Year (FY) 2021 under H.R. 8319, in hopes of avoiding a government shutdown at the end of the month and funding the federal government at current levels through December 11, 2020. The CR includes an extension of multiple expiring health programs including the Special Diabetes Program for Indians (SDPI) through December 11, the expiration date for the CR itself. This would equal the fifth short-term extension of SDPI in just the past year alone. With SDPI's current reauthorization set to expire on November 30, this extension under H.R. 8319 would last eleven days.

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Posted September 14, 2020

NIHB sends Joint Letter to Congressional Leadership for extension of SDPI and other health provisions

On Friday September 11, NIHB submitted a letter to Speaker Pelosi, Senate Majority Leader McConnell, House Minority Leader McCarthy, and Senate Minority Leader Schumer, urging immediate action in support of a 5-year extension of the Special Diabetes Program for Indians (SDPI) and other expiring health extenders. These include the National Health Service Corps, Community Health Center Fund, and Teaching Health Centers Graduate Medical Education. NIHB was joined by seventeen signatories including but not limited to JDRF, Endocrine Society, National Association of Community Health Centers, American Diabetes Association, Families USA, and the American College of Obstetricians and Gynecologists.

Read the full letter.



Posted September 11, 2020

NIHB sends letter urging IHS to retract and correct its TA to Congress regarding funding methods for SDPI

Earlier today, the National Indian Health Board (NIHB) sent a letter to the Indian Health Service (IHS) regarding the Technical Assistance it provided to Congress on the funding mechanisms for the Special Diabetes Program for Indians (SDPI) in July.

The letter urges IHS to retract its misleading TA, and instead work with Tribes to advance the proven method of self-determination and self-governance in furtherance of federal Treaty obligations to Tribal Nations and AI/AN Peoples.

Read the full letter.



Posted September 9, 2020

NIHB Leads Efforts for a Joint Letter to Congressional Leadership on Pandemic Relief Funding

On September 8, NIHB submitted a letter to congressional leadership alongside the National Congress of American Indians and National Council of Urban Indian Health urging immediate action on critical Tribal health priorities in response to COVID-19. In particular, the inter-organizational letter led by NIHB calls on Congress to immediately pass:

  • Minimum $2 billion in emergency funds to IHS for immediate distribution to the I/T/U system
  • Minimum $1 billion to replenish lost 3rd party reimbursements across the I/T/U system
  • Prioritize equitable distribution of a safe and effective COVID-19 vaccine across Indian Country, including a minimum 5% set-aside in vaccine funds for the I/T/U system
  • Minimum $1 billion for water and sanitation systems across IHS and Tribal communities
  • Passage of the bipartisan S.3937 – Special Diabetes Program for Indians Reauthorization Act of 2020

Read the full letter



Posted July 30, 2020

NIHB Sends Letter to Congressional Appropriators Urging Dedicated Funding to Indian Country for COVID-19 Vaccines

On July 30, 2020, NIHB joined by the National Congress of American Indians and National Council of Urban Indian Health submitted a letter to House and Senate appropriators urging them to ensure a minimum 5% statutory set-aside in funding for COVID-19 vaccine distribution for the Indian Health Service, Tribal Nations, and urban Indian organizations in this next COVID-19 pandemic relief package.

Read the full letter here.



Posted July 29, 2020

NIHB Leads Efforts for Joint Letter to Congress Opposing Policy Changes to Medicaid FMAP

On Tuesday July 27, the National Indian Health Board (NIHB) sent joint a letter to Congress firmly opposing any policy that would undo decades of precedent in federal Medicaid policy towards Tribal Nations by extending 100% Federal Medical Assistance Percentage (FMAP) to States for Medicaid services rendered by providers outside the Indian health system to American Indians/Alaska Natives. This policy would seek to stabilize state Medicaid programs at the direct expense of the Indian health system, and runs contrary to federal trust and treaty obligations.

NIHB joined Tribal Nations, National Congress of American Indians, National Council of Urban Indian Health, and multiple regional Tribal organizations in this important advocacy. NIHB encourages all Tribal Nations and organizations to join us in showing that Indian Country is uniformly opposed to this provision by sending similar letters. Please find this template letter on NIHB's Tribal COVID-19 Resource Center. Read the joint letter here.



Posted July 22, 2020

National Indian Health Board Supports House Bill to Require Veterans Health Administration to Reimburse Indian Health Providers

WASHINGTON, DC—July 22, 2020—The National Indian Health Board (NIHB) Acting Chairman William Smith testified today before the Subcommittee for Indigenous Peoples of the United States (SCIP) for a legislative hearing on the “PRC for Native Veterans Act” (H.R. 6237). This critical bill would amend the Indian Health Care Improvement Act to clarify that the Veterans Health Administration (VHA) and the Department of Defense are required to reimburse the Indian Health Service (IHS) and Tribal health programs for healthcare services provided to Native veterans through an authorized referral. Acting Chairman Smith, who is a Vietnam veteran, stressed that third-party reimbursement adds funds to the IHS Purchase/Referred Care (PRC) system so specialty services can be purchased and reiterated that the government has a dual responsibility to Native veterans.

Read the full release



Posted July 17, 2020

National Indian Health Board Cites Failed U.S. Policies Toward American Indians for Severe COVID-19 Impacts in Testimony Before U.S. Commission on Civil Rights

WASHINGTON, DC—July 17, 2020— The National Indian Health Board (NIHB) Acting Chairman William Smith from the Valdez Native Tribe of Alaska testified before the U.S. Commission on Civil Rights as part of a virtual public briefing, titled: COVID-19 in Indian Country: The Impact of Federal Broken Promises on Native Americans. In his oral remarks before the Commission, Acting Chairman Smith discussed the federal government’s failure to fulfill its treaty obligations to the Tribes for healthcare and public health, made evident by chronic underfunding of Indian Health Service (IHS), paternalistic oversight over Tribal programs and reluctance to expand self-determination and self-governance policies across federal agencies. The federal government’s failure to honor treaty obligations is directly tied to the disproportionate and extreme impacts of COVID-19 in Indian Country.

Read the full press release.



Posted July 9, 2020

Appropriations Committee Releases FY 2021 Report with Line ItemHouse Totals for IHS Budget

Each IHS Line Item Received At Least Slight Increase Over FY 2020 Levels

As NIHB reported earlier this week , the House Appropriations Subcommittee for Interior, Environment, and Related Agencies released its Fiscal Year (FY) 2021 spending bill, proposing to fund Indian Health Service (IHS) at just under $6.5 billion, an increase of $445 million overall above the FY 2020 enacted budget...

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Posted July 6, 2020

House Releases FY 2021 Budget for Indian Health Service

House FY 2021 Interior, Environment, and Related Agencies bill proposes funding Indian Health Service at $6.5 billion, with a separate, additional $1.5 billion in emergency funds for IHS Facilities

On Monday, July 6, 2020 the House Appropriations Subcommittee for Interior, Environment, and Related Agencies released its Fiscal Year (FY) 2021 spending bill, which has jurisdiction over the Indian Health Service (IHS) budget. Posting of the FY 2021 Interior spending bill follows the rapid release of four other FY 2021 spending bills earlier today and on Sunday July 5, in line with the full Committee's goal of marking up all twelve FY 2021 appropriations packages this week after months of inaction on appropriations due to the COVID-19 pandemic...

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Posted July 2, 2020

NIHB Continues to Educate Lawmakers, Requests Support from Senate Committee on Indian Affairs on Coronavirus Tribal Health Priorities

WASHINGTON, DC—July 1, 2020—Today, National Indian Health Board (NIHB) Secretary Lisa Elgin from the Manchester-Pt. Arena Band of Pomo Indians in California testified virtually before the Senate Committee on Indian Affairs (SCIA) during a hearing to "Evaluate the Response and Mitigation to the COVID-19 Pandemic in Native Communities." Secretary Elgin outlined top Tribal health and public health priorities in response to COVID-19 – some of which fall squarely under the Committee's jurisdiction, and others that rely on individual members to work with their colleagues serving on other committees.

"The National Indian Health Board continues to educate lawmakers on the devasting impacts of COVID-19 in Tribal communities. We urge increases to relief funding to address pressing Tribal health and public health priorities like water and sanitation, telehealth, electronic health records and reauthorization of the Special Diabetes Program for Indians," said NIHB Secretary Elgin, who also serves as the chairperson for the California Rural Indian Health Board.

Read the full release.



Posted June 23, 2020

NIHB Urges House Veterans Committee to Invest in Health IT, Electronic Health Records to Improve Native Veterans Care Beyond COVID-19 Pandemic
NIHB also shares care coordination challenges between VHA and IHS during the pandemic.

WASHINGTON, DC – June 23, 2020 – Today, the National Indian Health Board (NIHB) Vice Chair Chief Bill Smith from the Valdez Tribe of Alaska testified before the House Committee on Veterans Affairs, Subcommittee on Health and Subcommittee on Technology Modernization on the state of health for American Indian and Alaska Native (AI/AN) Veterans during the COVID-19 pandemic. The hearing titled, "VA Telehealth During the COVID-19 Pandemic: Expansion and Impact," provided an opportunity for NIHB to share its priorities for the Veterans Health Administration (VHA), including significant investments in Health Information Technology (HIT) and Electronic Health Records (EHR).

Read the full release.
Read the full testimony.



June 22, 2020

House of Representatives Introduces $1.5 Trillion Infrastructure Package - Outlines Important Tribal Health Funding

Today, the House of Representatives introduced a major, $1.5 trillion infrastructure package, titled H.R. 2 - The Moving Forward Act. The behemoth bill makes significant and wide-ranging investments into critical infrastructure nationwide including for roads and bridges, transit systems, education, green energy development, broadband, and healthcare.

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Posted June 12, 2020

National Indian Health Board Urges Congress to Include Tribal Priorities in Next Coronavirus Package, Pass IHS Budget with Meaningful Increases

WASHINGTON, DC—June 12, 2020—This week, the National Indian Health Board (NIHB), in a series of advocacy-driven engagements with Members of Congress, outlined for lawmakers a robust and comprehensive list of Tribal health and public health priorities that must be included in the next Coronavirus relief package in order for Tribes to address the pandemic and other related critical healthcare issues, including increased funding for telehealth and electronic health records, Medicare and Medicaid reimbursement provisions for Indian Health Care Providers and investments in water and sanitation. NIHB is also calling for meaningful increases to the Indian Health Service (IHS) Fiscal Year (FY) 2021 appropriations.

Read the full press release.



Posted June 3, 2020

NIHB Submits Letter to Senate Leadership on Tribal Priorities for next COVID-19 Relief package

On Tuesday June 2, NIHB submitted a letter to Senate Majority Leader McConnell and Minority Leader Schumer urging that as the U.S. Senate negotiates the next COVID-19 relief package, that they maintain and build upon each of the critical Tribally-specific funding and legislative provisions included in the Health and Economic Recovery Omnibus Emergency Solutions or “HEROES” Act. Specifically, NIHB requested:

  • At least $1 billion investment in water and sanitation development in Indian Country
  • Technical fixes to maximize third party revenue from Medicare and Medicaid
  • Permanent reauthorization of the Special Diabetes Program for Indians

Read the Full Letter



Posted April 22, 2020

Senate Confirms Rear Admiral Michael Weahkee as Director of the Indian Health Service

Excerpt: WASHINGTON, DC—April 22, 2020—The National Indian Health Board extends congratulations to Rear Admiral (Rear Adm.) Michael Weahkee who was confirmed on April 21, 2020 by the U.S. Senate as the Director of the Indian Health Service (IHS) for a four-year term. In this capacity, Rear Adm. Weahkee will continue the responsibility for administering health care to American Indians and Alaska Natives nationwide in IHS, Tribal and urban (ITU) health settings. Director Weahkee has served as the interim head of the agency for the past three years and has proven to be an effective leader of IHS through consistent, responsive and collaborative management in times of grave challenges and limited resources.

Read full release



Posted April 13, 2020

NIHB, Native Organizations Request Over $8 billion for the Indian Health System Ahead of Fourth Congressional COVID-19 Funding Package


Request includes funding for hospitals, equipment and specialty care.

WASHINGTON, DC—April 10, 2020—In active nationally coordinated effort to ensure Tribes are meaningfully included in COVID-19 relief funding, the National Indian Health Board (NIHB) along with a coalition of 10 national and regional Tribal organizations sent a letter outlining Tribal health care and public health priorities to House Speaker Nancy Pelosi, Senate Majority Leader Mitch McConnell, Senate Minority Leader Chuck Schumer, and House Minority Leader Kevin McCarthy late Wednesday night. The letter includes a robust and comprehensive list of Tribal priorities, including over $8 billion in funding for the Indian health system, in addition to multiple legislative priorities such as maximizing third-party health care revenue streams and ensuring Indian Country has direct access to the Strategic National Stockpile...

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March 17, 2020

Congress Introduces Measures to Address Tribal Public Health Needs Related to COVID-19

On Sunday, March 16, 2020, the National Indian Health Board (NIHB) sent a letter to House and Senate Appropriations Committee staff expressing support for the passage of H.R. 6201, or the “Families First Coronavirus Response Act.” This legislation injects an additional $64 million into the Indian Health Service (IHS) IHS Services Account and includes a provision requiring the U.S. Department of Health and Human Services (HHS) Secretary to cover coronavirus testing costs for all American Indians/Alaska Natives (AI/ANs) regardless of where the test is administered.

On Tuesday, March 17, 2020, Senator Elizabeth Warren (D-MA) and Vice Chairman of the Senate Committee on Indian Affairs Tom Udall (D-NM) introduced the Tribal Medical Supplies Stockpile Access Act, which would guarantee the IHS, Tribal health authorities, and urban Indian organizations have access to the Strategic National Stockpile (SNS), a federal repository of drugs and medical supplies that can be tapped if a public health emergency could exhaust local supplies.

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March 12, 2020

Sen. Udall Introduces Tribal Public Health Security and Preparedness Bill

Today Thursday March 12, U.S. Senator Tom Udall (D-NM), Vice Chairman of the Senate Committee on Indian Affairs, introduced the CDC Tribal Public Health Security and Preparedness Act. This legislation would ensure Tribes have direct access to Public Health Emergency Preparedness (PHEP) funds from the Centers for Disease Control and Prevention (CDC). Under current law, Tribes are not eligible to apply for PHEP funds. The bill includes a baseline requirement to fund at least ten Tribes for emergency preparedness, and also exempts Tribes fro having to put forth any matching funds. In addition, the bill waives many of the onerous reporting requirements that are imposed on state PHEP grantees. The full text of the CDC Tribal Public Health Security and Preparedness Act is available here.

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March 4, 2020

Congress Agrees to $8.3 Billion Coronavirus Emergency Funding

Today, House and Senate negotiators introduced an $8.3 billion package aimed at tackling the recent spread of COVID-19 ("coronavirus") in the United States. The package, under H.R.6074, provides billions of dollars to spearhead medical research and vaccine development, provide relief to local businesses impacted by the coronavirus, and bolster preparedness and response efforts for state, local, Tribal, and urban Indian health entities. Roughly $3 billion is allocated to the National Institutes of Health for research into vaccines, therapeutics, diagnostics, and other measures. In addition, $1 billion is allocated for purchasing of pharmaceuticals and medical supplies and another $264 million is to bolster operations at the U.S. Department of State. For a summary of the bill, click here.

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February 11, 2020

NIHB Testifies Before House Interior Appropriations Subcommittee

Today, National Indian Health Board (NIHB) Chair and Great Plains Area Representative, Victoria Kitcheyan, testified on behalf of NIHB for the annual American Indian and Alaska Native Public Witness Hearings on the Fiscal Year (FY) 2021 Indian Health Service (IHS) budget before the House Appropriations Subcommittee on Interior, Environment, and Related Agencies. To access NIHB's written testimony, click here.

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Posted: February 10, 2020

President Releases FY 2021 Budget Request

Includes some increases to IHS line items; major cuts to IHS also proposed

Today, the Trump Administration released the President's Fiscal Year (FY) 2021 Budget Request. The release of the President's Budget officially kicks off the FY 2021 appropriations cycle, which continues in earnest tomorrow with the American Indian and Alaska Native Public Witness Hearings on the FY 2021 budget before the House Appropriations Subcommittee on Interior, Environment, and Related Agencies. As NIHB reported last week, Chairwoman and Great Plains Area Representative, Victoria Kitcheyan, will be testifying on behalf of NIHB...

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Congress Must Hear from Indian Country NOW on 5-Year Renewal of the Special Diabetes Program for Indians

The National Indian Health Board (NIHB), National Congress of American Indians (NCAI), and National Council of Urban Indian Health (NCUIH) are working closely together to ensure that Congress passes a 5-year renewal of the Special Diabetes Program for Indians (SDPI) before it expires on May 22, 2020. But lawmakers NEED to hear directly from Tribes, Tribal organizations, and urban Indian organizations urging them to swiftly pass a 5-year reauthorization NOW!

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Legislative Inquiries:

Erin Morris
Interim Director, Congressional Relations

910 Pennsylvania Ave, SE
Washington, DC 20003
Phone: 202-507-4085
Email: [email protected]