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GAO Report Calls for VA and IHS to Strengthen Oversight and Coordination of Health Care for Native Veterans
The Government Accountability Office (GAO) released a report with updated information on the Department of Veterans Affairs' (VA) and the Indian Health Service's (IHS) efforts to implement their Memorandum of Understanding (MOU) to improve the health status of American Indian and Alaska Native (AI/AN) veterans through coordination and resource sharing among VA, IHS, and Tribes.
The GAO report focuses on implementation of the MOU since June 2014, the last time that GAO released a report on the topic. The GAO found that while the MOU had identified goals, there were not any sufficient measures for assessing progress. In some cases, a performance measure was established but lacked a target to measure performance. Overall, the GAO made three recommendations to strengthen the oversight and coordination of healthcare for AI/AN Veterans:
- Establish measurable targets for performance measures at the VA;
- Establish measurable targets for performance measures at the IHS;
- Establish written guidance at the VA for referring AI/AN Veterans to VA facilities for specialty care.
Both agencies have concurred with the reporting and have said they are currently in process of revising the MOU and updating their performance measures.
Click here to read the full GAO Report.
Posted: April 16, 2019
Congress Misses Budget Deadline
The House and Senate have failed to pass a budget resolution by the April 15 deadline, meaning that future spending negotiations will lack an agreed upon outline.
Congress is currently in recess, so members are working in their home states. When Congress returns to Washington on April 29, Speaker Pelosi and Senate Majority Leader McConnell plan to begin negotiations on a budget agreement for Fiscal Year 2020. These talks will be crucial to developing a spending agreement as Congress works to avoid sequestration.
Congress has successfully averted sequestration, the across the board spending cuts that are automatically triggered if Congress does not appropriate money within its established spending caps, every year since 2013. In 2011, Congress passed the Budget Control Act in an effort to control spending by applying sequestration across every federal department and agency on every fiscal year until 2021 unless Congress agrees to impose spending caps on itself.
In a failure to uphold the trust responsibility, the 2013 sequestration impacted the Indian Health Service and Indian Country. For more information on NIHB's work to protect the Indian health system from sequestration, click here.
Posted: April 16, 2019
HHS Annual Tribal Budget Consultation April 23 - 24
The HHS Annual Tribal Budget Consultation will be hosted by HHS next week on April 23 - 24, 2019 in Washington, DC. Click here for the Dear Tribal Leader Letter (DTLL) announcing the session and here for the final agenda.
A planning call for any final questions will be held Wednesday, April 17 at 3:00 PM ET. Call details can be found in the attached DTLL.
If you plan to attend the consultation, please RSVP to [email protected] with your name, title, and Tribe. If you plan on sending a designee, they should also RSVP.
*Please note, per the HHS Tribal Consultation Policy, non-elected Tribal designees must present a letter of designation on Tribal letter head to IEA before participating in the consultation.
Posted: April 8, 2019
Last week, the U.S. Department of Justice (DOJ) sent a one-page letter to the 5th Circuit Court of Appeals, supporting a Federal District Court's ruling from December 2018 that invalidated the entire Patient Protection and Affordable Care Act (ACA)
The case holds tremendous potential for impact to Indian Country. The ACA incorporated the Indian Health Care Improvement Act (IHCIA) through reference and was permanently reauthorized when Congress passed the ACA. In addition to the IHCIA, the ACA included other important Indian-specific provisions integral to the Indian health system. A court ruling that invalidates the ACA also jeopardizes the IHCIA and Indian specific provisions of the ACA.
The National Indian Health Board (NIHB), along with 483 Tribes and Tribal organizations, worked with the law firm of Hobbs Straus Dean & Walker, LLP to file an amicus brief that argues that the IHCIA and Indian-specific provisions are “severable” from the ACA and should be protected no matter what the 5th Circuit decides with respect to the rest of the ACA. That brief was filed on April 1.
On April 4, 2019, NIHB Director of Policy Devin Delrow took part in an interview with Montana Public Radio regarding protecting the Indian Health Care Improvement Act (IHCIA). Listen to the interview here: https://www.mtpr.org/post/native-health-advocates-weigh-obamacare-repeal-case
Posted: April 4, 2019
HRSA announces upcoming webinar on the Shortage Designation Modernization Project (SDMP).
The webinar will provide information about the national update of automatically designated Health Professional Shortage Areas (HPSA) for summer 2019. The webinar will also provide dedicated time for Tribes and Urban Indian organization leaders to provide input on the project.
You can view the full announcement here.
Posted: April 1, 2019
NIHB CEO, Stacy A. Bohlen, Speaks About Opioid Crisis in Indian Country on Democracy Now!
The opioid epidemic is one of the most pressing public health crises facing Indian Country. As of 2017, American Indians and Alaska Natives (AI/ANs) experience the second highest opioid overdose mortality rate nationwide at 15.7 deaths per 100,000. Drug overdose death rates increased 519% among AI/ANs from 1999-2015 – the sharpest such increase of any group nationwide. Tribal communities face significant challenges in turning this tide. Some of these obstacles include industry opioid dumping in Indian Country, overuse of opioids as a place-holder for unfunded medical treatments, critical shortages of medical and public health practitioners, poverty and chronic underfunding of the Indian health system. On March 27, 2019 NIHB’s Chief Executive Officer, Stacy A. Bohlen, joined DEMOCRACY NOW! to discuss the state of the opioid crisis in Indian Country and shared insight on the challenges and successes towards achieving healing and recovery for all American Indians and Alaska Natives. You can view this Democracy Now! Show here: https://www.democracynow.org/2019/3/27/an_invisible_crisis_native_american_tribes
Posted: March 26, 2019
IHS Congressional Justification for FY 2020 Now Available
On Monday, March 25, 2019, the Indian Health Service (IHS) released its Congressional Justification (CJ) which provides additional details in support of President Trump's Budget proposal priorities to enhance the health and well-being, strengthen direct medical services and expand efforts to improve medical quality at IHS facilities.
You can view the full CJ here.
Posted: March 11, 2019
President's FY 2020 Budget Request to Congress Released
Major Cuts to Domestic Spending
Today the President released his fiscal year (FY) 2020 Budget Request to Congress. This document contains funding recommendations to Congress as it begins to draft next year's appropriations bills.
Additional details on the FY 2020 request will be available in the coming weeks, but you can read the overall budget request here and the HHS Budget in Brief here (Indian Health Service (IHS) starts on page 36). You can also view the recommendations of the Tribal Budget Formulation Workgroup for FY 2020 here...
Posted: March 7, 2019
NIHB Testifies in front of Appropriations Subcommittee on Interior, Environment, and Related Agencies
On March 6, 2019, NIHB Chairwoman Victoria Kitcheyan of the Winnebago Tribe of Nebraska, testified before the House Appropriations Subcommittee on Interior, Environment, and Related Agencies. This was part of a two day public witness hearing that is focused on Tribal programs. The Subcommittee holds public witness hearings annually and provides an opportunity for testimony regarding the Indian Health Service, Bureau of Indian Affairs, and other critical Tribal programs...
Posted: March 5, 2019
NIHB Elects New Executive Board, Takes to Capitol Hill
On February 26, 2019, during the National Indian Health Board's 2019 quarterly Board of Directors Meeting, members of the Board held elections for the positions of Chairperson, Vice-Chair, Member-at-Large, and Secretary...
Posted: March 5, 2019
Advance Appropriations Support Letter - Outreach Needed!
The Co-Chairs of the Congressional Native American Caucus are circulating a Congressional sign on letter to the Chairman and Ranking Member of the House Budget Committee to support advance appropriations for the Indian Health Service (IHS) and the Bureau of Indian Affairs (BIA).
As noted above, advance appropriations would mean that the IHS budget would be enacted one year in advance of the fiscal year. This would mean IHS and BIA would not be subject to government shutdowns and continuing resolutions if Congress cannot get the budget passed by the start of the fiscal year. The recent 35-day partial government shutdown demonstrated the urgency to enact Advance Appropriations for programs serving Indian Country.
We are requesting that you contact your Representatives and encourage them to sign onto the letter. The deadline to sign onto the letter is Friday, March 8...
Posted: March 5, 2019
SDPI Letter Circulating on Capitol Hill - Tribal Outreach Needed!
The Co-Chairs of the House Diabetes Caucus are circulating a Congressional sign on letter to House leadership supporting the Special Diabetes Program, which funds type-1 research, and the Special Diabetes Program for Indians (SDPI), which supports Tribal programs focused on diabetes prevention and treatment.
Congressional authorization for SDPI will expire on September 30, 2019 unless Congress renews the program. Currently, legislation in the Senate would renew SDPI for five years at the current funding level of $150 million per year. House legislation will be introduced in the near future. The letter from the Diabetes Caucus will be a useful tool for advocates of SDPI, so NIHB is working to ensure as many congressional offices as possible sign onto the letter...
Posted: February 26, 2019
Input Needed on HIV and Viral Hepatitis Prevention in Indian Country
The federal government is seeking direct input from stakeholders on two key strategic documents that guide federal programmatic and policy decisions - the National HIV/AIDS Strategy (NHAS) and the National Viral Hepatitis Action Plan (NVHAP). NIHB is collecting comments, input, stories, and information on HIV and viral hepatitis prevention, care and treatment in response to this request for information. NIHB will bring together the comments from across Indian Country to submit to the U.S. Department of Health and Human Services, Office of HIV/AIDS and Infectious Disease Policy to inform the creation of the next iterations of the National HIV/AIDS Strategy and the National Viral Hepatitis Action Plan...
Posted: February 26, 2019
Latest Draft of Amicus Brief in Affordable Care Act Lawsuit Now Available - Tribal Nations and Organizations Encouraged to Sign-On
The law firm Hobbs, Straus, Dean & Walker is leading efforts to file an amicus brief on behalf of Tribal Nations and Tribal organizations in response to the December 2018 decision by a district court in Texas that ruled the entire Patient Protection and Affordable Care Act (ACA) to be unconstitutional. The Court's ruling was based on the premise that, because the individual mandate is an essential component of the ACA, that Congress' elimination of the tax penalty associated with the mandate in the Tax Cuts and Jobs Act of 2017 rendered the entire legislation unconstitutional. The ruling has faced heavy criticism from both ends of the political aisle and is currently on appeal in the United States Court of Appeals for the Fifth Circuit...
Posted: February 20, 2019
Trump Signs Budget Deal, IHS Funded Through September
Last Friday, February 15, 2019, President Trump signed legislation funding federal agencies through the end of Fiscal Year (FY) 2019 and ending the risk of a second 2019 government shutdown. With this legislation now signed into law, all federal agencies are funded through the end of the fiscal year.
Overall, the Indian Health Service (IHS) will receive $5.8 billion in FY 2019, an increase over FY 2018's $5.5 billion. This continues a historic trend of bipartisan budget increases for the agency, although the Tribal Budget Formulation Workgroup recommended $6.4 billion for IHS in 2019.
Posted: February 20, 2019
National Indian Health Board Co-Chairs National Partnership for Dental Therapy
After 15 years of practice in the United States, dental therapists are expanding access to oral health care in a number of states where they practice as part of dental teams. Despite the documented success, the majority of people in Indian Country and in the U.S. as a whole cannot get care from these dental professionals.
Community Catalyst and the National Indian Health Board are launching the National Partnership for Dental Therapy to accelerate the authorization of dental therapists nationwide so that people can get care where and when they need it, in their own communities.
Posted: February 20, 2019
SDPI Renewal Efforts Already Underway, Your Help Needed!
The Special Diabetes Program for Indians (SDPI) is one of the most successful public health programs in Indian Country. During the lifetime of the program, the rate of End Stage Renal Disease among the American Indian/Alaska Native population has plummeted by 54%!
Without renewal from Congress, the program will expire on September 30, 2019. The House Diabetes Caucus, led by Reps. Diana DeGette (D-CO) and Tom Reed (R-NY) have issued a letter to House leadership asking for their support for SDPI and the Special Diabetes Program (SDP), which funds research into Type 1 Diabetes. A letter for Senators will be available in the near future. The last time a letter for SDP and SDPI was circulated, over 75% of Congress signed on!
Posted: February 14, 2019
Congress Reaches Deal to Avert Government Shutdown
Passage Expected Today
Congressional leaders have submitted legislation that would end the funding impasse over border security by providing $1.375 billion for physical barriers on the U.S.-Mexico Border. The 1,100-page legislation also contains funding for 9 other federal departments and dozens federal agencies - including the Indian Health Service (IHS) - through September 30, 2019...
Posted: February 12, 2019
Congress Continues Exploring IHS Budget Solutions
On Friday, February 8, Congresswoman Betty McCollum (D-MN) and Congressman Don Young (R-AK) introduced two bipartisan bills to authorize advanced appropriations for essential Tribal services that are funded by the federal government. Congresswoman McCollum's bill, H.R. 1128, the Indian Programs Advanced Appropriations Act (IPAAA), would provide advanced appropriations to the Bureau of Indian Affairs, the Bureau of Indian Education, and the Indian Health Service. Congressman Young's, H.R. 1135, the Indian Health Service Advance Appropriations Act of 2019 provides advance appropriations authority for the Indian Health Service. Advance appropriations make funding available one year or more after the year of the appropriations act in which it is contained. Both bills are cosponsored by the Co-Chairs of the Native American Caucus, Congressman Tom Cole (R-OK) and Congresswoman Deb Haaland (D-NM)...
Posted: February 12, 2019
Administration Announces Goal of Ending New HIV Infections by 2030
HHS Releases Request for Information on Updating the National HIV/AIDS Strategy and National Viral Hepatitis Action Plan
During his 2019 State of the Union Address, President Trump announced that his Administration will be putting forth a national strategy for ending new HIV infections in the United States by the year 2030. In addition to the President's announcement, on Friday February 8, the U.S. Department of Health and Human Services (HHS) posted a request for information (RFI) on the Federal Register soliciting public comment on the next iteration of the National HIV/AIDS Strategy (NHAS) and the National Viral Hepatitis Action Plan (NVHAP) - both of which currently expire next year.
Posted: February 5, 2019
Office of National Drug Control Policy Releases 2019 National Drug Control Strategy Report
The Office of National Drug Control Policy (ONDCP) has released its annual report outlining the Administration's priorities and blueprint for addressing drug addiction and trafficking nationwide. Located in the Executive Office of the President, the ONDCP is the principal office that coordinates drug control and response efforts across all federal agencies involved in prevention, treatment and interdiction including the Substance Abuse and Mental Health Services Administration, Drug Enforcement Agency, and Food and Drug Administration...
Posted: February 5, 2019
Bernhardt Announced as New Interior Secretary
On Monday, President Trump announced that David Bernhardt would be the next Secretary of the Interior. Bernhardt has served as Acting Secretary since former Secretary Ryan Zinke announced his departure from the agency in January. Bernhardt's background is in energy and natural resources policy.
Because the Department of the Interior oversees the Bureau of Indian Affairs and the Bureau of Indian Education, as well as other agencies working in Indian Country, the Secretary often works closely with Tribes. The position is subject to confirmation by the Senate.
Posted: January 29, 2019
Udall Introduces Bill to Protect Tribal Health from Future Shutdowns
The Vice Chairman of the Senate Committee on Indian Affairs, Senator Tom Udall (D-NM), introduced legislation to protect the Indian Health Service (IHS), the Bureau of Indian Affairs, and the Bureau of Indian Education from future shutdowns. The legislation, the Indian Programs Advance Appropriations Act, would fulfill a longstanding Tribal health priority by providing advance appropriations to IHS, which means Congress would enact funding for the agency a year ahead of time. The shutdown, in which Tribes had to curtail health services or cut other services to keep health facilities open in the absence of funding from IHS, highlighted the need for a long term budget solution for Tribal programs...
Posted: January 29, 2019
Shutdown Ends, Government Funded Until February 15
Last Friday, President Trump signed a Continuing Resolution (CR) reopening the agencies that were subject to the federal government shutdown. Under the CR, these agencies, including the Indian Health Service, will receive funding through February 15, 2019.
Employees who had to work without pay during the shutdown or who were furloughed will receive back pay under the terms of the CR. These 800,000 employees had missed two pay checks during the shutdown. Additionally, the end of the shutdown means that the Indian Health Service can resume its payments to Tribes operating their own health systems, something the agency's leadership said it planned to do as soon as possible.
Posted: January 25, 2019
NIHB Submits Comments on Healthy People 2030 Framework
On January 17, 2019, NIHB submitted comments to the U.S. Department of Health and Human Services (HHS) on their proposed objectives for Healthy People 2030. Every ten years, the Healthy People initiative establishes core objectives and health topic areas to guide HHS in its efforts to improve the health of all Americans. The Healthy People framework acts as a blueprint that helps inform the major health goals and priorities of the department and its agencies including the Indian Health Service, Centers for Disease Control and Prevention, Substance Abuse and Mental Health Services Administration, and other agencies. The Healthy People initiative is managed by the Office of Disease Prevention and Health Promotion at HHS.
To access NIHB’s comments, click HERE. You can access all of NIHB’s Comments HERE.
To learn more about the Healthy People initiative, click HERE
Posted: January 25, 2019
White House Announces Deal to End Shutdown
Government to Reopen Until February 15
This afternoon, President Trump announced an agreement between himself and Congressional leaders to end the partial government shutdown, currently in its 35th day.
While this agreement will not supply funding for a border wall, the central issue of disagreement leading to the shutdown, the President said that Congress would study the issue.
Under the terms of the agreement, Congress will fund the closed agencies until February 15, 2019, at which point another deal will have to be reached. The 800,000 affected federal employees will return to work for that time period and also receive back pay for the past 35 days. This includes the employees of the Indian Health Service (IHS)...
Posted: January 19, 2019
CMS Grants Arizona Medicaid Waiver on Work Requirements - Exempts Members of Federally Recognized Tribes
Yesterday, the Centers for Medicare and Medicaid Services (CMS) approved Arizona's request for an amendment to add work and community engagement requirement to its Medicaid Program. As part of the approval by CMS, members of Federally Recognized Tribes will be exempted from work and community engagement requirements...
Posted: January 18, 2019
National Tribal Organizations Send Letter to President and Congressional Leadership Urging Action to End Shutdown
On January 10, 2019, eight national Tribal organizations, including the National Indian Health Board (NIHB), submitted a letter to the president and bi-partisan congressional leadership urging immediate action to end the partial government shutdown that is disproportionately impacting American Indian and Alaska Native Tribal Nations. The letter highlighted the shutdown’s impact on Tribal economies, access to healthcare, Tribal self-governance, and Indian housing, education, nutrition, and child welfare.
To read the letter, click HERE (PDF)
To read the accompanying statement, click HERE (DOC)
Posted: January 11, 2019
National Native Organizations Unite and Urge the President and Congress to Re-Open the Government
WASHINGTON, D.C. | On the 20th day of the government shutdown, eight national Native organizations are jointly urging the President and Congress to immediately end the partial government shutdown, which breaks the treaty and trust obligations the federal government owes to tribal nations. The organizations jointly sent a letter to Congress and the President outlining the wide-ranging impacts of the shutdown on Indian Country.
America’s longstanding, legally-mandated obligations to tribal nations should be honored no matter the political quarrels of the moment. “During this shutdown, Congress and the President are putting the well-being of our tribal nations and our citizens in jeopardy. As governmental leaders, we know that it is simply not an option to stop serving our citizens. On behalf of Indian Country, we urge the President and Congress to do their jobs and reopen the government immediately,” said National Congress of American Indians (NCAI) President Jefferson Keel...
Posted: January 10, 2019
Government Shutdown Puts the Public’s Health at Risk; Potential for Harm Increases as Impasse Continues
As the government shutdown reaches its 20th day, leaders across a spectrum of health, public health and civil rights organizations call on Congress and the President to immediately reopen the government.
The ongoing shutdown is having a negative impact on the public’s health, both directly and by impacting other factors that influence health such as nutrition support programs at the Department of Agriculture and rental assistance programs at the Department of Housing and Urban Development. That impact will only grow and become more detrimental if the shutdown continues...
Posted: January 7, 2019
Shutdown Continues into Second Week, Tribes Feeling Impact
Today is the 13th day of the partial government shutdown, and the federal agencies impacted are beginning to see their services effected as carry over funds diminish.
This shutdown is unlike others due to its limited impact: it only affects those agencies which have not been funded by Congress for the entirety of Fiscal Year (FY) 2019. Unfortunately, this includes the Department of Interior as well as the Indian Health Service. Other public health programs operating in Indian Country within HHS are funded and will continue without disruption...
Posted: January 4, 2019
Tell Congress How the Shutdown is Harming Your Tribe's Health!
Today, January 3, 2019, marks the 13th day of the partial government shutdown. The Indian Health Service (IHS) is one of the agencies affected by the lapse in funding, and both Direct Service and Self Governance Tribes have been impacted.
Even as IHS facilities remain open to provide medical care, Tribes are still feeling the impact of the shutdown. Due to the IHS's inability to provide funding to Tribes and many federal employees during the shutdown, many health programs and critical health services are unable to continue providing care...
Posted: January 4, 2019
Potential Government Shutdown Approaching:
Legislation Introduced to Keep IHS Funded
What Tribes Can Expect During & After a Shutdown
The federal government may be undergoing a partial shutdown if Congress fails to pass a Continuing Resolution (CR) by the end of the day today, December 21, 2018. At the time of this writing, it is unclear if the Congress and the President will reach an agreement to keep the government open by tonight. President Trump has indicated that he will not sign legislation that does not fund the border wall. Senate Democrats have said that they will not accept that option.
Posted: January 3, 2019
New Congress Sworn In, Pelosi Elevated to Speaker
Today the 116th Congress took the oath of office and began its two-year term. With Democrats in Control of the House and Republicans in the majority in the Senate, Congress is divided for the first time since 2014.
As NIHB detailed in a webinar analyzing the results of the 2018 midterm elections on Indian health, the new Congress includes four members of federally-recognized Tribes, the most ever in the history of Congress. Committee assignments for the two newly elected Tribal women, as well as the 88 other Congressmembers elected for the first time, will be known in the very near future.
As expected, former Speaker Nancy Pelosi (D-CA) reclaimed her place as the top member of the House, a post which she held from 2007-2011. While there had been some doubt as to whether the House Democrats would continue to support Pelosi, who has led the caucus since 2004, she won a crucial caucus vote following the 2018 elections. Pelosi has demonstrated familiarity with the federal government's trust responsibility to provide health to Tribes and has been a supporter of many of Indian Country's health priorities.
Posted: December 21, 2018
U.S. Commission on Civil Rights Releases Report on Federal AI/AN Funding Shortfalls
Today, December 20, 2018, the U.S. Commission on Civil Rights released "Broken Promises: Continuing Federal Funding Shortfall for Native Americans". The Commission evaluated whether the federal government is meeting its trust responsibilities to the Tribes by examining federal budgets and agency spending of on programs or initiatives designed to meet the needs of American Indian/Alaska Native (AI/AN) and Native Hawaiian communities, including programs under the Departments of Health & Human Services, Interior, Housing & Urban Development, Justice, and Education.
Posted: December 21, 2018
President Signs Farm Bill into Law; USDA to Release Proposed Rule on SNAP Work Requirements
On Thursday December 20, 2018, President Trump signed H.R. 2 - Agriculture Improvement Act of 2018 - better known as the "Farm Bill" into law. The 5-year reauthorization of the Farm Bill includes important gains in traditional food production, nutrition access, and agriculture infrastructure development for American Indian and Alaska Native (AI/AN) Tribes and Tribal communities...
Posted: December 20, 2018
GAO releases report on IHS funding levels compared to other federal health programs
On December 10, 2018, the Government Accountability Office (GAO), which acts as the "audit, evaluation, and investigative arm of Congress", published a report considering spending levels for the Indian Health Service (IHS), compared to three other federal health care providers. The report comes at the request of Congressional leaders on the Interior appropriations subcommittee of the House of Representatives.
In the report GAO compared the funding levels of IHS, the Veterans Health Administration (VHA), Medicare, and Medicaid. It looks at funding levels from 2013 through 2017 and analyzed budget and program documents from the four programs to determine total annual spending levels and spending on a per capita basis. The report found that IHS's per capita spending was $4,078, compared to $8,109 for Medicaid, $10,692 for VHA, and $13,185 for Medicare. The report highlights that IHS has a different by design form the other federal healthcare providers, in that it has smaller facilities that are more rural, and often offer mostly primary and emergency care services. In addition, the IHS and VHA depend on funding levels that are subject to the annual appropriations process, meaning that per capita spending could drop, with more people being served.
Posted: December 20, 2018
HHS Tribal Consultation Policy Deadline Extended by 90 days
On October 22, 2018, The Department of Health and Human Services (HHS), issued a Dear Tribal Leader Letter (DTLL), requesting feedback from Tribal representatives on HHS' Tribal Consultation Policy (TCP). The TCP is reviewed periodically. The original deadline for comments was December, 19, 2018 but thanks to Tribal advocacy, this deadline has been extended for 90 days and comments will now be due on Friday, March 15, 2019.
Specifically, HHS seeks input on:
The consultation mechanisms that work and those that do not; and
- What HHS can do to improve their activities to ensure an effective and meaningful Tribal Consultation Policy?
Comments can be sent to:
Stacey Ecoffey, Principal Advisor for Tribal Affairs
Office of Intergovernmental and External Affairs
U.S. Department of Health and Human Services
200 Independence Ave SW Room 620-E
Washington, DC 20201
Email: [email protected]
Posted: December 19, 2018
Federal District Judge Issues Ruling that the Affordable Care Act is Unconstitutional
On Friday December 14, 2018, United States District Judge for the Northern District of Texas, Reed O’Connor, ruled the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) to be unconstitutional after twenty states filed lawsuits in February 2018 arguing that the entire law was invalidated after congress repealed the individual mandate to purchase health insurance. The individual mandate – which was repealed as part of the Tax Cuts and Jobs Act of 2017 – was a central pillar of the health law that required individuals who could afford health coverage to obtain health insurance or face a financial penalty or tax.
Posted: November 12, 2018
Farm Bill Includes Important Provisions Promoting Tribal Health and Sovereignty
After months of negotiations, leaders from both the House and Senate Agriculture Committees came to an agreement on renewing the Farm Bill, which expired on September 30, 2018. On Tuesday December 12, the Senate passed the massive $867 billion legislation by a vote of 87-13, with the House set to vote on the bill this week. Tribes and Tribal organizations have long advocated for key provisions in the bill that improve food and nutrition access for American Indians and Alaska Natives. The Conference report on the 2018 Farm Bill was released Monday night and included many key Tribal provisions that support Tribal sovereignty and Tribal Health...
Posted: November 9, 2018
Congressional Co-Chairs of IHS Task Force Request Input from Tribal Leaders
Today, the Co-Chairs of the House of Representatives Indian Health Service (IHS) Task Force released a letter to Tribal leaders requesting information regarding the IHS' accessibility, resources, patient outreach, workforce, cost and other effectiveness metrics...
Posted: November 2, 2018
NIHB Analysis of H.R. 6 - SUPPORT for Patients and Communities Act
On October 24, 2018, the President signed into law H.R. 6 - SUPPORT for Patients and Communities Act - a comprehensive package of bills to address the opioid overdose epidemic.
Addressing the opioid crisis has been a top priority in Congress, and this legislation fulfills a long anticipated promise of delivering more federal dollars and resources to assist communities in their response efforts. Passed by margins of 98-1 in the Senate and 396-14 in the House, the bipartisan and bicameral support for passage of H.R. 6 speaks directly to the heightened national urgency to turn the tide on the epidemic...
Posted: September 27, 2018
Congress Passes Health Funding Bill
Trump to Sign Fiscal Year 2019 Labor-HHS Appropriations Bill and Continuing Resolution for Several Agencies
The House of Representatives last night passed H.R. 6157, the Fiscal Year (FY) 2019 Labor-HHS Appropriations bill, which contains funding for the Department of Health and Human Services (HHS) as well as the Departments of Labor, Education, and Defense. The bill funds these agencies until September 30, 2019.
H.R. 6157 also contains a Continuing Resolution (CR) funding several other agencies, including the Indian Health Service (IHS), until December 7, 2018...
Posted: September 25, 2018
Senate Passes Comprehensive Opioids Bill
Multiple Tribal Additions Included in Alexander Amendment
Today, the Senate passed its version of comprehensive opioids legislation. The Opioid Crisis Response Act (OCRA) passed as an amendment to H.R. 6, the Support for Patients and Communities Act, an opioids bill that passed the House on June 22, 2018.
The final version of OCRA, a bipartisan bill written by the Republican and Democratic leaders of the Health, Education, Labor, and Pensions (HELP) Committee, reflects many Tribal priorities and incorporates several suggestions from the National Indian Health Board (NIHB) and the Tribes. The original Senate bill, S. 2680, included Tribes in certain provisions...
Posted: September 10, 2018
NIHB Announces 2018 Jake White Crow Award Winner
The National Indian Health Board is pleased to announce that Congressman Tom Cole of Oklahoma (Chickasaw Nation) will receive the 2018 prestigious Jake White Crow Award. This award recognizes an individual or organization with outstanding lifetime achievements in elevating health care advocacy, raising awareness or affecting positive change for American Indian and Alaska Native health care.
The Congressman, one of only two American Indians in Congress, has been a champion for Indian Country throughout his career. He is a visionary leader in the U.S. Congress when it comes to ensuring that the federal government meets its trust responsibility to American Indians and Alaska Natives (AI/ANs). As a senior member of the House Appropriations Committee, Cole has been instrumental in securing funding for all of Indian Country by constantly advocating on behalf of the Tribes and educating his colleagues about the federal trust responsibility to Tribes. He chairs the subcommittee on Labor, Health and Human Services, Education and Related Agencies. In this role, he has worked to ensure that the Indian health system receives equitable funding across the Department of Health and Human Services. He also serves on the Appropriations subcommittee for Interior, Environment and Related Agencies appropriations where he has been a strong advocate for increased Indian Health Service funding. In the time that Congressman Cole has served on that Subcommittee, IHS funding has increased by $2 billion. Outside of the Appropriations Committee he serves as the Co-Chair of the Congressional Native American Caucus and in that role he works to ensure that the federal government honors its promises to American Indians and Alaska Natives in all legislation considered by Congress.
"I am thrilled that the Board has chosen to honor Congressman Tom Cole as the 2018 Jake White Crow Award winner. His leadership in Congress has advanced the needs of Indian health," said NIHB Chairman Vinton Hawley. "Mr. Cole works tirelessly to ensure that the federal government fulfills its trust responsibility for health and protects Tribal sovereignty at every turn" continued Chairman Hawley.
Upon being notified of the award Congressman Cole said, “I am very honored to receive the Jake White Crow Award from the National Indian Health Board. Supporting medical care, research and advocacy has been among my top priorities in Congress as the Chairman of the Labor, Health and Human Services Appropriations Subcommittee. And since my first day in Congress, supporting Native American and Tribal wellbeing across sectors has been a top priority as well. I will always continue to ensure that Native American citizens have proper and adequate access to healthcare in Tribal communities.”
The National Indian Health Board (NIHB) is a 501(c) 3 not for profit, charitable organization serving all 573 Federally recognized Tribal governments for the purpose of ensuring that the federal government upholds its trust responsibilities to provide health care to the Tribes. NIHB also works to elevate health care status, services and systems of the Tribes and our Peoples.
Other awards for National Impact, Area Impact, and Local Impact will be announced at the Annual Heroes in Health Awards Gala on Wednesday, September 19, 2018 in Oklahoma City, Oklahoma. This year’s theme is “Expanding the Horizon of Indian Health.”
Please visit this link for more information and to purchase tickets.
Posted: July 18, 2018
2018 Direct Service Tribes National Meeting
On July 11-12, 2018, the National Indian Health Board (NIHB) participated in the Direct Service Tribes National Meeting (DSTNM) in St. Paul, MN. The DSTNM was preceded by the fourth quarterly meeting of the Indian Health Service (IHS) Direct Service Tribes Advisory Committee (DSTAC) on July 10, 2018. The DSTAC is comprised of elected and appointed leaders from nine IHS areas with Direct Service Tribes (DSTs) that offers recommendations and policy guidance to the IHS. The DSTNM is an annual two-day event hosted by the Indian Health Service (IHS), focused on supporting community wellness and strength. The theme for the 2018 national meeting, “Utilizing people, partnerships, quality and resources to strengthen our communities” featured speakers and breakout sessions that addressed Direct Service Tribes (DST) health priorities...
Click Here to view NIHB Presentation Slides
Click Here to View Photos
Posted: July 12, 2018
House Appropriations Committee Advances FY 2019 Labor-HHS Appropriations Bill
Programs of Significance for Tribes in the FY 2019 House and Senate Labor-HHS Appropriations Bills
On Tuesday, July 11, 2018, the full House Appropriations Committee held a markup hearing and voted to advance the FY 2019 Appropriations Bill for Labor, Health and Human Services, Education and Related Agencies (commonly referred to as Labor-HHS) by a vote of 30-22. No Tribally-specific amendments were adopted during the markup; however, representatives from both parties adopted a number of amendments aimed at addressing the impact of family separation policies at the border. The bill must now be voted on the House floor before being sent on to the Senate. The full Senate Appropriations Committee advanced their Labor-HHS bill prior to the July 4th recess...
Posted: July 2, 2018
2019 House Labor-HHS Appropriations Bill
Markup Scheduled for After July 4th
Tribes Must Redouble Advocacy Efforts to Protect Gains
and Continue Momentum!
Yesterday, June 25, the House Appropriations Committee announced that it was postponing one of its last remaining mark-ups, delaying a vote on a bill crucial to public health programs in Indian Country. The mark-up for the Labor-HHS Appropriations bill had been scheduled for today, June 26, but will now take place after the July 4th Recess.
The House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies (Labor-H) had its markup of the appropriations bill for Fiscal Year (FY) 2019 on June 15. This bill funds several public health programs within the Department of Health and Human Services (HHS) that operate in Indian Country. The National Indian Health Board (NIHB) provided oral testimony and a written statement to the subcommittee outlining the success of these programs and providing recommendations for funding in FY 19...
Posted: April 18, 2018
The House Natural Resources Committee Ranking Member Raul Grijalva (D-AZ) and Representative Nanette Barragan (D-CA) hosted a Natural Resources Roundtable Conversation on Environment and Public Health.
The roundtable brought together a broad coalition of stakeholders working to improve the health of communities impacted by environmental impacts. The group highlighted the health challenges faced by communities across the United States related to air pollution, water contamination, and irresponsible mining and land management practices, among other concerns.
Stacy Bohlen, CEO of the National Indian Health Board (NIHB) participated in the roundtable to advocate for the environmental public health concerns of Tribes. Ms. Bohlen stated, "American Indian and Alaska Native people have lived for thousands of years in harmony with our surrounding environments, taking what we needed from the land for physical, cultural, and spiritual purposes. Tribal practices and lifeways were sustainable over time, and protected the health of current and future generations." She shared that, despite this tremendous respect for the environment, Tribes now find this harmony and balance slipping away as industry creates negative impacts that are far reaching and long lasting.
The need for Trial consultation in regards to public health was stressed by Ranking Member Grijalva, who emphasized that Tribal public health concerns should not be considered "after the fact" – rather, Tribes should have the opportunity to share their unique perspectives, needs, and experiences before any decisions or actions are taken.
Both Ranking Member Grijalva and Representative Barragan look to continue dialogue with organizational partners, to highlight environmental impacts on health, and galvanize action that can disrupt and prevent these health impacts from harming community health, especially those most vulnerable among us like children and elders. The National Indian Health Board will continue to work with the House Natural Resources Committee to ensure that the public health concerns of American Indians and Alaska Natives are addressed.
Posted: March 27, 2018
NIHB Testifies on the Opioid Crisis in Indian Country
Advocates for Specific Tribal Funding, Traditional Healing Practices and better data collection
The National Indian Health Board (NIHB) recently testified before two congressional committees on the need to improve the response to the opioid crisis in Tribal communities.
On March 14, 2018, NIHB Treasurer and Bemidji Area Representative Samuel Moose testified before the Senate Committee on Indian Affairs in a hearing titled: "Opioids in Indian Country: Beyond the Crisis to Healing the Community." On March 22, 2018, NIHB Chief Executive Officer Stacy A. Bohlen testified before the House Energy and Commerce Committee at a hearing titled, "Combating the Opioid Crisis: Prevention and Public Health Solutions."
Posted: March 23, 2018
The FY 2018 Omnibus & its Impact on Indian Health
Includes Tribal Set Asides for Opioid Funding, $500 million increase for IHS
Last night, Congressional leaders unveiled a massive $1.3 trillion spending bill that will fund the federal government through the rest of FY 2018. The Consolidated Appropriations Act, 2018 (H.R. 1625) contains funding for most of the federal government agencies including Department of Health and Human Services (HHS), and the Indian Health Service (IHS). The bill passed the U.S. House of Representatives on a bipartisan vote of 266-167 on Thursday, March 22. The Senate passed the bill 65-32 early Friday morning and sent it to President Trump for his signature...
Posted: March 23, 2018
UPDATE: President Trump Signs FY 2018 Omnibus
The Impact to Tribal Health: Tribal Set Asides for Opioid Funding, $500 Million Increase for IHS
President Trump announced today that, despite several objections to funding levels in the bill, he supported the Fiscal Year (FY) 2018 Omnibus. He signed the Omnibus into law shortly after 1:00 Eastern. This means that the government will be funded through September, the end of FY 2018.
Posted: February 27, 2018
HHS Releases Strategic Plan FY 2018-2022
Dear MMPC:
The US Department of Health and Human Services (HHS) has posted their Strategic Plan for FY 2018-2022 (Strategic Plan) to the HHS.gov website, linked above. Every four years, HHS updates its Strategic Plan, which describes its work to address health and human services issues. Tribes and Tribal health advocates may find this document useful in understanding administration priorities and their management perspective for federal agencies and programs that are implemented across Indian Country...
Posted: February 27, 2018
Congress Renews Health Programs Important to Tribes as Part of Budget Deal
On February 9, 2018, Congress passed a budget agreement that funded the government until March 23, 2018, and reauthorized several public health programs. Many of the programs either benefit Tribal members directly or provide funding to support Tribal public health programs. Reauthorization for these programs varied in length and amount. Below is a summary of renewed programs important to Tribes.
The Special Diabetes Program for Indians (SDPI) was renewed through September 30, 2019. The program will be funded at $150 million per year, the same amount it has received since 2004. SDPI currently funds 301 Tribal diabetes programs through a competitive grant process. The program has existed since 1997 and has helped lessen diabetes’s negative health impacts in Tribal communities. It has been cited as the most successful public health program in Indian Country...
Posted: February 21, 2018
Robert Weaver Withdraws From Consideration as Indian Health Service Director
Today, February 21, 2018, the White House announced that Robert Weaver, Quapaw Tribe, has submitted his withdrawal from consideration as Director for the Indian Health Service (IHS).
Mr. Weaver was announced as the new IHS Director on October 6, 2017. His name had been submitted to the United States Senate Committee on Indian Affairs, where his nomination had been pending. His nomination has been met with mixed reactions from Indian Country, and The Wall Street Journal detailed allegations of employment misrepresentation and financial mismanagement...
Posted: February 13, 2018
President Trump Releases FY 2019 Budget Request: Major Cuts to Domestic Spending and Social Safety Net, Investments in Opioid Treatment and Prevention
On Monday, February 12, 2018 President Trump released his fiscal year (FY) 2019 Budget Request to Congress. This is the proposal that the Administration provides the Congress as they will develop the FY 2019 appropriation including funds for the Indian Health Service and other health programs serving Indian Country. It will be up to Congress to make any final spending decisions about appropriations for FY 2019, which will begin on October 1, 2018...
Posted: February 9, 2018
Congress Passes Spending Bill to Fund Government, Renews SDPI
Early this morning, both chambers of Congress approved a spending bill written by the Majority and Minority leaders in the Senate. Following the vote, President Trump signed the bill into law, reopening the federal government after an hours-long shutdown. The bill funds the federal government until March 23, 2018...
Posted: February 8, 2018
Budget Deal Includes 2 Year SDPI Renewal, Other Public Health Programs
Senate leadership has announced a two-year budget agreement to avoid another shutdown and lessen Congress's reliance on short term Continuing Resolutions to fund the government. It would fund the federal government through March 23, 2018, and provide a pathway for Congress to determine the final spending amounts for the remainder of FY 2018. Congress must pass a spending bill by the end of the day TODAY, February 8, 2018, to avoid another shutdown...
Posted: February 6, 2018
New Continuing Resolution Includes SDPI:
Bill Would Reauthorize Program for 2 Years
Last night, the House Appropriations Committee released the text of the latest Continuing Resolution to fund the government until March 23, 2018. Included in the legislative text is a 2 year reauthorization of the Special Diabetes Program for Indians!
NIHB has made long term renewal of SDPI our top legislative priority, and success is in sight. But the journey to secure renewal is not over yet: Congress must still pass the Continuing Resolution with SDPI included!
Click here to view background materials for SDPI.
Click here to view updated talking points on how SDPI can be renewed NOW.
Posted: February 2, 2018
NIHB Issues Call to Action to Congress:
Finish the Job and Renew the Special Diabetes Program!
Today, Stacy A. Bohlen, Chief Executive Officer of the National Indian Health Board, in partnership with the Juvenile Diabetes Research Foundation, called upon Congress to reauthorize the Special Diabetes Program and the Special Diabetes Program for Indians in the Continuing Resolution that Congress will pass next week in order to keep the federal government funded past February 8.
The article will appear in print in The Hill, a nationwide publication. You can read the piece online here...
Posted: January 25, 2018
SDPI Outreach Needed: Next Continuing Resolution MAY Include Long-Term Renewal
As the National Indian Health Board has previously reported, one of our top legislative priorities is the long-term renewal of the Special Diabetes Program for Indians. Funding for this highly effective, life-saving program will expire on March 31, 2018, unless Congress reauthorizes it before then.
When SDPI renewal was not included in the last Continuing Resolution despite Congressional promises to Indian Country, NIHB promised to provide Tribes and advocates with Congressional outreach guidance, materials, and information in order to secure renewal for the program...
Posted: January 23, 2018
NIHB Participates in Native Foods Roundtable at the Senate Committee on Indian Affairs
On January 18, 2018, NIHB Executive Director Stacy A. Bohlen participated in a roundtable with the Senate Committee on Indian Affairs titled "Advancing Native Food Traditions in Indian Country." The purpose of the roundtable was to discuss Tribal policy recommends for the upcoming reauthorization of the Farm Bill.
Ms. Bohlen stressed the need for federal policy to support traditional food practices, Tribal sovereignty, and self-determination. She made the link between access to traditional food and health outcomes. She said that all American Indians and Alaska Natives (AI/ANs) have a "fundamental right to be a healthy person to have access to traditional...foods that are part of defining who we are culturally. We find that the intersection of public policy and health outcomes has a very profound, and often has negative consequence for AI/ANs." When indigenous people are removed from their ability to produce traditional food by federal policies like removal, federal food programs that support processed food, or damming of rivers that disturb agricultural and subsistence practices, health also greatly suffers. Ms. Bohlen also highlighted the major, positive impact that the Special Diabetes Program for Indians (SDPI) has had to bolster traditional food programs and urged that Congress swiftly reauthorize SDPI...
Posted: January 22, 2018
Senate Reaches Deal to End Government Shutdown
New CR Expires February 8
At noon today, the Senate voted to pass a Continuing Resolution (CR) to end the shutdown and fund the government through February 8, 2018. This vote is the result of a deal reached between Senate Majority Leader McConnell (R-KY) and Minority Leader Schumer (D-NY). The CR includes a 6-year renewal of the Children's Health Insurance Program (CHIP). As part of the deal, the Majority Leader promised a vote on codifying the Deferred Action for Childhood Arrivals Program (DACA) before the CR expires. The House has not yet voted on the new CR but is expected to in the near future. The President has announced his support for the CR...
Posted: January 18, 2018
We Fight On: Special Diabetes Program for Indians Renewal Efforts Continue
The Work Continues... Thank you to everyone who participated in Congressional outreach for the Special Diabetes Program for Indians (SDPI) renewal today. Unfortunately, we just learned that SDPI is not likely to be included in the current Continuing Resolution (CR). The House Rules Committee is considering the CR now - we expect that the Committee will issue a Closed Rule, meaning no amendments will be allowed, and SDPI renewal is not in the CR. The CR being considered the Rules Committee today, if approved, will expire February 16, 2018. The CR does contain a 6-year reauthorization for the Children's Health Insurance Program (CHIP). For many months, lawmakers and Congressional Leadership assured NIHB and Indian Country that the SDPI renewal would be taken up with CHIP: that did not happen today.
It is worthy of note, and we are grateful, that CHIP will be reauthorized for 6 years - because this program is so vital to American Indian and Alaska Native children...
Posted: January 17, 2018
New Continuing Resolution Does NOT Include Special Diabetes Program for Indians Reauthorization
Yesterday, January 16, 2018, House Republican leadership released language for the next Continuing Resolution (CR), which will fund federal government agencies until February 16. The CR includes a six-year reauthorization for the Children's Health Insurance Program (CHIP). Many American Indian/Alaska Native (AI/AN) children and their families receive coverage from this program, and NIHB supports its renewal. Unfortunately, the CR does NOT include any language renewing the Special Diabates Program for Indians (SDPI), which now expires on March 31, 2018!
Up to this point, NIHB had been told by Congressional staff that SDPI would be renewed with the long-term CHIP reauthorization...