Washington Report

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November STAC Covers Funding Updates and Tribal Community Outreach

The Department of Health and Human Services (HHS) Secretary’s Tribal Advisory Committee (STAC) took place on November 28 and 29, in Washington, DC. Leaders across HHS agencies, including Indian Health Service (IHS) Director Roselyn Tso, Centers for Disease Control and Prevention Director (CDC) Mandy Cohen, and National Institutes of Health (NIH) Director Monica Bertagnolli, among others, presented updates and engaged in discussion with Tribal leaders on current Tribal health issues and priorities. Among these discussions, IHS unobligated balances, the Presidential supplemental funding request, and outreach efforts in Indian Country emerged as stand-out topics.

IHS’s unobligated balances and the agency’s status on the Government Accountability Office’s High Risk List have been notable topics of discussion at previous Tribal advisory committee (TAC) meetings. At the latest STAC meeting, IHS Director Tso acknowledged the need to publicly share more information on the status and sources of these unobligated balances on the IHS website. STAC alternate delegate Councilman Andy Joseph spoke to the difficulties that the IHS hiring process and the delays it creates in acquiring necessary staff poses for obligating direct service Tribe balances. IHS also provided further information on their progress to address recommendations they received from the GAO High Risk Report— a GAO report that compiles guidance to address shortcomings from agencies that “provide critical services.” Director Tso noted that IHS has closed sixteen of the original twenty recommendations, with one more anticipated to be closed by the end of the year. One of these outstanding items relates to GAO’s criticism of IHS spending plans. IHS believes this issue could be addressed with further education with GAO and the Office of the Inspector General (OIG) on the importance of their use of locally developed spending plans.

HHS Chief Strategy Officer Lisa Molyneux touched on President Biden’s recent supplemental funding request and its $250 million Tribal set-aside. While the supplemental funding request is largely intended to respond to issues surrounding the Southern Border and Israel, it also includes $1.55 billion of funding for Substance Abuse and Mental Health Services Administration (SAMHSA) Opioid Response grants, setting aside $250 million for Tribes. Though it is not certain that Congress will move forward and pass the President’s request, Director Tso indicated that IHS is preparing for its potential passage and looking into procedures on how to effectively disperse these resources to Tribes. California Area delegate, Chairwoman Erica Pinto, requested that HHS recommend to Congress that the supplemental funds be transferred to IHS, eligible for distribution through IHS contracts and compacts, freely transferrable, and only be subject to a single audit.

Beyond covering issues surrounding funding, the Tribal STAC representatives meeting discussed health equity and gender-affirming care. Chairwoman Pinto requested the Office of the Assistant Secretary (OASH) to commit to enacting policies that protect gender-affirming care for Tribal people living in states that have enacted related bans. Chairwoman Pinto highlighted how recent legislative actions have “created fear” for many two-spirit and trans peoples. HHS Assistant Secretary Rachel Levine agreed that gender-affirming care is an important issue, the use of which is supported by evidence-based care principles. However, Assistant Secretary Levine added that she cannot comment on policy related to gender-affirming care at HHS. Director Tso shared that IHS wants to better understand the challenges in Indian Country related to this issue and that the agency is eager to know what actions it can take to help.

HHS agencies also provided details on their outreach efforts in Indian Country. Administration for Strategic Preparedness and Response (ASPR) Assistant Secretary Dawn O’Connell shared that the agency is working in partnership with SAMHSA and CDC with the Hoopa Valley Tribe to recover from damage caused by flooding. The Administration for Community Living (ACL) Acting Administrator Alison Barkoff shared that the ACL is planning to move forward on implementing new regulations relating to its Adult Protective Services program in Tribal communities. Additionally, Director Bertagnolli provided information on the NIH’s “Models of Tribal Research Governance” Webinar, which aims to foster ethical research practices and Tribal governance when partnering with American Indian/Alaska Native (AI/AN) communities.

The next STAC meeting will be May 7-8, 2024 in Washington, DC. HHS is currently inviting nominations for the STAC across several areas and at-large members. Applications are due by February 9.

Tribal advisory committees (TACs) provide advice, recommendations, and input on policy and program issues with implications for AI/AN healthcare providers and patients across various operating divisions within HHS. There are currently vacancies on several TACs that would benefit from nominations. More information can be found here. If you are interested in joining a TAC, you can contact Garrett Lankford, Federal Relations Analyst, [email protected].

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