June 25, 2019 |  Issue 19-25                 Missed Last Week's Washington Report? Click Here to Visit our Archives!
 UPCOMING EVENTS 

July 23, 2019
9:00 AM to 5:00 PM ET
Washington, DC
 

 July 24 - 25, 2019
Washington, DC  


July 29, 2019
Albuquerque, NM


July 30 - 31, 2019
Albuquerque, NM


August 6 - 9, 2019
Oklahoma City, OK

August 13 - 14, 2019
Cherokee, NC

Community Health Aide Program (CHAP) TAG Vacancies
 In February 2018, with the announcement of CHAP expansion to Tribes beyond Alaska, IHS created a CHAP Tribal Advisory Group.

 Information on CHAP and CHAP TAG, including vacant  positions, is available on the CHAP
website .

Join the National Partnership for Dental Therapy!
Click HERE for more information!

Stay Current: Health Alerts from the CDC!
Don't wait for the emergency to arrive before signing up for emergency alerts from the Centers for Disease Control & Prevention!

 
Follow NIHB on Twitter and Instagram
@NIHB1
 
Top Story
HouseInteriorApprops
House Set to Pass Appropriations Minibus that Includes Interior Bill, Funding for Indian Health Service
On Tuesday, June 25, 2019, the House of Representatives will resume consideration of H.R. 3055, which bundles together FY 2020 appropriations bills for Interior-Environment (including the Indian Health Service); Agriculture-FDA; Commerce-Justice-Science; Military Construction-VA; and Transportation-HUD. The House initiated votes on hundreds of amendments last week to the over $383 billion package, and Majority Leader Steny Hoyer (D-MD) has indicated that the package is slated to pass the House today (Tuesday June 25). As NIHB reported on last week , the Interior bill includes a $537 million overall increase to the Indian Health Service (IHS) budget, to a total funding level of $6.3 billion. To read NIHB's in-depth analysis of FY 2020 appropriations for IHS in the House Interior bill, click here .

Upon passage of the minibus that includes the Interior budget, the House will have completed nine out of twelve appropriations bills for FY 2020. It remains unclear if the increases included in the House package will carry over to the Senate, where appropriators have yet to release any FY 2020 funding bills. Given that Congress has yet to pass a budget deal, Senate Appropriations Chairman Richard Shelby (R-AL) has indicated that the Senate will use ballpark top-line spending limits, as the House has done, to begin work on spending packages.

Last Wednesday, House and Senate appropriators met with White House officials including Acting Chief of Staff Mick Mulvaney and Treasury Secretary Steven Mnuchin to negotiate a bipartisan budget deal that raises spending caps and the debt ceiling. Congress must pass a budget deal in order to stave off across-the-board spending cuts under budget sequestration and to avert another government shutdown. While last week's meeting did not result in a deal, White House officials indicated that they are open to a one-year continuing resolution at FY 2019 funding levels that adjusts the debt ceiling in order to avoid triggering sequestration. NIHB will provide more information on the budget and appropriations as it becomes available.

To read more about the minibus spending package,  click here
To read the FY 2020 House Interior report,  click here
In This Issue:

TOP STORY

NIHB UPDATES

CAPITOL HILL UPDATES
NIHB UPDATES
NTHC
NIHB's 2019 National Tribal Health Conference Call for Proposals Open!
The National Indian Health Board (NIHB) is excited to announce that the Call for Proposals for the 2019 National Tribal Health Conference (NTHC) is now available! This year's conference, scheduled for September 16-20, 2019, will be held at the Pechanga Resort Casino in Temecula, California.
Tribal leaders, health directors, policy specialists, advocates, and allies are invited to submit abstracts. NIHB encourages presentations highlighting innovative and Tribally-driven approaches to improving the quality of health systems, strengthening the business of medicine, expanding pathways for successful advocacy efforts, enhancing government to government relationships, and evidenced based, wise, best or promising practices developed in and for Tribal communities.
This year's five conference tracks address a wide breadth of Tribal health priorities. Namely, they are:
  • Legislation and Advocacy
  • Federal Relations and Advocacy
  • Native Health Infrastructure and Quality Improvement
  • Opioids, Methamphetamines, Substance Use, and Behavioral Health
  • Emerging Trends in Native Health and Sovereignty
Submissions are due by 11:59 pm ET on July 12, 2019.
To access the Call for Proposals page, click HERE.
NTHCRegistration
Registration for NIHB's 2019 National Tribal Health Conference Now Available!
NIHB invites Tribal leaders, health administrators, health policy experts, federal partners, and allies to register for the 2019 National Tribal Health Conference taking place in Temecula, California September 16-19, 2019 at the Pechanga Resort & Casino!
Take advantage of the Early Bird rate through July 31!

As the nation's premiere Tribal healthcare conference, the National Tribal Health Conference (NTHC) brings together over 800 individuals from across Indian Country to advance the promise of health and Tribes' own political and policy work in the arenas of healthcare, public, behavioral, and environmental health. 
Hotel and Venue Information
This year's NTHC is taking place at the Pechanga Casino & Resort in Temecula, California! NIHB has secured a Group Rate for hotel registration at $149 per night. NIHB's room block is only available through August 14, 2019 so book your stay today!
Gala
Deadline for Outstanding Service Award Nominations Extended to this Friday, June 28!
T he National Indian Health Board is inviting nominations for the 2019 Outstanding Service Awards. The awardees will be announced at the NIHB Annual Heroes in Native Health Gala on Wednesday, September 18th. This will coincide with the NIHB National Tribal Health Conference (NTHC) September 16- 20, 2019 at Pechanga Resort and Casino in Temecula, CA. 
 
The deadline for nominations is now June 28, 2019 at 11:59 PM ET!
 
In an effort to honor individuals, organizations and programs that have enriched and improved American Indian and Alaska Native health, health systems or policy each year, the NIHB invites nominations for awards that recognize excellence, achievement and contributions "above and beyond" the call of service. This is your opportunity to nominate individuals, organizations or programs that have significantly contributed to improving the health status, policy and/or health systems experienced by American Indians and Alaska Natives.  Click Here for a list of the 2018 Award Winners!
 
NIHB is seeking nominations for the following prestigious awards:
 
Local Impact Award  - Recognizes an individual or organization whose work has affected change or impacted health care on the local and or Tribal level. 
(24 awards available)
 
Area/Regional Impact Award  - Honors an individual or organization whose work has contributed to improving American Indian/Alaska Native health care or affected change on an area or regional basis.  (12 awards available - 1 from each IHS Service Area)
 
National Impact Award  - Honors an individual or organization whose work has made an impact on American Indian/Alaska Native health care on a national level.  (6 awards available)
 
Jake Whitecrow 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. (1 award available)
 
Youth Leadership Award - Commends a young American Indian or Alaska Native aged 14-22 for their leadership and outstanding efforts to increase the quality of healthcare or awareness of health issues within their peer group or community on a local or national level. (1 award available)
   

 
NIHB will present the awards during the NIHB 2019 National Tribal Health Conference (NTHC) at the Annual Heroes in Native Health Awards Gala in Temecula, CA on September 18, 2019. All nominations must be received through the online form by 11:59 PM  ET on June 28, 2019 .  Awardees will be notified by July 15th, 2019.  Additional information on the Heroes in Native Health Awards Gala, including the opportunity to purchase tickets or a table and be a sponsor will be forthcoming.
CAPITOL HILL UPDATES
senateHELP
Senate Health, Education, Labor and Pensions Committee to Markup Lower Health Care Costs Act of 2019, Includes Reauthorization of the Special Diabetes Program for Indians
On Wednesday, June 26, 2019, the Senate Health, Education, Labor, and Pensions (HELP) Committee is set to markup a package of bills titled S.1895 - the Lower Health Care Costs Act of 2019. The legislation includes five titles that individually address a wide scope of healthcare and public health priorities including surprise medical bills, pharmaceutical costs, health information exchanges, and maternal and child health. The landmark bipartisan package has been in the works since Fall 2018 when Chairman Alexander (R-TN) submitted a letter to public stakeholders requesting feedback on recommendations for lowering health care costs, to which NIHB also submitted comments.

Section 412 of the public health title of S. 1895 includes Chairman Alexander's bill that would reauthorize the Special Diabetes Program for Indians (SDPI) for five years at its current funding level of $150 million per year.

As NIHB previously reported, Congressman Tom O'Halleran (D-AZ) introduced a bill in the House of Representatives, H.R. 2680, that would also reauthorize SDPI for five years, but would increase funding for the program to $200 million - which has long been a goal of Tribes and NIHB. While the Senate is likely to pass the Lower Health Care Costs Act with SDPI reauthorization at its current spending level, NIHB will continue to push for an increase to SDPI once committee leaders move to conference.  The Senate HELP Committee will be marking up S.1895 in committee tomorrow, Wednesday, June 26, 2019, starting at 10:30 AM Eastern.

To watch a live recording of the hearing,  click here

To read the current text of the bill,  click here

To read a section by section of the bill,  click here
FEDERAL ADMINISTRATION AND STATE GOVERNMENT UPDATES
STAC
HHS Seeks Nominations for Secretary's Tribal Advisory Committee
HHS issued a Dear Tribal Leader Letter (DTLL) on May 7, 2019, calling for nominations for Tribal delegates to the Secretary's Tribal Advisory Committee (STAC). HHS announced last week that it would extend the deadline for nominations to June 26, 2019 for more information regarding who is eligible to represent STAC as a delegate or an alternate. Following a recent election, there are several vacancies to fill, including:
 
  1. Albuquerque Primary and Alternate
  2. Billings Primary and Alternate
  3. National At-Large Primary Delegate (3)
  4. National At-Large Alternate Delegate (1)
 
Nominations will be accepted through postal mail or email:
Jack Kalavritinos, Director
Office Of Intergovernmental Affairs
U.S. Department of Health and Human Services
200 Independence Avenue, SW, Room 620-E
Washington, DC 20201
Fax: 202-205-2727
Email: STAC@hhs.gov

CHAPProgram
CHAP Program deadline comments extended to July 8, 2019
One June 7, 2019, IHS released a Dear Tribal Leader Letter (DTLL) announcing the extension of comments for the CHAP program. This extension was a result of numerous requests from Tribal advocates for more time to review the CHAP policy and how best to implement CHAP expansion, or which alternatives are possible if a state wishes to continue using its CHR program. NIHB submitted comments on this Tribal Consultation - if you have any questions about CHAP program comments, please contact Devin Delrow, Director of Policy, at ddelrow@nihb.org

didyouknow
Did You Know?
NIHB is including brief reports from its Tribal Data Project Director, Ed Fox, in the Washington Report to engage our readers in the Center for Indian Health Policy and Research 's (CIHPR) work. Each week, NIHB will share a new report on AI/AN health, topics range from access to care, enrollment in federal health programs, occurrence of chronic conditions.  

drugdeaths
What do we know about American Indians and Alaska Native Deaths from Opioids, Heroin, Methamphetamines, and other Drugs?
In the United States, opioid, heroin, and methamphetamine-involved deaths have increased dramatically in recent years to over 70,000 deaths, according to the National Institute on Drug Abuse. A January 4, 2019, Morbidity and Mortality Weekly Report (MMWR) suggests that there is little difference between the Non-Hispanic White death rate(s) and American Indian and Alaska Native (AI/AN) rates. In fact, MMWR claimed that AI/ANs had mortality rates that were lower than Non-Hispanic whites. However, when a correction is made for what researchers call, 'racial misclassification', the true disparity surfaces. A recent MMWR report (December 2018) found that data produced by the Centers for Disease Control and Prevention and available on CDC  Wonder underreported AI/AN deaths by 40% after a data match of AI/AN patients with state-reported deaths revealed additional deaths of AI/ANs.   State reports like this one from Minnesota are likely to identify the disparities better than national reports, but further research is needed.
 
The issue of racial misclassification for AI/ANs is well documented, but so far no simple 'adjustment' of public data is feasible given the limited knowledge of how misclassification itself varies between different states.   The misclassification is always in the same direction, i.e., an underreporting of AI/AN deaths, but the degree of the error undoubtedly varies between states. One should not apply a simple adjustment across all states or the nation to 'correct' for racial misclassification.
 
The most advanced research on AI/AN misclassification, conducted by the Northwest Portland Area Indian Health Board is from the northwest states of Idaho, Oregon and Washington. While misclassification likely exists everywhere, it could be more pronounced in states like Washington and Oregon. These are states where the AI/AN population is both more multi-racial and composed of more AI/ANs who are not members of the Tribes of the state where they reside (and where a Tribal member's own Tribe is involved in their health care and attending them at the time of death). For example, in Alaska, North and South Dakota, and Montana, a very large percentage of AI/ANs are members of the states' Tribes and a large percentage identify as single race AI/ANs-we could hypothesize less racial misclassification exists. Further research is never likely to produce a simple 'adjustment factor' for racial misclassification, but attention to the variation in composition of the AI/AN population is a necessary component of understanding the existing data until such time as the reporting of deaths and race improves.
 
It remains to be seen if reports continue to understate AI/AN deaths from drug overdoses, for now caution is advised when interpreting the findings of many national reports.
UPCOMING EVENTS, CALLS, AND WEBINARS
CMSITUUUUUUU
CMS ITU Trainings
Don't miss the National Indian Health Board's (NIHB) presentation at the Centers for Medicare and Medicaid Services' (CMS), Indian Health Service (IHS), Tribal Health Programs, and Urban Indian Programs (CMS I/T/U) regional training sessions!  CMS is committed to helping the I/T/U facilities to maximize their ability to access third party resources.  To meet this objective, CMS, in partnership with the States, the Department of Veteran Affairs, the Social Security Administration, the DHHS Office of the Inspector General, IHS and NIHB provide training to patient benefits advocates on the programs and benefits available through Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and the Health Insurance Marketplace. 
 
The target audience for CMS ITU Trainings includes:
  • Business Office staff
  • Benefits Coordinators
  • Patient Registration staff
  • Medical Records staff
  • Purchased/Referred Care staff
Upcoming Regional Trainings:
June 25-26, 2019
700 East Main Street
Richmond, VA 23219
 
August 14-15, 2019
10 Laura Boulevard
Norwich, CT 06360
For more information, and to register, click here
HRSAwebinar
June 25: HRSA Webinar Detailing Auto-HPSA Changes
The Health Resources and Services Administration (HRSA) has announced a 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.

Date: June 25, 2019
Time: 2:00 - 4:00 PM ET
Dial-in: 888-282-0359
Code: 9059513
Link: https://hrsa.connectsolutions.com/auto-hpsa webinar/
MMPCftf
July 22-23: MMPC Face-to-Face Meeting
Strategic Planning Meeting
Monday, July 22
1:00pm to 5:00PM ET
American Immigration Lawyers Association Conference Center
1331 G Street NW
Washington, D.C., 20005

MMPC Face-to-Face Meeting
Tuesday, July 23
9:00AM to 5:00PM ET
Location TBD
Washington, D.C.
TTAGftf
July 24-25: TTAG Face-to-Face Meeting
TTAG Face-to-Face Meeting
Wednesday and Thursday, July 24-25
National Museum of the American Indian
Independence Avenue SW
Washington, D.C., 20560
nihdtll
NIH DTLL: NIH Policies on Intellectual Property, Inventions, and Patent Rights in Biomedical Research
  • Question: How do NIH Intellectual Property policies impact biomedical research with Tribal communities?
  • Consultation dates:
NIH DTLL: Request for Comments on NIH Draft Policy on Data Sharing  Management
  • Question: How do Tribes define Scientific Data? What are acceptable requirements when proposing research with Tribes?
  • Consultation dates:
    • June 18-20 Sacramento, CA.
    • July 15-18 in Washington, DC.
    • August 20-22 in Denver, CO.
    • A toll-free conference line will be made available.
    • Testimony, comments and questions before and after consultation are encouraged. Send email to NIHTribalCommittee@od.nih.gov
NIH DTLL: Tribal Consultation and Listening Session on the All of Us Research Program
  • June 24, preceding NCAI's 2019 Mid-Year Conference in Sparks, NV.
  • NIH will participate in HHS regional consultations in CA, DC, CO.
  • All of Us Tribal Engagement information HERE
CDCatsdr
The Summer 2019 CDC/ATSDR TAC Meeting and 19 th Biannual Tribal Consultation Session will provide opportunities for Tribal leaders to speak about the public health issues affecting their Tribal Nation. These meetings will include, but are not limited to, discussions about securing sustainable funding to Indian Country, ensuring a Tribal voice in CDC policy and programs, and current CDC priorities. Tribal Nations also will have an opportunity to present formal testimony about Tribal public health issues.

The CDC's Agency for Toxic Substances and Disease Registry (ATSDR) will hold a meeting and Tribal Consultation Session from August 13 to August 14, 2019. Tribes will also have an opportunity to present testimony about Tribal public health issues. The meeting will be open to the public and the agenda will include discussions on securing sustainable funding to Indian Country and ensuring a Tribal voice in CDC policy, programs, and current CDC priorities.
 
All elected Tribal officials are encouraged to submit written testimony (on official Tribal letterhead) by 5:00 p.m., EDT, Friday, July 19, 2019 to Captain Carmen Clelland, Pharm, MPA, MPH, Director, Office of Tribal Affairs and Strategic Alliances via mail to 4770 Buford Highway, Mailstop V18-4, Atlanta, GA 30341-3717, or by email at TribalSupport@cdc.gov

Attendees must pre-register HERE by Friday, July 19, 2019.
Testimony must be submitted by 5:00 p.m. ET on Friday July, 19, 2019 to TribalSupport@cdc.gov

Time and date:
Start Date - 8/13/2019, 9:30-5:45 (EDT)
End Date - 8/14/2019, 9:30-5:45 (EDT)

Event Location: Harrah's Cherokee, 777 Casino Dr, Cherokee, NC, 28719

Registration Information: The registration form, agenda, and hotel information will be available later in June on the CDC Tribal Health website at www.cdc.gov/tribal/index.html

CDC contact information : Email Address for event is TribalSupport@cdc.gov
Grants and Resources
ACLltss
ACL Funding Opportunity: Tribal LTSS Resource Center
NOFO Number:  HHS-2019-ACL-AOA-IELT-0349
Deadline: July 5, 2019
The Administration for Community Living (ACL) is proposing to aware a new cooperative agreement to find a National Resource Center of American Indian, Alaska Native, and Native Hawaiian Long Term Services and Supports (LTSS). This center will address the unmet need of Tribal-specific and culturally appropriate LTSS information and guidance to  Tribes. The outcomes of this project will be to:
  1. Create a network of navigators that will assist Tribes in development of appropriate LTSS in response to identified, tribally-specific needs; and
  2. Based on documented best practices, the Center will develop a practical and hands-on toolkit for Tribes to assist in implementing LTSS in their individual Tribal communities.
The Resource Center will target its services to the 270 tribes that receive Title VI grants, however it will also have publicly-available resources that are accessible to all Tribes and organizations that work with the AI/AN and Hawaiian populations. The Resource Center will focus on improving the lives of those served by ACL by supporting the development of Tribal-specific LTSS that assist older adults and people with disabilities while also empowering tribes to develop programs that are integrated into their unique culture.

Contact Cecelia Aldridge with questions: Cecelia.aldridge@acl.gov 
ACLTech
ACL Funding Opportunity: Technologies to Enhance Independence and Community Living for People with Cognitive Impairments
NOFO Number:  HHS-2019-ACL-NIDILRR-REGE-0343
Deadline: July 15, 2019

The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), within the Administration for Community Living (ACL), announced a new funding opportunity on May 16, 2019. The project that NIDILRR is funding is called the "Rehabilitation Engineering Research Centers (RERCs) Program: RERC on Technologies to Enhance Independence and Community Living for People with Cognitive Impairments", whose goal is to improve the effectiveness of services authorized under the Rehabilitation Act by conducting research and developing innovative technologies that solve rehabilitation problems or remove environmental barriers.
 
Federally-Recognized Tribal Governments, Native American Tribal organizations, and Nonprofits with a 501(c)(3) status are among the eligible applicants.
 
Contact Patricia Barrett with questions: patricia.barrett@acl.hhs.gov
medicareHANDBOOK
Pre-Order Your 2020 Medicare and You Handbook
Pre-orders can be made through June 2019. To pre-order your Medicare & You handbook, click here , log in, and follow the instructions on the website.
Resources
Resources Available to Tribes on Health Issues  
The following resources are now available to Tribes on issues related to health and wellness:

HRSA Grant Application Webinars
The Health Resources and Services Administration (HRSA) has created a series of FREE Grants Education and Technical Assistance Webinars for Tribes, Tribal Organizations, Indian Health, Tribal and Urban Indian Health Programs.  Topics include  the federal grant application process, how to write better grant proposals and evaluation plans for your projects, strategies for successful grant management, and more.  Please find below links to all the recorded sessions.
 
Apr 11, 2018
Federal Grants Application Process: The Basics
Where to Find Funding Opportunities, Grants Resources & Technical Assistance
Recording and slides available here .
May 9, 2018
Writing a Competitive Grant Application / HRSA Review Criteria
Recording and slides available here.
Jun 13, 2018
Applying for a HRSA Grant: A Grantee and a Reviewer's Perspectives /
The Benefits of Becoming a Reviewer
Recording and slides available here.
Jul 11, 2018
Writing a Successful Evaluation Plan for Your Grant Application
Recording and slides available here.
Aug 8, 2018
Preparing a Budget for your Grant Proposal
Part 1: Building a Budget recording and slides available here .
Part 2: HRSA Budget 101 / Tips & Resources recording and slides available here .
Sept 12, 2018
Effective Grants Management/Administration & Reporting
Recording and slides available here.

CMS  announced the five-year Maternal Opioid Misuse (MOM) model to help state Medicaid programs improve clinical care and social services for pregnant and postpartum women with opioid use disorder and their children. 
Resources
Resources Available to Tribes on Health Issues  
The following resources are now available to Tribes on issues related to health and wellness:

HRSA Grant Application Webinars
The Health Resources and Services Administration (HRSA) has created a series of FREE Grants Education and Technical Assistance Webinars for Tribes, Tribal Organizations, Indian Health, Tribal and Urban Indian Health Programs.  Topics include  the federal grant application process, how to write better grant proposals and evaluation plans for your projects, strategies for successful grant management, and more.  Please find below links to all the recorded sessions.
 
Apr 11, 2018
Federal Grants Application Process: The Basics
Where to Find Funding Opportunities, Grants Resources & Technical Assistance
Recording and slides available here .
May 9, 2018
Writing a Competitive Grant Application / HRSA Review Criteria
Recording and slides available here.
Jun 13, 2018
Applying for a HRSA Grant: A Grantee and a Reviewer's Perspectives /
The Benefits of Becoming a Reviewer
Recording and slides available here.
Jul 11, 2018
Writing a Successful Evaluation Plan for Your Grant Application
Recording and slides available here.
Aug 8, 2018
Preparing a Budget for your Grant Proposal
Part 1: Building a Budget recording and slides available here .
Part 2: HRSA Budget 101 / Tips & Resources recording and slides available here .
Sept 12, 2018
Effective Grants Management/Administration & Reporting
Recording and slides available here.

CMS  announced the five-year Maternal Opioid Misuse (MOM) model to help state Medicaid programs improve clinical care and social services for pregnant and postpartum women with opioid use disorder and their children. 
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