March 19, 2021 | Issue 21-09
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Xavier Becerra Confirmed by the U.S. Senate as President Biden’s Secretary of Health and Human Services.
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“NIHB is eager to work with Secretary Becerra to strengthen Tribal sovereignty and expand Tribal self-governance while providing the best quality health outcomes for American Indians and Alaska Natives, especially during the coronavirus pandemic. Tribes want to see representation and funding at all HHS divisions where many of the Tribal programs for public and behavioral health are managed,” said NIHB CEO Stacy A. Bohlen.
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NIHB Submits Testimony on the VA Hospital System to the House and Senate Committees on Veterans Affairs
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On March 18, NIHB submitted written testimony to Veterans Affairs Committees in the Senate and House of Representatives in response to a hearing held on March 3 titled "Joint Hearing on Legislative Presentations of Veterans Service Organizations.” NIHB’s testimony outlines the shortcomings of the Veterans Affairs hospital system as they pertain to American Indian and Alaska Native veterans. The hearing can be viewed on the House Veterans Affairs Committee website here. Read NIHB’s written testimony here.
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Senator Elizabeth Warren (D-MA) and Rep. Barbara Lee (D-CA) Introduce the COVID Community Care Act
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Provides $400 million to the Indian Health Service (IHS) to implement a comprehensive program to prevent and respond to COVID-19, in partnership with Tribal nations, Tribal organizations, and urban Indian organizations.
- Creates an $8 billion grant program for community organizations and nonprofits to conduct testing, contact tracing, and outreach in medically under-served communities.
- Complements the "CONTACT" initiative in the HEROES Act, which supports a nationwide test-and-trace initiative run through public health agencies, by engaging trusted community partners to reach communities that public health agencies have difficulty engaging.
- Requires individuals hired for contact tracing to have experience and relationships in medically under-served communities.
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Requires US Department of Health and Human Services (HHS) to develop a comprehensive strategy for addressing health disparities.
NIHB endorses the COVID Community Cares Act along with at least 14 other originations. Read the press release from Congresswoman Lee's office here.
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Senate Committee on Indian Affairs to Hold Oversight Hearing on March 24
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House Appropriations Committee hosting American Indian and Alaska Native Public Witness Day Hearings
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UPDATES FROM THE FEDERAL & STATE ADMINISTRATIONS
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New Dear Tribal Leader Letter on $6 Billion in Funding for Tribal Communities’ Healthcare Needs
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On March 8, the Indian Health Service (IHS) released a Dear Tribal Leader Letter on the allocation of $6 billion in funding from the American Rescue Plan Act of 2021. On March 17, IHS held a virtual Tribal Consultation on the distribution of this funding. Topics discussed during that consultation included how the funding would be allocated throughout the 12 IHS areas and how the funds might be used based on the different categories specified such as COVID-19 testing, lost third-party revenue, and construction or equipment for measures concerning the COVID-19 response. It is expected that through this funding current issues related to the pandemic and even long-standing issues within Tribal communities’ Indian Health Care facilitates may be alleviated. Comments on the distribution of this funding are due on March 19, 2021.
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An Extension to the Comment Period of the Modification of Standards for the Privacy Rule from HHS
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On March 10, the Department of Health and Human Services (HHS) published a proposed rule on an extension of a previously published rule’s comment period. This proposed rule details the specific standard for the privacy of individually identifiable health information under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. Specifically, this act ensures patients receiving care from the healthcare workforce are legally protected with the confirmation that their health records are kept private from anyone who is not their health care provider. Individuals at Tribal clinics or Tribal facilitates who work with electronic health records or beneficiaries should submit comments. Comments on this proposed rule should include topics centered around an individual’s engagement in their health care facilities, barriers in their coordinated care, and the regulatory burdens these standards may impose on the healthcare industry. The proposals are far-reaching and could have a substantial impact on hospital care operations. This Proposed Rule includes changes that reduce unnecessary administrative burdens and adds clarity to the HIPAA Privacy Rule, as well as changes that appear to complicate the health information system. Comments are now due May 6, 2021.
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700 New HRSA Supported Health Centers will be Invited to Join the COVID-19 Vaccine Program
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On March 3, The US Department of Health and Human Services (HHS) released an announcement on the expansion of the COVID-19 Vaccine Program to 950 Communities Health Centers in the United States. This is a joint program funded by the Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC) that was originally launched on February 9, 2021, in an effort to provide vaccines to those residing in underserved communities and those who are disproportionately affected by COVID-19. Community Health Centers in Indian Country who are not currently participating in the COVID-19 Vaccine Program can now participate and will be selected by the agency. Factors like the location of a community health center in relation to communities disproportionately hit by the pandemic will be taken into account during their selection. This program includes funding and resources related to the COVID-19 vaccine that could significantly aid community health centers in Tribal communities. In total, 700 HRSA-supported health centers will be invited to join the Health Center COVID-19 Vaccine Program. If you want to see if your Tribal center or health care facility is currently participating or have been invited to participate, a list by state can be found here.
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New Updates from CMS on their Toolkit for Coverage and Reimbursement of COVID-19 Vaccines and Burdens Associated with the Funding Related to the Vaccine
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On March 15, the Centers for Medicare and Medicaid Services (CMS) released an announcement on an update to the “Coverage and Reimbursement of COVID-19 Vaccines, Vaccine Administration, and Cost Sharing under Medicaid, Children's Health Insurance Program (CHIP) and Basic Health Program.” Some updates in this toolkit include those associated with the clinical and operational considerations for potential COVID-19 vaccines, changes to the adults covered under traditional Medicaid, changes to the Medicaid and CHIP Managed Care section, and changes to the CHIP SPA templates, BHP Blueprints, and Streamlined Review Process. These updates have been captured in toolkit form for state Medicaid officials to more easily understand reimbursement and funding changes. This toolkit also summarizes the administration payment rates. The toolkit will be updated again in the upcoming future to reflect the changes made by the American Rescue Plan Act (ARPA) signed on March 11, 2021.
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Update for Health Professionals and Health Professional Students on the PREP Act
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On March 16, the US Department of Health and Human Services (HHS) published a notice on the “Declaration Under the Public Readiness and Emergency Preparedness (PREP) Act for Medical Countermeasures Against COVID-19”. The PREP Act was signed into law in 2005 and ultimately allows for vaccine manufacturers to be shielded from any legal liability when administering their vaccines in the event of a public health emergency. This update from HHS notifies the healthcare workforce on the addition of specific categories of healthcare professionals and students in a healthcare professional program to now be eligible to administer the COVID-19 vaccine. If a Tribal facility or clinic has any students or any personnel who may be considered a “Covered Person” they are now protected under this declaration from liability when administering the COVID-19 vaccine. This notice is effective on March 11, 2021.
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GRANTS, RESOURCES AND EVENTS
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NIHB Accepting Applications for Infectious Disease Learning Community
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The National Indian Health Board (NIHB) is working with the Centers for Disease Control and Prevention (CDC) to support emergency-based infrastructure for Indian Country. American Indians and Alaska Natives have increased vulnerability to emerging and re-emerging infectious diseases due to a lack of resources, public health emergency planning and response infrastructure intended to control outbreaks, and the complexity around jurisdictions, as well as lack of understanding among partners working with Tribes. Through this initiative, NIHB will assist Tribes with public health capacity building and training activities that engage public health and healthcare professionals and vulnerable populations to increase their ability to prevent and control outbreaks. A vital activity to aid in building capacity is creating peer learning community networks. The application deadline is March 22.
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Tribal Public Health Summit: Call for Abstracts Open
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The National Indian Health Board (NIHB) is now accepting abstract submissions for its upcoming Tribal Public Health Summit which will be held virtually April 27th – 29th, 2021.
Every year the National Indian Health Board (NIHB) brings together public health practitioners, researchers, and policy experts to allow for conversation, mobilization, and strategy. This year is no different despite COVID-19. In fact, COVID-19 has made our work even more urgent and vital. The COVID-19 pandemic has illuminated, for all to see, the critical underfunding of the Indian Health Service (IHS) and the importance of improving Tribal public health infrastructure. We invite you to join us virtually, present your work, and kick off these important explorations.
Abstract submissions due by Friday, March 26, 2021.
Register for the National Tribal Public Health Summit here.
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Webinar: Understanding President Biden's Climate Change Executive Orders in Indian Country
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Please join the National Indian Health Board (NIHB) on Friday, March 26, for a Climate and Health Learning Community Webinar: “Understanding President Biden’s Climate Change Executive Orders in Indian Country” on Friday, March 26. This webinar will discuss the two executive orders (EO 13990 and EO 14008) regarding climate change and environmental health, and what the orders mean in the context of Tribal climate improvement efforts.
Learning Objectives:
Attendees will have a greater understanding of:
- The power of Executive Orders and Presidential Memorandums
- How the President’s climate change Executive Orders affect Indian Country
- The next steps after issuing an Executive Order.
Please come prepared to ask questions or share your own insights and experiences! The Learning Community is focused on knowledge exchange, and members are encouraged to network and build relationships with each other and the presenters. Click here to register.
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The IHS is Hosting a Webinar Series for Community Health Representatives
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Beginning April 8, 2021, the Indian Health Service (IHS) will be conducting a series of one hour webinars for Community Health Representatives (CHR) every Thursday. This series will be in four parts and is primarily for non-clinical staff in positions involving behavioral and community health care, HIV, Hepatitis C, Substance use disorder, and 2SLGBTQ health services. Over the course of this four-day webinar series, the speakers will include Janet Cifuentes, PharmD, Heather Huentelman, Jessica Rienstra, BSN, RN and Rick Haverkate, MPH. Individuals with a passion for improving the health disparities of American Indians and Alaska Native people are encouraged to join.
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Visit the NIHB COVID-19 Tribal Resource Center at:
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