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Congress Passes Health Funding Bill

September 28, 2018

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 untilSeptember 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.

The bill now heads to the White House for the President’s signature. President Trump announced his support shortly after House passage, ending worries about a possible government shutdown at the end of September.

The legislation was negotiated in conference committee by House and Senate leadership and includes many important gains for the Tribes. The National Indian Health Board (NIHB) previously reported on the progress of this legislation and the importance of the funded programs. For FY 2019, funding levels for these key HHS health programs in Indian Country are below.

Good Health and Wellness in Indian Country (GHWIC) +$5 million:

  • The final spending agreement includes $21 million for GHWIC, an increase of $5 million from FY 2018 (31%).
  • The House of Representatives version of the bill included NIHB’s recommendation of $32 million for the program.
  • The President’s FY 2019 Budget Request to Congress proposed eliminating GHWIC.

Resources to Combat the Opioid Crisis:

  • State Opioid Response Grants for FY 2019 include a $50 million set-aside for Tribes and Tribal organizations.
  • This continues the momentum from the FY 2018 Tribal set asides.
  • The total amount for FY 2019 State Response Grants is $1.5 billion.
  • $10 million is set aside for Tribes for Medication Assisted Treatment for Prescription Drug and Opioid Addiction, an increase of $5 million from last year.

Tribal Behavioral Health Grants (TBHG) +$10 million:

  • Congress approved $40 million for TBHG, which is $10 million above the FY 2018 level, or an increase of 33%.
  • $20 million for mental health, and $20 million for substance abuse.
  • NIHB recommended that TBHGs were funded at $50 million in FY 2019.

National Child Traumatic Stress Initiative (NCTSI) +$10 million:

  • In the agreement, the NCTSI receives $63.8 million, a $10 million increase.
  • $1 million is set-aside “to expand access to tribal populations.”

Suicide Prevention:

  • Garrett Lee Smith Suicide Prevention Tribal Set Aside is $2.9 million, which is equal to the FY 2018 level.
  • The Tribal set-aside for the Zero Suicide Prevention Initiative is $2.2 million, which is an increase of $200,000 from FY 2018.

Tribal Sovereignty Language:

  • The final bill included language drafted in the initial House committee report that affirms the federal government’s unique political relationship with Tribes as sovereign nations and directs that no funding included in the legislation can undermine that relationship.
  • This is in response to a determination by the Centers for Medicare and Medicaid Services that the agency cannot grant American Indians and Alaska Natives an exemption to state proposed work and community engagement requirements under Medicaid because to do so would be a favorable preference based on race, in violation of the Civil Rights Act. Click here to read more about the House Report language.

It is important to note that IHS funding was only included in the continuing resolution as part of this legislation. The agency’s funding for the full fiscal year comes from the Interior Appropriations bill. That bill’s final language is still being negotiated by a conference committee following the House and Senate’s passage of their own bills. Funding for IHS will now expire on December 7, 2018.

If you have any questions about legislation concerning the Labor-HHS bill in Indian Country, please contact Caitrin Shuy, NIHB Director of Congressional Relations, at cshuy@nihb.org.

Last modified: April 26, 2019