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HHS Tribal Affairs Newsletter March 24, 2023

March 24, 2023

Dear Tribal Leaders, Public Health Officials, and Indian Country Professionals:

Patient Protection and Affordable Care Act – 13th Anniversary!

This week the Patient Protection and Affordable Care Act, also known as the ACA, celebrated its 13th anniversary in expanding health coverage, lowering healthcare costs, and protecting beneficiaries with pre-existing conditions. The law was enacted on March 23, 2010, by President Barack Obama. The ACA permanently authorized the Indian Health Care Improvement Act (IHCIA), the backbone of the modern Indian health system that provides critical resources to Tribal serving health facilities, providers, patients, and communities. IHCIA establishes a continuum of care through integrated behavioral health programs (both prevention and treatment) to address alcohol/substance abuse problems and the social service and mental health needs of American Indians and Alaska Natives (AI/ANs). Examples of the IHCIA positively impacting the delivery of Tribal health programs are broad and numerous, including flexible licensing for medical professionals in the Indian health system, participation in the Federal Employee Health Benefits program, and the expansion of long-term care services.Other provisions of the ACA also play an important role in Indian health and ensuring federal resources are maximized for better health outcomes. These include establishing the Indian Health Service (IHS) as the payor of last resort (Section 2901); granting IHS and Tribal health programs permanent authority to collect reimbursements for all Medicare Part B services (Section 2902); and ensuring Tribally provided health benefits are not taxable income (Section 9021). Together the ACA and IHCIA lay cornerstones for the health of Tribal communities, families, and individuals nationwide. A press release on the ACA’s 13th anniversary is available HERE.

HHS Tribal Consultation & Listening Sessions

HHS Annual Tribal Budget Consultation – Final Planning Call with Tribal Leaders: HHS invites Tribal leaders to contribute to the planning for the Annual Tribal Budget Consultation on April 18-19 in Washington, DC. The consultation provides a forum for Tribes to collectively share their views and priorities with HHS officials on national health and human services funding priorities and make recommendations on HHS’s FY 2025 budget request. The final planning call with Tribal leaders for the consultation is on March 29 at 3:00pm ET. Registration information is available in this Dear Tribal Leader Letter.Save the Date – HHS Annual Regional Tribal Consultations this Summer 2023: Each of the ten HHS regions will again be hosting consultations with regional Tribes to discuss programmatic issues and Tribal priorities. Each session will include one-on-one opportunities with regional leadership. The sessions will largely take place in-person, with two regions offering virtual. Dates and locations for the following regions have been set:

·   Region 2 – June 6 in Syracuse, NY

·   Region 5 – July 11-12 in TBD

·   Region 9 – June 28-29 in Phoenix, AZ

·   Region 7 – June 20-22 in Kansas City, MO

·   Region 10 – August 10-11 in Anchorage, AK

The save the dates for all regions are noted in the same Dear Tribal Leader Letter as the Annual Tribal Budget Consultation. More details will be coming directly from each region to the Tribes in that region.Food and Drug Administration (FDA) Tribal Consultation on the Tobacco Product Manufacturing Practice: FDA is inviting Tribes to consult on its proposal to establish tobacco product manufacturing practice requirements for manufacturers of finished and bulk tobacco products. The changes are intended to assure greater public health protections and compliance with Chapter IX of the Federal Food, Drug, and Cosmetic Act. Full discussion on the potential changes is set forth in the Federal Register Notice of Proposed Rulemaking. The virtual Tribal consultation will be on April 11 at 2:00pm ET; please register HERE. A public written comment period on the FDA’s proposal is also open through September 6, 2023.Office of Child Support Enforcement (OCSE) Tribal Child Support Consultation: The Administration for Children and Families OCSE invites Tribes to consult on issues related to Tribal child support systems, including legislative proposals, regulatory changes, and program expenditures. Tribal leaders can attend either virtually or in-person in Atlantic City, New Jersey, on April 6 from 9:00am – 4:00pm ET. To facilitate the discussion, OCSE has prepared guiding questions for Tribal leaders to consider in its Dear Tribal Leader Letter on the consultation. Written comments are requested by May 6 (Sunday) to OCSE.Tribal@acf.hhs.gov.

Substance Abuse and Mental Health Services Administration (SAMHSA) Listening Session on Medication Access and Training Expansion Act: SAMHSA invites Tribal leaders to join an educator listening session in coordination with the Drug Enforcement Administration on implementation of the Medication Access and Training Expansion Act. The agencies seek Tribal perspectives on opioid and substance use disorder training elements, particularly as they relate to Tribes and Indian Country. The listening session will take place on March 27 at 12:00pm ET. Please see the https://www.samhsa.gov/sites/default/files/tribal-listening-session-tribal-letter-03272023.pdfDear Tribal Leader Letter for registration information and discussion questions.


Other Tribal Consultation

Department of the Interior and Office of Personnel Management Consultation on Tribal Consultation Training for Federal Employees: On November 30, 2022, the President issued a Memorandum on Uniform Standards for Tribal Consultation to provide greater consistency across the Federal Government in the Tribal consultation process. The Memorandum included a component on the establishment of training modules for Federal employees regarding Tribal consultation. The Department of the Interior and Office of Personnel Management invite Tribal leaders to provide suggestions on the initial design of these consultation training modules. The consultation will be on April 17 at 2:00pm ET with written comments being accepted through May 17, 2023. Please see the attached  Dear Tribal Leader Letter for more information.

Tribal Advisory Committee (TAC) Updates

ACF TAC Vacancies: The ACF is soliciting nominations from the Albuquerque, Billings, and Phoenix Areas to serve on its TAC and advise ACF leadership on priority areas impacting programs and services in Indian Country. Further information on the TAC, including is Strategic Priorities and Charter, is available HERE . The next meeting of the TAC will take place virtually on April 20. Nominations can be sent to anacomments@ACF.hhs.gov.

Centers for Disease Control and Prevention/ Agency for Toxic Substances and Disease Registry (CDC/ATSDR) TAC Vacancies: Nominations continue to be solicited for CDC/ATSDR TAC vacancies in the Albuquerque, Billings, Great Plains, and Tucson Areas, as well as two National At-Large positions. Elected Tribal officials and designated Tribal officials are eligible to serve on the TAC to advise the agencies on public health, disease prevention and mitigation, programmatic issues, and policy impacting Indian Country. Final nominations are due on March 31, and materials may be submitted to TribalSupport@cdc.gov.

Health Resources and Services Administration (HRSA) TAC Request for Nominations: HRSA is seeking nominations of qualified Tribal officials to serve on its TAC. Specifically, nominations are requested to fill five candidate vacancies and designated alternates from four Indian Health Service Areas: Bemidji, California, Phoenix, Great Plains, and Navajo. The HRSA TAC provides a forum for elected tribal officials and HRSA staff to exchange views, information, or advice about emerging public health issues in Indian Country, the identification of urgent public health resources and service needs, and collaborative approaches to address the issues and needs of AI/AN populations. TAC inquiries can be sent to aianhealth@hrsa.gov.National Institutes of Health (NIH) TAC Vacancies: NIH is soliciting nominations from the Alaska, Albuquerque, Bemidji, Billings, California, Navajo, Phoenix, Tucson, and National At-Large Aras to serve on its TAC and advise NIH leadership on priority areas impacting research, programs, and policies—including data—in Indian Country. Detailed information on the TAC and its activities is available HERE.SAMHSA is Soliciting Nominations for Tribal Technical Advisory Committee (TTAC) Delegates: TTAC Delegates advise SAMHSA on programs and initiatives impacting Tribal communities, including Tribal behavioral and mental health priorities. The TTAC currently has vacancies in the following areas and positions: Bemidji (Alternate), Billings (Alternate), California (Alternate), Nashville (Alternate), Phoenix (Primary and Alternate), Tucson (Primary and Alternate), and National At-Large (Primary). The next meeting of the TTAC will take place on April 25 in Rockville, Maryland. Links to the TTAC Charter and other background information are included in this Dear Tribal Leader Letter. Nominations may be sent to otap@samhsa.hhs.gov

Departmental Updates

President Biden Releases FY 2024 Budget Proposal: The President’s proposal continues to build towards fulfilling his Unity Agenda and addressing critical needs across all sectors. It includes $9.7 billion in total resources for the Indian Health Service, which would be an increase of $2.5 billion above FY 2023 enacted. The President proposes discretionary funding for the Services and Facilities accounts, and mandatory funding for Contract Support Costs and Payments for Tribal Leases. The budget would make all IHS funding mandatory beginning in FY 2025, and that funding would grow automatically based on a formula thereafter. The President’s Factsheet on funding for Tribes and Tribal serving programs under the FY 2024 Budget is accessible HERE. HHS Secretary Xavier Becerra’s statement on the FY 2024 budget and HHS Budget Justification to Congress are also both available HERE.HHS Announces Availability of $25 Million to Expand Mental Health and Primary Care Services in Schools: For the first time, school-based health centers funded by the Health Resources and Services Administration (HRSA) will be required to add or expand mental health services to receive their support. The requirement advances the Biden-Harris Administration’s priority of improving access to behavioral health services nationwide—a key pillar of the President’s Unity Agenda. Applications for an allocation of this funding are due on March 31 through the Competitive School-Based Service Expansion opportunity announcement.ACF National Convening on Building an Inclusive Human Services System: On March 28-29, ACF will host a free, hybrid event focused on inclusivity across the human services system. The event includes a session on “Empowerment for Equitable Outcomes in the Tribal Community” at 1:45pm ET on March 28. Education and skills-based sessions for practitioners, advocates, and researchers will also be amply provided. Please see the agenda for more information.Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and Disease Registry (ATSDR), and Office of Environmental Justice Information Session on the Environmental Justice Index: Tribal leaders will have an opportunity to receive an overview and demonstration of the Environmental Justice Index, a tool used to rank the cumulative impacts of environmental injustice on health for every tract in the Census. A Dear Tribal Leader Letter (attached) invites Tribal input on actions that can be taken to support Tribal representation within the Environmental Justice Index. Registration for the session, which begins at 3:00pm ET on April 19, is available HERE.Centers for Medicare and Medicaid Services (CMS) COVID-19 Public Health Emergency (PHE) Unwinding Communications Toolkit: The COVID-19 PHE will end on May 11, 2023. CMS has prepared an enrollment toolkit to assist individuals with Medicaid or in the Children’s Health Insurance Program on renewing their coverage or transition to other coverage if they are no longer eligible. The toolkit provides advice on how to effectively convey information on renewal forms, the Federal health insurance Marketplace, and more through different communication methods (email, U.S. Postal Service, social media, call center, etc.).CMS All Tribes Webinar on Returning to Routine Operations After the PHE: On March 27 at 3:00pm ET, CMS will be hosting a webinar to discuss the return to the regular operation of Medicaid and CHIP Disaster Relief state plan amendments and Section 1135 waivers. The session will provide an update on planning and actions for transitioning back to normal regulatory and statutory requirements. CMS has a Spotlight webpage where it has gathered registration information, background resources, and related materials for Tribes.FDA Calls on Manufacturers for Enhanced Powdered Infant Formula Safety Measures: FDA sent a letter to entities involved in the manufacturing and distribution of powdered infant formula on increasing protections to improve the microbiological safety of powdered infant formula. In late 2021 and early 2022, the industry was severely impacted by the contamination of Cronobacter in certain powdered infant formula, leading to infant illnesses and a nationwide supply shortage. FDA outlines areas of concern and industry calls to action.FDA Issues Request for Information on Commercial Tobacco Retailer Inspections: FDA is soliciting Tribal comments on the conduct of commercial tobacco retail inspections on Tribal lands. The inspections are for compliance with certain provisions of the Food, Drug, and Cosmetic Act. The Request for Information also includes a Contract Opportunity for conducting the inspections. Please see the FDA’s landing page on this solicitation for more detailed information.HRSA Grant Application Reviewers: HRSA is soliciting applications for qualified individuals to serve as AI/AN grant reviewers. The reviewers will serve on objective review committees comprised of outside experts (i.e., non-grantees) who review HRSA grant applications. There are currently 1,148 reviewers who identify as AI/AN in the agency’s Reviewer Recruitment Module database. HRSA would like to expand this number, and encourages interested individuals to visit its Reviewer Recruitment website for more information. IHS Women’s History Month Fireside Chat with Leadership: IHS is “Celebrating Women Who Tell Our Stories” through a fireside chat with IHS leaders on March 30 at 2:00pm ET. The panel discussion will feature IHS Director Roselyn Tso, IHS Deputy Director for Intergovernmental Affairs Stacey Ecoffey, Office of Urban Indian Health Programs Director Rose Weahkee, and several Area Directors. Registration information is available on the IHS Calendar.IHS Issues Dear Tribal Leader and Urban Indian Organization Leader Letter on its Communication Activities: IHS is sharing information with Tribal leaders on its communication activities across different platforms. These include invitations for Tribes and urban Indian organizations to join monthly calls, sign up for IHS Updates (via IHSPublicAffairsStaff@ihs.gov), and follow the agency on social media. IHS also highlights the ongoing development and implementation of its workplan, with key priorities summarized in a factsheet and summary. Please see the Dear Tribal Leader Letter for an assortment of helpful communications links.National Institutes of Health (NIH) Announces New Director of the Tribal Health Research Office (THRO): Karina Walters, Choctaw Nation of Oklahoma, has succeeded Dave Wilson as the Director of the THRO. Mr. Wilson is on assignment to the White House Council on Native American Affairs. Dr. Walters is a social epidemiology and health prevention scholar with more than 28 years of experience in AI/AN health research. You may read more about Dr. Walters’ background in the NIH’s Director’s Statement.  

Funding Announcements

ACF Tribal Court Improvement Program Accepting Grant Proposals: Tribal governments and consortia are eligible to apply for ACF funding to improve the handling of AI/AN child welfare cases before Tribal courts. The funds can be used for court assessments, implementing assessment-based changes, ensuring child well-being, and quality improvement of court proceedings and legal representation. Grant awards will range from $50,000 to $150,00. Additional information is available in the Notice of Funding Opportunity . Applications are due by June 15. Questions may be directed to Scott Trowbridge, Federal Project Officer, at scott.trowbridge@acf.hhs.gov.ANA Trainings on Grant Application Preparation: To assist Tribes in optimizing their grant applications for ANA funding, the agency is hosting a series of both in-person and virtual trainings. The trainings will cover navigating a Notice of Funding Opportunity, framing community-based projects per the scoring criteria, and steps of the submission process. ANA applicant training and technical assistance resources are available HERE.Administration for Native Americans (ANA) Native American Language Preservation and Maintenance (P&M) and Esther Martinez Immersion Grants: ANA is accepting applications for grant programs supporting Native language preservation, revitalization, and instruction. The Native American Language P&M Grants focus on Native language assessments, as well as curriculum and educational project planning, design, restoration, and implementation. The Esther Martinez Immersion Grants support immersion-based linguistic instruction provided in either a Native American Language Nest or Native American Survival School. Both grant awards may range from $100,000 to $300,000. Applications are due March 31, 2023 via www.grants.gov.ANA Environmental Regulatory Enhancement Grants: The Environmental Regulatory Enhancement program administered by the ANA provides funding to improve Tribal environmental programs and the internal regulatory capabilities of Tribal governments. Covered activities may be related to cultural preservation, natural resource stewardship, sustainability, and environmental quality (including Tribal law and policy). Additional information is available in the Notice of Funding Opportunity announcement. Applications are due March 31, 2023.ANA Social and Economic Development Strategies (SEDS) Grants: Applications are being solicited for the ANA SEDS and SEDS for Alaska-SEDS-AK grant programs. Both programs focus on supporting community-driven projects that strengthen Tribal social and economic infrastructure and preserve Native American cultures. The Alaska-SEDS-AK program includes additional targeted support for self-sufficiency for Alaska Natives. Applications for both grants are due March 31, 2023 via www.grants.gov. Please click HERE for the SEDS grant opportunity, and HERE for the SEDS for Alaska-SEDS-AK grant information.HRSA Advanced Nursing Residency and Fellowship Program: HRSA’s Bureau of Health Workforce is supporting nursing education and workforce development through the establishment, expansion and/or enhancement of existing community-based Nurse Practitioner residency and fellowship training programs. The program also focuses on the integration of behavioral health and/or maternal health into primary care with targeted training for new primary care providers, behavioral health providers, and Certified Nurse Midwives. Eligible entities have until April 11 to apply. Please see the Grant Opportunity announcement for more.IHS Grant for Preventing Alcohol-Related Deaths Through Social Detoxification: IHS is soliciting funding applications to increase access to community-based prevention strategies that provide social detoxification and treatment readiness support for individuals with alcohol and other substance use disorders. The program is part of IHS’s efforts to expand access to a continuum of services related to substance use disorders, detoxification, and recovery. There is no match requirement associated with this cooperative agreement opportunity, which can be flexibly designed to meet a Tribal community’s unique needs. Applications are due on March 31 via www.grants.gov (HHS-2023-IHS-PARD-0001).SAMHSA Native Connections Grant Opportunity for Tribal Behavioral Health: This program aims to prevent and reduce suicidal behavior and substance use disorders, as well as promote mental health among Native youth by fostering a healthy network of support services and partnerships. Projects may be designed for up to a 5-year duration with proposed budgets of up to $250,000. Additional eligibility information is set forth in the Grant Opportunity announcement. Applications are due by May 15 and will reopen on an annual basis.

Education and Professional Development

Berkley Public Health Scholarships for Master’s Degree in Rural Public Health: The University of California, Berkley, is sponsoring 100 fully paid scholarships for students to pursue an online Master’s Degree in Public Health through its Rural Health Innovation Program . The 27-month program is designed for working individuals interested in improving their knowledge and practice in public health. The scholarship covers tuition, books, fees, and travel expenses, among others. An additional opportunity to study rural public health policy in Washington, DC, is also available under the program. Applications are due August 13, 2023, to start in January 2024. CDC Epidemic Intelligence Service (EIS) Open Recruitment: The CDC is soliciting applications for its EIS Class of 2024. EIS officers practice applied epidemiology across a wide range of areas, such as infectious diseases, injury prevention, environmental health, and occupational health at the CDC or in health departments. Eligible applicants include physicians, veterinarians, nurses, physician assistants, and other Doctoral-level healthcare professionals and scientists. Among the program benefits is a student loan repayment in exchange for a two-year service agreement. Please visit the EIS Program website for full details.CDC ORISE Research Participation Program: The CDC offers an educational and training program to connect college students, recent graduates, and university faculty with research experiences at CDC facilities. Application deadlines vary by research and fellowship opportunity, please review the Opportunity Numbers HERE and contact CDCrpp@orau.org for more.  Young Native Women Mentorship Opportunities: The Indigenous Justice Circle and Indigenous Adolescent Girls’ Empowerment Network seek young Native women interested in gaining experience and mentorship for their professional development. The entities are funding applicants engaged in the following areas: (1) Civil Rights or Cultural Preservation/Renewal; (2) Earth, Land, and Climate Justice; (3) Accessibility and Disability Rights; and (4) Gender Transformative Justice. Applications close on March 31. More information is available HERE.

Other Resources and Opportunities

AmeriCorps State and National Native Nations Grants: AmeriCorps is an independent agency focused on civic engagement to strengthen communities. The National Native Nations Grants program prioritizes funding for an array of public health, climate, education, and economic opportunity projects in Tribal communities. Tribes and Tribally-authorized organizations may apply for either 3-year operating grants and/or 1-year planning grants. Applications are due by April 5, 2023, at 5:00pm EST.United States Global Change Research Program Requests Public Input on First Ever National Nature Assessment: The Office of Science and Technology Policy requesting the assistance of all Americans to increase our knowledge of nature and its links to global change. The input received during the National Nature Assessment will inform the framing, development, and eventual use of the information for national policy. The Request for Information includes guiding questions for the public to consider—such as what does nature mean to you and what existing knowledge should the report draw from and why—though wider comments are also welcomed. The solicitation closes on March 31, 2023.****Please don’t hesitate to contact us if you have any questions!Tribal Affairs TeamOffice of the Secretary | Intergovernmental and External AffairsDepartment of Health and Human Services

Last modified: March 29, 2023