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Washington Report: Issue 19-13

March 28, 2019

IHS Congressional Justification for FY 2020 Now Available

On Monday, March 25, 2019, the Indian Health Service (IHS) released its Congressional Justification (CJ) which provides additional details in support of President Trump’s Budget proposal priorities to enhance the health and well-being, strengthen direct medical services and expand efforts to improve medical quality at IHS facilities.

You can view the full CJ here.

Overall, the budget proposes increases to current services (+$68.8 Million), staffing and operating costs for newly-constructed Health Care facilities (+$97.5 Million) and the following programs:

  • Direct Health Care Services (+146.6 million): Expand access to hospitals and health clinics, dental health, mental health, and alcohol and substance abuse;
  • Contract Support Costs (+$137.0 million): Support self-determination by fully funding contract support costs for Tribes that manage their own programs;
  • Ending the Hepatitis C and HIV/AIDs Epidemic in Indian Country (+$25.0 million): Provide patients with treatment and case management services to prevent and treat Hepatitis C infection due to injection drug use and fund data collection to measure outcomes. The initiative would also enhance HIV testing and linkages to care in support of the Ending HIV Epidemic Initiative;
  • New Tribes (+$11.5 million):

Fund the delivery of health care services for six newly federally recognized Tribes.

  •  Recruitment & Retention (+$8.0 million) Provide competitive employment packages, including a housing subsidy for critical positions with high vacancies at remote sites and increased pay through the use of Title 38;
  • New ItemElectronic Health Record Modernization (+$25.0 million): Support the IHS Electronic Health Record System transition.

Also, the budget includes $24 million to begin phasing out the Community Health Representatives (CHRs) in favor of the Community Health Aide Program (CHAP) and would eliminate funding for the Health Education funding in FY 2020.  The Tribal Management Grant program was also recommended for discontinuation in favor of prioritizing health care services, staffing newly constructed facilities.

 

The President’s budget request to Congress is only a proposal, and Congress will have the final say in what funding IHS receives in FY 2020. You can read what the Tribal Budget Formulation Workgroup’s Request for FY 2020 here.

In This Issue:

 

TOP STORY

IHS Congressional Justification for FY 2020 Now Available

 

NIHB UPDATES

Register Now! Tribal Public Health Summit
Register Now! AI/AN National Behavioral Health Conference

NIHB to Celebrate National Tribal Public Health Week

NIHB Health Policy Fellowship Applications Are OPEN!

 

CAPITOL HILL UPDATES

Senator Tom Udall announces he will not seek reelection in 2020

 

FEDERAL ADMINISTRATION AND STATE GOVERNMENT UPDATES 

CMS Releases Report on Year One of its Quality Payment Program

Medicare Card Mailing Updates

Medicare Advantage Open Enrollment Period Ends This Week!

Most recent US Census estimates depict Disability Rates for American Indians and Alaska Natives that are double that of All Americans for adults 35 to 64 years old

UPCOMING EVENTS, CALLS, AND WEBINARS

April 3-4 & 23-24: CMS ITU Trainings

April 23-24: HHS Annual Tribal Budget Consultation

April 30: The U.S. Commission on Civil Rights Report “Broken Promises: Continuing Federal Funding Shortfall for Native Americans” Webinar

GRANTS AND RESOURCES

CDC Funding Opportunities

SAMHSA Funding Opportunity: Substance Abuse in Youth Living in Tribal Communities

HHS Grants to Prevent Teenage Pregnancy

Resources Available to Tribes on Health Issues

NIHB UPDATES
Register Now! Tribal Public Health Summit 

Please join The National Indian Health Board (NIHB) for the 10th Annual National Tribal Public Health Summit (TPHS) May 13-15, 2019 in Albuquerque, New Mexico at the Albuquerque Convention Center.  The National Tribal Public Health Summit is a premiere Indian public health event that attracts over 500 Tribal public health professionals, elected leaders, advocates, researchers, and community-based service providers.   This year’s Summit will feature dynamic national speakers, interactive workshops and roundtable discussions, a welcome reception, the annual Special Diabetes Program for Indians poster session, a morning fitness event, culture night, as well as the presentation of the 2019 Native Public Health Innovation awards!

Summit Tracks

  • Health Promotion and Disease Prevention
  • Public Health Policy, Infrastructure, and Systems
  • Substance Misuse and Behavioral Health
  • Environmental Health and Climate Change
  • Emergency Preparedness and Emerging Issues in Public Health

CLICK HERE to register!

 
Register Now!  AI/AN National Behavioral Health Conference 

Please join the National Indian Health Board (NIHB) for the 2019 American Indian and Alaska Native National Behavioral Health Conference at the Albuquerque Convention Center in Albuquerque, New Mexico. The American Indian and Alaska Native National Behavioral Health Conference is the premier behavioral health event attracting over 500 Tribal behavioral health experts, public health professionals, federal employees, advocates, researchers and community-based providers.

Conference Tracks

  • Community-Based Behavioral Health Services
  • Sharing Traditional Best and Promising Practices
  • Behavioral Health Integration – Substance Use Disorders, Mental Health Disorders, Suicide Prevention
  • Behavioral Health Workforce Innovation
  • Methamphetamine and Suicide Prevention Initiative and Domestic Violence Prevention Initiative Grantee Track

CLICK HERE to register!

 
NIHB to Celebrate National Tribal Public Health Week 

Monday to Friday, April 1-5, 2019

In recognition of the American Public Health Association’s (APHA) National Public Health Week, the National Indian Health Board (NIHB) is celebrating Tribal Public Health Week from April 1st-5th! Join us throughout the week by participating in one of our activities. See the list of events here.
NIHB Health Policy Fellowship Applications Are OPEN! 

Are you a Native youth 18-24 years old? Learn advocacy skills so you can make a difference in the health of your community!

 

Applications due: March 30th 2019

Learn more here

Got Questions? Contact NIHB’s Native Youth Engagement Manager, Dr. Wendee Gardner at wgardner@nihb.org or (202) 548-7297.

 

Click here to submit your application!

CAPITOL HILL UPDATES
Senator Tom Udall announces he will not seek reelection in 2020

On Monday, March 25, Senator Tom Udall (D-NM) announced that he will not seek reelection in 2020. The two

term Democratic Senator has had a long career serving the state of New Mexico. Before his two terms as Senator he served as the state’s Attorney General and then went on to serve in the House of Representatives. Although he will be leaving his Senate seat in 2020, Udall said, “Now, I’m most certainly not retiring. I intend to find new ways to serve New Mexico and our country after I finish this term. There will be more chapters in my public service to do what needs to be done.”

 

Udall currently serves as the Vice Chairman of the Senate Committee on Indian Affairs and is a strong ally to Indian Country. He is also the Ranking Member of the House Appropriations Subcommittee on Interior, Environment, and Related Agencies, which is responsible for funding the Indian Health Service. With almost two years left in his term, Udall said, he with continue “to fight the urgent threat of climate change, dramatically expand clean energy and protect our public lands and forests.”

 

You can read Senator Udall’s official statement here.

FEDERAL ADMINISTRATION AND STATE GOVERNMENT UPDATES
CMS Releases Report on Year One of its Quality Payment Program

On March 21, 2019, the Centers for Medicare and Medicaid Services (CMS) released a report on 2017’s data for its MIPS (Merit-Based Incentive Payment System) and Advanced Alternative Payment Models (Advanced APMs), both tracks of the Quality Payment Program.  The goal of these programs is to improve patient outcomes as well as quality of care.  In year one, MIPS data was collected from 95 percent of eligible physicians, and 93 percent of these participants received a positive payment adjustment.

 

For more information on this MIPS and Advanced APMs, please contact NIHB’s Director Policy, Devin Delrow, at ddelrow@nihb.org.

Medicare Card Mailing Updates

As of October 2018, the seven waves of new Medicare cards were sent to current Medicare beneficiaries.  From January through April 2019, new Medicare cards will be sent to newly-eligible people with Medicare.  If you haven’t received your card and you were eligible for Medicare before October 2018, please log into  mymedicare.gov or call1-800-MEDICARE (1-800-633-4227) for guidance.

 

For more information, please contact NIHB’s Director Policy, Devin Delrow, at ddelrow@nihb.org

Medicare Advantage Open Enrollment Period Ends This Week!

The Centers for Medicare and Medicaid Services (CMS) added a new Open Enrollment Period for Medicare Advantage enrollees to make changes to or drop their coverage.  The Medicare Advantage Open Enrollment Period (MA OEP) runs from January 1 – March 31, 2019.  This enrollment period is a good time to switch from Medicare Advantage plan to Original Medicare plan if you find that MA does not suit your needs.  For example, IHS and Tribal (I/T) providers may not always be in-network for MA plans.  AIANs can see their local Patient Benefit Coordinator (PBC) to assist them with understanding which changes are applicable during this enrollment period.

For questions about outreach and education, please contact Kristen Bitsuie at kbitsuie@nihb.org.

Most recent US Census estimates depict Disability Rates for American Indians and Alaska Natives that are double that of All Americans for adults 35 to 64 years old

New estimates from the five-year American Community Survey (ACS, 2013 to 2017) indicate very high disability rates for American Indians and Alaska Natives in every state with large Indian populations.  The five-year ACS estimate pools data over five years in order to allow estimates with smaller error rates for sub-categories such as states, age categories, and income categories.   Although the US Census does not produce reports on disability rates for American Indians and Alaska Natives, one can access and analyze this data using Dataferret or other statistical software.

 

A March, 2019 NIHB analysis of the 2017 five-year ACS estimates depicts very high rates of disability that are double that of all races rates for 35 to 64 year olds.   The rate nationally for all races is 13.2% and the rate for American Indians and Alaska Natives is 25.6%.  A very large disparity  (33% higher) also exists for those 65 years and older with the all races disability rate of 37% and the rate for American Indians and Alaska Natives 50% (despite a lower average age for American Indians and Alaska Natives 65 years and older).

 

The higher disability rates have many causes including high prevalence of diabetes, occupational risks, and the rural characteristics of many Indian communities.  Beyond the impact on human suffering, the cost of care for a population with higher rates of disability has a profound impact on an underfunded Indian health system.  More funding needs to be directed to the prevention of disabilities to lower these costs and more importantly reduce the inexcusably high level of suffering associated with these higher disability rates.

 

For questions regarding this topic, contact NIHB’s Data Project Director, Ed Fox, at efox@nihb.org.

UPCOMING EVENTS, CALLS, AND WEBINARS
Upcoming CMS ITU Trainings

April 3-4, 2019

Embassy Suites- Pioneer Square
255 South King Street
Seattle, WA 98104

 

April 23-24, 2019

Marriott Albuquerque

2101 Louisiana Boulevard NE

Albuquerque, NM 87110

 

For more information, and to register, click here.

April 23-24: HHS Annual Tribal Budget Consultation

The 21st U.S. Department of Health and Human Services (HHS) Annual Tribal Budget Consultation (ATBC) will take place April 23 – 24, 2019, at the Hubert H. Humphrey Building (200 Independence Avenue, SW, Washington, DC).

 

The annual consultation provides a forum for Tribes to collectively engage with HHS officials to share their views, priorities, and recommendations with HHS officials on national health and human services funding priorities for the Department’s FY 2021 budget request. The consultation provides a venue for a two-way conversation between Tribal leaders and HHS officials on program issues and concerns that lead to recommendations for action.

 

HHS will host planning calls with Tribes for the consultation to discuss agenda topics and structure.  The planning calls will begin on Wednesday, March 20 at 3:00 PM ET.  Please see below for a schedule for all planning calls:

  • March 27, 2019 @ 3:00 PM ET
  • April 3, 2019  @ 3:00 PM ET
  • April 10, 2019 @ 3:00 PM ET
  • April 17, 2019 @ 3:00 PM ET

Conference Call Number (for every call)

Call In Number: 866-617-3597

Participant Code: 3464707

 

Tribal Written Testimony Submission

HHS will accept written testimony from Tribes for the official record. Testimony should be submitted by Thursday, April 18, 2019. Testimony can be emailed to consultation@hhs.gov.  The consultation record will remain open for 30 days after the formal face-to-face consultation session wherein additional testimony will also be accepted.

 

Please contact Elizabeth Carr, Associate Director of Tribal Affairs, at 202-690-6060 or consultation@hhs.gov with any questions. Click here for the Dear Tribal Leader Letter announcing the consultation.

April 30: The U.S. Commission on Civil Rights Report “Broken Promises: Continuing Federal Funding Shortfall for Native Americans” Webinar

The Section of Civil Rights and Social Justice’s Native American Concerns Committee will host this webinar focusing on the U.S. Commission on Civil Rights latest report, Broken Promises: Continuing Federal Funding Shortfall for Native Americans.

The Broken Promises report is based on expert and public input, including from NIHB, and extensive research and analysis. The report found that funding for services critical to Native Americans was disproportionately lower than that for other populations.

Date: Tuesday, April 30, 2019

Time: 1:00 – 3:00 PM ET

Register Here: https://attendee.gotowebinar.com/register/5114893304572980738

Panelists:

  • W. Ron Allen, Tribal Chair/CEO, Jamestown S’Klallam Tribe
  • Lynn Malerba, Lifetime Chief, The Mohegan Tribe
  • Commissioner Karen K. Narasaki, United States Commission on Civil Rights
  • Geoffrey D. Strommer, Partner, Hobbs Straus Dean & Walker, LLP (Moderator)
Grants and Resources
CDC Funding Opportunities

National Institutes of Health*

    • Application Due Date: April 05, 2019
    • Application Due Date: April 05, 2019

 

National Institute for Occupational Safety and Health (NIOSH)

    • Application Due Date: September 8, 2019
    • Application Due Date: September 8, 2019

*The National Institutes of Health NOFOs are included in this list of CDC funding opportunities because these NOFOs are multi-agency collaborations with CDC. The National Institutes of Health are *not* a part of CDC.

SAMHSA Funding Opportunity: Substance Abuse in Youth Living in Tribal Communities

The program is intended to prevent underage drinking; at their discretion, grantees may also use funds to target up to two additional, data-driven substance abuse prevention priorities, such as the use of marijuana, cocaine, opioids, or methamphetamine, etc. Applications are due March 29th.

 

Eligibility is limited to 1) federally recognized American Indian/Alaska Native (AI/AN) Tribes, Tribal organizations, Urban Indian Organizations, or consortia of Tribes or Tribal organizations and 2) domestic public or private non-profit entities. Recipients who have received funding under SP-16-003 and SP-18-008 are not eligible to apply for funding under this FOA.

 

Website Info: https://www.samhsa.gov/grants/grant-announcements/sp-19-004

FOA Number: SP-19-004

HHS Grants to Prevent Teenage Pregnancy

The U.S. Department of Health & Human Services (HHS) will make 30 awards of up to $500,000 each to replicate programs that have been proven effective to reduce teenage pregnancy and the behavioral risk factors underlying it.  Eligible applicants include state, local and Tribal governments; nonprofit and for-profit organizations; community- and faith-based organizations; institutions of research and higher education; as well as small, minority, and women-owned businesses.  Approved projects will identify population segments within their community for which teenage pregnancy and contributing risk factors remain high and implement evidence-based strategies. Last year, the Robert Wood Johnson Foundation County Health Rankings found that while national teen birth rates have been declining for more than a decade, teen pregnancy in rural counties is still nearly twice the rate of teens in suburban counties.  Childbearing by teenage mothers has significant impact on rates of infant mortality and is an important indicator of maternal and child health.

 

Due: April 15, 2019 

Click here for a PDF version of the grant announcement.

 

Additional information: While younger adolescents may be included in the project, the HHS Office of Adolescent Health expects that services will also focus on adolescents 15-19 years of age, recognizing the importance of reinforcing healthy decision-making throughout adolescence. Each selected community must be defined by clear geographic boundaries in order to assure that the number of youth served can be identified and rates of teenage pregnancy and other associated risk factors can be monitored.

 

Federal Contacts: 

Administration and budget: HHS/Office of Grants Management Roscoe Brunson, 240-453-8822

Roscoe.brunson@hhs.gov

 

Program Requirements and Technical Assistance: HHS/ OASH Office of Adolescent Health

Latrece Timmons 240-453-2846 FY19TPPTier1FOA@hhs.gov

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.

 

Don’t miss this opportunity to learn about 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.

 

New Medicare Cards

New Medicare Cards are being mailed to beneficiaries, beginning April 2018 through April 2019 and may be used as soon as they are received. New Medicare cards will no longer include beneficiaries’ social security numbers and will use new, unique Medicare numbers.

 

CMS’s New Medicare Care Webpage includes additional resources, such as a “New Medicare Cards are Coming” informational video and materials on their New Medicare Card Mailing Strategy.

 

 

Maternal Opioid Misuse (MOM) Model

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.

Last modified: November 11, 2019