Policy Overview

The Northwest Portland Area Indian Health Board (NPAIHB) conducts health policy and legislative analysis on health care and budget issues affecting Indian health programs. The Board analyzes the Indian Health Service budget and other health care financing programs that impact Indian health care programs. NPAIHB also prepares Congressional testimony for health care financing and other important health policy issues at the federal and state levels. Click on the respective links to access detailed information about each aspect.


There is a “legal and political relationship” between the United States and Indian Tribes, which establishes a federal responsibility to provide health services to Indian people.  This federal obligation is established in the US Constitution, through treaties and Presidential Executive Orders entered into between the United States and Indian Tribes.  This obligation has been affirmed through numerous court decisions, legislation, and policy declarations by Presidential Administrations.  This federal relationship forms the legal and moral foundation for the creation of health policies between the United States and Indian Tribes.

The Northwest Portland Area Indian Health Board is dedicated to upholding the responsibility of the United States to provide health services to Indian people under the federal trust relationship by:

  • Advocating and educating Congressional representatives on treaty rights and how such rights relate to health care in Indian Country.
  • Developing an Annual Legislative plan to provide recommendations on the President’s annual budget and other health care financing programs like Medicare and Medicaid.
  • Tracking legislation and other important health policy issues that affect the delivery of health care to American Indian and Alaska Native people.
  • Finally, facilitating consultation between state and federal agencies and Tribal leaders on health policy issues in order to understand respective concerns to make important decisions on programs and services that effect Indian people.

To learn about Senate Bills and House Reports that may affect American Indian and Alaska Native people in the Northwest read on, or visit Resolutions.

See the Senate Indian Affairs Committee and the House Resources SubCommittee on Indian and alaska Native Affairs for a list of legislation that impacts Indian programs. Pending legislation can be tracked using the Floor Activity weekly feature of Thomas.


The most recent Federal policy updates:

Name Date Size Hits
CMS Emergency Preparedness Final Rule Webinar June 19, 2017 63.6 KiB 7
DTLL DUIOLL 05102017 May 12, 2017 142.1 KiB 32
03 Aoki SUPP May 4, 2017 156.9 KiB 33
DSTAC Draft Agenda May 2017 April 11, 2017 41.7 KiB 46
DTLL And UIO Leader Letter On IHS Funds Final 3-28-17 March 29, 2017 841.2 KiB 43


The Northwest Portland Area Indian Health Board (NPAIHB or Board) understands the significance of tracking appropriations for the Indian Health Service (IHS) budget.  The IHS budget is the most important source of funding for Indian health programs, and is a recognized obligation of the federal government to provide health services to Indian people.

NPAIHB continues a long-standing tradition of close scrutiny of the IHS budget that began in the 1980s.  The federal trust responsibility and the relationship between Tribes and the federal government, by definition, require a partnership in developing the IHS budget.  Northwest Tribes are dedicated to this partnership by creating an Annual Budget Analysis and Recommendations Report as well as tracking appropriations to IHS programs.

The Northwest Portland Area Indian Health Board’s (NPAIHB) resolution process is an important mechanism for policy making and is used to assist decision makers on Indian health matters. The usefulness and need of the Board’s resolution process and decision making are clear:

* Resolutions are used in the Board’s projects, programs, and policies.

* Resolutions assist in the development of Indian health policies.

* Resolutions are used to unite policies and people.

* Resolutions involve input from Tribal constituents (Tribal Leaders, Health Directors, Indian health policy experts, and other Indian health interests).

* Resolutions provide information about Tribal positions for decision makers.

* Resolution development is a proactive process that works toward positive outcomes.

Resolutions are introduced at NPAIHB Quarterly Board Meetings and carried on for introduction at the annual Affiliated Tribes of Northwest Indians (ATNI) conference.  A number of resolutions adopted by ATNI are later introduced at the National Congress of American Indians (NCAI) and form the basis of becoming national Indian health policy issues.  This process establishes an national Indian health policy agenda that becomes a focal point for Tribal leader and Congressional advocacy.

The Northwest Portland Area Indian Health Board is charged with facilitating State–Tribal relationships in Idaho, Oregon, and Washington.  This important aspect is carried out via quarterly meetings between key representatives from State health agencies, Tribal leaders and Health Directors, as well as other Indian health advocates to assure Tribal interests are taken into account as   health policy is formulated.

Information on state health policy matters and other related information that affects American Indian and Alaska Native health programs in the states of Idaho, Oregon and Washington are listed below:

The most recent State policy issues:

Name Date Size Hits
Senate Finance Attachment, 02152017 February 17, 2017 318.4 KiB 51
Letter-to-Governors-and-Commissioners February 17, 2017 1.1 MiB 59
Gov Inslee Finance Dem Medicaid Letter February 17, 2017 496.7 KiB 49
17-0002 Tribal Notice For 2017 COLA January 26, 2017 281.8 KiB 54
11-3-2016 Tribal Medicaid DRAFT Minutes (3) January 25, 2017 455.4 KiB 100

The most recent policy issues for Oregon:

Name Date Size Hits
SB738 March 14, 2017 57.1 KiB 44
Oregon Access Monitoring Review Plan November 1, 2016 767.7 KiB 149
Copy Of OHA Contacts For Tribes 10-28-16 November 1, 2016 33.9 KiB 241
Workgroups-external-roster-full June 9, 2016 144.8 KiB 292
Workgroup-outcomes-quality-efficiency-charter June 9, 2016 134.3 KiB 245

The most recent policy issues for Idaho:

Name Date Size Hits
1915bIBHPWorkgroup Tribal Ltr MW May 24, 2017 265.4 KiB 19
MA1702 1915b Formal Policy Statement May 24, 2017 152.3 KiB 21
17-088 Tribal Notice For Childrens DD March 31, 2017 389.0 KiB 45
17-066 Tribal Notice For A-D Adult DD Waiver Renewals March 9, 2017 423.0 KiB 47
17-0003 Tribal Notice For Covered Outpatient Drugs February 23, 2017 278.8 KiB 42

The most recent policy issues for Washington:

Name Date Size Hits
FAQ SSB 5079 Final March 16, 2017 379.5 KiB 74
5079-S SL March 14, 2017 63.9 KiB 52
Final Washington Tribes SB 5079 Support Letter February 22, 2017 360.8 KiB 79
Senate Finance Committee, Response Letter, 02152017 February 17, 2017 56.6 KiB 59
Senate Finance Attachment, 02152017 February 17, 2017 318.4 KiB 51