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.

Everyone is welcome to join the online Policy Forum

This forum is a discussion space for our tribal communities to share questions, tips, and resources.

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
Enclosure FY18 IHCIF Allocations August 20, 2018 0.1 MiB 3
DTLL FY18 IHCIFAllocations 08172018 August 20, 2018 0.2 MiB 3
NPAIHB Comment SDPI FY 19 Funding Distribution Final May 23, 2018 0.2 MiB 13
Tribal Medicaid Meeting May 2018 Draft Agenda May 10, 2018 66 KiB 22
Joint Letter Requesting Tribal Consultation 4 May 1, 2018 0.5 MiB 18


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 most recent IHS Budget updates:


Name Date Size Hits
NPAIHB Letter To IHS On 97-3 Option 5-18-18 Final May 23, 2018 0.3 MiB 13
DTLL Signed Letter February 16, 2018 0.2 MiB 137
2020-Budget Formulation Support Docs November 1, 2017 0.7 MiB 227
2020 Budget Formulation Deliverables November 1, 2017 0.1 MiB 225
Portland Area – FY2019 Final Budget Worksheet June 15, 2017 61 KiB 354

The most recent Portland Area Facilities (PAFAC) updates:

Name Date Size Hits
Regional Center Fact Sheet And FAQs – September 2, 2010 May 11, 2018 0.3 MiB 7
Pilot Study Interim PAFAC Report 30-Oct-09 May 11, 2018 5.5 MiB 15
9 RSRC – A Fact Sheet 2018 Update May 11, 2018 0.1 MiB 10

The most recent policy issues for Idaho:

Name Date Size Hits
Tribal Notice – SED Premiums SPA 09132018 September 20, 2018 91 KiB 0
2-22-2018 Idaho Tribes DRAFT Minutes May 10, 2018 46 KiB 21
18-001 Tribal Notice IDEA ITP SPA January 31, 2018 41 KiB 108
11-8-2017 Idaho Tribes DRAFT Minutes – Rfb January 29, 2018 0.3 MiB 127
17-255 Tribal Notice DME SPA January 2, 2018 33 KiB 116

The most recent policy issues for Washington:

Name Date Size Hits
FAQ SSB 5079 Final March 16, 2017 0.4 MiB 585
5079-S SL March 14, 2017 64 KiB 313
Final Washington Tribes SB 5079 Support Letter February 22, 2017 0.4 MiB 332
Senate Finance Committee, Response Letter, 02152017 February 17, 2017 57 KiB 281
Senate Finance Attachment, 02152017 February 17, 2017 0.3 MiB 282