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
NPAIHB Native Veterans Needs VA MISSION ACT June 13, 2019 0.3 MiB 1
DTLL VA Mission Act Roll Out June 19, 2019 0.4 MiB 1
Letter To Tribal Leaders April 19, 2019 59 KiB 4
SPONSOR PACKAGE 2019 February 4, 2019 0.5 MiB 6
SELFGOVERNANCE CONFERENCE 2019 February 4, 2019 0.1 MiB 7
DRAFT AGENDA TOPICS SG Conference Jan 30 February 4, 2019 0.9 MiB 8
NPAIHB CHAP Interim Policy Comment FINAL SUBMITTED June 13, 2019 0.1 MiB 8
DTLL FY18 IHCIFAllocations 08172018 August 20, 2018 0.2 MiB 11
CMS Medicaid And CHIP Managed Care Proposed Rule Comments January 14- 2019 January 15, 2019 0.4 MiB 12
Enclosure FY18 IHCIF Allocations August 20, 2018 0.1 MiB 15
NPAIHB ONC Health IT Strategy FINAL January 29, 2019 0.1 MiB 15
DTLL SDPI 04132018 April 20, 2018 0.1 MiB 20
NPAIHB Comment SDPI FY 19 Funding Distribution Final May 23, 2018 0.2 MiB 22
DTLL CSC 04132018 April 20, 2018 0.1 MiB 23
Joint Letter Requesting Tribal Consultation 4 May 1, 2018 0.5 MiB 33
Tribal Medicaid Meeting May 2018 Draft Agenda May 10, 2018 66 KiB 55
O'Halleran Ltr To Leadership – ACA And IHCIA February 1, 2017 0.1 MiB 143
TSGAC – Timeline Of Key ACA-Related Congressional Activities 2017-02-13b .. February 28, 2017 0.3 MiB 152
TSGAC Memo – Applicable Percentages Thresholds And Payments For ACA Prov .. February 28, 2017 0.3 MiB 158
DSTAC TSGAC Sep 14 Letter Response 10 October 25, 2017 47 KiB 160
TSGAC Memo-Net Marketplace Premium Costs Hold Or Lower In 2017 2017-01-1 .. February 28, 2017 0.3 MiB 186
DTLL And UIO Leader Letter On IHS Funds Final 3-28-17 March 29, 2017 0.8 MiB 198
TSGAC Memo – IHS Reimbursement Rates For CY 2017 – 2016-02-06b February 28, 2017 0.2 MiB 199
2016 12 09 ACA Letter February 17, 2017 0.1 MiB 203
IHS Letter To Tribal Leaders – CSC Policy Update – 10-27-2016 October 27, 2016 0.6 MiB 211

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
TAB 6(A) – 2020 PAIHS Submission National Budget Worksheet With Negative October 24, 2018 0.1 MiB 6
TAB 6(B) 2020 PAIHS Submission National Budget Worksheet Without Negative October 24, 2018 0.1 MiB 7
TAB 2 – FY 2021 Area Instructions Package October 24, 2018 0.8 MiB 8
TAB 4 – 2021-Budget Formulation Support Docs October 24, 2018 0.7 MiB 8
FY 2020 PA Budget Submission Summary HANDOUT October 24, 2018 53 KiB 9
TAB 7 – 2020 PAIHS Submission Hot Issues FY2020 FINAL October 24, 2018 93 KiB 9
TAB 3 -National Budget Worksheets Guidance And Budget Line Descriptions October 24, 2018 0.2 MiB 10
TAB 3 -National Budget Worksheets Guidance And Budget Line Descriptions October 24, 2018 0.2 MiB 10
TAB 5 – 2020 PAIHS Submission (Narrative) October 24, 2018 0.2 MiB 11
Agenda – FY 2021 PAO IHS Budget Formulation Meeting October 24, 2018 2.4 MiB 14
TAB 8 – FY 2020 National Tribal Budget Formulation Workgroup Recommendations October 24, 2018 1.3 MiB 18
NPAIHB Letter To IHS On 97-3 Option 5-18-18 Final May 23, 2018 0.3 MiB 30
DTLL Signed Letter February 16, 2018 0.2 MiB 250
tax cuts estimated at $900 billion over five years will remove resources available to fund government April 6, 2016 40 KiB 286
tax cuts estimated at $900 billion over five years will remove resources available to fund government April 6, 2016 40 KiB 308
Portland Area – FY 2019 Budget Formulation Presentation HQ June 15, 2017 0.1 MiB 356
2020-Budget Formulation Support Docs November 1, 2017 0.7 MiB 392
2020 Budget Formulation Deliverables November 1, 2017 0.1 MiB 400
tax cuts estimated at $900 billion over five years will remove resources available to fund government April 6, 2016 40 KiB 418
FY 2009 Budget Analysis – Final March 17, 2008 April 6, 2016 0.8 MiB 420
FY 2008 Budget Analysis – FINAL April 15, 2007 April 6, 2016 0.2 MiB 452
The HHS Region 10 April 6, 2016 0.1 MiB 463
55865-2 DTLLTribalPremiumSponsorship07182016 July 19, 2016 39 KiB 480
NPAIHB POLICY BRIEF April 6, 2016 0.1 MiB 491
Final 15th Annual IHS Budget Analysis And Recommendations June 14, 2016 0.4 MiB 503

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 19
9 RSRC – A Fact Sheet 2018 Update May 11, 2018 0.1 MiB 21
Pilot Study Interim PAFAC Report 30-Oct-09 May 11, 2018 5.5 MiB 32

The most recent policy issues for Oregon:

Name Date Size Hits
FW CCO RAC Stakeholders List Update Request September 13, 2018 61 KiB 10
RAC Notification 10.4.18 Teledentistry September 21, 2018 28 KiB 10
Tele-dentistry Administrative Rules V5 9-12-18 KMS September 21, 2018 20 KiB 11
FW Oregon Dept Of Human Services – APD Rules Advisory Committee (RAC) Updates September 13, 2018 62 KiB 12
FW Oregon Health Authority To Present At OrOHC Fall Conference September 13, 2018 76 KiB 12
Health Care Agenda 9.7.18 FINAL September 13, 2018 0.2 MiB 14
Governor Brown’s Health Care Agenda September 25, 2018 0.2 MiB 14
333-010 Notice Of Rulemaking 09-25-18 September 27, 2018 0.1 MiB 21
Tribal Consultation And Urban Indian Health Program Confer Policy-Signed 3 March 2, 2018 3.5 MiB 211
Oregon Insurance Exchange Proposal Workplan – June 29 2011 June 9, 2016 69 KiB 326
1115 Renewal-Tribal Consultation Letter-March 16, 2016 April 6, 2016 1.5 MiB 384
NPAIHB Comments On SB 99 – March 28 2011 (2) June 9, 2016 0.2 MiB 396
December 2011 June 9, 2016 0.2 MiB 424
Workgroup-global-budget-charter June 9, 2016 0.2 MiB 428
Oregon Tribal Leaders Letter to ODA July 28, 2017 0.4 MiB 441
Consultation Summary 11-30-11 June 9, 2016 98 KiB 447
OR HIX Board Packet 12 9 11 June 9, 2016 4.7 MiB 471
OHA Budget-reductions2011-13 June 9, 2016 57 KiB 555
SB738 March 14, 2017 57 KiB 583
Oregon Access Monitoring Review Plan November 1, 2016 0.7 MiB 591
Workgroup-outcomes-quality-efficiency-charter June 9, 2016 0.1 MiB 606
Workgroup-medicare-medicaid-integration-charter June 9, 2016 78 KiB 607
Workgroup-cco-charter June 9, 2016 79 KiB 642
Draft CCO Implementation Plan 12-09-11 June 9, 2016 1.7 MiB 781
Workgroups-external-roster-full June 9, 2016 0.1 MiB 998

The most recent policy issues for Idaho:

Name Date Size Hits
Tribal Update Letter Coverage Choice Waiver 7-3-19 FINAL Sign July 8, 2019 1.7 MiB 0
Waiver Medicaid Expansion Tribal Notice Post July 8, 2019 0.2 MiB 0
Full Public Notice 7-3-19 Coverage Choice Waiver Final July 8, 2019 0.2 MiB 1
19-0009 4 Walls IHS Tribal Solicitation FINAL 031219 Sign March 14, 2019 1.6 MiB 2
19-0008T Healthy Connections Fixed Enrollment Tribal Notice Sign March 27, 2019 1.9 MiB 2
Tribal Mtg Coordination 2019 February 15, 2019 92 KiB 5
18-0014 Medicaid Adult Expansion To ABP SPA Tribal Notice FINAL Sign December 19, 2018 1.9 MiB 10
Tribal Notice – SED Premiums SPA 09132018 September 20, 2018 91 KiB 39
2-22-2018 Idaho Tribes DRAFT Minutes May 10, 2018 46 KiB 60
17-230 Tribal Notice 1915c Adult DD & A&D Waiver Amendments Reshab October 30, 2017 0.5 MiB 125
17-229 Tribal Notice 1915i HCBS Adult DD SPA October 30, 2017 0.6 MiB 135
1915bIBHPWorkgroup Tribal Ltr MW May 24, 2017 0.3 MiB 180
17-0001 Base Benchmark Plan Alignment Tribal Notice January 24, 2017 0.3 MiB 186
YHI Idaho Tribal Meeting Agenda August 2017 July 26, 2017 0.2 MiB 191
A-D Waiver Amendment Tribal Notice November 3, 2017 0.6 MiB 195
18-001 Tribal Notice IDEA ITP SPA January 31, 2018 41 KiB 195
Adult DD 1915i HCBS Tribal Notice September 28, 2017 0.4 MiB 197
17-0003 Tribal Notice For Covered Outpatient Drugs February 23, 2017 0.3 MiB 199
17-255 Tribal Notice DME SPA January 2, 2018 33 KiB 200
IdahoInsuranceExchange April 6, 2016 0.1 MiB 206
Legal Notices PC Physician Codes & Rates 1-1-13 April 6, 2016 0.4 MiB 208
HCBS AD And Adult DD Reshab Tribal Notice 2 November 28, 2017 1.0 MiB 208
16-090 Tribal Letter SPA 16-0006 PCS April 6, 2016 0.3 MiB 215
17-088 Tribal Notice For Childrens DD March 31, 2017 0.4 MiB 225
17-0002 Tribal Notice For 2017 COLA January 26, 2017 0.3 MiB 228

The most recent policy issues for Washington:

Name Date Size Hits
Gov Inslee Finance Dem Medicaid Letter February 17, 2017 0.5 MiB 233
Dental Proviso Report Follow Up 122016 January 3, 2017 1.0 MiB 261
Letter-to-Governors-and-Commissioners February 17, 2017 1.1 MiB 387
Senate Finance Committee, Response Letter, 02152017 February 17, 2017 57 KiB 389
Senate Finance Attachment, 02152017 February 17, 2017 0.3 MiB 394
Nov 2007 AgendaDraft April 5, 2016 0.1 MiB 451
5079-S SL March 14, 2017 64 KiB 453
Sept 2007 MinutesDraft April 5, 2016 0.1 MiB 467
AIHC CR 102 Redline Changes (Final-04-10-14) April 5, 2016 34 KiB 492
16-087 HCBS Transition Plan Tribal Notice April 5, 2016 0.3 MiB 639
American Indian Health Commission for Washington State April 5, 2016 0.1 MiB 649
Final Washington Tribes SB 5079 Support Letter February 22, 2017 0.4 MiB 820
AIHC Dear Tribal Leaders OIC QHP Letter 4-10-14 April 5, 2016 0.4 MiB 845
Dear Interested Partners: April 5, 2016 0.6 MiB 1353
FAQ SSB 5079 Final March 16, 2017 0.4 MiB 1588

Coming soon!