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
03 Aoki SUPP May 4, 2017 0.2 MiB 362
2007 Legislative Plan – February 14, 2007 April 5, 2016 69 KiB 258
u April 5, 2016 0.3 MiB 386
2016 12 09 ACA Letter February 17, 2017 0.1 MiB 191
55865-1 Draft IHSCircularNo2016-08 TribalPremiumSponsorship July 19, 2016 53 KiB 736
55865-2 DTLLTribalPremiumSponsorship07182016 July 19, 2016 39 KiB 434
56995-1-DTLL-IHS-VAInteragencyAgreement-1 January 10, 2017 0.7 MiB 340
58580-1 DTLL SAP OEHE 08252017 August 28, 2017 92 KiB 308
58862-1 Chairman Barton SIGNED 12-8-17 December 11, 2017 0.8 MiB 229
7 Jim Roberts Legislative Update – October 23 2015 May 23, 2016 0.2 MiB 785
NIHB Health Care Litigation Update (9-13-16) September 19, 2016 0.9 MiB 287
AIHC Agenda August 24th 2017 Delegates Meeting August 22, 2017 0.2 MiB 421
CHAP DTLL 01042017 January 10, 2017 97 KiB 212
CMS Emergency Preparedness Final Rule Webinar June 19, 2017 64 KiB 403
CMS Medicaid And CHIP Managed Care Proposed Rule Comments January 14- 2019 January 15, 2019 0.4 MiB 11
Dear Tribal Leader Letter CHAP Expansion June 16, 2016 78 KiB 617
DHAT Fact Sheets And Reports Links July 25, 2016 1.4 MiB 560
DSTAC Draft Agenda May 2017 April 11, 2017 42 KiB 211
DRAFT AGENDA TOPICS SG Conference Jan 30 February 4, 2019 0.9 MiB 6
DSTAC TSGAC Sep 14 Letter Response 10 October 25, 2017 47 KiB 151
DTLL And UIO Leader Letter On IHS Funds Final 3-28-17 March 29, 2017 0.8 MiB 183
DTLL CSC 04132018 April 20, 2018 0.1 MiB 23
DTLL DUIOLL 05102017 May 12, 2017 0.1 MiB 359
DTLL FY18 IHCIFAllocations 08172018 August 20, 2018 0.2 MiB 11
DTLL SDPI 04132018 April 20, 2018 0.1 MiB 20

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
2004 Legislative Plan – FINAL On March 6, 2004 June 14, 2016 0.1 MiB 517
2020 Budget Formulation Deliverables November 1, 2017 0.1 MiB 352
2020-Budget Formulation Support Docs November 1, 2017 0.7 MiB 352
55865-1 Draft IHSCircularNo2016-08 TribalPremiumSponsorship July 19, 2016 53 KiB 736
55865-2 DTLLTribalPremiumSponsorship07182016 July 19, 2016 39 KiB 434
7 Jim Roberts Legislative Update – October 23 2015 May 23, 2016 0.2 MiB 785
Agenda – FY 2021 PAO IHS Budget Formulation Meeting October 24, 2018 2.4 MiB 14
DTLL Signed Letter February 16, 2018 0.2 MiB 228
Final 15th Annual IHS Budget Analysis And Recommendations June 14, 2016 0.4 MiB 482
FY 2008 Budget Analysis – FINAL April 15, 2007 April 6, 2016 0.2 MiB 413
FY 2009 Budget Analysis – Final March 17, 2008 April 6, 2016 0.8 MiB 390
FY 2020 PA Budget Submission Summary HANDOUT October 24, 2018 53 KiB 8
The HHS Region 10 April 6, 2016 0.1 MiB 430
National Tribal Budget Workgroup Testimony – FY 2019 FINAL June 15, 2017 4.0 MiB 749
NPAIHB Letter To IHS On 97-3 Option 5-18-18 Final May 23, 2018 0.3 MiB 28
NPAIHB POLICY BRIEF April 6, 2016 0.1 MiB 453
tax cuts estimated at $900 billion over five years will remove resources available to fund government April 6, 2016 40 KiB 299
tax cuts estimated at $900 billion over five years will remove resources available to fund government April 6, 2016 40 KiB 281
tax cuts estimated at $900 billion over five years will remove resources available to fund government April 6, 2016 40 KiB 398
Portland Area – FY 2019 Budget Formulation Presentation HQ June 15, 2017 0.1 MiB 316
Portland Area – FY2019 Budget Narrative June 15, 2017 0.1 MiB 480
Portland Area – FY2019 Final Budget Worksheet June 15, 2017 61 KiB 535
TAB 2 – FY 2021 Area Instructions Package October 24, 2018 0.8 MiB 7
TAB 3 -National Budget Worksheets Guidance And Budget Line Descriptions October 24, 2018 0.2 MiB 9
TAB 3 -National Budget Worksheets Guidance And Budget Line Descriptions October 24, 2018 0.2 MiB 7

The most recent Portland Area Facilities (PAFAC) updates:

Name Date Size Hits
9 RSRC – A Fact Sheet 2018 Update May 11, 2018 0.1 MiB 19
Pilot Study Interim PAFAC Report 30-Oct-09 May 11, 2018 5.5 MiB 29
Regional Center Fact Sheet And FAQs – September 2, 2010 May 11, 2018 0.3 MiB 19

The most recent policy issues for Oregon:

Name Date Size Hits
1115 Renewal-Tribal Consultation Letter-March 16, 2016 April 6, 2016 1.5 MiB 371
333-010 Notice Of Rulemaking 09-25-18 September 27, 2018 0.1 MiB 16
Consultation Summary 11-30-11 June 9, 2016 98 KiB 410
Copy Of OHA Contacts For Tribes 10-28-16 November 1, 2016 34 KiB 1123
December 2011 June 9, 2016 0.2 MiB 389
Draft CCO Implementation Plan 12-09-11 June 9, 2016 1.7 MiB 669
FW CCO RAC Stakeholders List Update Request September 13, 2018 61 KiB 10
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
Governor Brown’s Health Care Agenda September 25, 2018 0.2 MiB 11
Health Care Agenda 9.7.18 FINAL September 13, 2018 0.2 MiB 13
NPAIHB Comments On SB 99 – March 28 2011 (2) June 9, 2016 0.2 MiB 376
Oregon Tribal Leaders Letter to ODA July 28, 2017 0.4 MiB 394
OHA Budget-reductions2011-13 June 9, 2016 57 KiB 503
OR HIX Board Packet 12 9 11 June 9, 2016 4.7 MiB 445
Oregon Access Monitoring Review Plan November 1, 2016 0.7 MiB 556
Oregon Insurance Exchange Proposal Workplan – June 29 2011 June 9, 2016 69 KiB 309
RAC Notification 10.4.18 Teledentistry September 21, 2018 28 KiB 10
SB738 March 14, 2017 57 KiB 514
Tele-dentistry Administrative Rules V5 9-12-18 KMS September 21, 2018 20 KiB 10
Tribal Consultation And Urban Indian Health Program Confer Policy-Signed 3 March 2, 2018 3.5 MiB 181
Workgroup-cco-charter June 9, 2016 79 KiB 583
Workgroup-global-budget-charter June 9, 2016 0.2 MiB 412
Workgroup-medicare-medicaid-integration-charter June 9, 2016 78 KiB 563
Workgroup-outcomes-quality-efficiency-charter June 9, 2016 0.1 MiB 562

The most recent policy issues for Idaho:

Name Date Size Hits
11-3-2016 Tribal Medicaid DRAFT Minutes (3) January 25, 2017 0.4 MiB 541
11-8-2017 Idaho Tribes DRAFT Minutes – Rfb January 29, 2018 0.3 MiB 217
12-293 Tribal Solicitation Health Care Acquired Conditions April 6, 2016 0.5 MiB 279
12-463 Tribal Soliciation – Primary Care Physician Codes April 6, 2016 0.4 MiB 270
12-476 Tribal Solicitation -School Based Services April 6, 2016 0.5 MiB 373
13-116 Tribal Notice PRTF SPA April 6, 2016 78 KiB 342
13-123 1115 Demonstration Waiver Amendments April 6, 2016 0.4 MiB 250
16-090 Tribal Letter SPA 16-0006 PCS April 6, 2016 0.3 MiB 206
16-167 Tribal Notice For RAC June 13, 2016 0.3 MiB 383
17-0001 Base Benchmark Plan Alignment Tribal Notice January 24, 2017 0.3 MiB 172
17-0002 Tribal Notice For 2017 COLA January 26, 2017 0.3 MiB 212
17-0003 Tribal Notice For Covered Outpatient Drugs February 23, 2017 0.3 MiB 182
17-066 Tribal Notice For A-D Adult DD Waiver Renewals March 9, 2017 0.4 MiB 231
17-088 Tribal Notice For Childrens DD March 31, 2017 0.4 MiB 205
17-226 Tribal Notice For IHS Four Walls October 30, 2017 41 KiB 266
17-229 Tribal Notice 1915i HCBS Adult DD SPA October 30, 2017 0.6 MiB 116
17-230 Tribal Notice 1915c Adult DD & A&D Waiver Amendments Reshab October 30, 2017 0.5 MiB 111
17-255 Tribal Notice DME SPA January 2, 2018 33 KiB 188
18-001 Tribal Notice IDEA ITP SPA January 31, 2018 41 KiB 179
18-0014 Medicaid Adult Expansion To ABP SPA Tribal Notice FINAL Sign December 19, 2018 1.9 MiB 9
19-0008T Healthy Connections Fixed Enrollment Tribal Notice Sign March 27, 2019 1.9 MiB 0
19-0009 4 Walls IHS Tribal Solicitation FINAL 031219 Sign March 14, 2019 1.6 MiB 1
1915bIBHPWorkgroup Tribal Ltr MW May 24, 2017 0.3 MiB 165
2-22-2018 Idaho Tribes DRAFT Minutes May 10, 2018 46 KiB 54
A-D Waiver Amendment Tribal Notice November 3, 2017 0.6 MiB 178

The most recent policy issues for Washington:

Name Date Size Hits
16-087 HCBS Transition Plan Tribal Notice April 5, 2016 0.3 MiB 601
5079-S SL March 14, 2017 64 KiB 414
AIHC CR 102 Redline Changes (Final-04-10-14) April 5, 2016 34 KiB 472
AIHC Dear Tribal Leaders OIC QHP Letter 4-10-14 April 5, 2016 0.4 MiB 768
Dental Proviso Report Follow Up 122016 January 3, 2017 1.0 MiB 246
FAQ SSB 5079 Final March 16, 2017 0.4 MiB 1324
Final Washington Tribes SB 5079 Support Letter February 22, 2017 0.4 MiB 763
Gov Inslee Finance Dem Medicaid Letter February 17, 2017 0.5 MiB 219
Letter-to-Governors-and-Commissioners February 17, 2017 1.1 MiB 360
American Indian Health Commission for Washington State April 5, 2016 0.1 MiB 598
Nov 2007 AgendaDraft April 5, 2016 0.1 MiB 417
Senate Finance Attachment, 02152017 February 17, 2017 0.3 MiB 357
Senate Finance Committee, Response Letter, 02152017 February 17, 2017 57 KiB 362
Sept 2007 MinutesDraft April 5, 2016 0.1 MiB 423
Dear Interested Partners: April 5, 2016 0.6 MiB 1222

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