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 449
2007 Legislative Plan – February 14, 2007 April 5, 2016 69 KiB 304
u April 5, 2016 0.3 MiB 466
2016 12 09 ACA Letter February 17, 2017 0.1 MiB 223
55865-1 Draft IHSCircularNo2016-08 TribalPremiumSponsorship July 19, 2016 53 KiB 997
55865-2 DTLLTribalPremiumSponsorship07182016 July 19, 2016 39 KiB 551
56995-1-DTLL-IHS-VAInteragencyAgreement-1 January 10, 2017 0.7 MiB 440
58580-1 DTLL SAP OEHE 08252017 August 28, 2017 92 KiB 429
58862-1 Chairman Barton SIGNED 12-8-17 December 11, 2017 0.8 MiB 329
7 Jim Roberts Legislative Update – October 23 2015 May 23, 2016 0.2 MiB 996
NIHB Health Care Litigation Update (9-13-16) September 19, 2016 0.9 MiB 354
AIHC Agenda August 24th 2017 Delegates Meeting August 22, 2017 0.2 MiB 549
CHAP DTLL 01042017 January 10, 2017 97 KiB 244
CMS Emergency Preparedness Final Rule Webinar June 19, 2017 64 KiB 557
CMS Medicaid And CHIP Managed Care Proposed Rule Comments January 14- 2019 January 15, 2019 0.4 MiB 18
Dear Tribal Leader Letter CHAP Expansion June 16, 2016 78 KiB 733
DHAT Fact Sheets And Reports Links July 25, 2016 1.4 MiB 723
DSTAC Draft Agenda May 2017 April 11, 2017 42 KiB 253
DRAFT AGENDA TOPICS SG Conference Jan 30 February 4, 2019 0.9 MiB 9
DSTAC TSGAC Sep 14 Letter Response 10 October 25, 2017 47 KiB 191
DTLL And UIO Leader Letter On IHS Funds Final 3-28-17 March 29, 2017 0.8 MiB 226
DTLL CSC 04132018 April 20, 2018 0.1 MiB 24
DTLL DUIOLL 05102017 May 12, 2017 0.1 MiB 486
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 617
2020 Budget Formulation Deliverables November 1, 2017 0.1 MiB 503
2020-Budget Formulation Support Docs November 1, 2017 0.7 MiB 482
55865-1 Draft IHSCircularNo2016-08 TribalPremiumSponsorship July 19, 2016 53 KiB 997
55865-2 DTLLTribalPremiumSponsorship07182016 July 19, 2016 39 KiB 551
7 Jim Roberts Legislative Update – October 23 2015 May 23, 2016 0.2 MiB 996
Agenda – FY 2021 PAO IHS Budget Formulation Meeting October 24, 2018 2.4 MiB 18
DTLL Signed Letter February 16, 2018 0.2 MiB 308
Final 15th Annual IHS Budget Analysis And Recommendations June 14, 2016 0.4 MiB 546
FY 2008 Budget Analysis – FINAL April 15, 2007 April 6, 2016 0.2 MiB 499
FY 2009 Budget Analysis – Final March 17, 2008 April 6, 2016 0.8 MiB 487
FY 2020 PA Budget Submission Summary HANDOUT October 24, 2018 53 KiB 9
The HHS Region 10 April 6, 2016 0.1 MiB 539
National Tribal Budget Workgroup Testimony – FY 2019 FINAL June 15, 2017 4.0 MiB 1070
NPAIHB Letter To IHS On 97-3 Option 5-18-18 Final May 23, 2018 0.3 MiB 31
NPAIHB POLICY BRIEF April 6, 2016 0.1 MiB 557
tax cuts estimated at $900 billion over five years will remove resources available to fund government April 6, 2016 40 KiB 329
tax cuts estimated at $900 billion over five years will remove resources available to fund government April 6, 2016 40 KiB 310
tax cuts estimated at $900 billion over five years will remove resources available to fund government April 6, 2016 40 KiB 451
Portland Area – FY 2019 Budget Formulation Presentation HQ June 15, 2017 0.1 MiB 429
Portland Area – FY2019 Budget Narrative June 15, 2017 0.1 MiB 614
Portland Area – FY2019 Final Budget Worksheet June 15, 2017 61 KiB 754
TAB 2 – FY 2021 Area Instructions Package October 24, 2018 0.8 MiB 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

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 23
Pilot Study Interim PAFAC Report 30-Oct-09 May 11, 2018 5.5 MiB 32
Regional Center Fact Sheet And FAQs – September 2, 2010 May 11, 2018 0.3 MiB 21

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 421
333-010 Notice Of Rulemaking 09-25-18 September 27, 2018 0.1 MiB 27
Consultation Summary 11-30-11 June 9, 2016 98 KiB 524
Copy Of OHA Contacts For Tribes 10-28-16 November 1, 2016 34 KiB 1471
December 2011 June 9, 2016 0.2 MiB 511
Draft CCO Implementation Plan 12-09-11 June 9, 2016 1.7 MiB 1009
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 19
Health Care Agenda 9.7.18 FINAL September 13, 2018 0.2 MiB 15
NPAIHB Comments On SB 99 – March 28 2011 (2) June 9, 2016 0.2 MiB 425
Oregon Tribal Leaders Letter to ODA July 28, 2017 0.4 MiB 540
OHA Budget-reductions2011-13 June 9, 2016 57 KiB 646
OR HIX Board Packet 12 9 11 June 9, 2016 4.7 MiB 536
Oregon Access Monitoring Review Plan November 1, 2016 0.7 MiB 669
Oregon Insurance Exchange Proposal Workplan – June 29 2011 June 9, 2016 69 KiB 371
RAC Notification 10.4.18 Teledentistry September 21, 2018 28 KiB 11
SB738 March 14, 2017 57 KiB 688
Tele-dentistry Administrative Rules V5 9-12-18 KMS September 21, 2018 20 KiB 11
Tribal Consultation And Urban Indian Health Program Confer Policy-Signed 3 March 2, 2018 3.5 MiB 280
Workgroup-cco-charter June 9, 2016 79 KiB 781
Workgroup-global-budget-charter June 9, 2016 0.2 MiB 458
Workgroup-medicare-medicaid-integration-charter June 9, 2016 78 KiB 695
Workgroup-outcomes-quality-efficiency-charter June 9, 2016 0.1 MiB 691

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 694
11-8-2017 Idaho Tribes DRAFT Minutes – Rfb January 29, 2018 0.3 MiB 305
12-293 Tribal Solicitation Health Care Acquired Conditions April 6, 2016 0.5 MiB 310
12-463 Tribal Soliciation – Primary Care Physician Codes April 6, 2016 0.4 MiB 303
12-476 Tribal Solicitation -School Based Services April 6, 2016 0.5 MiB 425
13-116 Tribal Notice PRTF SPA April 6, 2016 78 KiB 409
13-123 1115 Demonstration Waiver Amendments April 6, 2016 0.4 MiB 277
16-090 Tribal Letter SPA 16-0006 PCS April 6, 2016 0.3 MiB 244
16-167 Tribal Notice For RAC June 13, 2016 0.3 MiB 410
17-0001 Base Benchmark Plan Alignment Tribal Notice January 24, 2017 0.3 MiB 205
17-0002 Tribal Notice For 2017 COLA January 26, 2017 0.3 MiB 253
17-0003 Tribal Notice For Covered Outpatient Drugs February 23, 2017 0.3 MiB 222
17-066 Tribal Notice For A-D Adult DD Waiver Renewals March 9, 2017 0.4 MiB 280
17-088 Tribal Notice For Childrens DD March 31, 2017 0.4 MiB 263
17-226 Tribal Notice For IHS Four Walls October 30, 2017 41 KiB 393
17-229 Tribal Notice 1915i HCBS Adult DD SPA October 30, 2017 0.6 MiB 185
17-230 Tribal Notice 1915c Adult DD & A&D Waiver Amendments Reshab October 30, 2017 0.5 MiB 163
17-255 Tribal Notice DME SPA January 2, 2018 33 KiB 251
18-001 Tribal Notice IDEA ITP SPA January 31, 2018 41 KiB 239
18-0014 Medicaid Adult Expansion To ABP SPA Tribal Notice FINAL Sign December 19, 2018 1.9 MiB 12
19-0008T Healthy Connections Fixed Enrollment Tribal Notice Sign March 27, 2019 1.9 MiB 6
19-0009 4 Walls IHS Tribal Solicitation FINAL 031219 Sign March 14, 2019 1.6 MiB 2
19-0020 Pregnant Women – S28 Med Exp Tribal Notice Sign August 4, 2019 1.5 MiB 5
1915bIBHPWorkgroup Tribal Ltr MW May 24, 2017 0.3 MiB 208
2-22-2018 Idaho Tribes DRAFT Minutes May 10, 2018 46 KiB 73

The most recent policy issues for Washington:

Name Date Size Hits
16-087 HCBS Transition Plan Tribal Notice April 5, 2016 0.3 MiB 736
5079-S SL March 14, 2017 64 KiB 529
AIHC CR 102 Redline Changes (Final-04-10-14) April 5, 2016 34 KiB 534
AIHC Dear Tribal Leaders OIC QHP Letter 4-10-14 April 5, 2016 0.4 MiB 954
Dental Proviso Report Follow Up 122016 January 3, 2017 1.0 MiB 297
FAQ SSB 5079 Final March 16, 2017 0.4 MiB 1919
Final Washington Tribes SB 5079 Support Letter February 22, 2017 0.4 MiB 906
Gov Inslee Finance Dem Medicaid Letter February 17, 2017 0.5 MiB 281
Letter-to-Governors-and-Commissioners February 17, 2017 1.1 MiB 431
American Indian Health Commission for Washington State April 5, 2016 0.1 MiB 761
Nov 2007 AgendaDraft April 5, 2016 0.1 MiB 527
Senate Finance Attachment, 02152017 February 17, 2017 0.3 MiB 462
Senate Finance Committee, Response Letter, 02152017 February 17, 2017 57 KiB 447
Sept 2007 MinutesDraft April 5, 2016 0.1 MiB 547
Dear Interested Partners: April 5, 2016 0.6 MiB 1601

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.
RESOLUTIONS FY 2019
OCTOBER
JULY
19-04-01 OHA and OHSU_HOWTO_Grant.pdf
19-04-02__334-08-19_Call to Congress to Support Advance Appropriations for IHS.pdf
19-04-03__335-08-19_Full Funding for IHS.pdf
19-04-04__336-08-19_Call Congress to Support Mandatory Appropriations for IHS.pdf
19-04-05__337-08-19_Call to Congress to Fully Fund Section 105i ISDEAA Lease.pdf
19-04-06__338-08-19 National Child Traumatic Stress Initiative.pdf
19-04-07__339-08-19_Ensure Medicaid Fulfills Federal Trust Responsibility to AI_AN
19-04-08__340-08-19_HHS OMH_AI-AN HRAC
19-04-09__341-08-19_Increase Funding for Special BH Program Title I_Title V.pdf
19-04-10__342-08-19_IHS to move the PRC Dependent Factor in the PRC Funding Formula.pdf
19-04-11__343-08-19_Support Legislation that Establishes VA_TAC.pdf
19-04-12__344-08-19_Support for Perment ReAuth SDPI.pdf
19-04-13__345-08-19_SAMSHA_Modernization Act Reporting Requirements for Opioid Tx.pdf
19-04-14_DHAT_Education Curricula North Sound Accountable Communities of Health (ACH) Revised.doc
19-04-14_DHAT_Education Curricula North Sound Accountable Communities of Health (ACH).pdf
19-04-15_RES RWJ_HER RESOLUTION.pdf
19-04-15_RES RWJ_HER RESOLUTION_ 07-10-19.doc
19-04-16_CDC Supplement Resolution July2019.doc
19-04-16_CDC Supplement Resolution.pdf

APRIL
19-02-05 State_Tribal Youth Suicide Prevention Grant.pdf
19-03-01_Native_Boost.pdf
19-03-02_NDTI_Ford_Family_Foundation_Dental_Pilot.pdf
19-03-03_NDTI_NWHF_Policy_and_Systems_Change.pdf
19-03-04_NBJD_WEAVE.pdf
19-03-05_ISDEAA_105(I)Lease.pdf
19-03-06_FY_2020_IHS_Funding.pdf

JANUARY
19.02.01 WE R NATIVE_TAM.pdf
19-02-02 Advance Appropriations for IHS.pdf
19-02-03 Tribal Youth Delegate Program.pdf
19-02-03_Resolution_TYD_DRAFT.doc
19-02-04 Establish a Food Sovereignty Sub-Committee.pdf

RESOLUTION ARCHIVES   2005 – 2015

Resolutions FY 2016 – 2018
APRIL 2018
18-03-01 Support for NNACOE.pdf
18-03-02_NIJ_NWTribal Juvenile Justice Alliance.pdf
18-03-03_CDC_Tribal Public Health Capacity.pdf
18-03-04 Prevention Research Center PRC.pdf
18-03-05 SAMSHA Funding.pdf
18-03-06 Continued Support for Mandatory Funding for SDPI.pdf
18-03-07 IHP Funding Increase.pdf
18-03-08 CJR Tribal Management Health Ed Health Workforce Support.pdf
18-03-09 CHAP MTD DSRIP Funding.pdf
JANUARY 2018
18-02-01 HCV Medication Access_State.pdf
18-02-02 HCV Medication Access_Federal.pdf
July 2018
18-04-01 Reserach to improve AI Health.pdf
18-04-02_FLIGHT_Broadt_OHSU_HRSA.pdf
18-04-03 SAMHSA MAT Initiative.pdf
18-04-04_SAMSHA_TOR.pdf
OCTOBER 2018
18-01-01 DVPI Response Circles Project 08-30-2017 (00000002).pdf
18-01-02_NWTEC OHSU SEPA 2017.docx.pdf
18-01-03_ Addressing Suicide Research Gaps Understanding Mortality Outcomes.doc.pdf
18-01-04_Urging AMA to Adopt a Policy Statement on ACE and Toxic Stress.docx.pdf
18-01-05 Collaborative Minority Health and Health Disparities Research with Tribal Epidemiology Centers.pdf

Resolutions FY 2017
APRIL 2017
17-03-01 IHCIA.pdf
17-03-02 Supporting Native Expectant and Parenting Teens.pdf
17-03-03_OMH Partnership for Health Equity_IDEA-NW grant r.pdf
17-03-04 LOS Dr Grim and Resolution.pdf
17-03-04 Support for Dr. Grim for Director of IHS.pdf
12-03-05 NARCH.pdf
17-03-06 HSA Approval and Adoption.pdf
17-03-07_Opposition to FY2018 Budget Cuts to US HHS.pdf
17-03-08_Support_Reauthorization_of_SDPI.pdf
JANUARY 2017
17-02-01_Pathways into Health NW Native American Center of Excellence.pdf
17-02-02 National Indian Health Policy Education Foundation.pdf
17-02-03 Support submission of grant for CDC NTCCP.pdf
17-02-04 Background Check Policy.pdf
JULY 2017
17-04-01_Increased TEC Infrastucture.pdf
17-04-02_i-LEAD Grant.pdf
17-04-03_OMH Empowered Communities for a Healthier Nation Initiative Reso template1.doc.pdf
17-04-04_ Joint Resolution 100 Percent FMAP.docx
17-04-05 Joint Resolution ACA-IHCIA 2017.docx
17-04-06_Joint Resolution Adoption of CDC Opioid Guideline.docx
17-04-07 Joint Resolution ACA-IHCIA 2017.docx
17-04-07_Joint Resolution Budget 2017.docx
OCTOBER 2016
17-01-01 Supporting Standing Rock.pdf
17-01-02 Support of CHAP National Expansion.pdf
17-01-03 Support Engagement of Youth and Development of Youth Track.pdf
Resolutions FY 2016
APRIL 2016
16-03-01_Elder Falls Prevention Funding.pdf
16-03-02_Renewal of NW Tribal Epidemiology Center.pdf
16-03-03_NIH_New Digital Media R01.pdf
16-03-04_NIH U19 Collabroative Hubs to Reduce the Burden of Suicide among AIAN.pdf
16-03-05_Portland Area Could Be Treated As a State for the Purpose of Medicaid.pdf
AUGUST 2016
16-04-01 NW NARCH 9 Program v3.pdf
16-04-01 NW NARCH 9 Program.pdf
16-04-02 Portland Area Fetal Alcohol Spectrum Disorders Funding.pdf
JANUARY 2016
16-02-01_We R Native_Text 4 Sex Ed.pdf
OCTOBER 2015
16-01-01 Persons who Inject Drugs(PWID).pdf
16-01-02 Tribal Exemption from the ACA Employer Mandate.pdf
16-01-03 WTDP_SDPI.pdf

11) CMS Medicaid Fiscal Accountability – February 1

12) Medicare and State Healthcare Programs: Revisions to Safe Harbors Under the Anti-Kickback Statute (AKS), and Civil Monetary Penalty (CMP) Rules– December 23

13) Inclusion of Federally Operated Facilities (Direct Service Tribes) in the Community Health Aide Program (CHAP) Expansion – December 3

14) IHS Special Diabetes Program for Indians (SDPI) Distribution of Funding in Fiscal Year (FY) 2021 – November 27

15) IHS NTAC Behavioral Health Funding Mechanism Recommendations – October 1, 2019

14) HRSA Rural Access to Health Care Services Request for Information (RFI) – October 9, 2019

13) VA MISSION Act Strategic Plan Native Veteran Healthcare Needs – June 10, 2019

12) IHS CHAP Interim Policy Comments – June 7, 2019

11) HHS ONC Draft Strategy on Reducing Regulatory and Administrative Burdens Relating to the Use of Heath IT and EHRs – January 28

10) Comments on Arizona State-wide PRCDA Study Tribal Consultation – January 15

9) Request for Creation of a U.S. Department of Veterans Affairs Tribal Advisory Committee – January 18

8) CMS Medicaid and CHIP Managed Care Proposed Rule Comments January 14, 2019

7) IHS Draft Indian Health Service Strategic Plan Fiscal Year 2018-2022    August 23

6) IHS Funding Mechanism to Distribute Behavioral Health Initiatives Currently Distributed through Grants     August 1

5) IHS Section 105(l) Lease Funding “Dilemma” July 25

4) IHS Indian Health Care Improvement Fund Formula      July 13

3) IHS Tribal Consultation on Changes to the Indian Health Manual PRC Chapter, Part 2, Chapter 3 “Services to Indians and Others”     July 6

2) IHS Distribution of Funding for the Special Diabetes Program for Indians (SDPI) in Fiscal Year (FY) 2019     May 18

1) IHS Proposal to Amend “97/3 Method” for Determining Indirect Costs in Service Unit Shares     May 18