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
NIHB Health Care Litigation Update (9-13-16) September 19, 2016 0.9 MiB 148
DTLL And UIO Leader Letter On IHS Funds Final 3-28-17 March 29, 2017 0.8 MiB 64
NPAIHB Comments On MACRA QPR Rule 6 2016 June 24, 2016 0.8 MiB 177
FINAL CHAP And CHRP Background July 25, 2016 0.7 MiB 295
56995-1-DTLL-IHS-VAInteragencyAgreement-1 January 10, 2017 0.7 MiB 102

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
7 Jim Roberts Legislative Update – October 23 2015 May 23, 2016 0.2 MiB 358
Portland Area – FY2019 Budget Narrative June 15, 2017 0.1 MiB 119
Portland Area – FY 2019 Budget Formulation Presentation HQ June 15, 2017 0.1 MiB 68
NPAIHB POLICY BRIEF April 6, 2016 0.1 MiB 256
2004 Legislative Plan – FINAL On March 6, 2004 June 14, 2016 0.1 MiB 301

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
Tribal Consultation-SPA-TCM BF April 4, 2016 0.5 MiB 249
Tribal Leader Letter – Medicaid 2012 04-10 April 4, 2016 0.5 MiB 242
Gov Inslee Finance Dem Medicaid Letter February 17, 2017 0.5 MiB 84
ANTHC Press Release Medicaid Expansion April 4, 2016 0.5 MiB 181
Anthcpressrelease Medicaidexpansion May 23, 2016 0.5 MiB 253

The most recent policy issues for Oregon:

Name Date Size Hits
NPAIHB Comments On SB 99 – March 28 2011 (2) June 9, 2016 0.2 MiB 217
Workgroup-global-budget-charter June 9, 2016 0.2 MiB 259
December 2011 June 9, 2016 0.2 MiB 168
Workgroups-external-roster-full June 9, 2016 0.1 MiB 419
Workgroup-outcomes-quality-efficiency-charter June 9, 2016 0.1 MiB 321

The most recent policy issues for Idaho:

Name Date Size Hits
A-D Waiver Amendment Tribal Notice November 3, 2017 0.6 MiB 12
12-293 Tribal Solicitation Health Care Acquired Conditions April 6, 2016 0.5 MiB 179
12-476 Tribal Solicitation -School Based Services April 6, 2016 0.5 MiB 260
17-230 Tribal Notice 1915c Adult DD & A&D Waiver Amendments Reshab October 30, 2017 0.5 MiB 15
11-3-2016 Tribal Medicaid DRAFT Minutes (3) January 25, 2017 0.4 MiB 199

The most recent policy issues for Washington:

Name Date Size Hits
FAQ SSB 5079 Final March 16, 2017 0.4 MiB 167
Final Washington Tribes SB 5079 Support Letter February 22, 2017 0.4 MiB 139
Senate Finance Attachment, 02152017 February 17, 2017 0.3 MiB 117
16-087 HCBS Transition Plan Tribal Notice April 5, 2016 0.3 MiB 385
Sept 2007 MinutesDraft April 5, 2016 0.1 MiB 197