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 Comment SDPI FY 19 Funding Distribution Final May 23, 2018 0.2 MiB 10
Tribal Medicaid Meeting May 2018 Draft Agenda May 10, 2018 66 KiB 17
Joint Letter Requesting Tribal Consultation 4 May 1, 2018 0.5 MiB 16
DTLL CSC 04132018 April 20, 2018 0.1 MiB 13
DTLL SDPI 04132018 April 20, 2018 0.1 MiB 11


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 11
DTLL Signed Letter February 16, 2018 0.2 MiB 119
2020-Budget Formulation Support Docs November 1, 2017 0.7 MiB 206
2020 Budget Formulation Deliverables November 1, 2017 0.1 MiB 209
Portland Area – FY2019 Final Budget Worksheet June 15, 2017 61 KiB 326

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 5
Pilot Study Interim PAFAC Report 30-Oct-09 May 11, 2018 5.5 MiB 11
9 RSRC – A Fact Sheet 2018 Update May 11, 2018 0.1 MiB 8

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
041818 Dear TL 2018 SDPI Tribal Consultation April 24, 2018 0.2 MiB 8
18-0003 MMCP Tribal Notice March 29, 2018 43 KiB 15
100517 TL Re ASAP Pool Letter S Signature October 7, 2017 0.3 MiB 173
Senate Finance Attachment, 02152017 February 17, 2017 0.3 MiB 269
Letter-to-Governors-and-Commissioners February 17, 2017 1.1 MiB 278

The most recent policy issues for Oregon:

Name Date Size Hits
Tribal Consultation And Urban Indian Health Program Confer Policy-Signed 3 March 2, 2018 3.5 MiB 72
Oregon Tribal Leaders Letter to ODA July 28, 2017 0.4 MiB 220
SB738 March 14, 2017 57 KiB 340
Oregon Access Monitoring Review Plan November 1, 2016 0.7 MiB 432
Copy Of OHA Contacts For Tribes 10-28-16 November 1, 2016 34 KiB 782

The most recent policy issues for Idaho:

Name Date Size Hits
2-22-2018 Idaho Tribes DRAFT Minutes May 10, 2018 46 KiB 15
18-001 Tribal Notice IDEA ITP SPA January 31, 2018 41 KiB 96
11-8-2017 Idaho Tribes DRAFT Minutes – Rfb January 29, 2018 0.3 MiB 110
17-255 Tribal Notice DME SPA January 2, 2018 33 KiB 105
HCBS AD And Adult DD Reshab Tribal Notice 2 November 28, 2017 1.0 MiB 101

The most recent policy issues for Washington:

Name Date Size Hits
FAQ SSB 5079 Final March 16, 2017 0.4 MiB 524
5079-S SL March 14, 2017 64 KiB 297
Final Washington Tribes SB 5079 Support Letter February 22, 2017 0.4 MiB 312
Senate Finance Committee, Response Letter, 02152017 February 17, 2017 57 KiB 268
Senate Finance Attachment, 02152017 February 17, 2017 0.3 MiB 269