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
DTLL DUIOLL 05102017 May 12, 2017 0.1 MiB 433
03 Aoki SUPP May 4, 2017 0.2 MiB 417
DSTAC Draft Agenda May 2017 April 11, 2017 42 KiB 236
DTLL And UIO Leader Letter On IHS Funds Final 3-28-17 March 29, 2017 0.8 MiB 206
TSGAC Memo-Comparison House Repub Plan Vs Current Law-ACA As Of 2017-03- .. March 16, 2017 0.4 MiB 415
TSGAC Memo-Tribal Sponsorship Of Medicare Part B D Premiums – 2016-11- . . February 28, 2017 0.3 MiB 228
TSGAC Memo-Net Marketplace Premium Costs Hold Or Lower In 2017 2017-01-1 .. February 28, 2017 0.3 MiB 196
TSGAC Memo-ACA In 2017 And Trump-Ryan Health Care Plans – 2017-01-06a February 28, 2017 0.3 MiB 268
TSGAC Memo – IHS Reimbursement Rates For CY 2017 – 2016-02-06b February 28, 2017 0.2 MiB 213
TSGAC Memo – Applicable Percentages Thresholds And Payments For ACA Prov .. February 28, 2017 0.3 MiB 167
TSGAC Brief – CMS Restrictions On Billing Medicaid For Services Outside .. February 28, 2017 0.3 MiB 802
TSGAC – Timeline Of Key ACA-Related Congressional Activities 2017-02-13b .. February 28, 2017 0.3 MiB 158
Senate Finance Committee, Response Letter, 02152017 February 17, 2017 57 KiB 410
Senate Finance Attachment, 02152017 February 17, 2017 0.3 MiB 415
Letter-to-Governors-and-Commissioners February 17, 2017 1.1 MiB 403
2016 12 09 ACA Letter February 17, 2017 0.1 MiB 210
O'Halleran Ltr To Leadership – ACA And IHCIA February 1, 2017 0.1 MiB 148
Faq11817 January 20, 2017 0.2 MiB 324
56995-1-DTLL-IHS-VAInteragencyAgreement-1 January 10, 2017 0.7 MiB 396
Enclosure IHS VA CMOP Agreement-1 January 10, 2017 0.3 MiB 398
CHAP DTLL 01042017 January 10, 2017 97 KiB 230
FINAL 11-30-16 Letter To Administration On Dental Therapy Issues December 1, 2016 0.2 MiB 453
Quality Framework Implementation Plan Authored By QF Steering Committee .. November 16, 2016 0.6 MiB 547
Quality Framework DTLL UIOLL Signed 11-16-16 November 16, 2016 0.7 MiB 260
Quality Framework Authored By QF Steering Committee FINAL October 2016 November 16, 2016 0.3 MiB 464

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 Portland Area Facilities (PAFAC) updates:

Name Date Size Hits

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 405

The most recent policy issues for Idaho:

Name Date Size Hits
17-088 Tribal Notice For Childrens DD March 31, 2017 0.4 MiB 236
17-066 Tribal Notice For A-D Adult DD Waiver Renewals March 9, 2017 0.4 MiB 262
17-0003 Tribal Notice For Covered Outpatient Drugs February 23, 2017 0.3 MiB 208
17-0002 Tribal Notice For 2017 COLA January 26, 2017 0.3 MiB 238
11-3-2016 Tribal Medicaid DRAFT Minutes (3) January 25, 2017 0.4 MiB 621
17-0001 Base Benchmark Plan Alignment Tribal Notice January 24, 2017 0.3 MiB 193
MMCP Servcie Area Reduction Tribal Notice October 28, 2016 0.3 MiB 298
16-167 Tribal Notice For RAC June 13, 2016 0.3 MiB 400
Yellowhawk Tribal Health Center April 6, 2016 40 KiB 481
Wildhorse Resort April 6, 2016 56 KiB 538
5 April 6, 2016 14.4 MiB 804
3 April 6, 2016 8.1 MiB 952
12-476 Tribal Solicitation -School Based Services April 6, 2016 0.5 MiB 399
IdahoInsuranceExchange April 6, 2016 0.1 MiB 212
12-293 Tribal Solicitation Health Care Acquired Conditions April 6, 2016 0.5 MiB 296
SPA 13-004 Incentive Payments For Primary Care Codes April 6, 2016 1.4 MiB 252
Legal Notices PC Physician Codes & Rates 1-1-13 April 6, 2016 0.4 MiB 214
ID13-006 Tribal Letter April 6, 2016 0.4 MiB 345
13-123 1115 Demonstration Waiver Amendments April 6, 2016 0.4 MiB 265
13-116 Tribal Notice PRTF SPA April 6, 2016 78 KiB 379
12-463 Tribal Soliciation – Primary Care Physician Codes April 6, 2016 0.4 MiB 289
Oregon Community Partner April 6, 2016 1.7 MiB 466
16-090 Tribal Letter SPA 16-0006 PCS April 6, 2016 0.3 MiB 234
Idaho State Tribes Meeting 6-15-07sb April 6, 2016 42 KiB 514
Save The Date FlyerNov April 6, 2016 0.1 MiB 344

The most recent policy issues for Washington:

Name Date Size Hits

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.
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_ 07-10-19.doc
19-04-16_CDC Supplement Resolution July2019.doc
19-04-16_CDC Supplement Resolution.pdf
OHA and OHSU HOWTO grant application for Oregon BHA training center 2019 FINAL.doc
RES DHAT Education Curricula North Sound Accountable Communities of Health (ACH) Revised.doc
19-02-05 State_Tribal Youth Suicide Prevention Grant.pdf
RES ISDEAA 105(l) leases FINAL .docx
RES on FY 2020 IHS FUNDING final.docx
Resolution_Native Boost_resolution_FINAL 4-12-19.doc
RESOLUTION_NDTI – Ford Family Foundation Dental Pilot Project FINAL 4-12-19.docx
RESOLUTION_NDTI – NWHF Policy and Systems Change Grant FINAL 4-12-19.docx
Resolution_SAMHSA SM-19-006_GLS_FINAL (00000002).doc
19.02.01 WE R NATIVE_TAM.pdf
19-02-02 Advance Appropriations for IHS.pdf
19-02-03 Tribal Youth Delegate Program.pdf
19-02-04 Establish a Food Sovereignty Sub-Committee.pdf
Resolution_Advance Appropriations IHS.doc
Resolutions_Food Sov SubCom_NPAIHB-RES.docx
Youth Delegates.docx


Resolutions FY 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
18-04-03 SAMHSA MAT Initiative.pdf
October 2017
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
January 2017
July 2017
October 2016

Resolutions FY 2016
April 2016
January 2016
July 2016
October 2015