WASHINGTON, DC— The National Indian Health Board(NIHB), in a series of advocacy-driven engagements with Members of Congress, outlined for lawmakers a robust and comprehensive list of Tribal health and public health priorities that must be included in the next Coronavirus relief package in order for Tribes to address the pandemic and other related critical healthcare issues, including increased funding for telehealth and electronic health records, Medicare and Medicaid reimbursement provisions for Indian Health Care Providers and investments in water and sanitation. NIHB is also calling for meaningful increases to the Indian Health Service (IHS) Fiscal Year (FY) 2021 appropriations. 

“The National Indian Health Board proudly and humbly represents 574 federally-recognized Tribes, and our work and advocacy, especially during a public health crisis, does not stop. This week’s Congressional activities are examples of the dedication and determination from Board members and staff to ensure our people have the tools they need to protect their communities from COVID-19,” said NIHB CEO Stacy A. Bohlen. “The COVID-19 pandemic has further exposed the vast deficiencies in health care access, quality and availability that exists across the Indian health system. Now is an opportune time for Congress to make it right and live up to its trust and treaty obligations to Tribal Nations.”

Earlier in the week, NIHB Chairwoman Victoria Kitcheyan and Vice Chairman Bill Smith participated in a national call with Senate Democratic leadership to emphasize Tribal priorities detailed in a June 2 letter sent to Senate Majority Leader Mitch McConnell and Senate Minority Leader Chuck Schumer. In addition to the Tribal provisions outlined in the House-passed HEROES Act, NIHB urges Senate leaders to include the following priorities in their bill: 

  • Provide a minimum $1 billion for water and sanitation infrastructure development
  • Eliminate the sunset provisions under Section 30106 of the HEROES Act to remove the “four walls” Medicaid billing restriction and permanently extend 100 percent
  • Authorize Indian Health Care Providers to receive Medicaid reimbursement for all medical services delivered to Medicaid-eligible AI/ANs authorized under the Indian Health Care Improvement Act
  • Permanently reauthorize the Special Diabetes Program for Indians 
  • Permanently extend waivers under Medicare for use of telehealth 
  • Enact certain sections of the bipartisan CONNECT to Health Act 
  • Include pharmacists, Licensed Marriage and Family Therapists, licensed counselors as eligible providers under Medicare for reimbursement to Indian Health Care Providers
  • Ensure parity in Medicare reimbursement for Indian Health Care Providers 

Also, NIHB submitted written testimony in response to a May 27 House Ways and Means Committee hearing titled, “The Disproportionate Impact of COVID-19 on Communities of Color,” that stressed Tribal priorities within the jurisdiction of the Committee including:

  • Ensure parity in Medicare reimbursement for Indian Health Care Providers 
  • Include pharmacists, licensed marriage and family therapists, licensed counselors as eligible provider types under Medicare for reimbursement to IHS, Tribal and urban Indian health programs
  • Expand telehealth capacity and access in Indian Country by permanently extending waivers under Medicare for use of telehealth and enacting certain sections of the CONNECT to Health Act
  • Pass the Indian Health Service Health Professions Tax Fairness Act of 2020 that would make the IHS Scholarship and Loan Repayment Program tax exempt

Bohlen testified before the House Interior Appropriations Subcommittee on Interior, Environment and Related Agencies stating that though the organization is pleased that Tribal healthcare and public health provisions were included in previous COVID-19 relief packages, it is clear that more funding is needed to sufficiently address the grave impacts of COVID-19 in Indian Country.

“We know this pandemic will not be resolved anytime soon and it is absolutely essential that fiscal year 2021 appropriations for IHS be passed on time, and with meaningful increases recommended by the IHS Tribal Budget Formulation Workgroup,” said Bohlen. “As many Tribes are struggling with the pandemic, we urge the Administration to fulfill its historic agreements by passing a budget that will finally eradicate the persistent health disparities that have impacted Tribal communities for generations, and are now exacerbated by COVID-19.”

The National Tribal Budget Formulation Workgroup (TBFWG) recommendations includes funding the IHS at $9.1 billion in FY 2021, strengthening Tribal access to Medicare and Medicaid programs and expanding grants for Tribal behavioral health.

NIHB urged the Subcommittee to implement the following recommendations to ensure Indian Country has sufficient resources to tackle the COVID-19 pandemic.

  • Ensure timely passage and meaningful increases to the overall Indian Health Service budget for Fiscal Year 2021 in line with the Tribal Budget Formulation Workgroup recommendations
  • Provide a minimum of $1 billion for water and sanitation development across IHS and Tribal facilities
  • Provide meaningful increases to the IHS budget for telehealth, electronic health records and health IT infrastructure development
  • Ensure inclusion of language permitting an HHS to IHS interagency transfer of Tribally-specific funding 

In her oral testimony, Bohlen shared how these are challenging times but also times of opportunity to achieve redress of hundreds of years of injustices and colonization, citing the Black Lives Matter movement.

NIHB continues to work with allies in Congress and partner organizations to make sure Tribes are included in the COVID-19 funding packages. Learn more about NIHB’s advocacy efforts around COVID-19 at: www.nihb.org/covid-19/advocacy-tools.

 

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