On June 1, 2016, IHS initiated tribal consultation through a Dear Tribal Leader Letter and a draft policy statement titled, “Creating a National Indian Health Service Community Health Aide Program.” A national Community Health Aide Program (CHAP) would increase access to quality health care for American Indians and Alaska Natives through the expansion of community health aides at facilities operated by tribes and the Indian Health Service (IHS), including administrative requirements, such as the creation of a national certification board. To assist tribes with developing thoughtful comments, the National Indian Health Board (NIHB), in partnership with the Northwest Portland Area Indian Health Board (NPAIHB) developed a Briefing Paper to provide some background information on the CHAP program and some preliminary ideas on what to include in any comments that tribes might submit. On July 7, NIHB and NPAIHB held a tribal-only call to solicit initial feedback on IHS’ proposal and answer any questions.
On July 15, NIHB will provide tribes with another opportunity to learn more about the CHAP program and its success in Alaska through a webinar from 2 p.m. to 3 p.m. eastern. The purpose of the webinar will be to provide a more comprehensive overview of the CHAP program and answer any remaining questions that tribes might have.
- Welcome & Purpose of the Webinar: Devin Delrow, Director of Federal Relations at the National Indian Health Board
- CHAP Overview in Alaska: Dr. Robert Onders, Medical Director Health Systems and Community Services at Alaska Native Tribal Health Consortium
- Review How the Program Can Be Replicated: Christina Peters, Oral Health Director at NPAIHB
- Questions: All presenters
For more information on joining the webinar, please contact Sarah Freeman at email@example.com
Dear Tribal Leader:
How the Department of Veterans Affairs (VA) delivers benefits and services for Veterans is growing and changing rapidly. In this environment of change, VA is more committed than ever to fulfilling its tribal consultation policy, which includes strengthening VA’s relationship with tribes and consulting with tribal governments on all VA policies and actions that may impact tribes and Veterans across Indian Country.
VA wants to ensure that the needs of American Indian and Alaska Native Veterans and the priorities of tribal governments are part of these changes, now and in the future. To that end, VA is seeking input from tribal leaders on the top 3 to 5 priorities that tribes have for serving Veterans in Indian Country. Once identified, these priorities may be used to assist with the collaborative development of an Indian Country Veterans Affairs policy agenda, which will inform tribal governments, VA, members of Congress, and other Veteran-serving partners in coming years.
To gather this input, VA plans to hold two tribal consultation sessions in 2016.
The first consultation will take place Wednesday, June 29, 2016, at 5:15 p.m. at the Spokane Convention Center, at 334 W. Spokane Falls Blvd., Spokane, WA 99201. This session is held in conjunction with the National Congress of American Indians (NCAI) Mid-Year Conference, taking place June 27-30, 2016, in Spokane, WA.
The second consultation will be scheduled later this year. VA will send a second letter to confirm this session when the date and time are finalized.
VA also invites written comments on the consultation topics, particularly for tribal leaders and representatives who may be unable to attend the consultation meetings in person. Written comments may be submitted as follows:
Mail: U.S. Department of Veterans Affairs
Office of Intergovernmental Affairs (075F)
810 Vermont Avenue, NW, Suite 915G
Washington, DC 20420
Written comments should be submitted no later than October 7, 2016. For questions, please contact VA’s Office of Tribal Government Relations at 202-461-7400 or at the email address above.
VA will compile all 2016 testimony received into a tribal consultation report to be disseminated in 2017. VA wishes to thank tribal leaders for their continued support, input, and engagement as we continue our work to honor and serve American Indian and Alaska Native Veterans.
ASHNHA has partnered with AK Health Reform to present “Medicaid Redesign: Unbundled” a health reform webinar series. The webinars will run May 24 – June 21 on Tuesdays and Thursdays from noon – 1 p.m. The series will cover various elements of SB 74 starting with an overview followed by topics such as prescription drug monitoring, telemedicine, demonstration projects, tribal health and more.
Following is a schedule by date:
Presented by: Rebecca Madison, Alaska e-Health Network and Chuck Kopp, Chief of Staff to Senator Pete Micciche
6/9/2016: Behavioral Health
Presented by: AMHTA
6/14/2016: Promising Demonstration Projects
Presented by: Rick Davis, Central Peninsula Hospital, Elizabeth Ripley, Mat-Su Health Foundation, and Jocelyn Pemberton, Alaska Innovative Medicine
6/16/2016: Emergency Room (ER) Project
6/21/2016: Tribal Health Policy
Presented by: Jim Roberts, ANTHC
No registration is required. To join the webinars, click on this link:
Call-in number: 1-800-832-0736
Room number *4117317#
For more information, click on this link.
The Health Resources and Services Administration (HRSA) will be holding its annual Tribal consultation with Tribes on June 15, 2015, from 8:30 AM to 5:15 PM in Washington, DC, in partnership with the Administration for Children and Families (ACF). HRSA is the Federal agency charged with improving access to health care through the health care workforce, building healthy communities and achieving health equity.
HRSA’s programs specialize in providing health care to people in geographically isolated, economically or medically vulnerable communities. The consultation will focus on three priority areas: Improving Access to Quality Health Care and Services; Strengthening the Health Workforce; and Building Healthy Communities. Written testimony or questions for HRSA can be submitted no later than June 8, 2016 to firstname.lastname@example.org.
To register for the consultation, please go to:
Access code: ACFHRSAConsultation
For more information, please see the attached “Dear Tribal Leader Letter” or click on this link.
On June 1, 2016, the Indian Health Service (IHS) released a Dear Tribal Leader letter requesting Tribal Consultation on a draft policy statement detailing the planned national expansion of the Community Health Aide Program (CHAP), including the creation of a national certification board.
The national expansion of the CHAP would mean an increase in paraprofessionals and workers providing services for health education, communicable disease control, maternal and child health, dental health, behavioral health, family planning, and environmental health. Community health aide is an encompassing term that includes behavioral health aides, nursing aides, and dental health aides.
The Dental Health Aide Therapist (DHAT) program currently exists in in Alaska, which brings dental education and routine dental services to rural Alaska Native communities. DHATs have provided dental services to over 40,000 Alaska Native people since 2004. Many rural Alaskan Native villages also have Community Health Aides (CHA). CHAs serve as a primary provider for many individuals, providing emergency first aid, patient examinations and follow-ups in conjunction with the treating physician, and carrying out treatment recommendations, education and instruction, and conducting preventive health programs. Behavioral Health Aides (BHA) work within Tribal communities to address behavioral health needs, including substance abuse and mental health problems. BHAs address these needs by serving as counselors, health educators, and advocates.
Comments are due to IHS on Friday, July 29, 2016.
Comments may be submitted to email@example.com, with the subject IHS Expansion of Community Health Aide Program Draft Policy Statement Consultation.
Mail your comments to:
Alec Thundercloud, M.D.
Director, Office of Clinical and Preventive Service
Indian Health Service
5600 Fishers Lane Mail Stop: 08N34-A
Rockville, MD 20857
ATTN: IHS Expansion of Community Health Aide Program Draft Policy Statement Consultation
For additional information, please click on this link.
The Alaska Native Health Board and Self-Governance Communication & Education Tribal Consortium Co-Host:
Self-Governance and Affordable Care Act Training
The purpose of this training is to provide background and history of the Self-Governance Program and its adoption in Alaska, to explain the annual negotiation process and financial aspects of the Alaska Tribal Health Compact, to discuss Self-Governance evolution with new and changing policies, and to review insurance and employer responsibilities under the Affordable Care Act.
If you plan to join either day of this training event, please click on this link to register (follow the instructions on the bottom of the page). This is a free training event.
Host Hotel: Hilton-Anchorage
The Hilton Anchorage hotel is in the heart of downtown Anchorage, an ideal location near the city’s most popular attractions. For the ideal Anchorage experience, enjoy the Alaskan art in the lobby, while at the hotel you are just steps away from excellent dining and shopping in the Anchorage Convention District. Take time after the meeting to unwind comfortably with views of the cityscape or enjoy Alaskan cuisine at one of the onsite restaurants. If fitness is what your interested in enjoy the hotels fully equipped fitness center. SGCE has established a room block for our attendees at the government rate. This rate is available three days before and three days following the event, so bring your family and enjoy your stay in beautiful Alaska.
500 W 3rd Ave
Anchorage, AK 99501
To register online click here.
Call in: 1-800-HILTONS
Group code: SGCE16
Deadline extended- March 25th is the last day to book in the room block.
Highlights of the two-day training:
Day 1-Self Governance Training
On April 5, 2016 the Indian Health Service (IHS) Office of Tribal Self-Governance (OTSG) and Alaska Area Tribal Experts will provide advanced training including an overview of the Indian Self-Determination and Education Assistance Act (ISDEAA), the history and application of the Alaska Tribal Health compact with IHS, Annual ISDEAA Title V Negotiation Process for the Alaska Tribal Health Compact, and the history of Financial Developments in Alaska.
Day 2-Patient Protection and Affordable Care Act
On April 6, 2016 we will continue with to cover topics and data specifically important to Self-Governance Tribes, including Tribal Sponsorship, Employer Options under the Patient Protection and Affordable Care Act and one-on-one sessions where participants can interact directly with Tribal experts. Information covered during this session will be specific to Tribal programs.
IHS Implements New Medicare Like Rate Regulation for Tribes
The Indian Health Service (IHS) announced that it will be implementing a new regulation that gives IHS, Tribal, and Urban Indian health programs the ability to cap payment rates at a “Medicare-Like rate” to physician and other non-hospital providers and suppliers who provide services through the Purchase and Referred Care (PRC formally CHS) program.
Background: The PRC budget supports essential health care services from non-IHS or non-Tribal providers and includes inpatient and outpatient care, emergency care, transportation, and medical support services such as diagnostic imaging, physical therapy, laboratory, nutrition, and pharmacy services. PRC programs routinely pay full-billed charges for non-hospital services, including physician services. On average, this would add up to 70% more than would be paid by Medicare. As a result, the PRC program was running out of funds each year.
There was some Tribal concerns on changing this rule because many believed that lowering the rates would cause many providers to stop contracting with I/T/Us. However, implementing rates for non-hospital based providers will more likely increase the volume of services being sought which will result in providers achieving more volume to offset the decrease in rates.
The proposed rule is opt-in and not a requirement. This is in recognition of Tribal sovereignty and self-determination as Tribes have the right to negotiate with providers and determine how best to meet the needs of their community when providing health care.
The IHS announcement and the published rule states that the final rule became effective on March 20, 2016. IHS recognizes that this rule will have significant Tribal implications so in order to ensure that all concerns are taken into account, it will be implemented as a final rule with another 60 days for the public to provide comment on the rule. In addition, IHS will be conducting outreach and education to PRC administrators and participating providers and suppliers so that everyone is on the same page with the rule and there are no adverse impacts on the PRC system.
If you have comments or questions, please contact Eric Jordan, ANHB Policy Analyst at firstname.lastname@example.org.
On February 26, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a letter to states and Tribes providing guidance about an update to CMS policy regarding the circumstances in which 100 percent federal funding would be available for services furnished to Medicaid-eligible American Indians and Alaska Natives (AI/AN) through facilities operated by the Indian Health Service (IHS) or Tribes under the Indian Self-Determination and Education Assistance Act, P.L. 93-638. Through this letter, CMS is re-interpreting its payment policy with respect to services “received through” an IHS/Tribal facility, and is expanding the scope and nature of services that qualify for this matching rate. CMS will be holding an All Tribes’ Call to walk through the policy and provide time for questions and answers. NIHB will provide the call-in information as soon as it is available.
The WWAMI Rural Health Research Center recently released a new report titled Access to Rural Home Health Services: Views from the Field.
In this report, key informants identified solutions for consideration to address barriers to access to home health services including, payment reforms (e.g. approving new provider types for reimbursement) and increasing telehealth options. Participants also raised concern about the growing burden of administrative requirements associated with reimbursement.
For the full report, click here.
On March 1, 2016 Secretary Burwell announced Mary Smith’s assumption of the IHS Principle Deputy Director position, reporting that Robert McSwain requested to serve in another capacity so as to spend more time with his family. The Alaska Native Health Board congratulates Mary Smith on her new role and expressed our appreciation for Mr. McSwain for his service.
Secretary Sylvia M Burwell’s announcement:
I am pleased to announce that IHS Deputy Director Mary Smith, an enrolled member of the Cherokee Nation, has agreed to serve as the Principal Deputy of the Indian Health Service and will be delegated the responsibilities of the Director, effective today. As such, she will report directly to the Secretary and be responsible for the day to day operations of the IHS as well as our priority IHS initiatives. She will also work directly with Acting Deputy Secretary Mary Wakefield on the Executive Council on Quality focused on our critical work related to the Great Plains Area and making sustainable improvements for direct service tribes throughout Indian country.
Since joining IHS in October 2015, Mary has led a number of key agency priorities including providing leadership on the progress we have made in behavioral health, native youth initiatives, such as Generation Indigenous, and serving as the primary IHS liaison to other federal agencies. She has also made significant contributions to the progress we’ve made on contract support costs as well as in our work on Medicaid in states where expansion will be of particular benefit to Native Americans. Mary has significant management experience from her time working in federal and state government and in the private sector. Mary’s expertise on Native American issues and track record of delivering impact for the tribal community will undoubtedly be great assets to IHS as she assumes this new role. I am very pleased to have Mary serve as Principal Deputy, and look forward to working with her in her new role.
I also want to express my appreciation to Bob McSwain, who has diligently carried out the responsibilities of the Director since February 2015. Bob has requested to serve in another capacity within IHS to allow more time to be with his family. Bob, a member of the North Fork Rancheria of Mono Indians of California, is a long time civil servant who began his federal career with the Indian Health Service in 1976. Bob has been a steward for IHS and committed to its mission of ensuring high quality comprehensive health services are available and accessible to American Indian and Alaska Native people across the United States. I appreciate Bob’s willingness to lead IHS during this important time.
Please join me in thanking Bob for his leadership and congratulating Mary on her new position.
Sylvia M. Burwell