January 14, 2014  |  Issue 13- 40


In This Issue




Congress Releases FY 2014 spending plan - IHS gets $4.4 billion

Last night, the House and Senate Appropriations Committees released the "omnibus" spending package which would fund the government for the remainder of FY 2014.  The House is expected to vote on the bill on Wednesday and the Senate will likely pass the legislation later in the week, avoiding a government shutdown. 


The Indian Health Service (IHS) received $4.4 billion for FY 2014.  This is $78 million above the FY 2013 enacted level before sequestration.  This about 7 percent higher than the post sequestration level for FY 2013 of $4.131 billion.  The measure includes $3.7 billion for health services and $451.6 million for health facilities.  The omnibus also contains $878 million for Purchased/ Referred Care (aka Contract Health Services) which is about $77 million above post-FY 2013 sequester level.  You can read a House summary of the Interior, Environment and Related Agencies Appropriations measure (which contains funding for almost all Indian-related programs) here and the Senate summary is available here


The Joint Explanatory Statement accompanying the bill contained additional information about Contract Support Costs (CSC). Congress rejected the Administration's proposal to place individual caps on each Tribal contract or compact.  The statement says, "That proposal was developed without tribal consultation and the Committees heard from numerous Tribes voicing their strong opposition."  The bill also does not include language that was in previous appropriations bills that limited the amount available to pay CSC in any year.  "Instead," the statement says, "the question of contract support cost amounts to be paid from within the fiscal year 2014 appropriation is remanded back to the agencies to resolve," but notes that the appropriate House and Senate Committees should consider a long-term solutions.  Finally, the bill's explanatory statement directs the Departments of Interior and Health and Human Services to consult with Tribes, the relevant Congressional committees and the Office of Management and Budget to "formulate long-term accounting, budget, and legislative strategies to address the situation."  Congress also directs the agencies to develop a consultation plan on this issue within 120 days of the passage of the omnibus.


You can read the full omnibus appropriations act here.  The Indian Health Service portion starts on page 804.  The Interior Appropriations explanatory statement can be found here.  If you have any questions on the FY 2014 omnibus please contact, Caitrin Shuy, Manager of Congressional Relations at cshuy@nihb.org or (202) 507-4085.

On Thursday, January 9, the Energy and Commerce Subcommittee on Health held an oversight hearing called, ""The Extenders Policies: What Are They and How Should They Continue Under a Permanent SGR Repeal Landscape?"  As you may recall, the so-called "Medicare Extender" legislation typically has been the legislative vehicle for the passage of the Special Diabetes Program for Indians (SDPI).


At the hearing, there were not any witnesses directly related to SDPI.  However, several subcommittee members noted the importance of the Special Diabetes Program (SDP), noting that it served as an example for how other programs should operate.  While the Senate Financial Services Committee has passed a measure that renews SDPI for 5 years, the House has not taken action yet.  The bipartisan statements at the hearing reflect the popularity of SDP/ SDPI, and is an encouraging sign as we move toward renewal of the program which expires on September 30, 2014.


You can read the statement that the National Indian Health Board submitted for the hearing here.


If you have any questions on SDPI renewal please contact, Caitrin Shuy, Manager of Congressional Relations at cshuy@nihb.org or (202) 507-4085.


G IHS holds CSC Workgroup Meeting

On January 7 and 8, 2014, the Indian Health Service (IHS) hosted a meeting of the Contract Support Costs (CSC) workgroup at their headquarters in Rockville, Maryland.  The purpose of the meeting was to find areas where Tribes and the agency agree when it comes to calculating CSC in order to move forward on a long-term solution.


During the meeting, the group discussed indirect cost rates, pass through and exclusion amounts, necessary and allowable costs, and proposals for programs, functions, services, or activities (PFSAs).  The workgroup found several areas where Tribes and the agency agree but left a few outstanding items for further discussion. The next CSC Workgroup meeting is tentatively scheduled for February 24 and 25, 2014.

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