In This Issue

The National Indian Health Board and Congressman Tom Reed are pleased to invite you to a panel discussion with tribal leaders and experts from the diabetes community to discuss the Special Diabetes Program for Indians.  This session will take place at 4pm on March 12 and will be located on Capitol Hill in B-318 Rayburn House Office Building. 

As SDPI is set to expire on September 30, 2014 we have a critical opportunity to have this program renewed by March 31, when Congress must renew the Medicare Extender legislation that is typically the legislative vehicle for SDPI.  This is your opportunity to hear directly from SDPI stakeholders on specifically how SDPI funding is changing the diabetes landscape for American Indians/Alaska Natives (AI/ANs) and how SDPI is saving lives, lowering medical expenditures and demonstrating a real return on the federal investment.

Panelists Include:

• Mickey Peercy, Executive Director, Health Services, Choctaw Nation of Oklahoma, on behalf of the National Indian Health Board
• Barry E. Snyder, President of the Seneca Nation of Indians
• Tekisha Dwan Everette, PhD, American Diabetes Association
• Curt Oltmans, Corporate Vice President and General Counsel- Novo Nordisk

RSVP to [email protected] in Rep. Tom Reed's office or call (202) 225-3161

On Friday, March 6-7, 2014, Tribal leaders participated in a Department-wide Health and Human Services Consultation on the FY 2016 President's budget. NIHB Board Chairperson Cathy Abramson participated in the consultation as did NIHB Board Treasurer Rex Lee Jim, Vice President of the Navajo Nation.

The leaders had the opportunity to voice their concerns directly with Secretary Kathleen Sebelius who visited with the group during the afternoon session. Leaders discussed important topics such as contract support costs; impacts of sequestration; Head Start; advance appropriations for IHS; high school graduation rates; alcohol and substance abuse; consultation policies and collaboration with the Veterans' Administration. The session also consisted of a panel on the implementation of the Affordable Care Act. NIHB Chairperson Cathy Abramson delivered testimony for this panel. You may read it here.

In addition to Secretary Sebelius, the participants heard from department officials such as Norris Cochran, Deputy Assistant Secretary for Budget; Lillian Sparks,Commissioner, Administration for Native Americans, ACF; Gary Cohen, Deputy Administrator and Director, Center for Consumer Information and Insurance Oversight and Yvette Roubideaux, Acting Director, Indian Health Service.

Finally, the two of the four IHS Budget formulation Co-chairs, President Bryan Brewer with the Oglala Sioux Tribe and Vice President Rex Lee Jim of the Navajo Nation presented on the Tribal Budget Workgroup's Recommendations for the FY 2016 IHS budget. These recommendations are:

1. Phase In Full Funding of IHS - Total Tribal Needs Budget of $28.7 Billion Over 12 Years

2. Present a 17.58% increase in the overall IHS budget from the FY 2014 President's Budget request planning base*

3. Restore Cuts/Shortfalls in FY2013-15resulting from sequestration, inadequate increases to cover Congressionally mandated budget categories, and no provision for inflation for Continuing Services & Binding Obligations

4. Advocate that Tribes and Tribal programs be permanently exempted from sequestration

5. Provide an additional $300 million to implement the provisions authorized in the Indian Health Care Improvement Act (IHCIA) 

You may view the Tribal budget Testimony brief here.

Last Tuesday, members of the Tribal Leaders Diabetes Committee (TLDC) braved the weather and traveled to the National Indian Health Board in Washington D.C. They spent the entire day volunteering their time to advocate on Capitol Hill for the Special Diabetes Program for Indians. TLDC members met with eleven offices total, including a meeting with Congresswoman Diana DeGette. Congresswoman DeGette is on the Energy and Commerce Committee and Co-Chairs the House Diabetes Caucus. She is a strong champion on SDPI in the House and has spoken at NIHB conferences in the past on this topic. The group ended the day in a meeting with Congressman Tom Cole. Congressman Cole, an enrolled Chickasaw representing Oklahoma, is a Co-Chair of the Congressional Native American Caucus, and is a proven champion for Indian Country.

The attendees received only good information from the offices who reiterated their strong support for this program. The offices also expressed optimism that there will likely be a short-term renewal of the program by March 31. This is the date by which Congress must renew the "Sustainable Growth Rate (SGR) Fix," which governs the reimbursement rates Medicare pays doctors. SDPI has typically been included as part of this legislative vehicle in what are known as the "Medicare Extenders."  

If you would like to reach out to your own Members of Congress to voice your support of SDPI please click here for a list of Congressional Talking points.

If you have any questions, contact Caitrin Shuy, Manager of Congressional Relations at the National Indian Health Board at [email protected] or 202-507-4085.

President Barack Obama released a $3.9 trillion budget request for FY 2015 to Congress on Tuesday, March 4. The FY 2015 Budget requests $6 billion for the Indian Health Service (IHS), which means an increase of approximately $199.7 million over FY 2014. The Budget fully funds Contract Support Costs (CSC) at the estimated need, totaling $617 million, which represents an increase of $30 million above FY 2014 enacted levels.

The Budget request also contains an increase of $50 million (5 percent) over FY 2014 for the Purchased/Referred Care Program, formerly known as Contract Health Services. This program provides purchased medical care outside of IHS when it cannot provide needed services. There is also an increase of $200 million for the provision of health care services and public health programs for American Indians and Alaska Natives (AI/ANs) and an extra $8 million for preventative health. The Budget request also restores the cuts made to Indian Health Professions; tribal management and self-governance accounts in order to fully fund CSC in the FY 2014 operating plans.

On Friday, IHS released more details of their plan in the Congressional Justification. This more detailed document identifies three legislative priorities for IHS. As in FY 2014, the request includes support for a provision to provide the IHS Health Professionals Scholarship Program and Health Professionals Loan repayment Program with a Tax Exemption. NIHB has been working with Congress to enact this provision and there has already been a bill introduced in the House of Representatives (H.R. 3391).

The request also supports the renewal of the Special Diabetes Program for Indians for $150 million for three years in order to "address the ongoing epidemic of diabetes complications and reverse the increasing incidence of diabetes through primary prevention in AI/AN communities." Finally, the budget also supports enactment of legislation to permit IHS, Tribes or Urban Indian organizations (I/T/Us) to pay Medicare rates for outpatient services funded through the Purchased/Referred Care Program (formally called contract health services). This simple change will allow I/T/Us to be able to use these precious dollars more effectively and will save millions. NIHB is also working with several in Congress to get this address through legislation.

In weeks ahead, the Budget will be reviewed by Congress, and hearings will be held by appropriations committees on the proposals within the President's Budget request. Stay tuned to the National Indian Health Board for a more detailed analysis in the coming days. Click here to view the Congressional Justification for FY 2015, and click here to view a breakdown of FY 2015 funding by category.

If you have any questions, contact Caitrin Shuy, Manager of Congressional Relations at the National Indian Health Board at [email protected] or 202-507-4085.