In This Issue

President Obama, the White House Office of Intergovernmental Affairs and the White House Domestic Policy Council cordially invitee you to join him and senior members of his Administration for the 2014 White House Tribal Nations Conference.  The goal of this year's Conference is to bolster the meaningful discussion between Tribal leadership and the Administration, and further strengthen the Nation-to-Nation relationship between the United States and American Indian and Alaska Native Tribes.  

The Conference will be held on Wednesday, December 3, 2014, at the Capital Hilton located at 1001 16th St NW, Washington, D.C. from 8:30 a.m. to 4:00 p.m.  Supplementary programming will take place the afternoon of December 2nd (please click here for a draft agenda and FAQ).  

As we reported last week, the fate of the FY 2015 federal budget remains uncertain.  Congress may choose to enact a full appropriations bill in December, or push to next year. Congress could also choose to enact a year-long continuing resolution (CR) which would keep funding at FY 2014 levels for FY 2015.  Leaders in Congress are currently divided on a strategy forward, and much will hinge on the outcome of next week's elections.  However, with so many close races in the Senate, we might not know who will control the Senate until December. 

This uncertainty in the federal budget makes it difficult for many in the Indian health delivery system to provide seamless care to American Indians and Alaska Natives.  This is why NIHB supports advance appropriations for the Indian Health Service (IHS).  Advance appropriations means that IHS would get its budget one year ahead of time (but could not spend the money until the start of the fiscal year) so that there would not be any gaps or questions about future funding.  There would be no additional cost to the federal government.  

We need your help convincing Congress! Here's what you can do:

• Share your story! Demonstrating how short-term funding or gaps in funding affect the delivery of care is important.  Click here for more information on sharing your story.
• Send in #AdvanceIHS postcards to your representatives and senators.  Contact NIHB's Director of Congressional Relations Caitrin Shuy at (202) 507-4085 or [email protected] to get cards. 
• Send a letter or resolution to Congress - you can view samples here.

Centers for Disease Control and Prevention (CDC) continues to provide current 

CDC has outlined what it means to be "high risk", "some risk", "low but not zero risk", and "no identifiable risk".  High risk includes those individuals who may have had a needle stick or mucous membrane exposure to blood or body fluids of a person with Ebola while the person was symptomatic.  The article outlines what it means to be in the other categories.  The CDC is suggesting five recommendations at this time:

1. Symptomatic individuals in the "high", "some", or "low risk" categories who meet the symptom criteria should undergo required medical evaluation with appropriate infection control precautions in place.  Isolation may be considered.
2. Individuals without symptoms in the "high risk" category should have direct active monitoring for 21 days after the last potential exposure.
3. Persons without symptoms in the "some risk" category should have direct monitoring until 21 days after the last potential exposure.
4. Persons without symptoms in the "low but not zero" risk category should be actively monitored until 21 days after the last potential exposure.
5. Individuals in the no identifiable risk category do not need monitoring or to be restricted unless these are indicated due to a diagnosis other than Ebola.

For definitions for what constitutes "some risk", "low but not zero risk", and "no identifiable risk, go to the website, www.cdc.gov/vhf/ebola/.

How is Ebola spread?  With all of the recent TV, newspaper, and Internet articles on the Ebola crisis in West Africa, the Centers for Disease Control and Prevention (CDC) has published an article entitled, "What's the Difference Between Infections Spread Though the Air or by Droplets?"  The CDC notes that germs like chickenpox and tuberculosis are airborne spread when a germ floats though the air after a person coughs, talks, or sneezes.  Germs may land in the eyes, mouth, or nose of another person.  In contrast, infections by droplet happen when germs traveling inside droplets that are coughed or sneezed from a sick person enter the eyes, nose, or moth of another person.  The CDC article indicates that droplets travel short distances, normally, less than 3 feet from one person to another.  A person might also get infected by touching a surface or object that has germs on it and then touching their mouth or nose.  Ebola is spread by droplets.

The article suggests five things a person can do to minimize their risk of contracting Ebola and other diseases such as the flu:

1. Wash your hands often with soap and water.  If soap and water are not available use an alcohol-based hand sanitizer.
2. Cover your cough.
3. Avoid close contact with people who are sick.
4. Avoid touching your eyes, nose, and mouth.
5. Clean and disinfect commonly touched surfaces like doorknobs, faucet handles, toys, computer keyboards, and other commonly touched surfaces.  The Ebola virus has been known to live on surfaces for up to several hours.

Ebola is spread through droplets, and infection can only occur through direct contact with infected bodily fluids.  For more information please visit the CDC website at www.cdc.gov/vhf/ebola. 

The Health Resources and Services Administration (HRSA) is the primary federal agency for improving access to health care services for people who are uninsured, isolated, or medically vulnerable.  HRSA has announced a number of funding opportunities for Tribes and Tribal organizations.  

Last week HRSA released an opportunity for Family-to-Family Health Information Centers.  This announcement solicits applications for the Family-to-Family Health Information Centers Program.  The purpose of this grant program is to provide information, education, technical assistance, and peer support to families with children and youth with special health care needs (CYSHCN) and professionals who serve such families.  The closing date is December 16, 2014. You can read more about the opportunity here.

HRSA Funding Opportunity Announcements can be submitted through http://www.grants.gov/web/grants/home.html.

 HRSA Main Web Page:  http://www.hrsa.gov/index.html