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Tribal Self-Governance Consultation Conference Update: IHS Appropriations, Government Shutdown Impacts, and Special Diab

This presentation provides an update on IHS advance appropriations, the impacts of the government shutdown on Native health delivery, and the renewal of the Special Diabetes Program for Indians. It also includes information on the FY 2020 IHS appropriations and upcoming conferences.

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Tribal Self-Governance Consultation Conference Update: IHS Appropriations, Government Shutdown Impacts, and Special Diab

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  1. Stacy A. Bohlen, Chief Executive Officer NIHB Legislative Update to The Tribal Self-Governance Consultation ConferenceApril 1, 2019

  2. Presentation Overview • IHS Advance Appropriations • Special Diabetes Program from Indians • FY 2020 Appropriations for IHS • Upcoming Conferences

  3. Government Shutdown Impacts • During the 35-day government shutdown NIHB held 2 national calls on this effort and we learned of serious impacts including: • Clinic closures • Nurses and doctors leaving for the private sector • Administrative staff going without pay • Difficulties in PRC reimbursement • Bottom line: the shutdown destabilized Native health delivery and health care provider access; as well as Tribal Governments, families, children and individuals

  4. IHS Advance Appropriations • What is Advance Appropriations? • Funding that becomes available one year or more after the year of the appropriations act in which it is contained. • The appropriations law is passed, but funds cannot be used until the FY year in which they are allocated for arrives

  5. IHS Advance Appropriations • What advance appropriations IS NOT: • “forward funding” allows funds to become available beginning late in the budget year and is carried into at least one following fiscal year. Forward funding is counted against the same budget year. i.e.- it has a cost score! • “Mandatory appropriations” is funding that is automatic when Congress passes an authorization law, such as Medicare, Medicaid, or SDPI

  6. IHS Advance Appropriations • How to we get Advance Appropriations? • Budget Resolution – exemptions list • House Rules – Budget Committee Chairman must comply • Enacting law – S.229/ H.R. 1128/ H.R. 1135 • In the first year, there must be a double appropriation – one for FY 2020 and on for FY 2021

  7. IHS Advance Appropriations • Three bills introduced for Advance Appropriations • Legislation Introduced • S.229 / H.R. 1128 – Indian Programs Advance Appropriations Act • Sponsors: Sen. Udall (D-NM)/ Rep. McCollum (D-MN) • IHS Services and CSC as well as BIA • H.R. 1135 – IHS Advance Appropriations Act • Sponsor: Rep. Don Young (R-AK) • All of IHS, not BIA • Senate bill coming soon

  8. IHS Advance Appropriations Activities: • Letter to Appropriations Committee on Hearing • Meeting with Chairman of the Budget Committee and Reps. Kennedy and Kildee • Meeting with Senate Budget Committee Democratic Staff • Sign on Letter to House Budget Committee • 60 Signatures Actions needed! • Legislation Co-sponsorship! View NIHB’s Website for resources at: https://www.nihb.org/legislative/advance_appropriations.php

  9. Special Diabetes Program for Indians • SDPI expires on September 30, 2019 • Senate HELP Committee leaders introduced a 5 year renewal for SDPI at the current $150 million/ year • House will take separate legislation for each program – 5 years likely, hopefully funding increase. • Rep. O’Halleran (D-AZ) to introduce SDPI bill. • Working with partners at American Diabetes Association, Juvenile Diabetes Research Foundation and the Endocrine Society to increase funding to $200 million • Congressional Sign on letter is open– Congressional Outreach needed

  10. Special Diabetes Program for Indians More resources Available at www.nihb.org/sdpi

  11. Indian Health Service Appropriations FY 2020 • President’s budget was released March 11 • IHS funded at $5.9 billion • Increases in H&C; Behavioral Health; Health IT • Decreases to facilities, CHRs; and Health Education • $25 million for HIV/HCV prevention • NIHB testified on March 6 – House Interior Appropriations Subcommittee • Advance Appropriations • End to Sequestration • TBFWG request of $7.1 Billion for IHS

  12. NIHB Conferences: TPHS & Behavioral Health

  13. SAVE THE DATE: National Tribal Health Conference The National Tribal Health Conference will be September 16-20, 2019 at Pechanga Resort and Casino

  14. Thank you! For more information please contact:Stacy A. Bohlen sbohlen@nihb.orgNIHB Chief Executive Officer

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