Transcript Legislative Update NPAIHB Quarterly Board Meeting Thunder

Legislative & Policy Update
NW Portland Area Indian Health Board
Quarterly Board Meeting
Hosted by Grand Ronde Tribe
April 22, 2015
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Report Overview
1. IHS Budget Updates
2. CHS Meeting & MLR Regs & CHEF
3. FAAB & CHS Workgroups
4. MLR for non-hospital based services
5. ACA Updates
FY 2016 Budget Update
• President’s FY 2016 budget provides BIG
increase for IHS - $461 million increase (10%)
– In FY 2010 $471 million increase – Dems in control
• Will Republican controlled Congress agree to
provide such a large increase?
• Political grandstanding by the Administration
recognizing Congress has tight purse strings?
• Great increase but there are some problems
with the overall distribution to direct funds for
construction, program increases & not enough
for inflation/population growth
IHS Budget – Detail of Changes
• Overall Increase is $461 million
• Current Services - $147.3 million
– Federal Pay Costs $7.7 million
– Tribal Pay costs $11.7 million
– Medical Inflation $71.2 million (3.8%)
– Population Growth $56.7 million
• Program Increases - $313.3 million
IHS Budget – Detail of Changes
• Overall Increase $461 million
• Program Increases $313.3 million
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Staffing new facilities $17.8 million
H&HC 3rd Party Improvement $10 million
CHS/PRC increase $25.5 million
H&HC Health IT $10 million
ASA/Behavioral Health $25 million
Contract Support Costs $55 million
Facilities: M&I $35 million; SFC $35 million;
Health Facilities Construction $100 million
NPAIHB Budget Analysis on
FY 2016 President’s Request
• More Discussion on this tomorrow!
• Board has completed annual budget analysis and
recommends $297 million needed for inflation and
population growth.
• Additional $175 million is recommend for Program
increases (based on FY 2016 Budget Formulation):
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CHS/PRC
Dental Health
Mental Health
A/SA
Health Facilities: SFC, M&I
Urban Indian Health
House Interior Appropriations Subcommittee
on Environment & Related Agencies
• Subcommittee conducted Native American Witness
day March 24th
• Andy Joseph, Jr, NPAIHB Chair testified on behalf of
Board
• Budget Analysis Recommendations:
– Reprogram President’s increase to adequately fund
inflation, pop-growth
– If Subcommittee funds Health Facilities than include
funding for SAP, JV, and Area Distribution (Regional
Referral Centers)
– CHS/PRC increase to $100 million
– Support for Administration’s proposal to make CSC a
mandatory appropriation
Senate Committee on Indian Affairs
• New Chairman John Barrasso (R-WY); Vice-Chair Jon
Tester (D-MT)
• Issues:
– Address & find innovative solutions to reduce federal
bureaucracy in Indian programs
– Interior Self-governance amendments; HHS expansion
– February 25th hearing on FY 2016 budget; Yvette Roubideaux,
Sr. Advisor to HHS Secretary, Administration’s witness
– Support Self-Determination and contract support costs
– March 4 Views and Estimates letter:
http://www.indian.senate.gov/sites/default/files/upload/files/
FY%202016%20VE%20Letter.pdf
– Facilities construction
– Special Diabetes Program for Indians
Health Legislative Updates
• Special Diabetes Program for Indians
– DTLL Tribal Consultation on FY 2016 funds
– Medicare Access and CHIP Reauthorization Act of 2015 –
“Doc-fix” bill – Includes extension of SDPI through FY 2018;
• S. 286, A bill to amend the ISDEAA to provide further selfgovernance by Indian tribes;
• Empowering Indian Country in the Republican Congress –
SCIA
• Labor-HHS Committee holding hearing this week on
Administration’s coordination with Tribes on health issues
• IHS Director Nomination? Likely to acting thru end of
Administration
• Administration’s Proposal to make CSC a mandatory
appropriation
FAAB Update
• FAAB Meeting, Rockville, MD, March 31 – April 2,
2015
– Recommendation on revised Health Facility Construction
Priority System (HFCPS)
– Preparation for IHCIA Facilities Report due to Congress
March 23, 2016
– Area Master Planning criteria and process
– Budget issues related to maintaining M&I and SFC
– Consultation on new IHCIA authorities
• DTLL requesting input identifying Tribe’s top five
health care facilities construction needs – new
authorities in the IHCIA
– June 1, 2015 Deadline
– Discuss Process to develop comment and recommendations
Contract Support Costs Update
• President’s Budget includes proposal to
make CSC funding mandatory
– 3 year mandatory authorization
– Tribes support a permanent authorization
– Administration proposes caps “as
necessary”; Tribes support no caps
– 2% administration set-aside; relates to
ongoing reconciliation process?
– Process still being considered by Congress
and has a ways to go
Discussion?