The Department of Health and Human Services (HHS) Secretary’s Tribal Advisory Committee (STAC) was hosted at the Puyallup Tribe of Indians from September 10-13, 2024. The National Indian Health Board’s Chairman Chief William Smith and honorable Tribal leaders from the 12 Indian Health Service (IHS) regions were joined by Secretary Xavier Becerra and HHS agencies, including Deputy Secretary Andrea Palm, Assistant Secretary for Health Rachel Levine, Indian Health Service (IHS) Director Roselyn Tso, Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, National Institutes of Health (NIH) Director Monica Bertagnolli, Centers for Disease Control and Prevention (CDC) Director Mandy Cohen, HHS Office of Intergovernmental and External Affairs (OIEA) Director Bertha Alisia Guerrero, and other divisions, who provided updates and engaged in dialogue with Tribal leaders on emerging Tribal health priorities and issues.
Secretary Beccera made his opening remarks honoring the government-to-government relationship and referenced previous actions to achieve advance appropriations. To increase resources reaching Tribes, his team is reviewing HHS’s ten block grants to set-aside funding for Tribes. However, the Secretary emphasized the threat of a government shutdown impacting HHS divisions, confining extensions of Tribal contracts, and restricting funding to address arising concerns, like syphilis. Deputy Secretary Palm conveyed that HHS and the Centers for Medicare and Medicaid Services (CMS) is finalizing the OPPS draft rule which contains many important priorities of the CMS Tribal Technical Advisory Group like a fix for the “four walls” issue and adequate reimbursement for Tribal facilities for high-cost drugs.
While the Secretary shared there are limited resources available to address the syphilis crisis, he emphasized that agencies are utilizing resources available to support Tribal communities. The Office of the Assistant Secretary for Health (OASH) shared departmental actions and publicly available resources to address syphilis. OASH also shared that Pfizer is working on increasing production for syphilis treatment, and several members of the Public Health Service Corps (PHSC) have already been deployed to the Great Plains area, and they will investigate whether additional PHSC members can be deployed to regional areas experiencing high rates of syphilis. With full FY 2025 government funding not available until at least December, it is unclear if any additional funds will be made available to address this crisis in the short term.
Tribal leaders called for the expansion of self-determination and self-governance under Executive Order 14112. During the STAC meeting, Wampanoag Tribe of Gay Head Aquinnah Chairwoman Cheryl Andrews Maltais stated the federal government has a fiduciary responsibility to Tribes as distinct entities that must be continued when Tribes receive federal funding, citing previously rescinded funds from the Health Resources and Services Administration (HRSA) that the Tribe was unaware about. IHS Director Tso shared their efforts to deliver on the strategic plan, including drawing down PRC unobligated funds and recognizing distribution gaps of PRC to Tribal clinics that may require adjustments of the funding methodology. The Office of the Assistant Secretary for Financial Resources (ASFR) stated they are reviewing the Notice of Funding Opportunities (NOFOs) to build in considerations for Tribes and recently published the Tribal Customer Service Experience Report. Agency heads are investigating other concerns raised by TAC members, like the Arizona Medicaid fraud scandal, unwinding of AI/AN beneficiaries left with hefty medical bills, and inadequate HPSA scoring methodologies.
Other updates provided to Tribal leaders include the upcoming HHS Tribal Data Access Policy Consultation on October 1, 2024 (register here); Traditional Medicine Summit on November 18-19, 2024; and to expect the release of the Traditional Healing Framework by the end of the year.
The next STAC meeting will be held November 19-20, 2024 in Washington, DC. Tribal Advisory Committees (TAC) are critical for providing advice, recommendations, and input on policies, programs and activities that directly impact AI/AN beneficiaries across HHS divisions and agencies. There are several vacancies across TACs found here if you or someone you know would be interested in joining.
National Indian Health Board