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Analysis of Tribal Consultation Policies For Health Insurance Exchanges Attachment A Dear Governor: THE SECRETARY OF HEALTH AND HUMAN SERVICES WASHINGTON, D.C. 20201 September 14, 2011 Over the last two years, the Department of Health and Human Services (HHS) has taken a number of steps to strengthen our partnership with American Indian and Alaska Native Tribal Nations. We take seriously the federal government's obligation to help improve the health of American Indians and Alaska Natives through the various health and human services programs administered by the Department. However, improving the health and well-being of Tribal nations is contingent upon understanding the specific needs of Tribal communities. Tribal consultation is an essential tool in understanding these unique needs and ensuring government to government relations. I am writing to you today to encourage you to consult with Tribes as you administer health and human services programs that are supported with federal funding. HHS has made significant progress in strengthening our partnership with Tribes, and Tribal consultation is one piece of our efforts to fulfill our responsibility to represent the best interests of Tribes. Since President Obama signed an Executive Order on Tribal Consultation in 2009, HHS has also updated its formal Tribal consultation policy. The updated policy includes the responsibility of states to consult with Tribes when HHS has transferred the authority and funding for programs to states that are intended to benefit Tribes. States must consult with Tribes to ensure the programs that they administer with federal funding meet the needs of the Tribes in that state. Tribes should be considered full partners by states during the design and implementation of programs that are administered by states with HHS funding. The requirement of states to consult with Tribes in the development of the Affordable Insurance Exchanges is an example of how states can proactively include and partner with Tribes during the planning stages of a program that has the potential to benefit Tribal members greatly. Consultations can identify strengths and barriers to Tribes accessing these services and ensure that Tribes have the opportunity for greater health care coverage for their members and employees. I believe we share a vision of the future where our nation is strong and where every individual and every community has the opportunity to reach their full potential. We can continue to strengthen our partnership with Tribes and improve health and human service opportunities for all. Together, we have the opportunity to build something great. Kathleen Sebelius 6
Analysis of Tribal Consultation Policies For Health Insurance Exchanges Attachment B State Health Insurance Exchanges, Status of Tribal Consultation Policies, 10-18-12 Stat e Contact Polic y? 7 Status (latest status report date) Establishm ent Grant? Type Exchan ge Expecte d AK No FFE AL Kathleen Healy HIX No FFE Kathleen.healey@myalabama.gov establishme nt on hold until after elections. Only one federallyrecognized tribe seems to be reason for State not to have formal policy. (7/20/12) AZ Donald Hughes Expected to Yes dhughes@az.gov (602-542-1334) be completed in October. CA Jessica Abernethy Working on Yes State Jessica.abernethy@hbex.ca.gov it. Check in November CO Myung Kim yes CO Health Yes State mkim@cohbe.org Benefit Exchange Policy Regarding Consultation with Colorado’s American Indian Tribes was signed in December 2011. CT Julie Lyons Finalize Yes State
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MEDICARE, MEDICAID, & HEALTH REFORM
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GENERAL INFORMATION TABLE OF CONTEN
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Last Updated: November 12, 2012 2.
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Ref. # 2. Task/Issue Person(s) CMS
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Ref. # II. POLICY Task/Issue Person
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Ref. # Task/Issue Person(s) 9. Stra
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Ref. # Task/Issue Person(s) 15. Eva
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IV. OUTREACH AND EDUCATION MMPC: SU
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Ref. # Task/Issue Person(s) 25. Med
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MMPC October 9, 2012 Teleconference
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To do List: -Myra will have draft b
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Internal Revenue Service Meeting No
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with a “interim/acting”. Can al
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8/7/12 DRAFT COMPANION TO ADDENDUM
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Indian Self-Determination and Educa
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Under federal law, There are privac
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1. Purpose of Addendum; Supersessio
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(1) ISDEAA, 25 USC §450 et seq.; (
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13. Medical Quality Assurance Requi
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edits on documents are due back fro
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d. CCIIO Philosophy - CCIIO is taki
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- I/T/U provider receives their all
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i. CMS rep. commented that an analy
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IHS TRIBAL SELF-GOVERNANCE ADVISORY
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Letter: Dr. Robert Petzel, Under Se
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October 17, 2012 Dr. Robert Petzel,
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A BILL To correct inconsistencies i
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California Rural Indian Health Boar
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As people have changes in employmen
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Indian eligibility determinations,
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v.7, 2012‐09‐23a ACA, (2) the s
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Indian tribe means any Indian tribe
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v.7, 2012‐09‐23a In issuing thi
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(1) to ensure the highest possible
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v.7, 2012‐09‐23a Delays in acc
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v.7, 2012‐09‐23a 1997. The prov
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v.7, 2012‐09‐23a 48 Enacted thr
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Prepared by James Crouch MPH Chair,
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Summary T he Indian Health Service
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Summary providers that were either
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Introduction Reliable determination
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Analysis Groups IHS AIAN Methods Th
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Methods group for the statistical m
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Enrollees with no Payments Methods
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Methods Table 5. Mean Medicaid and
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Restricted Benefits Methods Enrolle
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Age and Sex Methods Medical care pa
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Methods Table 9. Findings for all s
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Methods Map 1. 12 IHS Areas: Contra
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Findings Figure 1. Adjustment of Me
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Findings Payments are Higher for IH
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Findings for Group 3 was $600 and W
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Findings Unadjusted mean payments f
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Findings Table 10. Unadjusted Mean
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Findings Figure 13. Adjusted Mean T
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Analysis Group Compiled Findings fo
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Findings Adjusted Mean Payments for
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Findings Figure 18. Percent differe
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Findings providers for services nee
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Findings Figure 21. Medicaid Altern
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Conclusions and Recommendations pro
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Indian Health Service, 2012. Federa
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Tribal Consultation Policy HHS 1. P
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defined in Sections 8 and 9 of this
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2. Office of Intergovernmental Affa
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will give equal consideration to th
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provide Indian Tribes with a region
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4. Each Operating Division Head/Dep
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Department’s ability to address i
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17. Sovereignty - The ultimate sour
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1. Selection of workgroup co-chairs
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It is unclear if this was just an o
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November 14 -15, 2012 TTAG FACE TO
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AGENDA: Day 2 Thursday - Nov. 15, 2
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Subpart G--Social Services Block Gr
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organization applying for or receiv
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members of a tribe receiving direct
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is at or below the poverty line. (d
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under this part. Grantees that rece
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income home energy assistance progr
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Need for Uniform Operational Guidan
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Dear Tribal Representatives, Octobe
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There is a strong correlation betwe
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Wed. Nov 14 th : SDPI National Call
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Future MMPC Meetings & Conference C
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Regulation Review and Impact Analys
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64. Policy on Conferring with Urban
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RRIAR Ref. # 1.c. 8. 9. 13. Short T
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RRIAR Ref. # 20. 23. 26. 28.a. Shor
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RRIAR Ref. # 43. 44. 46. 61. Short
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Page 227 and 228: November 12, 2012 Centers for Medic
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Page 231 and 232: November 9, 2012 Page 2 We are comm
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Draft Report: Currently being circu
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