AIHC Legislative Updates

AIHC Legislative Updates

AIHC's Tribal Health Legislative Priorities 2022

Together we can educate, influence, and help the legislature partner with us to strengthen and redesign our Indian Health system of care into one that reflects our indigenous values.

American Indian Health Commission Legislative Priorities 2022

AMERICAN INDIAN HEALTH COMMISSION LEGISLATIVE PRIORITIES 2022

With the continuation of the pandemic and ongoing COVID efforts by Tribal Leaders and staff, AIHC staff are handling the meetings with legislators again this year. Visits are being done via zoom by AIHC’s Executive Director, Legislative Liaison and Legislative Intern. Approximately 60 zoom meetings, over a three–week period are currently scheduled.  Advocacy is focused on the priorities list below.   Additionally, education of legislators, caucus members and legislative staff was also undertaken. Training included Tribal health priorities, the Tribal health system, including Tribal Behavioral Health Services and Tribal Sovereignty.

TRIBAL TRAINING:

Continued education is necessary to institutionalize sustainable knowledge of tribal sovereignty, health programs and challenges faced by tribal communities. It is anticipated training may facilitate legislator awareness about the impact laws may have on tribes before laws are written.

Training to educate caucus members and legislative staff.

Working with Representative Lillian Ortiz-Self and Senator Derrek Stanford trainings will be held to over Zoom.

AIHC 2022 Priorities

2 AIHC Bills:

Updating Involuntary Commitment Laws to Include Tribal Governments:

BACKGROUND: A budget neutral bill. This legislation continues with the efforts of Indian Behavioral Health Act of 2020 to address barriers in the involuntary treatment laws (RCW 71.05) for Tribal governments to help their Tribal citizens/members experiencing behavioral health crisis. This bill adds tribal law enforcement and tribal courts to RCW 71.05. This bill also adds access to traditional cultural healers where there is access to a religious advisor and as treatment under a less restrictive alternative.

Public Records Request:

Sponsor Sen. Saldana

BACKGROUND: This bill will exempt disclosure of any information pertaining to American Indians and Alaska Natives (AI/AN) or Indian tribes or information received by Indian tribes maintained in the files or databases of agencies listed in RCW 43.71B.020(1)(b)(i).  Per RCW 26.25.010, “The legislature recognizes that Indian tribes are sovereign nations and the relationship between the state and the tribes is sovereign-to-sovereign.” Requiring state agencies to disclose data that belongs to Tribal nations is in direct conflict with state and federal laws respecting Tribal sovereignty.  In addition, the intent of the Indian Health Improvement Act, RCW 43.71B, is to “implement the national policies of Indian self-determination …” and “to recognize the sovereign authority of tribal governments to act as public health authorities.”  Disclosing Tribal and AI/AN data without the permission of Tribal nations is in conflict with RCW 43.71B, and the spirit and intent of the government-government relationship required under RCW 43.376.  Parties interested in obtaining Tribal and AI/AN data should contact Tribes directly.  The Public Records Act should be amended to include an exemption for Tribal and AI/AN data since these data belong to the Tribes and are not for state agencies to share.

 

Support for Agency requested bills:

Tribal Administration of Long-Term Support Services Programs (ALTSA):

Sponsored by

BACKGROUND:   Addressing barriers identified in the Washington Indian Health Improvement Act when non-governmental entities are gate keepers to coverage for American Indians and Alaska Natives.  This act enables Tribal staff to determine eligibility, including assessments and reassessments, authorize and reauthorize services, and perform case management functions within its community. The staff at Tribes understand best tribal income and assets specific to their Tribal government. These staff are part of the Tribal community and have the appropriate trust relationship to work with Tribal Elders and their families on this sensitive information.

ASK: Support this bill.

 Creation of an Endangered Persons Designation for Missing Indigenous Women and Persons (Attorney General’s office):

HB 1725 Sponsored by Lekanoff, Goodman, Leavitt, Bateman, Ryu, Simmons, Shewmake, Berry, Ramel, Wicks, Berg, Valdez

BACKGROUND:  Violence against Indigenous women and within Indigenous communities continues to be underreported and misunderstood throughout Indian Country and the United States. Complex issues around jurisdiction often become barriers for law enforcement to act on a missing person report.  Similar to “Amber Alert” and “Silver Alert”, the endangered person designation for Missing Indigenous Women and People will allow emergency messages to be issued so communities can assist in the recovery of a missing indigenous woman or person.

ASK: Support this bill.

Dental Health Aide Therapist (HCA):

HB 1885 Sponsored by Rep. Cody and Bateman

BACKGROUND:   This bill will expand the ability of dental therapists (including DHATs) to provide services across the state focusing on providing access to Medicaid clients. This updated bill will include the recommendations A through C from Dental Health Therapy Taskforce Report.

Office of the Insurance Commissioner:

Balance Billing LegislationHB 1688/SB 5618 Aligns the Washington State Balance Billing Protects Act, passed in 2019, with the Federal bill – No Surprises Act passed in December 2020.

Prohibiting the use of credit scores to determine rates for personal lines of insuranceWe support SB 5010 but oppose SB 5623, as it does not go far enough to address the issues caused by this practice.

Follow the link to view the documents that support these priorities:

https://drive.google.com/drive/folders/1-GcZpi-ZlWWS6igi-grG4RQVG9qlp–H?usp=sharing

American Indian Health Commission Legislative Priorities 2021

The 2021 session created challenges to our annual “Tribal Legislative” Day event and had some interesting results. During the last 2 sessions, the AIHC facilitated in-person on campus “Tribal Legislative” Day visits with representatives. Visits were primarily scheduled between tribal members and their district representatives to discuss Tribal legislative priorities. This year’s focus on COVID efforts by tribal members made it necessary for AIHC to be creative in reaching legislators during the 2021 session. Visits were done via zoom by a small committee that included Tribal & UIHP Policy, AIHC Executive and Legislative staff. Approximately 30 zoom meetings, over a threeweek period, were held to discuss Tribal legislative priorities. Although, not pursuing specific legislation this session, the committee focused their advocacy on several important issues which are listed below. Additionally, education of legislators, caucus members and legislative staff was also undertaken. Training included Tribal health priorities, the Tribal health system and Tribal Sovereignty.

TRIBAL TRAINING:

Continued education is necessary to institutionalize sustainable knowledge of tribal sovereignty, health programs and challenges faced by tribal communities. It is anticipated training may facilitate legislator awareness about the impact laws may have on tribes before laws are written.

Training was initiated to educate representatives, caucus members and legislative staff.

Working with Representative Lillian Ortiz-Self, Israel Rios (her staff) and Amy Ruble, House Democratic Caucus staff, a training on the 2021 Tribal Health Priorities was accomplished on February 19th. Representative Lillian Ortiz-Self sponsored the event, sending invitations to both Democratic and Republican legislator and Legislative staff. The training was well attended by Legislators and resulted in Representative Ortiz-Self requesting it be repeated next year.

Additionally, during “Legislative Day” discussions with other legislators, training was requested on Tribal Sovereignty and the Indian Health Care system and the UIHP Health Care system.

The Tribal Sovereignty training for legislative interns has been scheduled for March 22 and 23rd.

Training on the UIHP health care system has been requested by Senator Stanford and will be scheduled towards the end of session and/or after session ends.

Senator Stanford is also interested in sponsoring a bill next year that will require commissions and boards to include tribal representatives. Sen. Stanford was made aware of concern over the lack of representation on the EMD Council. He believes this bill could remedy this problem. Senator Stanford is the prime sponsor of this years EMD Tribal member bill.

Senator Stanford has informed us he is the contact for Tribal issues on the Senate side and he takes this role very seriously. Senator Stanford’s staff (Erica Mendez) is a Quinault Tribal member and thanked the AIHC for all its efforts on behalf of tribes in Washington state.

All Documents in a Google folder

AIHC Legislative Priorities One-pager

Testifying During 2021 Session – Accessing the Legislature Remotely

Add Tribal Representation on the Emergency Management Council:

Status (3/5/21) – On the Governor’s desk.

SB5101 Sponsored by Sens. Stanford, Conway, Dhingra, Hasegawa, Hunt, Nguyen, Randall, Saldaña, Wagoner, Wilson, C.

BACKGROUND: Washington State has a government-to-government relationship with Tribal Governments and has designated Tribal Governments as one of the four parts of the Public Health System. To honor these relationships, tribal representation should be added to the Washington State Emergency Management Council. This amendment is budget neutral. Washington State Legislature

ASK: Please consider supporting this bill with language to ensure Tribal representation is chosen by Tribes. 

Attachment

Tribal Involuntary Treatment Provisions:

Status: Amended into 5073. On the Governor’s desk for signature. 

BACKGROUND: Language will be amended into SB 5073. This legislation cleans up language in the Indian Behavioral Health Act from 2020; adds Tribes and Indian health care providers among entities able to petition courts for Involuntary Treatment Admissions of a minor under Joel’s Law. Removes jurisdictional language that was confusing.

OUR ASK: Amendment Needed still, then Support SB 5073: Concerning Involuntary Commitment.

Missing and Murdered Indigenous Women:

Status: Provisio passed in budget.

Supported by Sen. Dhingra and Rep. Lekanoff in coordination with the Office of the Attorney General

BACKGROUND: The rate for missing American Indian and Alaska Native women in Washington State is 4.2 times higher than that for white women. Tribal and urban Indian communities have called for the formation of a community-led statewide task force to continue Washington State’s work to address the crisis of Missing and Murdered Indigenous Women and Girls. A statewide task force would take the next step to determine legislative versus administrative fixes to address challenges in data collection and reporting practices, tribal-state jurisdiction, and direct prevention and response services for American Indian and Alaska Native people impacted by gender-based violence.

ASKSupport this $500,000 budget proviso for the Office of the Attorney General to convene a MMIWG Statewide Task Force.

Tribal Youth Suicide Prevention:

Status: Passed in budget

BACKGROUND: DOH funding request for an additional $400k to build Tribal specific community tools to help those helping other community members and family when they are in crisis. Includes funding for the AIHC Annual Tribal Youth Suicide Prevention Summit.

ASK: Support this DOH funding in the budget.

Fund Foundational Public Health Services (FPHS) Budget Request:

Status: ESHB 1152 on Governor’s desk, funded additional $147 million with an increase to $296 million in next biennium. 

BACKGROUND: A strong governmental public health system is essential to keep Washington healthy and safe. We support full funding of FPHS. The Governor’s budget has $143 million, this is a good start. Sustainable funding to ramp up to full funding of $450 million over the next few years.

ASK: Fund FPHS at the level in the Governor’s Office based on sustainable funding.

Dental Therapist:

Status- Failed. DHAT Taskforce and continued Medicaid funding for DHAT services in budget.

SB 5142 Sponsored by Frockt, Das, Dhingra, Hasegawa, Lovelett, Randall, Rivers, Robinson, Saldaña, Stanford, Wilson, C.

BACKGROUND: This bill will expand the ability of dental therapists (including DHATs) to provide services across the state focusing on providing access to Medicaid clients. This bill has two significant changes to meet lawmaker concerns. Private practice dental clinics are no longer eligible practice settings for dental therapists, and preceptorship hours have been extended. These changes allow for incremental expansion of the profession with additional oversight.

ASK: Please support this bill as it moves through Senate and then the House.

Health Equity Zones:

Status- On the Governor’s desk.

SB 5052 Sponsored by Sens. Keiser, Randall, Cleveland, Conway, Das, Frockt, Hasegawa, Kuderer, Lovelett, Nguyen, Nobles, Robinson, Saldaña, Salomon, Wilson, C.

BACKGROUND: Health equity zones are specifically identified geographic areas that have the goal of achieving health equity by eliminating health disparities. Subject to funding, DOH, in coordination with the Governor’s Interagency Council on Health Disparities, local health jurisdictions, and accountable communities of health, must review relevant health and population data to identify, or allow communities to self-identify, potential health equity zones in the state and develop projects to meet the unique needs of each zone. Recognized American Indian Organizations (RAIOs) and Urban Indian communities are specifically called out in the bill as communities that must be worked with.

ASK: Please support this bill as it moves through senate and then the House.

Other Legislation/Budgets AIHC supports:

Universal SB 5399– Need to ensure AI/AN population is exempt with ability to opt-in and there is limited or zero cost-sharing. Passed- on Governor’s desk

Medicaid Postpartum extension SB 5068- Improving maternal-infant health outcomes by extending Medicaid postpartum coverage for up to twelve months after the last day of pregnancy. Signed into law.


Questions can be directed to:

Vicki Lowe, Executive Director, AIHC vicki.lowe.aihc@outlook.com or 360-460-3580

Maria Gardipee Ness, Legislative Liaison, AIHC maria.gardipee@outlook.com or 360-742-2532

 

To view 2020’s Legislative Priorities and Results, click here.

To view 2019’s Legislative Priorities and Results, click here.

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