Save the Date! Legislative Day 2020!
The 2019 Washington State Legislative Session saw the first every AIHC Tribal and Urban Indian Health Program Legislative Day held on January 16, 2019. Representatives from 12 Tribes, both UIHP and AIHC staff and consultants visited 50 legislators to ask them support for our Legislative Priorities for 2019. JOIN US FOR 2020!
American Indian Health Commission Legislative Priorities 2020
Washington State AI/AN Behavioral Health Crisis (Opioid and Suicide Response) Act:
BACKGROUND: American Indians and Alaska Natives experience access to care issues for culturally relevant crisis services throughout Washington State. This legislative fix does not require new funds; it redirects the management of crisis services and 12% of crisis funds to the Tribal Centric Plan to maintain the appropriate availability of behavioral health beds for American Indians and Alaska Natives patients. Bill language is based upon recommendations from the Tribal Evaluation Treatment Facilities Report to the Legislature and was reviewed and edited by the Governor’s Indian Health Advisory Council in preparation for this session. This legislation addresses serious access issues for American Indians and Alaska Natives seeking help through Washington State’s Behavioral Crisis Care System. (https://docs.google.com/document/d/14h8Sh337S9RR0sz9Fh4TpcCQ6At8awG7/edit#)
ASK: Please consider sponsoring this bill.
Missing and Murdered Indigenous Women:
BACKGROUND: Invest in Tribal Epidemiology Centers to create indigenous methodologies designed to inform, improve, and mandate demographic data collection by law enforcement agencies. Bring together Tribal and State Partners to address current, proposed policies and actions that have implications, facilitate training for state agency leadership, staff, and legislators on the jurisdictional issues on tribal reservation land; and provide recommendations for program and services through state agencies.
ASK: Please consider supporting this proviso.
Tribal Youth Suicide Prevention:
BACKGROUND: Legislation will provide funding to develop toolkits for communities to address suicidal ideation. These tools need to be appropriate for Tribal communities. Rep. Mosbrucker will have legislation to implement a Youth Suicide Review Panel. Tribal representation on this panel will be designated through the GIHAC.
ASK: Support funding for Tribal specific tools, $75k to continue the AIHC Annual Tribal Youth Suicide Prevention Summit and coordination with the Tribes and UIHPs for appointment on Youth Suicide Review Panel to ensure appropriate interpretation of data.
Fund Foundational Public Health Services (FPHS) Budget Request:
BACKGROUND: A strong governmental public health system is essential to keep Washington healthy and safe. AIHC supports the recommendations developed by the FPHS Steering Committee to transform Washington State public health systems by filling in gaps in public health funding to save long-term costs, prevent public health disasters, and increase Statewide capacity to deal with public health issues quickly and effectively. (Support for a tax increase that equals the amount of nicotine in product.)
ASK: Support funding fix and gaps from vapor tax to keep FPHS at $22 million from last budget session.
Add Tribal Representation on the Emergency Management Council:
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. (https://aihc-wa.com/wp-content/uploads/2019/01/Tribal-Rep-EM-Council-Bill-12-21-18.pdf)
ASK: Amend RCW 38.52.040 to include tribal representation on the Washington State Emergency Management Council.
Dental Health Aid Therapist:
BACKGROUND: This House Bill 1317 will expand the ability of dental health aid therapists (DHAT) to provide services across the state in federally qualified health centers. This passed through the House Health Care and Wellness Committee and the House Appropriations Committee, it will start in the House Rules Committee. (http://lawfilesext.leg.wa.gov/biennium/2019-20/Pdf/Bills/House%20Bills/1317-S.pdf) ASK: Please support this bill passing through House Rules and to the Chamber for a vote.
Tribal Certification of Community Health/Behavioral Health and Dental Health Aides:
BACKGROUND: Tribal Governments will certify trained Community Health Aid Program graduates to provide services in their communities. (Working with NPAIHB on bill language)
ASK: Please sponsor and or support this bill.
More info at https://aihc-wa.com/aihc-tribal-health-legislative-day/ or contact Vicki Lowe at email@example.com
2019 Priorities and results:
The Washington Indian Health Improvement
- Recognizes the United States’ trust responsibility to provide “quality health care and allied health services to American Indians and Alaska Natives, including those individuals who are residents of this state”; and implement the national policies of Indian self-determination with the goal of reducing health inequities for American Indians.”
2. Establishes the Governor’s Indian Health Advisory Council that will:
- a. Adopt a biennial Indian health improvement advisory plan, developed by the Indian Health Improvement Reinvestment Committee;
- b. Address issues with tribal implications that are not able to be resolved at the agency level; and
- c. Provide oversight of the Indian Health Improvement Reinvestment Account;
3. Establishes the Indian Health Improvement Reinvestment Account Committee to develop the biennial Indian Health Improvement Plan
4. Establishes the Indian Health Improvement Reinvestment Account where new savings created by “100% FMAP received through a Tribal Facility” savings will be deposited beginning November 1, 2019.
Senator John McCoy was the main sponsor of SB 5415. Other sponsors were: Senators Rivers, Cleveland, Saldaña, Van De Wege, Billig, Conway, Frockt, Kuderer, Nguyen, and Rolfes. The bill passed through all committees and both chambers unanimously in each case. Not a single legislator voted “no.”
A companion bill, HB 1365 was primarily sponsored by Representative Steve Tharinger. Other sponsors were: Reps. Harris, Chapman, Appleton, Dolan, Fitzgibbon, Jinkins, Riccelli, Stanford, Robinson, Kloba, Doglio, Pollet, Levitt, Santos, Ormsby, Ortiz-Self. This bill did not make it to a vote in the House Health Committee in recognition that the Senate bill would be the vehicle to get the act passed.
The Washington Indian Health Care Improvement Act was signed into law by Governor Inslee on Tuesday, May 7th, 2019.
Washington State Behavioral Health Crisis Care Act
This bill was not introduced during the session. The Senate and House agreed to incorporate the work needed on this bill into the work of the Governor’s Indian Health Advisory Committee. Over the next year, this bill will go through the same process that the Washington Indian Health Improvement Act went through, it will be reviewed by the Tribe, UIHP, State Legislative and Agency representatives on the council, pared down to what is needed to be in legislation and worked through any operational or programmatic changes that need to be made.
For the 2019 Legislative Session, the purpose of this bill was to address long-standing issues in the Behavioral Health Crisis Care system that are causing access barriers for American Indians and Alaska Natives needing inpatient behavioral health services. These issues have been ongoing since the implementation of the Regional Support Networks (RSN) and, more recently, the Behavioral Health Organizations (BHO), as the “gatekeepers” for inpatient mental and behavioral health services. More information on the legislation can be found here:
Funding to Continue Tribal Evaluation and Treatment Facility Workgroup:
The Washington State Legislature funded $150,000 over the next biennium to continue the work of this committee. Beginning in July, this workgroup will be moving to become the board or Tribal consortium to oversee the rollout of Tribal Evaluation and Treatment or Secure Detox facilities and lease agreements across the State. If you are interested in more information about this workgroup, you can find it on our website here:
Foundation Public Health Services Policy Bill and Funding Request:
The Foundational Public Health Services Policy bill passed the legislature and was signed into law by the Governor on April 3rd. The law:
- Requires the Department of Health, federally recognized Indian tribes, a state association representing local health jurisdictions, and the State Board of Health to agree to the distribution and use of funds appropriated for foundational public health services in order for the funds to be distributed.
- Defines foundational public health services.
- Repeals statutes related to the public health services improvement plan.
Full funding of Foundational Public Health Services in Washington State was determined by the Foundational Public Health Services Steering Committee to be $496 million per year. The Steering Committee asked for $296 million for the first year, the Governor funded $22 million in his budget and that is the amount that passed the legislator.
Over the next year, AIHC will be working with Tribes and UIHPs to define Tribal Foundation Public Health Services in Washington State. The Northwest Tribal Epidemiology Center and the Urban Indian Health Institute will work with Tribes, UIHPs and Local Health Jurisdictions (LHJs) to provide information on prevention and control of communicable diseases across jurisdictions, identify assets in Indian Health delivery system for prevention and control of communicable disease, and ensure disease surveillance, investigation, and control.
In the next legislative session, AIHC will continue to support full funding of Foundational Public Health Services in our State.
Add Tribal Representation on the Washington State Emergency Management Council
The requested was language was to be incorporated into SB 5106- Concerning the creation of a work group to study and make recommendations on natural disaster mitigation and resiliency activities. Because the scope of the bill being about the workgroup, the legislation that passed incorporated Tribal representation onto the workgroup. We will continue to work next year to get Tribal representation for the Washington State Emergency Management Council.
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.