Biden Announces Nomination of Roselyn Tso for Director of the Indian Health Service

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On March 9, 2022, President Biden announced the appointment of Roselyn Tso, an enrolled member of the Navajo Nation, as the Director of the Indian Health Service (IHS). Tso previously worked in the Portland Area where she began her career with IHS in 1984 and served in several capacities, including working with the three urban programs in the Portland Area that provide services ranging from community health to comprehensive primary health care services. Tso is currently the Director of the Navajo Area of IHS and most recently served as the Director of the Office of Direct Services and Contracting Tribes (ODSCT) within IHS. Tso holds a Bachelor of Arts in interdisciplinary studies and a master’s degree in organizational management from Marylhurst University in Portland, Oregon. As the IHS Director, Tso will be responsible for administering a nationwide health care delivery program that is responsible for providing comprehensive health care services to American Indians and Alaska Natives through the Indian Health Service, Tribes, Tribal organizations, and urban Indian organizations. The National Council of Urban Indian Health has previously stressed the importance of a appointing a permanent IHS Director and called for the elevation of the role to Assistant Secretary.

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Omnibus Bill Released with VAWA and Strides for Urban Indian Health

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The bill includes $73.4 million for urban Indian health and $6.6 billion for IHS

On March 9, 2022, the House Appropriations Committee released a draft of the Consolidated Appropriations Act, 2022 (H.R. 2471) for Fiscal Year (FY) 2022 (also known as the “Omnibus”) consisting of $1.5 trillion in discretionary spending and $15.6 billion to manage the COVID-19 pandemic. This bill comes after Congress passed three Continuing Resolutions maintaining the FY 2021 budget, with the most recent CR set to expire on March 11, 2022. The 2741-page omnibus bill authorizes $6.6 billion for the Indian Health Service (IHS) for FY 2022, a 6.3% increase above the FY 2021 enacted level; $73.4 million for urban Indian health for FY 2022, a 17.13% increase above the FY 2021 enacted level and the highest increase in the past 10 years; 2022 Violence Against Women Act (VAWA) Reauthorization with Tribal and urban Indian provisions; and COVID-19 supplementals to manage the pandemic domestically and abroad.

The Tribal Budget Formulation Workgroup (TBFWG) requested $12.8 billion for the Indian Health Service and the House included $8.1 billion in its passed legislation, however, the amount enacted would be the highest increase of any account for the Department of Interior and Related Agencies, which demonstrates a strong bipartisan commitment from Congress to improving health outcomes for American Indians and Alaska Natives. Unfortunately, though, the final amount still falls well short of fully funding the Indian Health Service to properly provide health care services for all American Indians and Alaska Natives in the United States to meet the trust responsibility. Additionally, the bill does not include Advance Appropriations despite robust advocacy from Tribes and Urban Indian Organizations.

Current Status and Next Steps

Funding for the federal government expires on March 11. Congress will likely approve the current continuing resolution through March 15. It is expected that the Omnibus will be approved by Congress and signed into law by the President. As of 2:45 p.m. ET today, the COVID-19 supplemental funding has been removed and Speaker Pelosi says the House will move forward to vote on the Omnibus without the COVID funding. The National Council of Urban Indian Health (NCUIH) will continue to monitor developments and provide more in-depth analysis as legislation continues to move forward.

Overview of IHS and Urban Indian Health Requests

Line Item FY21 Enacted FY22 TBFWG Request FY22
President’s
Budget		 FY22 House
 Passed		 FY22 Senate
Proposed		 FY22 Draft Omnibus
 Urban Indian
Health		  $62,684,000  $200,548,000  $100,000,000  $200,500,000  $92,684,000 $73,424,000
Indian Health Service $6,236,279,000 $12,759,004,000 $8,471,279,000 $8,100,000,000 $7,616,250,000 $6,630,986,000
Advance Appropriations – – – – $6,586,250,000 (FY23) –
Missing and Murdered Indigenous Women – – – – $24,900,000 –

Summary

In summary, the package includes the following NCUIH priorities for Urban Indian health:

  • $73.4 million for urban Indian health for FY 2022
  • Inclusion of UIOs in the 2022 VAWA reauthorization
  • $30 million annually from FY23-FY27 for grants for Creating Hope Through Outreach, Options, Services, and Education for Children and Youth (CHOOSE Children & Youth) grants to enhance the safety of youth and children who are victims of, or exposed to, domestic violence, dating violence, sexual assault, stalking, or sex trafficking and prevent future violence.
    • UIOs added as eligible entities.
  • $10 million annually for a new 3-year program (FY23-FY27) to award grants for the clinical training of sexual assault forensic examiners to administer medical forensic examinations and treatments to survivors of sexual assault. Of the $10 million, there is a set aside of 15 percent for purposes of making grants to entities that are affiliated with Indian Tribes or Tribal organizations or Urban Indian organizations.
    • UIOs included as eligible entities.
  • $5 million for a new 5-year demonstration grants (FY23-FY27) established for comprehensive clinical training of health care providers to provide generalist forensic services and trauma-informed care to survivors of interpersonal violence of all ages. Of the $5 million, there is a set-aside of 10 percent for purposes of making grants to support training and curricula that addresses the unique needs of Indian Tribes, Tribal organizations, Urban Indian organizations, and Native Hawaiian organizations.
    • UIOs included as eligible entities.
  • Title VIII “Safety for Indian Women” includes the following purposes:
    • to empower Tribal governments and Native American communities, including urban Indian communities and Native Hawaiian communities, with the resources and information necessary to effectively respond to cases of domestic violence, dating violence, stalking, sex trafficking, sexual violence, and missing and murdered Native Americans; and
    • to increase the collection of data related to missing and murdered Native Americans and the sharing of information among Federal, State, Tribal, and local officials responsible for responding to and investigating crimes impacting Indian Tribes and Native American communities, including urban Indian communities and Native Hawaiian communities, especially crimes relating to cases of missing and murdered Native Americans.

In summary, the bill provides the following for IHS, tribal organizations, and Urban Indian Organizations (UIOs):

  • $6.6 billion for the Indian Health Service for fiscal year 2022
  • $4.7 billion for the IHS health services account
  • Fully funds Contract Support Costs and Payments for Tribal Leases
  • $940 million for health facilities construction
  • $12 million from Substance Abuse and Mental Health Services Administration (SAMHSA) to Indian Tribes, Tribal Organizations, or consortia for Medication-Assisted Treatment for Prescription Drug and Opioid Addiction
  • Increase to SAMHSA State Opioid Response (SOR) Grants for tribes and tribal organizations
    • UIO are not included
  • $22.5 million for the Good Health and Wellness in Indian Country program
  • $15.6 million to make payments under the National Health Service Corps loan repayment program

Background and Advocacy

The National Council of Urban Indian Health (NCUIH) has long advocated for larger investments in AI/AN health care and has called on Congress to strengthen their commitment to Indian Country with increased funding in the FY 2022 appropriations:

Most recently, NCUIH joined the National Indian Health Board (NIHB) and 70 organizations in a letter to several Members of Congress and Congressional Committees urging for Advance Appropriations and no less than the House-passed level of $8.114 billion for IHS in the final Appropriations bill for FY 2022:

VAWA

NCUIH has been tirelessly advocating for an expansion of resources for all AI/ANs, including those who reside off-reservation, in the VAWA reauthorization. Since the passing of the House bill on VAWA (H.R. 1620) early last year which excluded support for off-reservation AI/ANs, NCUIH successfully advocated for urban Indian communities to be added in the Senate draft bill released on December 8, 2021. NCUIH, UIOs, and stakeholders supporting Indian health provided written comments to Senate Committee on Indian Affairs (SCIA) leadership to retain the provisions to assist all AI/ANs in the final VAWA reauthorization bill.

Policy Alert: COVID-19 and Omnibus Include Huge Wins for Urban Indians

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The bills include a $5 million increase for urban Indian health.

Today, Congress released the “Consolidated Appropriations Act, 2021” (H.R. 133) consisting of a $900 billion COVID-19 pandemic relief bill and a $1.4 trillion omnibus spending bill. The package includes funding for Fiscal Year (FY) 2021 and provides COVID-19 vaccine funding along with other pandemic relief measures. The package includes $6.236 billion for Indian Health Service (IHS) in FY21 and extends the Special Diabetes Program for Indians (SDPI) until 2023.

In summary, the package includes the following National Council for Urban Indian Health (NCUIH) priorities for Urban Indian Organizations (UIOs):

  • $62.7 million for Urban Indian Health in FY21, a $5 million increase from FY20
  • $1 million to conduct an infrastructure study for facilities run by UIOs
  • Reimbursement from VA to UIOs for urban Native veterans’ health (H.R. 4153/S. 2365)
  • FTCA Coverage for UIOs (H.R. 6535/S. 3650)— This bill passed the Senate yesterday and is currently headed to the President’s desk for signature.

The package provides the following for IHS, Tribal organizations and UIOs:

  • Extends SDPI through 2023 at current levels
  • $210 million from CDC to IHS to plan, prepare for, promote, distribute, administer, monitor, and track coronavirus vaccines to ensure broad-based distribution access and vaccine coverage
  • $790 million from CDC to IHS for necessary expenses for testing, contact tracing, surveillance, containment, and mitigation
  • $125 million set aside for ITU in funding for Substance Abuse and Mental Health Services Administration (SAMHSA)
  • $15 million to make payments under the National Health Service Corps loan repayment program
  • Obesity prevention and reduction programs in consultation with Indian Tribes, Tribal organizations, and urban Indian organizations
  • Establish “Sec. 330n. Expanding Capacity for Health Outcomes” in Title 3 of the Public Health Service Act to include Indian Tribes, Tribal organizations, and urban Indian organizations

Next Steps

  • Congress plans to vote tonight on the Consolidated Appropriations Act, 2021.
  • NCUIH will conduct further in-depth analysis which will be forthcoming.

Memo: No Surprises Act and the Impact on Urban Indian Organizations

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NCUIH prepared the following memo for Urban Indian Organizations with respect to the No Surprises Act:

Background on the No Surprises Act

  • The No Surprises Act was passed as part of the Consolidated Appropriations Act of 2021. The No Surprises Act went into effect January 1, 2022. The Act includes provisions that take effect in 2022 for medical providers.
  • The bill focused on banning surprise billing and is focused on high-cost services and providers.
  • Surprise billing happens when a patient with health insurance receives care from an out-of-network provider or an out-of-network facility, even unknowingly, and their plan does not cover the entire out-of-network cost. The provider or facility could then bill the patient for the difference between the billed charge and the amount their health plan covered. The No Surprises Act bans this practice.

How does the No Surprises Act affect UIOs?

  • Patients enrolled in federal programs such as, Medicare, Medicaid, Indian Health Service (IHS), Veterans Affairs Health Care, or TRICARE, already had protections against surprise billing. As such, most of the provisions in the No Surprises Act do not apply to UIOs.  But on September 30, 2021, HHS released an Interim Final Rule (IFR) with an important provision that does impact UIOs – the Good Faith Estimate (GFE).

What is the Good Faith Estimate?

  • The GFE is documentation that includes charge info for services and items provided by the provider.
  • A GFE is provided to patients that are uninsured or self-pay, that make an appointment more than three days in advance, or specifically request a GFE.
  • This documentation is provided when the patient makes their appointment, and has a requirement of listing a diagnostic code, essentially requiring administrative staff to diagnose patients who have yet to be seen.
  • For services that are recurring a single GFE can be issued for up to 12 months.

How does the GFE apply to UIOs?

  • The rule does not apply to people with coverage through programs such as Medicare, Medicaid, Indian Health Services, Veterans Affairs Health Care, or TRICARE. These programs already prohibit balance billing.
  • AI/AN patients are considered insured when they receive care at an Indian Health Service facility, tribal health programs (also known as tribal 638 programs or tribal health clinics), or urban Indian organizations.
  • As such, UIOs do not need to provide a GFE for AI/AN patients. However, if a UIO provides care for non-AI/AN patients, those patients would be eligible for GFEs if they meet the other requirements (e.g., uninsured.)

Waivers and Exemptions

  • There is no development of a waiver program in the legislative text of the Act.
  • However, the National Association of Community Health Centers (NACHC) is advocating for HRSA FQHCs and “look-alikes” to be exempt from the Good-Faith Estimate (GFE) provision.
    • NACHC’s argument centers around the fact that the GFE would be redundant with the requirements (sliding scale fee) of section 330 of the Public Health Service Act (PHSA) and undermine its protections.
    • NACHC’s request is that Agencies use their discretion under the No Surprise Act in defining the terms “facility” and “provider” for purposes of the good faith estimate requirement in Section 112 and omit community health centers and clinics.

Does GFE apply to UIOs referring patients to other providers for services?

  • The GFE only applies to the provider that is collecting the check. If a patient is referred out for additional services, then the UIO only has to provide a GFE for the services the UIO is being paid for, and the referred to provider will have to provide a GFE for their services provided. However, services where the UIO is dependent on them to provide care, like labs, will need to be included in a GFE.

Conclusion

  • The No Surprises Act went into effect January 1, 2022.
  • This includes phase one of the GFE implementation which requires a GFE for charge info for services and items provided.
  • This requires that UIOs provide a GFE to non-AI/AN patients who are uninsured or self-pay and make their appointment more than three days in advance.
  • On February 3, 2021, on an All Tribal and UIO leaders Call, Capt. John Rael said IHS continues to work with CMS on the No Surprises Act and will provide UIOs with additional assistance on the Act.
  • NCUIH is advocating with a coalition of partners to have UIOs waived from the GFE provision.

 

For additional information, please contact Jeremy Grabiner, Policy Analyst, JGrabiner@NCUIH.org or email Policy@NCUIH.org.

EPA Seeks Applications from Underserved Communities to Address Drivers and Environmental Impacts of Energy Transitions

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On January 18, 2022, the Environmental Protection Agency (EPA) initiated an application process seeking applicants proposing community-engaged research that will address drivers and environmental impacts of energy transitions in underserved communities. The EPA defines “underserved communities” as “populations sharing a particular characteristic, as well as geographic communities, that have been systematically denied a full opportunity to participate in aspects of economic, social, and civic life, including people of color, low income, rural, tribal, indigenous, and other populations that may be disproportionately impacted by environmental harms and risks.”

 

The Science to Achieve Results (STAR) Program is seeking applicants who can provide research that addresses the following research areas:
  1. Understanding how air quality, the environment, and public health in underserved communities might be improved through the transformations of the energy sector (e.g., wide-spread adoption of renewable energy sources and energy efficient technologies, electrification of transportation services and household energy use) while minimizing potential negative impacts;
  2. Identifying approaches or strategies to ensure that energy transitions provide air quality benefits and reduce environmental risks while meeting the energy and mobility needs of underserved communities;
  3. Understanding how socioeconomic, cultural, behavioral, institutional, and systems factors drive individual and household decisions regarding the adoption of renewable energy sources, energy-efficient technologies and building modifications, and new transportation modes in underserved communities;
  4. Understanding how socioeconomic, organizational, and institutional factors affect decisions at the organizational, governmental, and community levels regarding the adoption and diffusion of renewable energy sources, energy-efficient technologies, building modifications, and new transportation modes in underserved communities; and,
  5. Identifying and evaluating potential multi-pollutant and/or multi-sectoral approaches to achieve climate, air quality, and other environmental goals while maximizing potential positive impacts as well as minimizing potential negative impacts to underserved communities arising from large-scale energy systems transformation

Awards and Application Eligibility

The EPA anticipates awarding eleven grants or cooperative agreements totaling $10 million. Eligible applicants include public and private nonprofit institutions/organization and certain hospitals.  Profit-making firms and individuals are not eligible to apply.

 

Learn More & Apply Here

 The application period closes April 28, 2022.

IHS Issues Final Rule Implementing “Buy Indian Act”

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On January 13, 2022, the Indian Health Service (IHS) announced publication of the final rule implementing the Buy Indian Act (“Final Rule”).  This rule supplements the Federal Acquisition Regulation (FAR) and the Department of Health and Human Services Acquisition Act (HHSAR). The rule will become effective March 14, 2022.  Once the rule is effective, IHS will update the Indian Health Manual, Part 5, Chapter 5, Section 6-1 Buy Indian Policy.

The Buy Indian Act provides the IHS with authority to set-aside procurement contracts for Indian-owned and controlled businesses.  The Buy Indian Act rule has been in development at the Indian Health Service (IHS) since 2016, in collaboration with the Health and Human Services (HHS) and the Assistant Secretary for Financial Resources (ASFR). Over the course of four (4) public consultation sessions, comments were received, reviewed, addressed, and incorporated into the final rule.

The Final Rule is intended to encourage procurement relationships with Indian labor and industry.  It formalizes the administrative procedure by which IHS carries out acquisition activities with the intent of ensuring uniformity for offers submitted by Indian labor and industry under solicitations set-aside under the Buy Indian Act and the Final Rule.

According to IHS Acting Deputy Director Elizabeth Fowler, this rule aims to improve business processes that support value-based purchasing and standardized management strategies in contracts. IHS hopes that the Rule advances the IHS mission and supports economic sustainability and development across Indian Country. Dr. Fowler also indicated that IHS intends to use the rule to set-aside for Indian Economic Enterprises a significant portion of the $1 billion in commercial contract dollars it currently obligates per year.

As identified by IHS, the final rule has capacity to:

  • alleviate unnecessary regulatory burden on Indian Economic Enterprises
  • expand application of the Buy Indian Act to all construction including the planning, design and construction of health care facilities, personnel quarters, and water supply and waste disposal facilities;
  • better adhere to the language of the Buy Indian Act;
  • strengthen oversight of the Buy Indian Act to reduce the potential for fraud and abuse;
  • and clarify the preference for Indian Economic Enterprises;

IHS has committed to providing support during the implementation phase of incorporating the new strategies and is dedicated to improving compliance, training, and reporting in respect to the Buy Indian Act.

Indian-owned and controlled businesses which are interested in competing for IHS Buy Indian Act set-aside acquisitions will be required to fill out an IHS Indian Economic Enterprise self-certification form. The form will be attached to all IHS solicitations set-aside under the Buy Indian Act.  Completed and signed forms must be submitted with a quote/proposal in response to the specific IHS solicitation.  Potential offerors can also reach out to any IHS Contracting Officer to obtain a copy of the form.  Once IHS has updated the Indian Health Manual the form will also be made available on the IHS Division of Acquisition Policy webpage.

Potential offerors with additional questions, can contact Santiago Almaraz, IHS head of contracting activity at santiago.almaraz@ihs.gov or Ken Truesdale, acting director-division of acquisition policy, at kenneth.truesdale@ihs.gov.

For technical questions concerning this rule contact: Carl Mitchell, Director, Division of Regulatory Policy Coordination (DRPC), Office of Management Services (OMS), IHS, 301-443-6384, carl.mitchell@ihs.gov; or Santiago Almaraz, Acting Director, OMS, IHS 301-443-4872, santiago.almaraz@ihs.gov.

DOJ Consultation Meeting on the Public Safety and Criminal Justice Needs of Native Americans

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On January 14, 2022, the U.S. Department of Justice (DOJ) Office of Tribal Justice (OTJ) issued a Dear Tribal Leader letter inviting Tribal leaders to a two-day government-to-government consultation on March 16 and 17, 2022. The purpose of this two-day consultation is to discuss “DOJ’s efforts to address the unacceptably high rate of violent crime in Native communities, including the rates of missing or murdered indigenous persons.” Deputy Attorney General Lisa Monaco directed this consultation in her November 15, 2021  memorandum establishing the DOJ’s Steering Committee to address the crisis of missing and murdered indigenous persons (MMIP). The OTJ is also welcoming written comments via email to OTJ@usdoj.gov until April 15, 2022. The meetings will be held from 3:00 p.m. – 4:30 p.m. EST on both days.

On November 15, 2021, during the White House Tribal Nations Summit, President Biden signed Executive Order 14053 (E.O.) “Improving Public Safety and Criminal Justice for Native Americans and Addressing the Crisis of Missing or Murdered Indigenous People,” which directed the Administration to work together with Tribes to “build safe and healthy Tribal communities and to support comprehensive law enforcement, prevention, intervention, and support services.”  The E.O. also recognizes that because “approximately 70 percent of American Indian and Alaska Natives live in urban areas and part of this epidemic of violence is against Native American people in urban areas, we must continue that work on Tribal lands but also build on existing strategies to identify solutions directed toward the particular needs of urban Native Americans.”  To that end, in her November 15, 2021 memorandum, Deputy Attorney General Monaco directed DOJ’s Steering Committee to seek and consider the views of stakeholders including Urban Indian Organizations.

Meeting of the Advisory Committee on Infant and Maternal Mortality

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On March 15 and 16, 2022, the Health Resources and Services Administration (HRSA) Advisory Committee on Infant and Maternal Mortality (ACIMM) will be hosting a public meeting to discuss Federal program updates; COVID-19 updates; race-concordant care; health of Indigenous mothers and babies; and the impact of violence on infant and maternal mortality. During this two-day meeting, members of the public will have the opportunity to provide written or oral comments. Requests to submit a written statement or make oral comments to ACIMM should be sent to Anne Leitch at SACIM@hrsa.gov. at least 3 business days prior to the meeting. The meeting will be held from 12:00 p.m. to 4:00 p.m. EST both days.

Background

Formed in 1991, the ACIMM advises the Secretary of Health and Human Services (HHS) on department activities, partnerships, policies, and programs directed at reducing infant mortality, maternal mortality and sever maternal morbidity, and improving the health status of infants and women before, during, and after pregnancy. The ACIMM consists of public and private members and provides advice on how to coordinate governmental efforts to improve infant mortality, related adverse birth outcomes, and maternal health, as well as influence similar efforts in the private and voluntary sectors. With its focus on underlying causes of the disparities and inequities seen in birth outcomes for women and infants, the ACIMM advises the Secretary on the health, social, economic, and environmental factors contributing to the inequities and proposes structural, policy, and/or systems level changes.

AI/AN Infant and Maternal Mortality

According to HHS Office of Minority Health American Indian and Alaska Natives (AI/AN) have almost twice the infant mortality rate as non-Hispanic whites. AI/AN infants are also 2.7 times more likely than non-Hispanic white infants to die from accidental deaths before the age of one year and AI/AN infants are 50 percent more likely to die from complications related to low birthweights as compared to the same group. AI/AN mothers are also disproportionately represented in maternal mortality. In 2019, AI/AN mothers were almost three times as likely to receive late or no prenatal care as compared to non-Hispanic white mothers.

Bureau of Indian Education Hosting Two-Day Meeting to Discuss Mandates of the Individuals with Disabilities Education Act of 2004 for Indian Children with Disabilities

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On March 9-10, 2022, the Bureau of Indian Education (BIE) Advisory Board for Exceptional Children will host an online meeting open to the public to discuss the Individuals with Disabilities Education Act of 2004 (IDEA) and its impact on Indian children with disabilities.  The Advisory Board will consider agenda items regarding special education topics from the:

  • BIE Central Office
  • BIE/Division of Performance and Accountability (DPA)/Special Education Program
  • BIE Office of Sovereignty in Indian Education
  • Four Public Commenting Sessions will be provided during both meeting days.

The meeting will be from 8:00 a.m. to 4:00 p.m. Mountain Standard Time both days.  For more information on the upcoming meeting, please visit: Federal Register :: Advisory Board of Exceptional Children

Background

The goal of IDEA is to ensure that students with a disability are provided with free appropriate public education that is tailored to their individual needs, with the overall goal to provide children with disabilities the same opportunity for education as those students who do not have a disability. The Advisory Board was established under IDEA to advise the Secretary of the Interior, through the Assistant Secretary of Indian Affairs, on the needs of Indian children with disabilities.  According to the Office of Special Education Programs, in school year 2018-2019, “20.1% of American Indian or Alaska Native children with disabilities served under IDEA, Part B were in Oklahoma, 9% in Arizona, 7.6% in BIE, 5.9% in New Mexico, 5.9% in California, 5.5% in Alaska, 3.9% in New York, and 4.1% in Minnesota.”

According to a recent report by the U.S. Census Bureau, American Indian and Alaska Native (AI/AN) children represent the highest rate of disability among U.S. children. In 2019, more than 3 million children in the U.S. had a disability, with  5.9 percent of AI/AN children having a disability. Various social factors impact the disproportionate number of AI/AN children with a disability, including household income, as well as lack of access to high quality-health care services.

CMS Commits Over $49 Million to Reduce Uninsured Rate Among Children and Boost Medicaid Enrollment Among Parents, and Pregnant People

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On January 27, the Centers for Medicare & Medicaid Services (CMS) announced that it will commit $49.4 million in cooperative agreements in an effort to fund organizations that can connect more eligible children, parents, and pregnant individuals to health care coverage through Medicaid and Children’s Health Insurance Program (CHIP). Eligible awardees include state and local governments, tribal organizations, federal health safety net organizations, and non-profits, as well as schools and other organizations. Each awardee may receive $500,000 up to an anticipated $1,500,000 over a three-year award period.  Awardees must use the funding to reduce the number of uninsured and advance Medicaid and CHIP enrollment and retention. Application proposals are due on March 28, 2022.  The anticipated award issuance date for these awards is July 1, 2022.

Background

The Connecting Kids to Coverage HEALTHY KIDS 2022 Outreach and Enrollment Cooperative Agreements provide funding opportunities to reduce the number of children who are eligible for, but not enrolled in, CHIP and to improve retention of eligible children who are enrolled.  According to CMS, the rate of uninsured children increased to 5.2 percent in 2019, meaning that around 4 million children are uninsured.  In addition, Medicaid and CHIP participation rates have declined, indicating that a greater proportion of eligible children are not accessing the health benefits that Medicaid and CHIP provide.  CMS estimates that among the 4 million uninsured children, 2.3 million children are eligible for Medicaid and CHIP and CMS further estimates that AI/AN children continue to experience the highest uninsured rate at 11.8 percent.

Funded organizations will provide enrollment and renewal assistance to children and their families, as well as pregnant people—a new optional target population in this year’s award announcement.  Applicants will be encouraged to consider a range of activities, including:

  • Engaging schools and other programs serving young people;
  • Bridging racial and demographic health coverage disparities by targeting communities with low coverage rates;
  • Establishing and developing application assistance resources to provide high-quality, reliable enrollment and renewal services in local communities;
  • Using social media to conduct virtual outreach and enrollment assistance; and
  • Using parent mentors and community health workers to assist families with enrolling in Medicaid and CHIP, retaining coverage, and addressing social determinants of health.

How to Apply

Applicants must submit their application electronically through the grants.gov website.  The following forms must be completed with an electronic signature and enclosed as part of the application:

  1. Project Abstract Summary
  2. SF-424: Official Application for Federal Assistance
  3. SF-LLL: Disclosure of Lobbying Activities
  4. Project Site Location Form(s)

In addition, Applicant’s must provide the following information with their application

  1. Application cover letter or cover page (optional)
  2. Project Narrative
  3. Data Collection and Reporting Plan
  4. Work Plan and Timeline
  5. Budget Narrative
  6. Evaluation Plan
  7. Staffing Plan
  8. Business assessment of applicant organization

All applications must be submitted electronically and be received through www.grants.gov by 3:00 pm, Eastern Time, on March 28, 2022.  More information on this funding opportunity as well as application materials, can be found  here.