Health Policy Analysis at Your Tribe Mim Dixon Health Policy 101 Workshop NIHB Consumer Conference Washington, DC September 22, 2015

How many times have you said... “They don’t get it.” “They don’t understand us.” “This program is designed for some other type of organization.” “This is too complicated.” “This program isn’t worth it for us to apply.” “If only, they had...” 2

POLICY ANALYSIS You can do something to make things work better through 3

Today We’ll Talk About Tribes need to be involved in policy at the state and national levels. What is health policy analysis? Who pays for this work to be done from a Tribal perspective? How does a person get the training to do this? How can you get involved in national efforts? If your Tribe can't afford a full-time employee to do policy work, there are other alternatives. 4

Tribes Need to be Involved in Policy at the State and National Levels Policy affects your Tribe. Opportunities and limitations. You have knowledge that is needed. Makes you a more effective advocate. 5

Two-Step Process Step 1: Tribes get their act together and decide what they want. This is informal, exploratory, collaborative. Policy analysts do this work. Step 2: Tribes interact with state and federal agencies. This is more strategic, more formal, more scripted. Tribal Leaders usually delivers the message. 6

What do Health Policy Analysts Do? Subject matter experts on IHS budget and programs, functions, services, and activities (PFSAs). Read proposed laws and regulations. Imagine how this would work in your Tribal health program. Imagine how this would affect the people that you serve. Try to quantify costs, numbers of people affected, etc. List the pros and cons. Consider the alternatives that might be better. Develop recommendations. Review them with knowledgeable people. See if there is consensus. Look for examples, data and legal arguments to support your recommendations. Write position papers and comments to submit to agencies. 7

Who Pays for This Work to be Done from a Tribal Perspective? There are few external funding sources. Most state and federal agencies have goals and objectives that are different from Tribes. Many agencies have policy analysts on staff and they don’t fund external analysis. Grants from foundations are very limited. Bottom line: Tribes need to fund this themselves. 8

How does a Person get Training to Do Policy Analysis? Educational background Experience in Indian health care delivery systems Internships at Area Health Boards, NIHB, NCAI Meetings, teleconferences, webinars Read position papers, comment letters, strategic plans Check websites and subscribe to newsletters Develop Tribal position papers on policy issues from a Tribal perspective 9

How to Get Involved in National Efforts Attend meetings as an observer NIHB Annual Consumer Conference MMPC and TTAG TSGAC NCAI Ask to be on mailing list -- read discussions Join a Workgroup or Subcommittee Find a mentor Talk with people in your Tribe and Tribal health program about issues that may be important to them. Share your Tribe’s perspective in Step 1, Tribal-only discussions. Assist your Tribal Leader to submit written comments when requested to do so by NIHB or Area Health Board. Templates for letters are usually provided. 10

If your Tribe can't Afford a Full-time Employee to do Policy Work... Develop a policy team at your Tribe and assign different topics to different people to cover. Give people time to participate in teleconferences and meetings. Provide funding for key employees to attend state, Area, and national meetings. Hire a consultant on an hourly basis. Share the cost with other Tribes. Help fund a position at the Area Health Board. 11

QUESTIONS? 12