Grantee: Seattle Indian Health Board
Timeframe: July 2025 – June 2027 | Amount: $225,000
- Year 1: July 2025 – June 2026 | Amount: $100,000
- Year 2: July 2026 – June 2027 | Amount: $125,000
The Seattle Indian Health Board (SIHB) leads advocacy efforts to make Traditional Indian Medicine (TIM) a reimbursable health service for American Indian and Alaska Native (AI/AN) communities in Washington State. Grounded in the recognition that TIM is central to AI/AN wellbeing, SIHB’s work addresses deep health disparities caused by the historical exclusion of TIM from mainstream healthcare systems. SIHB’s preliminary data show meaningful improvements in mental health and substance use outcomes among patients who access TIM as part of holistic care.
A significant 2024 federal policy shift allowed Medicaid and the Children’s Health Insurance Program (CHIP) to pilot TIM coverage in four states. For Washington State to participate, an amendment to the Section 1115 Medicaid waiver is required. A critical equity concern is that Washington State’s urban AI/AN residents, 81% of whom access care through Urban Indian Organizations (UIOs) like SIHB, face exclusion from the waiver due to the state’s budget shortfall. SIHB is actively advocating to ensure equitable coverage across the full Indian Health Service (IHS), Tribal, and Urban Indian Organization (I/T/U) system of care.
In Year 1, SIHB successfully advocated alongside tribal partners and UIOs for a Section 1115 waiver amendment to include TIM, drafted the amendment language, and secured legislative approval. SIHB also advocated for a budget proviso ensuring reimbursement for TIM accessed through UIOs. SIHB is currently part of the Health Care Authority (HCA) workgroup, collaborating with Washington State’s 29 tribes and 2 UIOs to supply data and a projected budget to accompany the federal waiver submission. Waiver approval activities and efforts funded through this program in Year 1 do not include lobbying.
In Year 2, SIHB will focus on two priorities: (1) provide education and awareness of the efforts for federal legislators and the Centers for Medicare and Medicaid Services (CMS) to approve the waiver amendment, and (2) support the state in developing a TIM credentialing and provider framework. As the only organization to have completed a pilot covering TIM coding, credentialing, and electronic health record integration, SIHB will advise HCA and Department of Health (DOH) workgroups and provide technical assistance to tribal partners through the American Indian Health Commission (AIHC). Activities and efforts funded by this program in Year 2 do not include lobbying.
If the waiver is approved, an estimated 54,200 AI/AN residents of King County, two federally recognized tribes (Snoqualmie and Muckleshoot), and AI/AN communities across Washington State would gain access to reimbursable TIM services. Expected health outcomes include increased TIM access, improved care plan compliance, reduced health disparities, and decreased reliance on costly emergency services. National research supports TIM as a driver of cultural connectedness; a resilience factor associated with improved long-term health outcomes and reduced preventable acute conditions.
ABOUT OUR GRANTEE
“Seattle Indian Health Board is a community health center that provides health and human services to its patients, while specializing in the care of Native people. We are recognized as a leader in the promotion of health improvement for urban American Indians and Alaska Natives, locally and nationally.”
