- Technical Assistance
- Policy & Legislation Center
- Communications & Technology
Useful External Links:
Native One Stop
If you are a NCUIH Member and would like to receive Policy and Legislation updates, or would like to submit a request for assistance, please contact Francys Crevier, Policy Analyst at FCrevier@ncuih.org
For information on the National Indian Health Outreach and Education (NIHOE) Initiative or to access the Affordable Care Act-related Urban Indian Health Portal's Enrollment tools please click here or select one of the following topics:
NIHOE event in Michigan
Policy and Legislation Technical Assistance customized to the Urban Indian Health circumstances The National Council of Urban Indian Health is uniquely positioned to provide policy education, training, and technical assistance to Urban Indian Organizations. For over sixteen (16) years, NCUIH has been devoted to providing policy education, training and assistance to its 38 member health programs.
Current Policy Challenges facing Urban Indian Health communities
The passage of Health Care Reform in 2010 included the re-authorization of the Indian Health Care Improvement act, however, many of the provisions included do not directly apply to the Urban Indian Health Programs (UIHPs). The latter creates an extra struggle for Urban Indian Health Programs to remedy in order to access those benefits on behalf of their patients. UIHPs have to implement innovative strategies in order to attain specialty care services because, unlike tribal health programs, they do not have access to contract health service funds. More…
100% Federal Match for Medicaid (100% FMAP)
Urban Indian Health Programs are also excluded from the 100% federal match for Medicaid services. This protection, also known as 100% FMAP, would provide states with 100% of the cost of payments made to Urban Indian Health providers for service provided to American Indian Medicaid patients, rather than requiring the states to assume a percentage of the cost of Indian health care.
Federal Tort Claims Act (FTCA)
A similar situation takes place under the protections of the Federal Tort Claims Act (FTCA)—only Urban Indian Health Programs are excluded from this benefit. Consequently, UIHPs are required to spend thousands of programmatic dollars each year to purchase malpractice insurance for their providers.
Prospective Payment System (PPS)
The transition from fee-for-service payment model to a value-based reimbursement, as one of the components of Affordable Care Act implementation, created needs for data and quality improvements. AI/AN population has historically had little experience dealing with private health insurance companies, the challenge of patient recruitment and retention—via brokers and insurance agents—becomes far more critical. The complexity of this situation is also related to the fact that, contrary to IHS direct service or Tribal Health programs, Urban Indian Health Programs are often located quite far from tribal areas. The result is twofold: Urban Indian Health Programs struggle to retain patients; and are increasingly faced with the need to become a reliable source of information for their patients.
Definition of Indian
The Affordable Care Act relies upon three different definitions of “Indian” in three different sections of the law. While these three definitions are similar, they are not identical, and this lack of a uniform definition has the potential to create administrative difficulties and inconsistencies in applying AI/AN-specific provisions of the ACA. HHS has already issued proposed Exchange rules that significantly misstate the various definitions of Indian throughout the ACA, and the proposed rules actually recommend an interpretation of the definition of “Indian” which is limited only to members of a federal-recognized tribe – despite the fact that none of these three definitions limit the definition of “Indian” in this way.
The Policy and Legislation Center (PLC)
NCUIH’s primary educational arm acting on the behalf of urban Indian health providers and urban Indian communities. Guided by the NCUIH Board of Directors and through member feedback, the Center strives to provide quality technical assistance and training on national policy and legislative priority topics to NCUIH’s membership; and it responds to specific requests from Membership organizations on national issues. Through its efforts, NCUIH aims to create educational tools for policymakers, Congress and the general Public on the specific circumstances of the Native communities living in urban settings. The Policy and Legislation Center’s services can be divided into 6 categories:
NCUIH represents and coordinates the delivery of membership feedback to pertinent federal agencies on Budget Formulation-related issues and meetings, including:
NCUIH strives to engage IHS, other federal agencies and NCUIH members on the conferring policy that was included in the Re-Authorization of the Indian Health Care Improvement Act (IHCIA,2010); officially effective on November, 2014. Outreach efforts include Conferring policy basics; dissemination of information; other technical assistance and coordination. Recent work include conferring sessions and offical correspondance with the Indian Health Services on Data Report & Standards, the Meth and Suicide Prevention Initiative, and the Distribution of Funding for IHCIA Title V Programs through the Indian Health Service’s Office Urban Indian Health Programs.
NCUIH represents the interests of Urban Indian communities across the nation and educates other audiences—such as research institutes, foundations, federal and local agencies, etc.- on the specific legislative and policy circumstances of Urban Indian Health Programs and the community they serve throughout the United States.
NCUIH provides ongoing policy updates and legislative alerts on topics pertaining the Urban Indian Health and Urban Indian Communities through a variety of platforms, including the policy blog, newsletters, website posts, and social media. Likewise, its Policy and Legislation Center provides a policy update at NCUIH’s Annual Leadership Conference. If you are a NCUIH Member and have questions on policy and legislation, or would like to submit a request for assistance, please contact Rudy Soto, Policy Analyst at email@example.com
The main goals of this Indian Health Service- funded program are the dissemination of educational information to all AI/AN Tribal and Urban Indian communities and addressing both health policy and health program issues. The program’s activities take place at public forums as well as at regional and national meetings with the purpose of dissemination of information regarding changes and updates on the Affordable Care Act (ACA) that are crucial to the AI/AN community. NCUIH actively helps coordinate outreach and education programs such as ACA Tribal Days of Action Outreach and Enrollment, and is the only national agency representing, collecting UIH information, and customizing materials for Urban Indian communities. NCUIH has developed a web-portal specifically devoted to provide Affordable Care Act- related tools to ease the understanding of its provisions’ benefits for Native Americans living in urban settings.
Direct Links to the NCUIH ACA Portal’s Tools:
Be sure to visit our partner organizations for additional information