On April 30, 28 Congressional leaders requested $200.5 million for urban Indian health in FY22 from the House Appropriations Committee.

Reps. Grijalva and Gallego requested $200.5 million for urban Indian health with $12 billion for IHS as recommended by the Tribal Budget Formulation Workgroup in a forward appropriations letter to Chairwoman Pingree and Ranking Member Joyce of the House Interior Appropriations Committee. The letter cited that this increase in funding would “make a huge difference to UIOs in providing care to urban Indians due to historically low funding levels for urban Indian health. Another letter by Reps. Adam Smith and Don Young included $200.5 million for urban Indian health and $24 million for Tribal Epidemiology Centers in FY22.

These appropriations letters come as a continued effort by NCUIH to address acute health disparities for AI/ANs living in urban areas, who suffer greater rates of chronic disease, infant mortality and suicide compared to all other populations that have only been exacerbated by COVID-19. Congress has acknowledged these the significant health care disparities in Indian Country, but continuously underfunds IHS at around $4,000 per patient, and UIOs at less than $700 per patient even though AI/ANs living in urban areas comprise over two-thirds of the total American Indian Alaska Native population.

These Appropriations letters send a powerful and straightforward message to Chairwoman Pingree and Ranking Member Joyce and members of Congress to fulfill the federal government’s trust responsibility to all AI/ANs to provide safe and quality healthcare, funding for urban Indian health must be significantly increased.

NCUIH is grateful for the support of the following Representatives:

• Ruben Gallego
• Raul Grijalva
• Adam Smith
• Don Young
• Nanette Diaz Barragan
• Karen Bass
• Earl Blumenauer
• Emanuel Cleaver II
• Sharice L. Davids
• Diana DeGette
• Suzanne DelBene
• Sylvia Garcia
• Steven Horsford
• Sheila Jackson Lee
• Pramila Jayapal
• Ro Khanna
• Teresa Leger Fernandez
• Zoe Lofgren
• Doris Matsui
• Gwen Moore
• Eleanor Holmes Norton
• Tom O’Halleran
• Ilhan Omar
• Raul Ruiz, MD
• Kim Schrier, MD
• Greg Stanton
• Marilyn Strickland

On April 27, Sen. Tina Smith and Sen. Lisa Murkowski re-introduced NCUIH endorsed legislation to improve tribal health data surveillance. The bill intends to address challenges faced by tribes and tribal epidemiology centers when trying to access federal healthcare and public health surveillance data systems. NCUIH worked closely on the development of this bill to ensure urban Indians are adequately counted. If passed, the bill would require:

• The Department of Health and Human Services to give tribes, tribal epidemiology centers, and the Indian Health Service access to public health surveillance programs and services.
• The Centers for Disease Control (CDC) to give technical assistance to tribes and tribal epidemiology centers and to engage in tribal consultations on American Indian/Alaska Native (AI/AN) birth and death records
• CDC to enter cooperative agreements with tribes, tribal organizations, urban Indian organizations, and tribal epidemiology centers to address misclassification of AI/AN birth and death records and public health surveillance information

Encourage states to enter into data sharing agreements with tribes and tribal epidemiology centers.

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On April 23, the Indian Health Service (IHS) released a Frequently Asked Questions (FAQ) document regarding Federal Tort Claims Act (FTCA) Coverage for Urban Indian Organizations (UIOs). This FAQ document follows Congress’ amendment to 25 U.S.C. § 5321(d) on January 3, 2021 to extend FTCA coverage to UIOs and their employees to the same extent and in the same manner as to Tribes and Tribal Organizations.

Why Does this Matter to UIOs?:

FTCA coverage for UIO allows for funding that would have been spent on the purchase of medical malpractice insurance to be used on programs and services that benefit their clients.

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On April 8, 2021, Rep. David Trone introduced a bill titled “State Opioid Response Grant Authorization Act of 2021” to amend the 21st Century Cures Act to reauthorize and expand a grant program for State response to the opioid use disorders crisis, and for other purposes. This bill authorizes funding at $1.75 billion for each of fiscal years 2022 through 2027, to remain available until expended.

This bill includes a 5% set aside of the funds made available for each fiscal year for Indian Tribes, Tribal organizations, and Urban Indian Organizations (UIOs) to address substance abuse disorders through public health-related activities such as implementing prevention activities, establishing or improving prescription drug monitoring programs, training for health care practitioners, supporting access to health care services, recovery support services, and other activities related to addressing substance use disorders.

NCUIH has long advocated for UIOs to be added to the SOR grants given the extent of the impact of the opioid epidemic on urban Indians. NCUIH supports Rep. Trone’s legislation to reauthorize the 21st Century Cures Act grant program for State response to the opioid crisis and its inclusion of UIOs.

On April 7, Indian Health Service (IHS) Acting Director, Elizabeth Fowler, and Billings Area Indian Health Service Director, Bryce Redgrave, visited the Indian Family Health Clinic (IFHC) in Great Falls, Montana to commentate the millionth dose of the COVID-19 vaccine administered across the Indian Health Delivery System.

Fowler highlighted the UIO’s efforts and successful contribution to combat the pandemic as part of the reason why she chose to visit the clinic: “What has stood out to me so far is hearing stories from our dignitaries, their experience here, and just my initial entrance. The focus on the screening, how they’ve re-purposed some of their areas in order to do the screening.”

During the commemoration, IFHC announced their new “I Made the Choice” program to encourage vaccinations among youth and further their efforts in tackling COVID-19.

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