NCUIH Vice President Testifies on FTCA Coverage for UIOs

On July 22, Robyn Sunday-Allen, NCUIH Vice President and Chief Executive Officer of the Oklahoma City Indian Clinic, testified before the House Subcommittee for Indigenous Peoples of the United States. Ms. Sunday-Allen testified in support of H.R. 6535, the Coverage for Urban Indian Health Providers Act. H.R. 6535 would extend Federal Tort Claims Act coverage to urban Indian organizations (UIOs).

“At the Oklahoma City Indian Clinic, we spend approximately $200,000 annually on malpractice insurance, money which would be more effective if used to provide culturally competent health care to urban AI/ANs. If UIOs were covered under the FTCA, we would put every one of these dollars back into services including, but not limited to mammograms, pap smears, immunizations (adult and children), and dental sealants," said Ms. Sunday-Allen.

During the hearing multiple parties expressed support for H.R. 6536:

“This fix would save UIOs up to $250,000 per year in coverage costs, money that can be instead spent directly on patient care. This is especially important during the current crisis which has hit UIOs extremely hard, with over 80 percent of clinics reporting cuts to services due to resource shortages. 70 percent of Native Americans today live in urban settings making our support for urban Indian organizations essential to ensuring that health care is accessible to all native people and that our trust responsibility is upheld.” said Chairman Gallego.


“COVID-19 has had a devastating impact on Native communities. In Chicago, Native Americans chart a 15 percent COVID-19 mortality rate, but we know these numbers could be higher. COVID-19 did not cause these disproportionate outcomes, rather it has exposed longstanding, systemic inequities. We cannot afford to leave urban Indians without access to care during this public health crisis. It’s long overdue to give our Urban Indian Health Centers a boost in resources to ensure our Native communities have access to high-quality health care. The ability of urban Indian organizations to provide cost-effective health services has been jeopardized by the lack of FTCA coverage commonly afforded to other federally funded Indian health programs. This should not be the case, especially during a pandemic," said Representative Jesús “Chuy” García.

“UIOs are purchasing liability insurance with resources that could be better utilized to expand services available to Urban American Indian and Alaska Native patients. The rising cost of liability insurance and the general cost of providing health care services adversely impact the ability of UIOs to provide needed services. As a result, UIOs have had to substantially reduce or eliminate certain kinds of staff and health services, such as dental services. UIOs are an integral part of the IHS health care system. They provide high quality, culturally relevant health care services and are often the only health care providers readily accessible to Urban American Indian and Alaska Native patients. IHS endorses the policy to extend FTCA coverage to UIOs, which is consistent with the FY 2021 Budget request,” said Rear Admiral Weakhee, IHS Director.

NCUIH is grateful for the support of our Congressional and IHS partners and will continue to push for FTCA coverage and parity for urban AI/ANs and UIOs.

The Senate held a hearing on the companion bill (S. 3650) on July 1, 2020.

By NCUIH, posted on Monday July 27, 2020
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