House Appropriations Approves Bill with Nearly $30 Million Increase for Urban Indian Health

House Appropriations Full Committee Markup of Interior Bill Held on Wednesday, May 22, 2019

NCUIH supports the bill in its present form. 

Last week the House Appropriations full Committee passed their FY2020 Interior, Environment,and Related Agencies Appropriations bill – This bill includes $81 million for Urban Indian Health Programs, which is $29 million above FY 2019 enacted levels, and $32 million above the President’s budget request. This increase would assist urban Indian health programs in their continued efforts to provide high-quality, culturally-competent care.

The committee also released its report on the FY2020 spending package.  The 221-page report provides details on the bill the Subcommittee had previously passed earlier this month.

Please let your Member of Congress know that you support the bill’s inclusion of the $81 million line item for Urban Indian Health.

“NCUIH applauds the leadership of Chair Betty McCollum and her longstanding commitment to fulfilling the trust and treaty responsibilities of the US government with American Indians and Alaska Natives by investing in the Indian Health Service and urban Indian health programs. After years of stagnation and chronic underfunding to urban Indian health and the Indian Health Service (IHS) budget, NCUIH is hopeful that Chair McCollum’s bill requesting $6.3 billion for IHS, which is higher than the proposed budget by the President of $5.9 billion, and $81 million for urban Indian health will continue to move forward for consideration by the full House,” said NCUIH Executive Director Francys Crevier.

Please read full Press Release here.

Please find below a brief overview of some of the key programs included affecting AI/AN communities.

Topic/Program Amount Proposed Excerpt – Key Text to Be Aware of or Watch
Urban Indian Health $81,000,000 $1,429,000 for current services

$26,887,000 for direct patient care services/program adjustments

*Includes the proposed transfer of $1,369,000 from former NIAAAs from Alcohol and Substance Abuse line item to this line item

* “The Committee recognizes nonprofit organizations such as the Siouxland Human Investment Partnership that help American Indians in urban areas outside of the Urban Indian Health Program, and encourages the Service to offer technical assistance to such organizations whenever possible and within Service authority.”

Advance Appropriations N/A The Committee directs IHS to examine its existing processes and determine what changes are needed to develop and manage an advance appropriation and report to the Committee within 180 days of enactment of this Act on the processes needed and whether additional Congressional authority is required in order to develop the processes.
Domestic Violence Prevention Program $12,967,000 The recommendation includes $12,967,000, as requested, for Domestic Violence Prevention, $4,000,000 above the enacted level.
IHS-VA MOU N/A “The Committee is aware of the recent Government Accountability Office (GAO) report on the Memorandum of Understanding (MOU) between the VA and IHS. The Committee urges IHS to ensure performance measures related to the MOU are consistent with the key attributes of successful performance measures, including having measurable targets, as recommended by GAO.”

*Does not reference implementation for UIOs.

Alcohol and Substance Use $ 280,051,000

 

$34,485,000 above the enacted level and $34,017,000 above the budget request.
Unfunded IHCIA Provisions N/A “The Committee requests that the Service provide, no later than 90 days after enactment, a detailed plan with specific dollars identified to fully fund and implement the IHCIA.”
Hepatitis C & HIV/AIDS Initiative $25,000,000 “for the Administration’s new Ending the HIV Epidemic: A Plan for America and Eliminating Hepatitis C in Indian Country initiative.”

*”The Committee encourages IHS to confer with Urban Indian Organizations (UIOs) to determine how UIOs may participate in this Initiative.”

Maternal and Child Health N/A “The Committee encourages IHS to establish a pilot program to determine the most effective ways to: (1) educate IHS health care providers on how to evaluate risk factors that could interfere with successfully meeting breastfeeding goals; (2) provide necessary support to AI/AN mothers to prevent or address delayed initiation of milk production during the critical period immediately following birth; and (3) provide support to AI/ AN mothers to help them understand the benefits of long-term breastfeeding and improve clinically recommended rates, particularly when they return to work. The Committee also directs IHS, where possible and within scope of agency authority, to encourage breastfeeding support recommendations within the workplace which encourage job retention.”
Electronic Health Records $25,000,000 To improve the current IT infrastructure system.

“The bill includes language prohibiting IHS from obligating or expending funds to select or implement a new IT infrastructure system unless IHS notifies the Committee at least 90 days before such funds are obligated or expended.” (also outlines requirements to include in the notification and requires IHS to look at the VA system to, among other things, determine if it is feasible for IHS and tribal facilities).

Legislation to Renew Special Diabetes Program for Indians (SDPI) Introduced in the House

NCUIH urges support for H.R. 2680 and H.R. 2668. 

Representatives Tom O’Halleran (D-AZ) and Diana DeGette (D-CO) have introduced legislation requesting the renewal and increased funding of the Special Diabetes Program (SDP) and the Special Diabetes Program for Indians (SDPI).

  • Rep. DeGette’s bill, H.R. 2668 calls for the renewal of the SDP, including the research of Type-1 diabetes treatment.
  • Rep. O’Halleran’s bill, H.R. 2680 requests a long overdue funding increase for SDPI, authorizing a 5 year renewal at $200 million per year.  Increasing the funding from $150 million every year to $200 million every year, will ensure the continued work and success of the SDPI in the prevention and treatment of diabetes across Indian Country.

NCUIH has worked hard to make certain these bills had support in Congress and will continue support and work to ensure these bills pass – 376 out the 435 members of the House of Representatives signed a bipartisan letter of support. See the letter here.

For questions, comments or concerns, feel free to contact NCUIH Director of Congressional Relations Carla Lott, cmlott@ncuih.org.

PRESS RELEASE: House Interior Appropriations Bill Advances to the Full Committee with NCUIH Request of $81 Million for Urban Indian Health

FOR IMMEDIATE RELEASE 

Contact: Meredith Raimondi
Manager, Communications & Events
National Council of Urban Indian Health
202-544-0344
mraimondi@ncuih.org

House Interior Appropriations Bill Advances to the Full Committee with NCUIH Request of $81 Million for Urban Indian Health

Chair Betty McCollum’s draft bill that advanced to full committee includes a $30 million increase to the urban Indian health line item.

Washington, DC (May 16, 2019) — Yesterday, the House Appropriations Subcommittee on Interior, Environment, and Related Agencies approved by voice vote its fiscal year 2020 bill with the National Council of Urban Indian Health’s request of an increase for the urban Indian health line item to $81 million. The fiscal year 2020 bill draft from Chair Betty McCollum includes this increase of approximately $30 million for the urban Indian health line item from current funding levels and a $537 million increase to $6.3 billion for the Indian Health Service overall budget from fiscal year 2019.

Chair McCollum’s bill incorporates a solution of addressing the unmet needs of urban Indians by increasing the overall IHS budget without taking away any money from Tribes. This needed increase would allow the 42 Urban Indian Organizations (UIOs) to hire more staff, expand vital services from behavioral health to substance misuse programs, and improve health outcomes for the growing demand of health care for urban Indians.

“NCUIH applauds the leadership of Chair Betty McCollum and her longstanding commitment to fulfilling the trust and treaty responsibilities of the US government with American Indians and Alaska Natives by investing in the Indian Health Service and urban Indian health programs. After years of stagnation and chronic underfunding to urban Indian health and the Indian Health Service (IHS) budget, NCUIH is hopeful that Chair McCollum’s bill requesting $6.3 billion for IHS, which is higher than the proposed budget by the President of $5.9 billion, and $81 million for urban Indian health will continue to move forward for consideration by the full House,” said NCUIH Executive Director Francys Crevier.

“This bill continues our subcommittee’s nonpartisan approach to addressing issues facing our Native American brothers and sisters. I am committed to honoring our trust and treaty obligations,” said Chair McCollum in her opening remarks during yesterday’s hearing.

“We strongly agree on Indian Country. It’s a testament to [Chair McCollum] and the rest of the members on this subcommittee that we continue our nonpartisan approach to programs for American Indians and Alaska Natives which constitute roughly a quarter of this bill. In this often hyper partisan environment, the work we do together on behalf of Indian Country is a welcome change.” said Ranking Member Dave Joyce during his opening remarks before the bill was approved.

Earlier this year, NCUIH President Maureen Rosette testified before the Interior Appropriations Subcommittee for this increase of the urban Indian line item to a total of at least $81 million. NCUIH also sent a letter to all Members of Congress with facilities in their districts to support higher funding for urban Indian health. 16 Members of Congress signed the final letter, led by Rep. Raul Grijalva, to the Interior Appropriations Committee, in support at least $81 million for the urban Indian health line item.

The increased funding would be critical to the 42 UIOs across the country. These UIOs an integral part of the Indian health system, which is comprised of the IHS, federally recognized Tribes, tribal organizations, and urban Indian organizations (I/T/Us). UIOs provide culturally-competent healthcare to approximately 70% of American Indians and Alaska Natives (AI/AN) living in urban settings. UIOs are on the front lines in assisting the federal government in providing for the health and well-being of urban Indians.

The full text of the bill is here. The bill next heads to the full Committee for markup.

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About the National Council of Urban Indian Health (https://ncuih.org)

The National Council of Urban Indian Health (NCUIH) is the only national organization devoted to the support and development of quality, accessible, and culturally-competent health services for American Indians and Alaska Natives (AI/ANs) living in urban settings. NCUIH envisions a nation where comprehensive, culturally competent personal and public health services are available and accessible to AI/ANs living in urban communities throughout the United States.  NCUIH is the only organization that represents all 42 Urban Indian Organizations (UIOs) federally funded by the Indian Health Service.

NCUIH Technical Assistance and Research Center Presents at American Indian and Alaska Native National Behavioral Health Conference

Albuquerque, NM (May 16, 2019) –  Today, Dr. Kimberly Fowler, Director, and Sebouh Kouyoumjian, Public Health Associate, from the National Council of Urban Indian Health’s Technical Assistance and Research Center presented at the 2019 American Indian and Alaska Native National Behavioral Health Conference.

The presentation titled, “National Council of Urban Indian Health – National Urban Indian Youth & Young Adult Advisory Council: Suicide & Substance Abuse & Misuse Prevention” was a part of the Behavioral Health Poster Session. The 2019 American Indian and Alaska Native National Behavioral Health Conference at the Albuquerque Convention Center in Albuquerque, New Mexico is hosted by National Indian Health Board (NIHB).

The poster presentation addressed best practices and highlighted achievements of NCUIH’s inaugural Youth Council. It discussed their journey from their initial orientation to developing a national suicide prevention awareness campaign. The campaign will be released via social media in the coming weeks. The Youth Council consists of 5 young adults chosen from 18 -24 year old applicants recruited from across the nation. Members were trained on topics including trauma-informed care, positive mental health and emotional wellness best practices, and effective communication with peers designed to assist youth impacted by stressful events and environments.

View a PDF of the poster here.

PRESS RELEASE: NCUIH Request of $81 Million for Urban Indian Health included in House Interior Appropriations Bill

FOR IMMEDIATE RELEASE 

Contact: Meredith Raimondi
Manager, Communications & Events
National Council of Urban Indian Health
202-544-0344
mraimondi@ncuih.org

NCUIH Request of $81 Million for Urban Indian Health included in House Interior Appropriations Bill

The draft bill includes a $30 million increase to the urban Indian health line item.

Washington, DC (May 14, 2019) — The National Council of Urban Indian Health’s request of at least $81 million for the urban Indian health line item was included in the draft fiscal year 2020 Interior, Environment, and Related Agencies funding bill released today by the House Appropriations Committee. The $37.3 billion spending package includes an approximately $30 million increase over current levels and $6.3 billion for the overall Indian Health Service budget (a $537 million increase).

Earlier this year, NCUIH President Maureen Rosette testified before the Interior-Environment Appropriations Subcommittee for this increase of the urban Indian line item to a total of at least $81 million. NCUIH also sent a letter to all Members of Congress with facilities in their districts requesting their signature on a letter in support of the increase led by Rep. Raul Grijalva. 16 Members of Congress signed the final letter, which was sent to the Interior Appropriations Committee, in support of the $81 million urban Indian health line item.

“NCUIH is pleased that the Interior Appropriations draft bill includes our request of at least $81 million for urban Indian health. The federal trust obligation to provide healthcare to American Indians and Alaska Natives must be upheld regardless of geography. This increase will be a big step by the US government toward working to better fulfill its obligations to American Indians and Alaska Natives no matter where they live,” said NCUIH Executive Director Francys Crevier.

The bill will be considered in Subcommittee tomorrow, on May 15.  You can view the Appropriations Committee press release here. The bill is located here.

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About the National Council of Urban Indian Health (https://ncuih.org)

The National Council of Urban Indian Health (NCUIH) is the only national 501(c)(3) organization devoted to the support and development of quality, accessible, and culturally-competent health services for American Indians and Alaska Natives (AI/ANs) living in urban settings. NCUIH envisions a nation where comprehensive, culturally competent personal and public health services are available and accessible to AI/ANs living in urban communities throughout the United States.  NCUIH represents 42 Urban Indian Health Programs (UIHPs) in the United States.

Budget Formulation Update: The National Tribal Budget Formulation Workgroup’s Recommendations Include Urban Indian Health Increase for the Indian Health Service Fiscal Year 2021 Budget

May 6, 2019 Update

Last month Tribal sovereign leaders on the National Tribal Budget Formulation Workgroup (TBFWG) met to provide input regarding the Indian Health Service (IHS) budget request for FY 2021 (FY). After a thorough discussion of healthcare needs, their recommendations include $2.7 billion in program increases for the most critical health issues, including $50.9 Million for Urban Indian Health. The National Council of Urban Indian Health provided testimony concerning the status of the Urban Indian Health Programs (UIHPs). The TBFWG recommendations are an approximate 46% increase above the Fiscal Year 2019 funding, highlighting the crucial need for funding of the Indian healthcare system. Additionally, a recommendation was made to fund the Special Diabetes Program for Indians, increasing funding to $200 million per year, to include inflation. 105(l) leases were also a subject of importance, and while IHS does have an obligation towards fulfilling its 105(l) leases, adequate steps have been encouraged to protect other IHS programs for FY2021. The TBFWG understands that before significant steps are taken to address the healthcare concerns in Indian country, the fundamentals such as the I/T/U system, must have precedence.

April 30, 2019: The National Tribal Budget Formulation Workgroup’s Recommendations on the Indian Health Service Fiscal Year 2021 Budget

https://www.tribalselfgov.org/wp-content/uploads/2019/04/307871_NIHB-IHS-Budget-Book_WEB.pdf

March 14, 2019: NCUIH Recommendations for the FY 2021 Indian Health Service Budget

Hot Topics/Requests – National Budget Recommendations

  • Hot Topics/Requests 1: Increased funding for urban Indian line item to at least 2% of IHS or $116m
  • HotTopics/Requests 2: Respecting Tribal requests for direct funding but ensuring grants to continue for Title V UIOs only
  • Hot Topics/Requests 3: Implementation of unfunded IHCIA provisions
  • Hot Topics/Requests 4: Ensuring UIHPs are held harmless from unrelated budget shortfalls, including creating a new line item for §105(l) leases
  • Hot Topics/Requests 5: Funding initiatives should include funds for Title V UIHPs
    • Opioid funding
    • Behavioral health funding
  • Hot Topics/Requests 6: 100% FMAP for UIHPs
  • Hot Topics/Requests 7: Funds for UIHPs to modernize Health IT
  • Hot Topics/Requests 8: Suicide and substance use disorder among youth
    • -One urban youth residential treatment center

Priorities

  • Priority 1: Advanced appropriations
  • Priority 2: SDPI
  • Priority 3: Substance use and mental health
  • Priority 4: Opioids funding

Budget Formulation Update: The National Tribal Budget Formulation Workgroup’s Recommendations Include Urban Indian Health Increase for the Indian Health Service Fiscal Year 2021 Budget

May 6, 2019 Update

Last month Tribal sovereign leaders on the National Tribal Budget Formulation Workgroup (TBFWG) met to provide input regarding the Indian Health Service (IHS) budget request for FY 2021 (FY). After a thorough discussion of healthcare needs, their recommendations include $2.7 billion in program increases for the most critical health issues, including $50.9 Million for Urban Indian Health. The National Council of Urban Indian Health provided testimony concerning the status of the Urban Indian Health Programs (UIHPs). The TBFWG recommendations are an approximate 46% increase above the Fiscal Year 2019 funding, highlighting the crucial need for funding of the Indian healthcare system. Additionally, a recommendation was made to fund the Special Diabetes Program for Indians, increasing funding to $200 million per year, to include inflation. 105(l) leases were also a subject of importance, and while IHS does have an obligation towards fulfilling its 105(l) leases, adequate steps have been encouraged to protect other IHS programs for FY2021. The TBFWG understands that before significant steps are taken to address the healthcare concerns in Indian country, the fundamentals such as the I/T/U system, must have precedence.

April 30, 2019: The National Tribal Budget Formulation Workgroup’s Recommendations on the Indian Health Service Fiscal Year 2021 Budget

https://www.tribalselfgov.org/wp-content/uploads/2019/04/307871_NIHB-IHS-Budget-Book_WEB.pdf

March 14, 2019: NCUIH Recommendations for the FY 2021 Indian Health Service Budget

Hot Topics/Requests – National Budget Recommendations

  • Hot Topics/Requests 1: Increased funding for urban Indian line item to at least 2% of IHS or $116m
  • HotTopics/Requests 2: Respecting Tribal requests for direct funding but ensuring grants to continue for Title V UIOs only
  • Hot Topics/Requests 3: Implementation of unfunded IHCIA provisions
  • Hot Topics/Requests 4: Ensuring UIHPs are held harmless from unrelated budget shortfalls, including creating a new line item for §105(l) leases
  • Hot Topics/Requests 5: Funding initiatives should include funds for Title V UIHPs
    • Opioid funding
    • Behavioral health funding
  • Hot Topics/Requests 6: 100% FMAP for UIHPs
  • Hot Topics/Requests 7: Funds for UIHPs to modernize Health IT
  • Hot Topics/Requests 8: Suicide and substance use disorder among youth
    • -One urban youth residential treatment center

Priorities

  • Priority 1: Advanced appropriations
  • Priority 2: SDPI
  • Priority 3: Substance use and mental health
  • Priority 4: Opioids funding