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

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