PRESS RELEASE: Phase 3 of Coronavirus Pandemic Package Signed into Law

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FOR IMMEDIATE RELEASE

Contact: Meredith Raimondi, 202-417-7781, mraimondi@ncuih.org

The bill provides $1.032 to the Indian Health Service for COVID-19 response efforts.

Washington, DC (March 27, 2020) – Today, the President signed the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which is the third phase of legislation in response to the coronavirus pandemic. The CARES Act passed the House of Representatives today and cleared the Senate earlier this week.  The bill provides $1.032 billion to the Indian Health Service (IHS) in critically needed resources to support the Indian Health System during the pandemic, including expanded support for medical services, equipment, supplies and public health education for IHS direct service, tribally operated and Urban Indian Organizations; expanded funding for purchased/referred care; and new investments for telehealth services, electronic health records improvement, and expanded disease surveillance by tribal epidemiology centers.

Earlier this month H.R. 6201, the Families First Coronavirus Response Act was enacted on March 18, and H.R. 6074, the Coronavirus Preparedness and Response Supplemental Appropriations Act was enacted on March 6.

NCUIH has been laser focused on ensuring Tribes and urban Indian organizations are included in the response efforts for the COVID-19 pandemic. NCUIH has created a COVID-19 Resource Center and a COVID-19 legislative tracker where you can find a summary of actions to date, which includes coalition letters, legislative actions, recent news, and other developments. NCUIH is honored to partner with NCAI and NIHB and other organizations throughout this process to fight for Indian Country in the Congressional and Federal COVID-19 response.

“As Indian Country is always the first to get cut and last to get funding, we are encouraged by the leadership of Congress in working to include Indian Country in its priorities throughout the response to the coronavirus pandemic. As COVID-19 cases continue to rise in Indian Country, Tribes and urban Indians have been on the front lines of this public health crisis yet they have been operating with woefully inadequate funding and resources. Our top priority is to get this money to Tribes and our Native communities who need it most to mitigate this pandemic. We will continue to work with our national partners including NIHB and NCAI to push for parity for Tribes, tribal organizations and urban Indian organizations in future legislation,” said Francys Crevier, Executive Director.

Funding

Indian Health Service (IHS)

  • The bill provides $1.032 billion to the Indian Health Service (IHS) in critically needed resources to support the Indian Health System during the pandemic, including expanded support for medical services, equipment, supplies and public health education for IHS direct service, tribally operated and Urban Indian Organizations; expanded funding for purchased/referred care; and new investments for telehealth services, electronic health records improvement, and expanded disease surveillance by tribal epidemiology centers.
  • Not less than $450 million shall be distributed through Tribal shares and Urban Indian Organizations.

Center for Disease Control and Prevention (CDC)

  • Provides for a total of $4.3 billion for program wide activities and support with no less than $1.5 billion to be made available to States, localities, territories, tribes, tribal organizations, UIOs, or health service providers to tribes. Activities include:
  • Surveillance, Epidemiology, Laboratory Capacity, Infection Control, Mitigation, Communications, Other Preparedness and Response Activities
  • Of this, at least $125 million is to be made available to tribes, tribal organizations, UIOs or health service providers to tribes.

Substance Abuse and Mental Health Services Administration (SAMHSA)

  • A total of $435 million is allocated for Health Surveillance and Program Support for SAMHSA. This includes prevention, preparation, and response to COVID-19.
  • No less than $15 million is to be allocated for tribes, tribal organizations, UIOs or health/ behavioral health service providers to tribes.

Health Resources and Services Administration (HRSA)

  • HRSA Rural Health is appropriated $180 million of which no less than $15 million is to be allocated for tribes, tribal organizations, UIOs, or health service providers to tribes to carry out telehealth and rural health activities.

Legislative Authorizations

Special Diabetes Fund for Indians (SDPI)

  • Reauthorizes SDPI at current funding levels through November 30, 2020. Allocates $25,068,493 for the period from October 1, 2020 to November 30, 2020.

Next Steps

Congressional leadership has indicated that there will be a fourth phase of coronavirus response legislation. The Congressional Progressive Caucus has outlined priorities, which includes ensuring, “Parity for Tribes, Tribal Organizations, and Urban Indian Organizations”. Similarly, Senator Tom Udall, Vice Chairman of the Senate Committee on Indian Affairs said the fourth package must include a, “Tribal-specific title, and for pushing Congress and the Trump administration to make sure Indian Country has equal access to federal coronavirus resources.”

Additional Information

TOPIC FUNDING/ SECTON LANGUAGE
Indian Health Service $1,032,000,000 For an additional amount for ‘‘Indian Health Services’’, $1,032,000,000, to remain available until September 30, 2021, to prevent, prepare for, and respond to coronavirus, domestically or internationally, including for public health support, electronic health record modernization, telehealth and other information technology upgrades, Purchased/Referred Care, Catastrophic Health Emergency Fund, Urban Indian Organizations, Tribal Epidemiology Centers, Community Health Representatives, and other activities to protect the safety of patients and staff
$65,000,000 up to $65,000,000 is for electronic health record stabilization and support, including for planning and tribal consultation
$450,000,000 That of amounts provided under this heading in this Act, not less than $450,000,000 shall be distributed through IHS directly operated programs and to tribes and tribal organizations under the Indian Self-Determination and Education Assistance Act and through contracts or grants with urban Indian organizations under title V of the Indian Health Care Improvement Act
Centers for Disease Control and Prevention $4,300,000,000 For an additional amount for ‘‘CDC-Wide Activities and Program Support’’, $4,300,000,000, to remain available until September 30, 2024, to prevent, prepare for, and respond to coronavirus, domestically or internationally
$1,500,000,000 That not less than $1,500,000,000 of the amount provided under this heading in this Act shall be for grants to or cooperative agreements with States, localities, territories, tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes, including to carry out surveillance, epidemiology, laboratory capacity, infection control, mitigation, communications, and other preparedness and response activities
$125,000,000 That of the amount in the first proviso, not less than $125,000,000 shall be allocated to tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes
SAMHSA $425,000,000 For an additional amount for ‘‘Heath Surveillance and Program Support’’, $425,000,000, to remain available through September 30, 2021, to prevent, prepare for, and respond to coronavirus, domestically or internationally
$15,000,000 That of the funding made available under this heading in this Act, not less than $15,000,000 shall be allocated to tribes, tribal organizations, urban Indian health organizations, or health or behavioral health service providers to tribes
PUBLIC HEALTH SERVICES EMERGENCY FUND $27,014,500,000 For an additional amount for ‘‘Public Health and Social Services Emergency Fund’’, $27,014,500,000, to remain available until September 30, 2024, to prevent, prepare for, and respond to coronavirus, domestically or internationally, including the development of necessary countermeasures and vaccines, prioritizing platform-based technologies with U.S.-based manufacturing capabilities, the purchase of vaccines, therapeutics, diagnostics, necessary medical supplies, as well as medical surge capacity, addressing blood supply chain, workforce modernization, telehealth access and infrastructure, initial advanced manufacturing, novel dispensing, enhancements to the U.S. Commissioned Corps, and other preparedness and response activities
HRSA $180,000,000 That $180,000,000 of the funds appropriated under this paragraph shall be transferred to ‘‘Health Resources and Services Administration—Rural Health’’ to remain available until September 30, 2022, to carry out telehealth and rural health activities under sections 330A and 330I of the PHS Act and sections 711 and 1820 of the Social Security Act to prevent, prepare for, and respond to coronavirus, domestically or internationally
$15,000,000 That of the funding in the previous proviso, no less than $15,000,000 shall be allocated to tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes
SDPI SEC. 3832. INDIANS.—Section 330C(c)(2)(D) of the Public
Health Service Act (42 U.S.C. 254c–3(c)(2)(D)) is amended by striking ‘‘and 2019, and $96,575,342 for the period beginning on October 1, 2019, and ending on May 22, 2020’’ and inserting ‘‘through 2020, and $25,068,493 for the period beginning on October 1, 2020, and ending on November 30, 2020’
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Policy Analysis: The Coronavirus Aid, Relief, and Economic Security Act (CARES Act)

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Washington, DC (March 27, 2020) – Today, the President signed the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which is the third phase of legislation in response to the coronavirus pandemic. The CARES Act passed the House of Representatives today and cleared the Senate earlier this week.  The bill provides $1.032 billion to the Indian Health Service (IHS) in critically needed resources to support the Indian Health System during the pandemic, including expanded support for medical services, equipment, supplies and public health education for IHS direct service, tribally operated and Urban Indian Organizations; expanded funding for purchased/referred care; and new investments for telehealth services, electronic health records improvement, and expanded disease surveillance by tribal epidemiology centers.

Overview

Funding

Indian Health Service (IHS)

  • The bill provides $1.032 billion to the Indian Health Service (IHS) in critically needed resources to support the Indian Health System during the pandemic, including expanded support for medical services, equipment, supplies and public health education for IHS direct service, tribally operated and Urban Indian Organizations; expanded funding for purchased/referred care; and new investments for telehealth services, electronic health records improvement, and expanded disease surveillance by tribal epidemiology centers.
  • Not less than $450 million shall be distributed through Tribal shares and Urban Indian Organizations.

Center for Disease Control and Preventions

  • Provides for a total of $4.3 billion for program wide activities and support with no less than $1.5 billion to be made available to States, localities, territories, tribes, tribal organizations, UIOs, or health service providers to tribes. Activities include:
  • Surveillance, Epidemiology, Laboratory Capacity, Infection Control, Mitigation, Communications, Other Preparedness and Response Activities
  • Of this, at least $125 million is to be made available to tribes, tribal organizations, UIOs or health service providers to tribes.

Substance Abuse and Mental Health Services Administration (SAMHSA)

  • A total of $435 million is allocated for Health Surveillance and Program Support for SAMHSA. This includes prevention, preparation, and response to COVID-19.
  • No less than $15 million is to be allocated for tribes, tribal organizations, UIOs or health/ behavioral health service providers to tribes.

Health Resources and Services Administration (HRSA)

  • HRSA Rural Health is appropriated $180 million of which no less than $15 million is to be allocated for tribes, tribal organizations, UIOs, or health service providers to tribes to carry out telehealth and rural health activities.

Legislative Authorizations

Special Diabetes Fund for Indians (SDPI)

  • Reauthorizes SDPI at current funding levels through November 30, 2020. Allocates $25,068,493 for the period from October 1, 2020 to November 30, 2020.
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PRESS RELEASE: National Council of Urban Indian Health Announces New Board of Directors

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FOR IMMEDIATE RELEASE 

Contact: Meredith Raimondi, 202-417-7781, mraimondi@ncuih.org

Washington, DC (March 25, 2020) – The National Council of Urban Indian Health (NCUIH) announces the election of the new members to its Board of Directors. The election took place during the 2020 Annual Virtual Meeting on March 25, 2020.

“I am pleased to welcome our newest members to our Board of Directors. All individuals are poised to support the development of quality, accessible, and culturally-competent health services for American Indians and Alaska Natives living in urban areas,” said Francys Crevier, Executive Director of NCUIH.

Officers

President Walter Murillo*
Vice-President Robyn Sunday-Allen
President-Elect Sonya Tetnowski
Secretary Linda Son-Stone
Treasurer Scott Black

Note: Walter Murillo was confirmed in a previous election.

Board Members

Region Board Members
1 Kerry Lessard
2 RoxAnne Lavallie-Unabia
3 Reid Wendel
4 Todd Wilson
5 Maureen Rosette
6 Sonya Tetnowski, Scott Black
7 Walter Murillo, Linda Son-Stone, Robyn Sunday-Allen
8 Adrianne Maddux

NCUIH 2020 – 2021 Board of Directors

Region 1
Kerry Lessard, Board Member
Descendant of Absentee Shawnee
Executive Director
Native American Lifelines of Baltimore
106 West Clay St. Baltimore, MD 21201
Region 3
Reid Wendel, Board Member
Rosebud Sioux Tribe
Executive Director
South Dakota Urban Indian Health, Inc.
1200 N West Ave, Sioux Falls, SD 57103
Region 4
Todd Wilson, Board Member
Crow
Executive Director
Helena Indian Alliance-Leo Pocha Clinic
501 Euclid Ave, Helena, MT 59601
Region 6 (b)
Scott Black, Board Treasurer
Descendant of Miami of Ohio and Mohican of Ohio 
Executive Director
American Indian Health Services
4141 State Street #B-11, Santa Barbara, CA 93110
Region 7 (a)
Linda Son-Stone, Board Secretary
Executive Director
First Nations Community HealthSource
5608 Zuni NE, Albuquerque, NM 87108
Region 7 (c)
Robyn Sunday-Allen, Board Vice-President
Cherokee
Chief Executive Officer
Oklahoma City Indian Clinic
4913 West Reno Avenue, Oklahoma City, OK 73127
Region 2
RoxAnne M Lavallie-Unabia, Board Member
Turtle Mountain Band of Chippewa
Interim Executive Director
American Indian Health Service of Chicago
4326 W Montrose Ave, Chicago, IL 60641
Region 5
Maureen Rosette, Board Member
Chippewa Cree
Chief Operations Officer
N.A.T.I.V.E. Project
1803 Maxwell Ave. Spokane, WA 99201
Region 6 (a)
Sonya Tetnowski,Board President-Elect
Makah Tribe
Executive Director
Indian Health Center of Santa Clara Valley
1211 Meridian Avenue. San Jose, CA 95125
Region 7 (b)
Walter Murillo, Board President
Choctaw
Chief Executive Officer
Native Health Center
4041 North Central Avenue, Building C. Phoenix, AZ 85012
Region 8
Adrianne Maddux, Board Member
Hopi
Executive Director
Denver Indian Health and Family Services
2880 W. Holden Place. Denver, CO 80204

 

 

 

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The National Council of Urban Indian Health (NCUIH) is the national non-profit organization devoted to the support and development of quality, accessible, and culturally-competent health and public health services for American Indians and Alaska Natives (AI/ANs) living in urban areas. NCUIH is the only national representative of the 41 Title V Urban Indian Organizations (UIOs) under the Indian Health Service (IHS) in the Indian Health Care Improvement Act (IHCIA). NCUIH strives to improve the health of the over 70% of the AI/AN population that lives in urban areas, supported by quality, accessible health care centers.

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Policy Analysis of House Coronavirus Relief Package

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NCUIH Legislative Alert:
Analysis of House Coronavirus Relief Package

Dear UIOs,

Yesterday, the House of Representatives released their latest piece of legislation in response to the novel coronavirus (COVID-19), entitled the Take Responsibility for Workers and Families Act. This bill includes major policy changes NCUIH and UIOs have been working towards, such as 100% FMAP and a fix for the Medicaid clinic “four walls” issue.

NCUIH supports this bill and asks that you please contact your Senators to support the inclusion of UIO-specific authorizing language and emergency supplemental appropriations provisions in the Senate’s coronavirus relief legislation. The Senate is currently working on its next draft of the third coronavirus bill and past drafts have not included authorizing language for 100% FMAP applicability to UIOs.

Below you will find a summary of the relevant provisions to UIOs. Some major pieces include:

The funds in the provisions highlighted below would remain available until September 30, 2021, unless otherwise noted. Provisions with specific references to urban Indian organizations (UIOs) appear highlighted.
Click Here for PDF Version

 

DIVISION A—THIRD CORONAVIRUS PREPAREDNESS AND RESPONSE SUPPLEMENTAL APPROPRIATIONS ACT, 2020

TITLE I—Agriculture, Rural Development, Food and Drug Administration, and Related Agencies

INDIAN HEALTH SERVICE (pages 72- 74)

  • The bill provides for a total of $1,032,000,000 for preparedness, response, surveillance, and health service activities for coronavirus, including for:
    • Urban Indian Organizations
    • Public Health Support
    • Electronic Health Record Modernization
    • telehealth and other IT upgrades
    • Purchased/Referred Care
    • Catastrophic Health Emergency Fund
    • Community Health Representatives
    • Tribal Epidemiology Centers
    • Other activities to protect the safety of patients and staff
  • Not less than $450,000,000 shall be distributed through Tribal shares and contracts with Urban Indian Organizations. Any remaining funding that is not distributed through Tribal shares or UIO contracts “shall be allocated at the discretion of the Director of the Indian Health Service.”
  • When these funds are transferred to tribes and tribal organizations under the Indian Self-Determination and Education Assistance Act (ISDEAA), they will be transferred on a one-time basis (non-recurring), are not part of the amount required by ISDEAA, and may only be used for the purposes of coronavirus preparedness, response, surveillance, and health service activities.
  • Funds may be used to supplement amounts otherwise available under the ‘‘Indian Health Facilities’’ account.
  • In order to use any of these funds to select core components appropriate to support the initial capacity of an Electronic Health Record system, the Committees on Appropriations of the House of Representatives and the Senate must be briefed 90 days in advance of executing a Request for Proposal for the components.
TITLE VIII—DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES

HEALTH RESOURCES AND SERVICES ADMINISTRATION (page 85)

PRIMARY HEALTH CARE

  • $1,300,000,000 for necessary expenses to prevent, prepare for, and respond to coronavirus, for grants and cooperative agreements under the Health Centers Program, as defined by section 330[1] of the Public Health Service Act, and for eligible entities under the Native Hawaiian Health Care Improvement Act, including maintenance of current health care center capacity and staffing levels.RYAN WHITE HIV/AIDS PROGRAM
  • $90,000,000 for the ‘‘Ryan White HIV/ AIDS Program’’ to prevent, prepare for, and respond to coronavirus through modifications to existing contracts and supplements to existing grants and cooperative agreements.[2]
  • Supplements shall be awarded using a data-driven methodology determined by the Secretary of Health and Human Services.

HEALTH CARE SYSTEMS

  • $5,000,000 to prevent, prepare for, and respond to coronavirus, for activities authorized under sections 127 and 1273 of the Public Health Service Act to improve the capacity of poison control centers to respond to increased calls and communications.
  • Of this amount, not less than $15,000,000 shall be allocated to tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes.

RURAL HEALTH

  • $460,000,000 to prevent, prepare for, and respond to coronavirus, including telephonic and virtual care for the underinsured, and for continuation and expansion of telehealth and rural health activities under sections 330A and 330I of the Public Health Service Act and section 711 of the Social Security Act.
  • Not less than $15,000,000 of this amount shall be allocated to tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes.

CENTERS FOR DISEASE CONTROL AND PREVENTION (page 87)
CDC–WIDE ACTIVITIES AND PROGRAM SUPPORT

  • Total of $5,500,000,000 to prevent, prepare for, and respond to coronavirus, domestically or internationally.
  • Not less than $2,000,000,000 of the amount provided shall be for grants to or cooperative agreements with States, localities, territories, tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes, for such purposes including to carry out surveillance, epidemiology, laboratory capacity, infection control, mitigation, communications, and other preparedness and response activities.
  • Every grantee that received a Public Health Emergency Preparedness grant for fiscal year 2019 shall receive not less than 100 percent of that grant level.
  • Of this amount, not less than $125,000,000 of such funds shall be allocated to tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes.
  • The Director of CDC may satisfy the funding thresholds above by making awards through other grant or cooperative agreement mechanisms.
  • $500,000,000 shall be for public health data surveillance and analytics infrastructure modernization.
  • That funds may be used for grants for the rent, lease, purchase, acquisition, construction, alteration, or renovation of non-Federally owned facilities to improve preparedness and response capability at the State and local level.
  • Funds shall remain available until September 30, 2024.

NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES (page 90)

  • $10,000,000 for worker-based training to prevent and reduce exposure of hospital employees, emergency first responders, and other workers who are at risk of exposure to coronavirus through their work duties.

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (page 93)
HEALTH SURVEILLANCE AND PROGRAM SUPPORT

  • Total of $435,000,000 to prevent, prepare for, and respond to coronavirus, for program support and cross-cutting activities that supplement activities funded under the headings ‘‘Mental Health’’, ‘‘Substance Abuse Treatment’’, and ‘‘Substance Abuse Prevention’’.[3]
  • Of this amount, not less than $15,000,000 shall be allocated to tribes, tribal organizations, urban Indian health organizations, or health or behavioral health service providers to tribes.
  • $60,000,000 of these funds shall be for services to the homeless population.
  • $50,000,000 of these funds shall be for suicide prevention programs.

CENTERS FOR MEDICARE & MEDICAID SERVICES (page 94)

  • For ‘‘Program Management’’, $550,000,000, to remain available until September 30, 2022 to prevent, prepare for, and respond to coronavirus, of which $100,000,000 shall be for necessary expenses of the survey and certification program, prioritizing nursing home facilities in localities with community transmission of coronavirus.

ADMINISTRATION FOR CHILDREN AND FAMILIES (pages 95-102)
LOW INCOME HOME ENERGY ASSISTANCE

  • $1,400,000,000 for ‘‘Low Income Home Energy Assistance’’

CHILDREN AND FAMILIES SERVICES PROGRAMS (pages 98-102)

  • Total of $5,202,000,000.
  • $2,500,000,000 for activities to carry out the Community Services Block Grant Act
  • $25,000,000 shall be available for grants to support the procurement and distribution of diapers through non-profit organizations
  • Each State, territory, or tribe shall allocate not less than xx percent of its formula award to non-profit organizations
  • $100,000,000 for carrying out activities under the Runaway and Homeless Youth Act

ADMINISTRATION FOR COMMUNITY LIVING (pages 102-103)
AGING AND DISABILITY SERVICES PROGRAMS

  • $1,205,000,000 total to prevent, prepare for, and respond to coronavirus
  • $1,070,000,000 shall be for activities authorized under the Older Americans Act of 1965
    • $200,000,000 for supportive services
    • $720,000,000 for nutrition services
    • $30,000,000 for nutrition services under title 19 VI
    • $100,000,000 for support services for family caregivers under part E of title III
    • $20,000,000 for elder rights protection activities

OFFICE OF THE SECRETARY (pages 104- 109)
PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

  • $6,077,000,000 for ‘‘Public Health and Social Services Emergency Fund’’, to remain available until September 30, 2024, to prevent, prepare for, and respond to coronavirus, domestically or internationally, including the development of necessary countermeasures and vaccines, prioritizing platform-based technologies with U.S.-based manufacturing capabilities, the purchase of vaccines, therapeutics, diagnostics, and necessary medical supplies, as well as medical surge capacity, workforce modernization, enhancements to the U.S. Commissioned Corps, telehealth access and infrastructure, initial advanced manufacturing, and related administrative activities 
  • The Secretary may take such measures authorized under current law to ensure that vaccines, therapeutics, and diagnostics developed from funds provided in this Act will be affordable in the commercial market
  • Products purchased with funds appropriated in this paragraph may be:
    • Deposited in the Strategic National Stockpile, at the discretion of the Secretary of Health and Human Services
    • Used for grants for the construction, alteration, or renovation of non-Federally owned facilities to improve preparedness and response capability at the State and local level
    • Used for the construction, alteration, or renovation of non-Federally owned facilities for the production of vaccines, therapeutics, and diagnostics where the Secretary determines that such a contract is necessary to secure sufficient amounts of such supplies
  • Not later than seven days after the date of enactment of this Act, and weekly thereafter until the Secretary declares the public health emergency related to coronavirus no longer exists, the Secretary shall report to the Committees on Appropriations of the House of Representatives and the Senate on the current inventory of personal protective equipment in the Strategic National Stockpile, including the numbers of face shields, gloves, goggles and glasses, gowns, head covers, masks, and respirators, as well as deployment of personal protective equipment during the previous week, reported by state and other jurisdictions
  • $100,000,000,000, to remain available until expended, to prevent, prepare for, and respond to coronavirus, to provide grants to public entities, not-for-profit entities, and Medicare and Medicaid enrolled suppliers and institutional providers, including for profit entities, to reimburse for health care related expenses or lost revenues directly attributable to the public health emergency resulting from the coronavirus
    • Grants shall be awarded in coordination with the Administrator of the Centers for Medicare & Medicaid Services and shall not be used to provide grants to reimburse for health care related expenses or lost revenues that have been reimbursed or are eligible for reimbursement from other sources
  • $4,500,000,000, to remain available until September 30, 2022, to prevent, prepare for, and respond to coronavirus, to reimburse the Department of Veterans Affairs for expenses incurred by the Veterans Affairs health care system to provide medical care to civilians

PUBLIC HEALTH EMERGENCY FUND (page 109)

  • $5,000,000,000 for the ‘‘Public Health Emergency Fund’’to remain available until expended, to prevent, prepare for, and respond to coronavirus, to be deposited into the Public Health Emergency Fund, as established under section 319(b) of the Public Health Service Act.
    • Funds appropriated under this heading in this Act may, at the discretion of the Secretary of Health and Human Services, be deposited in the Strategic National Stockpile

GENERAL PROVISIONS—TITLE I (page 127-133)
SEC. 10803.
(a) Funds appropriated in this title may be made available to restore amounts, either directly or through reimbursement, for obligations incurred by agencies of the Department of Health and Human Services to prevent, prepare for, and respond to coronavirus, domestically or internationally, prior to the date of enactment of this Act.
(b) Grants or cooperative agreements with States, localities, territories, tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes, under this title, to carry out surveillance, epidemiology, laboratory capacity, infection control, mitigation, communications, and other preparedness and response activities to prevent, prepare for, and respond to coronavirus shall include amounts to reimburse costs for these purposes incurred between January 20, 2020, and the date of enactment of this Act.

[1] Sections 330(r)(2)(B), 330(e)(6)(A)(iii), and 330(e)(6)(B)(iii) shall not apply to funds provided under this heading in this Act.
[2] Under parts A, B, C, D, F, and section 2692(a) of title XXVI of the Public Health Service Act. Sections 2604(c), 2612(b), and 2651(c) of the Public Health Service Act shall not apply to funds provided under this heading in this Act.
[3] In carrying out titles III, V, and XIX of the Public Health Service Act.

 

DIVISION G—HEALTH POLICIES

TITLE I—MEDICAID

SEC. 70101. INCREASING FEDERAL SUPPORT TO STATE MEDICAID PROGRAMS DURING ECONOMIC DOWNTURNS.

SEC. 70102. LIMITATION ON ADDITIONAL SECRETARIAL ACTION WITH RESPECT TO MEDICAID SUPPLEMENTAL PAYMENTS REPORTING REQUIRE20
MENTS.

  • During the period that begins on the date of enactment of this section and ends the date that is 2 years after the last day of the emergency period, the Secretary of Health and Human Services shall not take any action (through promulgation of regulation, issue of regulatory guidance, or otherwise) to—
    • (1) finalize or otherwise implement provisions contained in the Medicaid Fiscal Accountability Regulation proposed rule published on November 18, 2019; or
    • (2)promulgate or implement any rule or provision similar to the provisions described in paragraph (1) pertaining to the Medicaid program established under title XIX of the Social Security Act[1] or the State Children’s Health Insurance Program established under title XXI of such Act[2]

SEC. 70103. AUTHORITY TO AWARD MEDICAID HCBS GRANTS TO RESPOND TO THE COVID–19 PUBLIC HEALTH EMERGENCY. (pages 254-268)

  • This section includes UIOs in the definition of “Indian tribe” for purposes of awarding home and community-based services (HCBS) grants. 
  • “Indian tribe.—The term ‘‘Indian tribe’’ means an Indian tribe, a tribal organization, or an urban Indian organization (as such terms are defined in section 4 of the Indian Health Care Improvement Act (25 U.S.C. 1603)), and includes a tribal consortium of Indian tribes or tribal organizations (as so defined).”
  • GRANTS TO INDIAN TRIBES.
    • During the COVID–19 public health emergency period, the Secretary may award grants to an Indian tribe in the same manner, and subject to the same requirements, as apply to a State, except as otherwise provided in this paragraph.
    • The bill includes information on the application, monthly grant payment amounts, tribal share of monthly HCBS expenditures, and the grant period.

SEC. 70105. COVERAGE AT NO COST SHARING OF COVID–19 VACCINE AND TREATMENT. (pages 269 – 274)

SEC. 70106. OPTIONAL COVERAGE AT NO COST SHARING OF COVID–19 TREATMENT AND VACCINES UNDER MEDICAID FOR UNINSURED INDIVIDUALS. (pages 275 – 276)

SEC. 70107. TEMPORARY INCREASE IN MEDICAID FEDERAL FINANCIAL PARTICIPATION FOR TELEHEALTH SERVICES. (pages 277 – 278)

SEC. 70108. EXTENSION OF FULL FEDERAL MEDICAL ASSISTANCE PERCENTAGE TO INDIAN HEALTH CARE PROVIDERS. (page 278)

  • Extends 100% FMAP to Urban Indian organizations,[3] Indian health care providers[4]
  • Provides a fix for the Medicaid clinic “four walls” issue.
  • The section reads:
    • Section 1905 of the Social Security Act (42 U.S.C. 1396d) is amended—
      • (1) in subsection (a)(9), by inserting ‘‘and including such services furnished in any location by or through an Indian health care provider (as defined in section 1932(h)(4)(A))’’ before the semicolon; and
      • (2) in subsection (b)—
        • (B) by striking ‘‘Indian Health Care Improvement Act)’’ and inserting ‘‘Indian Health Care Improvement Act), or through an urban Indian organization (as defined in section 4 of the Indian Health Care Improvement Act) pursuant to a grant or contract with the Indian Health Service under title V of the Indian Health Care Improvement Act’’.“

SEC. 70110. INCREASED FMAP FOR MEDICAL ASSISTANCE TO NEWLY ELIGIBLE INDIVIDUALS. (page 282 – 283)

SEC. 70111. RENEWAL OF APPLICATION OF MEDICARE PAYMENT RATE FLOOR TO PRIMARY CARE SERVICES FURNISHED UNDER MEDICAID AND INCLUSION OF ADDITIONAL PROVIDERS. (page 283- 290)

  • Includes FQHC

SEC. 70114. EXTENSION OF EXISTING SECTION 1115 DEMONSTRATION PROJECTS. (page 292- 295)

  • Upon request by a State, the Secretary of Health and Human Services shall approve an extension of the waiver and expenditure authorities for a demonstration project described in subsection (a) for a period up to and including December 31,2021, to ensure continuity of programs and funding during the emergency period.
EXPEDITED APPLICATION PROCESS.
  • The Federal and State public notice and comment procedures or other time constraints otherwise applicable to demonstration project amendments shall be waived to expedite a State’s extension request pursuant to this section.

SEC. 70118. EXTENSION OF THE COMMUNITY MENTAL HEALTH SERVICES DEMONSTRATION PROGRAM.

  • Extends program end date from May 22, 2020 to November 30, 2020.
[1] 42 U.S.C. 1396 et seq.
[2] 42 U.S.C. 1397aa et seq.
[3] As defined in section 4 of the Indian Health Care Improvement Act.
[4] As defined in section 1932(h)(4)(A) of the Social Security Act.
TITLE II—MEDICARE

SEC. 70201. COVERAGE OF THE COVID-19 VACCINE UNDER THE MEDICARE PROGRAM WITHOUT ANY COST-SHARING. (page 298-300)

SEC. 70202. HOLDING MEDICARE BENEFICIARIES HARMLESS FOR SPECIFIED COVID-19 TREATMENT SERVICES FURNISHED UNDER PART A OR PART B OF THE MEDICARE PROGRAM. (page 300-305)

SEC. 70204. ENHANCING MEDICARE TELEHEALTH SERVICES FOR FEDERALLY QUALIFIED HEALTH CENTERS AND RURAL HEALTH CLINICS DURING THE EMERGENCY PERIOD. (page 305-308)

  • The Secretary shall pay for telehealth services that are furnished via a telecommunications system by an FQHC to an eligible telehealth individual SPECIAL PAYMENT RULE.—
  • The Secretary shall develop and implement payment methods that apply under this subsection to an FQHC that furnishes a telehealth service to an eligible telehealth individual during such emergency period.
  • Such payment methods shall be based on payment rates that are similar to the national average payment rates for comparable telehealth services under the physician fee schedule.
TITLE V—PUBLIC HEALTH POLICIES

Subtitle A—Improving Public Health and Medical Response
PUBLIC HEALTH DATA SYSTEM TRANSFORMATION. EXPANDING CDC AND PUBLIC HEALTH DE PARTMENT CAPABILITIES.—(page 417)

Subtitle B—Tribal Health (pages 435 – 443)
SEC. 70521. IMPROVING STATE, LOCAL, AND TRIBAL PUBLIC HEALTH SECURITY. (pages 435-442)

  • Includes urban Indian organizations’ as eligible entities and describes the determination of funding amount.
  • The Secretary shall award at least 10 cooperative agreements under this section

SEC. 70522. PROVISION OF ITEMS TO INDIAN PROGRAMS AND FACILITIES. (page 442)

  • Ensures that items (drugs, vaccines and other biological products, medical devices, and other supplies) from the Strategic National Stockpile are deployed to urban Indian organizations.

SEC. 319F–5. DISTRIBUTION OF QUALIFIED PANDEMIC OR EPIDEMIC PRODUCTS TO INDIAN PROGRAMS AND FACILITIES. (page 443)

  • Specifically includes urban Indian organizations
  • Secretary distributes qualified pandemic or epidemic products[1] to States or other entities, such products are distributed directly to health programs or facilities operated through an urban Indian organization

SEC. 70542. DIABETES PROGRAMS.

  • Extends Special Diabetes Program for Indians (SDPI) to November 30, 2020.
[1] As defined in section 319F–3(i)(7).
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PRESS RELEASE: HHS Announces Action by CDC to disburse $80 Million for Indian Country including Urban Indian Health

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FOR IMMEDIATE RELEASE

Contact: Meredith Raimondi, 202-417-7781, mraimondi@ncuih.org

14 days after the supplemental bill was enacted, HHS announced action to disburse funds.

Washington, DC (March 20, 2020) – On March 20, 2020, the Department of Health and Human Services (HHS) announced action by the Centers for Disease Control and Prevention (CDC) to provide $80 million in funding to tribes, tribal organizations, and Urban Indian Organizations for resources in support of our nation’s response to the 2019 novel coronavirus (COVID-19).

“While the cities across the country are shutting down, our Urban Indian Organizations (UIOs) are doing all they can to stay open for the patients and communities. As UIOs have risen to the challenge without any additional federal funding to date, helping not only their patients but their counties, the timing of this is critical and will be essential to protecting the personnel who are risking their lives without proper protective equipment. This is an important step in the right direction to helping Indian Country mitigate this deadly virus. We must thank our leaders in Congress – Rep. Betty McCollum, Rep. Tom Cole, Rep. Markwayne Mullin, Rep. Paul Cook, Rep. Raul Grijalva, Rep. Ruben Gallego, Sen. Chuck Schumer, Sen. Elizabeth Warren and Sen. Tom Udall – who have been instrumental in ensuring this funding reaches the most vulnerable populations impacted by this pandemic,” said Francys Crevier, Executive Director of NCUIH.

Current Status

The Indian Health Center of Santa Clara Valley, the UIO in San Jose, California, is at the front lines of the COVID-19 pandemic, where it confirmed its first COVID-19 case on March 13 and cases have increased more than threefold in that area over the past few days. In Utah, the Urban Indian Center of Salt Lake has several patients who were exposed to COVID-19 through a March 9 event where a number of girls interacted directly with Utah Jazz player Rudy Gobert (the namesake of Rudy’s Kids Foundation) – who tested positive for COVID-19 two days later.  The UIO located in Seattle, WA, an area currently experiencing a significant level of outbreak, is projecting a monthly loss of $734,922 during this pandemic.  Another UIO has had to reduce operations to two days a week. A UIO is also considering layoffs due to lack of PPE. And, one UIO has determined it must close for 30 days – with a handful of rotating staff (to minimize the potential for spread) providing telemedicine services only.

On March 6, 2020, H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (Act) became law (P.L. 116-123). The Act provides $8.3 billion in emergency funding for federal agencies to respond to the COVID-19 outbreak, including $2.2 billion for the Centers for Disease Control and Prevention (CDC), of which not less than $950,000,000 will be distributed via grants or cooperative agreements to states, localities, territories, tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes, and a proviso that “not less than $40,000,000 of such funds shall be allocated to tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes.” Grants or cooperative agreements with urban Indian health organizations will provide these funds to carry out surveillance, epidemiology, laboratory capacity, infection control, mitigation, communications, and other preparedness and response activities to prevent, prepare for, and respond to COVID-19, as well as to reimburse costs expended for these purposes incurred between January 20 and March 6, 2020.

Background

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The National Council of Urban Indian Health (NCUIH) is the national non-profit organization devoted to the support and development of quality, accessible, and culturally-competent health and public health services for American Indians and Alaska Natives (AI/ANs) living in urban areas. NCUIH is the only national representative of the 41 Title V Urban Indian Organizations (UIOs) under the Indian Health Service (IHS) in the Indian Health Care Improvement Act (IHCIA). NCUIH strives to improve the health of the over 70% of the AI/AN population that lives in urban areas, supported by quality, accessible health care centers.

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Families First Coronavirus Response Act includes $64 Million for Indian Health Service

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On March 18, 2020, H.R. 6201 The Families First Coronavirus Response Act (Act) was signed into law. The legislation allocates $64 million to the Indian Health Service to cover the costs of COVID-19 diagnostic testing for Indians receiving care through the Indian Health Service or through an Urban Indian Health Organization. The Act also guarantees coverage of testing for COVID-19 at no cost sharing for Indians receiving contract health services. In addition, the legislation includes $250 million for the Senior Nutrition program in the Administration for Community Living (ACL). This will provide approximately 25 million additional home-delivered and pre-packaged meals to low-income seniors who depend on the Senior Nutrition programs in their communities.

Currently, Congress is working on a third relief package that is expected to pass soon. The package is expected to provide $1.2 trillion in relief to individuals, governments, and industries. The tribal and urban Indian priorities in this package focus on healthcare, health system capacity, economic development, and governance.

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PRESS RELEASE: Congressional Native American Caucus Supports Policy Priorities Identified by NCUIH and Other National Native Organizations for Third Funding Bill

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FOR IMMEDIATE RELEASE

Contact: Meredith Raimondi, 202-544-0344, mraimondi@ncuih.org

As Indian Country awaits funding, Congress continues to prioritize Native Americans and UIOs are keeping their doors open.

Washington, DC (March 18, 2020) – On March 17, 2020, the Congressional Native American Caucus sent a letter to the House Committee on Appropriations Chair Nita Lowey and Ranking Member Kay Granger urging the inclusion of tribal priorities in the third supplemental coronavirus package.

The request from the Native American Caucus incorporates a joint letter submitted by the National Council of Urban Indian Health (NCUIH), National Indian Health Board (NIHB), and National Congress of American Indians (NCAI) (collectively, Native Organizations).  The Native Organizations outlined the need to address critical funding and policy priorities to protect and prepare the American Indian/Alaska Native (AI/AN) communities for COVID-19.

“We are encouraged by the attention of Congress to Indian Country as it continues to advance legislation to address this global pandemic. From Santa Clara Valley to Baltimore, our communities are ground zero for this health crisis, providing life-saving critical care without any additional federal resources to date. Despite a complete lack of additional federal resources, Urban Indian Organizations are doing everything they can to keep their doors open and ensure their patients and staff are safe. As this crisis continues to unfold, however, some programs are being forced to reduce hours due to funding shortages and potentially lay off staff to cope due to a lack of personal protective equipment. All Indian Health Care Providers are experiencing devastating impacts from this pandemic yet they continue to step up every day as operators on the front lines. The trust responsibility to Indian Country must not end in this time of crisis when it is needed most of all,” said Francys Crevier, Executive Director of NCUIH.

The Congressional Native American Caucus letter provides that “[i]t is imperative that the requests of American Indians and Alaska Natives (AI/ANs) are thoroughly considered in the preparation of this package to reflect the needs of all 574 federally-recognized Native Nations and 41 urban Indian organizations (UIOs) in furtherance of the federal trust responsibility.”

The Caucus further notes that “[t]he inclusion of these urgent recommendations is imperative for the health of tribal communities and their citizens as this unforeseen pandemic continues to escalate in the United States.”

The priorities include requesting that Congress provide $1.1 billion in funding for the Indian Health Service (IHS) Services Account – funding that is essential to meet the increased demand for health services and education, recruit providers, increase testing capacity, and address other needs of Indian Health Care Providers including UIOs, as well as enable them to secure medical supplies. In addition, Native Organizations requested Congress to ensure parity across the IHS system by extending the full Federal Medicaid Assistance Percentage to services provided at UIOs.

NCUIH Letter to Native American Caucus

Additionally, NCUIH sent a letter to the House Native American Caucus, advocating for the inclusion of Indian Health Care Providers, including UIOs, in emergency coronavirus legislation.

To date, UIOs have received zero federal dollars to combat COVID-19; yet, currently, at least 10% of UIOs have patients that have tested positive or are under investigation/quarantine for COVID-19 and the remainder have expended resources to prepare for the likely spread of the novel coronavirus to patients in their cities. NCUIH therefore requested a minimum of $58-$94 million in funding to be provided for emergency supplies and services for urban Indian organizations and parity among the IHS/Tribal/UIO system through Medicaid reimbursement and medical malpractice coverage.

Letters

Press Releases

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The National Council of Urban Indian Health (NCUIH) is the national non-profit organization devoted to the support and development of quality, accessible, and culturally-competent health and public health services for American Indians and Alaska Natives (AI/ANs) living in urban areas. NCUIH is the only national representative of the 41 Title V Urban Indian Organizations (UIOs) under the Indian Health Service (IHS) in the Indian Health Care Improvement Act (IHCIA). NCUIH strives to improve the health of the over 70% of the AI/AN population that lives in urban areas, supported by quality, accessible health care centers.

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Senators Warren and Udall Unveil Bill to Guarantee Tribal Health Authorities Access to the Strategic National Stockpile

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Source: https://www.warren.senate.gov/newsroom/press-releases/senators-warren-and-udall-unveil-bill-to-guarantee-tribal-health-authorities-access-to-the-strategic-national-stockpile

Indian Health Service and other tribal health organizations currently lack guaranteed, direct access to federal repository of drugs and medical supplies for emergencies; Legislation would allow the Indian Health Service, tribal health authorities, and urban Indian organizations to access the Strategic National Stockpile and help combat the coronavirus crisis

Text of Bill (PDF) | One-Pager (PDF)

Washington, D.C. — United States Senators Elizabeth Warren (D-Mass.) and Senate Committee on Indian Affairs (SCIA) Vice Chairman Tom Udall (D-N.M.) today unveiled the Tribal Medical Supplies Stockpile Access Act, legislation that would guarantee that the Indian Health Service (IHS), tribal health authorities, and urban Indian organizations have access to the Strategic National Stockpile (SNS), a federal repository of drugs and medical supplies that can be tapped if a public health emergency could exhaust local supplies.

Currently, IHS and tribal health authorities’ access to the SNS is very limited and is not guaranteed in the SNS statute. In contrast, states’ and large municipalities’ public health authorities have ready access to the SNS. The lawmakers’ bill comes as the Department of Health & Human Services (HHS) indicated that IHS is likely to face shortages of necessary equipment as coronavirus disease 2019 (COVID-19) continues to spread.

“We must ensure that IHS, tribal nations, and Native communities are prepared to confront the coronavirus outbreak head-on, and that means ensuring that their health services have access to crucial medical supplies and equipment during public health emergencies,” Senator Warren said. “It is as important as ever to empower Indian Country to tackle a public health crisis, and that is what our bill does.”

“Tribal communities face unique challenges in responding to public health threats — that is why it is critical that we listen and respond to Tribal leaders and experts at IHS who say they are likely to face shortages of essential equipment and medical supplies that are needed to respond to this public health crisis,” said Senator Udall. “We must do everything we can to make sure Tribes don’t bear the worst costs of this public health crisis. This legislation will ensure that IHS facilities, Tribal health departments and urban Indian organizations have access to the emergency medical supplies they need. I will continue to push Congress and the Trump administration to make sure Indian Country has access to federal coronavirus resources and that there is meaningful engagement with Native communities and Tribal leaders in our response to COVID-19.”

The Tribal Medical Supplies Stockpile Access Act is supported by the National Indian Health Board, the National Congress of American Indians, the National Council of Urban Indian Health, United South and Eastern Tribes Sovereignty Protection Fund, Seattle Indian Health Board, and the Friends Committee on National Legislation.

“The COVID-19 pandemic has placed immense pressures on the chronically underfunded and under-resourced Indian health system. Direct access to the Strategic National Stockpile will bring much-needed relief and critical medical and pharmaceutical supplies into IHS, Tribal and urban Indian health facilities to prepare and respond to the current COVID-19 pandemic, and future health emergencies.” — National Indian Health Board

“We are encouraged by the leadership of Senator Warren and Senator Udall to increase health care access for American Indians and Alaska Natives through the Strategic National Stockpile. As the coronavirus continues to have greater impacts, Congress must do everything possible to uphold its trust responsibility to Indian Country by providing appropriate resources including N95 respirators. The stockpile is designed for those who need it most in times of emergency and Indian Country should not be left behind.” — Francys Crevier, Executive Director, National Council of Urban Indian Health

“We are grateful for the leadership of Senator Warren and Senator Udall and recognizing the importance of addressing the COVID-19 pandemic in American Indian and Alaska Native communities. Seattle Indian Health Board is right in the epicenter of the outbreak in the United States, and we continue to do everything possible to limit the spread of the virus while taking every safety precaution for our patients, staff, and community. This has come at the cost of revenue, staff, and resources. But with access to the Strategic National Stockpile, we can mitigate future impacts and continue to be leaders in addressing the COVID-19 pandemic.” — Esther Lucero, Chief Executive Officer, Seattle Indian Health Board

“As a Quaker organization who works to hold the United States to its trust and treaty obligations with Native nations, we thank Senators Warren and Udall for ensuring that American Indians and Alaska Natives are not forgotten during this global pandemic. The chronic underfunding of tribal and urban Indian health organizations has led Indian Country to be ill-prepared for a health crisis of this scale. Access to the Strategic National Stockpile will provide supplies and medicines critical to addressing the COVID-19 outbreak. Congress has a trust obligation to provide health facilities serving American Indians and Alaska Natives with the resources needed to protect the well-being of Native people and communities.” — Kerri Colfer, Congressional Advocate on Native American Policy at the Friends Committee on National Legislation

During her time in the Senate, Senator Warren has worked to protect and advance tribal sovereignty, to emphasize the federal government’s trust and treaty responsibilities to tribal nations, and to affirm Washington’s government-to-government relationship with tribal nations. She has introduced a number of bills to advance the health and welfare of Native peoples, including the Native American Suicide Prevention Act, the American Indian and Alaska Native Child Abuse Prevention and Treatment Act, and the Comprehensive Addiction Resources Emergency (CARE) Act, and has cosponsored other legislation to achieve that goal. She has also unveiled with Congresswoman Deb Haaland (D-N.M.) a proposal for the Honoring Promises to Native Nations Act, legislation that will address chronic underfunding and barriers to sovereignty in Indian Country.

In response to the coming economic downturn due to coronavirus, Senator Warren has called for a $750 billion economic stimulus package that would focus on recovery from the grassroots up, not Wall Street down. Such a package would apply the lessons from the 2008 bailout and provide direct help to families harmed by the coronavirus outbreak, including universal paid leave, increasing Social Security benefits by $200 a month, broad cancellation of student loan debt, and protecting and expanding housing.

 

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PRESS RELEASE: Federal Government Has Yet to Disburse Funds to UIOs

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FOR IMMEDIATE RELEASE

Contact: Meredith Raimondi, 202-417-7781, mraimondi@ncuih.org

UIOs have received no funding from COVID-19 emergency bill.

Washington, DC (March 17, 2020) – To date, urban Indian organizations (UIOs) across the country have yet to receive any federal funding from the $8.3 billion emergency supplemental appropriations to combat the COVID-19 coronavirus pandemic, despite having been specifically listed in the legislation. UIOs already have an immediate funding need for services and supplies to combat the pandemic, and as the urgency, infection rate, and death toll intensifies, UIOs will need more funding resources to protect and preserve human life.

“As Congress and the Administration is working hard to address COVID-19, we are gravely concerned about the timeline for funds and resources to Indian Country. We have seen urban areas be adversely impacted by this virus and our Urban Indian Organizations have yet to receive any funding from the Administration despite Congress including UIOs in the bill. Lives are at stake and time is of the essence for action as our programs are already tackling this crisis without the resources they need,” said Francys Crevier, Executive Director of NCUIH.

The National Council of Urban Indian Health (NCUIH) partnered with the National Indian Health Board, National Congress of American Indians, Native American Finance Officers Association, and the United South and Eastern Tribes Sovereignty Protection Fund in a letter to Congressional appropriators detailing the need for UIO COVID-19 emergency supplies and services funding to be set at a minimum of $58-$94 million. UIOs receive primary IHS funding from only one line item in the IHS budget, which provides a mere $57,684,000 for urban Indian health. 41 UIOs that operate 74 health facilities in 22 states are thus faced with significantly constrained budgets.

With over two-thirds of the American Indian and Alaska Native (AI/AN) population living in urban areas, UIOs fill a crucial gap in the health care system for AI/ANs that do not have access to more remote facilities run by the Indian Health Service (IHS). UIOs must receive this critical funding without delay so that they may continue to provide high quality care to their patients while also managing local outbreaks and minimizing risks to their communities.

UIOs already have an immediate need for access to the emergency funding appropriated by Congress, as many are located in some of the hardest-hit areas of the United States.

  • The Indian Health Center of Santa Clara Valley, the UIO in San Jose, California, is at the front lines of the COVID-19 pandemic, where it confirmed its first COVID-19 case on March 13 and cases have increased more than threefold in that area over the past few days. In Utah, the Urban Indian Center of Salt Lake has several patients who were exposed to COVID-19 through a March 9 event where a number of girls interacted directly with Utah Jazz player Rudy Gobert (the namesake of Rudy’s Kids Foundation) – who tested positive for COVID-19 two days later.
  • The UIO located in Seattle, WA, an area currently experiencing a significant level of outbreak, is projecting a monthly loss of $734,922 during this pandemic.
  • These are only a few examples of the impacts UIOs are already experiencing – yet they have not received any COVID-19 funding to date.

On March 6, H.R.6074, the “Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020” (Act) became law. The Act provides $8.3 billion in emergency funding for federal agencies to respond to the COVID-19 outbreak, and includes at least $950,000,000 for states, localities, tribes, tribal organizations, and UIOs. A further proviso provides that “not less than $40,000,000 of such funds shall be allocated to tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes” through the Centers for Disease Control and Prevention (CDC). Grants or cooperative agreements with urban Indian health organizations will be to carry out surveillance, epidemiology, laboratory capacity, infection control, mitigation, communications, and other preparedness and response activities to prevent, prepare for, and respond to COVID-19, as well as to reimburse costs for these purposes incurred between January 20 and March 6, 2020.

NCUIH will continue to monitor this rapidly evolving situation, the ongoing health risks to AI/AN patients, and the urban Indian communities where they reside.

Letters and Press Releases

Related Bills

News

Background

###

The National Council of Urban Indian Health (NCUIH) is the national non-profit organization devoted to the support and development of quality, accessible, and culturally-competent health and public health services for American Indians and Alaska Natives (AI/ANs) living in urban areas. NCUIH is the only national representative of the 41 Title V Urban Indian Organizations (UIOs) under the Indian Health Service (IHS) in the Indian Health Care Improvement Act (IHCIA). NCUIH strives to improve the health of the over 70% of the AI/AN population that lives in urban areas, supported by quality, accessible health care centers.

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Udall Leads Bipartisan Group of Senators Urging Vice President Pence to Ensure Coronavirus Resources for Tribes and Urban Native Communities

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Call comes as first case is confirmed in Indian Country, and following Congressional approval of coronavirus emergency funding bill that includes $40 million in funds for Tribes, Tribal organizations and Urban Indian Health Organizations

WASHINGTON — Today, U.S. Senator Tom Udall (D-N.M.). vice chairman of the Senate Committee on Indian Affairs, led a bipartisan group of 27 senators in writing to Vice President Mike Pence requesting the administration meaningfully engage with Native communities and Tribal leaders on their response to the 2019 novel coronavirus (COVID-19).  The senators sent the letter following congressional passage of a coronavirus emergency supplemental appropriations bill that includes $40 million for Tribes, Tribal organizations and Urban Indian Health Organizations impacted by COVID-19.

In addition to Udall, the letter is signed by Senate Democratic Leader Chuck Schumer (D-N.Y.), and U.S. Senators Lisa Murkowski (R-Alaska), Jeff Merkley (D-Ore.), Dan Sullivan (R-Alaska), Ron Wyden (D-Ore.), Bernie Sanders (I-Vt.), Kamala Harris (D-Calif.), Jack Reed (D-R.I.), Tina Smith (D-Minn.), Elizabeth Warren (D-Mass.), Sheldon Whitehouse (D-R.I), Jacky Rosen (D-Nev.), Patty Murray (D-Wash.), Amy Klobuchar (D-Minn.), Martin Heinrich (D-N.M.), Jon Tester (D-Mont.), Dianne Feinstein (D-Calif.), Gary Peters (D-Mich.), Richard Blumenthal (D-Conn.), Tammy Baldwin (D-Wisc.), Cory Booker (D-N.J.), Brian Schatz (D-Hawaii), Debbie Stabenow (D-Mich.), Maria Cantwell (D-Wash.), Catherine Cortez Masto (D-Nev.), and Tammy Duckworth (D-Ill.).

The United States has confirmed COVID-19 cases in a number of states where Tribes and urban Indian communities are located. Given these developments and past issues accessing federal resources for the Zika, Ebola, H1N1, and SARS outbreaks, Tribes and Urban Indian Organizations are concerned that federal COVID-19 response efforts and resources will not reach them.

In their letter to the Vice President, the senators wrote, “As you undertake your work leading the Administration’s 2019 novel coronavirus (COVID-19) response, [we] urge you to meaningfully engage with Native communities and Tribal leaders.”

“The U.S. government has specific trust and treaty responsibilities to provide American Indians and Alaska Natives (AI/ANs) with comprehensive quality healthcare.  While the IHS serves as the primary agency charged with provision of AI/AN healthcare, all federal healthcare-related programs and initiatives – including the COVID-19 response – share equally in the requirement to fulfill these trust and treaty obligations,” the senators continued.

“Additionally, to ensure proper precautions and response measures are deployed efficiently, it is imperative that Tribal and urban Indian health teams have access to Congressionally-allocated COVID-19 resources and the most up-to-date information regarding the presence of COVID-19 in their communities,” wrote the senators.

The full text of the letter can be found below and HERE.

Dear Mr. Vice President,

As you undertake your work leading the Administration’s 2019 novel coronavirus (COVID-19) response, we urge you to meaningfully engage with Native communities and Tribal leaders.  Specifically, we ask that you ensure the Administration: 

– Includes a representative of the Indian Health Service (IHS) on the Administration’s COVID-19 task force;

– Provides Tribal leaders, Tribal health departments, and urban Indian health programs with equal access to COVID-19 related information that is provided to their state and local counterparts; and

– Directs all COVID-19 resources identified by Congress for Native communities’ use to impacted IHS facilities, Tribes, and urban Indian health programs in a timely manner.

The U.S. government has specific trust and treaty responsibilities to provide American Indians and Alaska Natives (AI/ANs) with comprehensive quality healthcare.  While the IHS serves as the primary agency charged with provision of AI/AN healthcare, all federal healthcare-related programs and initiatives – including the COVID-19 response – share equally in the requirement to fulfill these trust and treaty obligations.

Additionally, to ensure proper precautions and response measures are deployed efficiently, it is imperative that Tribal and urban Indian health teams have access to Congressionally-allocated COVID-19 resources and the most up-to-date information regarding the presence of COVID-19 in their communities.  As the IHS noted in its February 24th announcement, the state of the COVID-19 threat “is a rapidly evolving situation, and information is likely to become dated quickly.”[1]  As such, it is incumbent on the Administration to keep Indian Tribes, Tribal health departments, and urban Indian health programs apprised of any relevant developments in real time.

Thank you for your attention to these matters.  We look forward to working with you to uphold the Federal government’s Tribal trust and treaty responsibilities and to engage in meaningful government-to-government relations with Indian Tribes and urban Indian communities regarding the national COVID-19 response.

Sincerely,

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