NCUIH Statement Condemning Racist Vandalism at Indian Health Center of Santa Clara Valley

FOR IMMEDIATE RELEASE 

Contact: Meredith Raimondi, 202-932-6615, mraimondi@ncuih.org

WASHINGTON, DC (July 8, 2020) – Today, the National Council of Urban Indian Health released the following statement:

The Indian Health Center of Santa Clara Valley in San Jose, California was a target of a recent racist vandal. As the national representative of 41 Urban Indian Organizations (UIOs), including this one, we vehemently admonish this horrifying attack against our community.

We stand in solidarity with our Black relatives whose voices are finally beginning to be heard. This recent attack highlights the centuries of racism against people of color. Unfortunately, the structures which created this country left a legacy of systemic racism that has directly affected our communities. As Natives, we know we are all connected and that racism knows no bounds.

The Indian Health Center of Santa Clara Valley has been a pillar of support for the community from day 1 of the COVID-19 pandemic and was among one of the first counties in the United States to shelter-in-place. During this crisis, their staff continued to come to work every day despite the many fears and unknowns that come with this virus. This clinic will not be undeterred by this cowardly attack on their property.

We stand with the Indian Health Center of Santa Clara Valley. We are resilient and we are still here because we can stand together.

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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.

PRESS RELEASE: House FY21 Interior Appropriations Bill includes $66 Million for Urban Indian Health, $8.4 Million above FY20

FOR IMMEDIATE RELEASE 

Contact: Meredith Raimondi, 202-932-6615, mraimondi@ncuih.org

The bill includes $6.5 Billion for Indian Health Service.

Washington, DC (July 9, 2020) – Today, the House Appropriations Committee released the bill report for the Fiscal Year (FY) 2021 Interior, Environment, and Related Agencies funding bill. The bill includes $6.5 billion for the Indian Health Service (IHS), an increase of $445 million above the FY 2020 enacted level and $199 million above the President’s budget request for FY 2021. The full Appropriations Committee will mark up the bill on Friday at 9:00 a.m.

The bill includes $66.1 million for Urban Indian Health line item in the IHS budget. The National Council of Urban Indian Health (NCUIH) requested $106 million Urban Indian Health as recommended by the Tribal Budget Formulation Workgroup (TBFWG) for FY 2021. The bill also includes $83.9 million in Direct Operations for IHS and directs IHS to confer with UIOs to conduct a study on infrastructure needs. Additionally, Alzheimer’s Disease and the Hepatitis C & HIV/AIDS Initiative would receive $5 million respectively with provisions to work with UIOs.

“We are grateful for Chair McCollum, Ranking Member Joyce and the Committee for their tireless efforts in ensuring all of Indian Country has the resources needed to protect and care for our relatives. We are encouraged by the inclusion of $66.1 million for urban Indian health and the long-needed infrastructure study for urban Indian health facilities who require new resources to safely operate amid this pandemic,” said Francys Crevier, Executive Director of NCUIH.

In June, NCUIH testified before the House Committee on Appropriations Subcommittee on Interior, Environment and Related Agencies for a hearing on the Indian Health Service (IHS) COVID-19 Response. NCUIH highlighted the dire need for facilities and infrastructure funding, which is currently unfunded, in the wake of the COVID-19 crisis. In February, NCUIH testified as part of American Indian and Alaska Native Public Witness Day.

Indian Health Service

Note: Additional analysis is forthcoming.

Indian Health Service – $6.5 billion, an increase of $445 million above the FY 2020 enacted level and $199 million above the President’s budget request.

  • Urban Indian Health – $66.1 million, $8,443,000 above the FY20 enacted level and $16,491,000 above the President’s budget request
  • Health Services – $4.5 billion, an increase of $225 million above the FY 2020 enacted level and $33 million above the President’s budget request. This reflects the move of Payment for Tribal Leases (Indian Self-Determination and Education Assistance Act section 105(l) lease cost agreements, commonly referred to as “section 105(l)” leases) to a separate, indefinite appropriation account.
    • Note: UIOs are ineligible for the 105(l) leases. Over the past few years, IHS has diverted over $1.5 million of UIO funds to cover the cost of these leases, so a separate appropriation to cover 105(l) lease costs will ensure future UIO funding is not diverted again for this reason.
  • Health Facilities – $935 million, an increase of $23 million above the FY 2020 enacted level and $166 million above the President’s budget request.
    • Note: Even though the bill language does not exclude UIOs, there is still the limitation found in 25 U.S.C. § 1659 that limits UIO facility renovation or construction to “minor” activities for the sole purpose of meeting Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accreditation standards.
  • Alzheimer’s Disease – $5 million
    • The Committee directs IHS, in consultation with Indian Tribes and Urban Indian Organizations (UIOs), to develop a plan to assist those with Alzheimer’s, the additional services required, and the costs associated with increasing Alzheimer’s patients and submit this information to Congress within 270 days of enactment of this Act.
  • Hepatitis C & HIV/AIDS Initiative- $5 million
    • The Committee encourages IHS to confer with UIOs to determine how they may participate in this Initiative.

Next Steps

On Tuesday, the House Interior Appropriations Subcommittee approved the bill with funding for the Indian Health Service. On Friday, the full House Appropriations Committee will markup the Interior bill. While the House is expected to move swiftly, the Senate is in recess until July 20 and has yet to begin their COVID-19 emergency response package. Majority Leader Mitch McConnell has signaled the Senate will still recess for August meaning that the Senate Appropriations process may not be underway until September. As it is an election year, the chances of a passage for an Interior Appropriations Bill in both chambers is dwindling and it’s looking like a Continuing Resolution will be needed.

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.

Indian Health Service Endorses Urban Indian Health Federal Tort Claims Act Bill at Senate Indian Affairs Hearing

NCUIH provided written testimony for the legislative and oversight hearing on COVID-19 in Indian Country. Many members of the Senate Indian Affairs Committee expressed support for urban Indian health parity.

WASHINGTON, DC (July 1, 2020) – Today, the Senate Committee on Indian Affairs (SCIA) held an oversight hearing on “Evaluating the Response and Mitigation to the COVID-19 Pandemic in Native Communities” and a legislative hearing on S. 3650, the Coverage for Urban Indian Health Providers Act.  NCUIH Vice President Robyn Sunday-Allen, who is also the CEO of the Oklahoma City Indian Clinic, submitted written testimony emphasizing the importance S. 3650, which has been exacerbated by the COVID-19 pandemic.

S. 3650 is a bipartisan bill – introduced by Senators Lankford, McSally, Smith, and Udall– that includes a technical fix to provide parity in the Indian Health Service (IHS) system by extending Federal Tort Claims Act (FTCA) coverage to urban Indian organization (UIO) employees such that UIOs would no longer need to utilize limited federal funds to purchase costly malpractice insurance.

During the hearing, many Senators emphasized the critical nature of this legislative fix to help expand resources for urban Indian health services.  Chairman Hoeven offered remarks on S. 3650 and stated that “Urban Indian organizations are not offered malpractice liability protections that are already provided to IHS and Tribal health programs’ employees. Urban Indian organizations are providing culturally competent care to natives living in urban areas.” Senator Udall stated the FTCA bill is an “excellent example of the type of practical bipartisan solution we should all be pushing for. This bill not only creates parity with the IHS system but also helps urban Indian health programs reduce operating costs due to COVID-19 budget related shortfalls.”  IHS Director RADM Michael Weahkee also expressed support mentioning that the “IHS endorses the policy to extend Federal Tort Claims Act Coverage to UIOs, which is consistent with [IHS’] FY 2021 budget request”.

S. 3650 represents a technical fix that has long enjoyed broad bipartisan support, including from both sides of the aisle and both Chambers of Congress as well as from the Administration and the Tribal Budget Formulation Work Group. IHS facilities and Tribal Health Programs, as well as Community Health Centers, already receive FTCA coverage.

A recording of the hearing can be found here.

Next Steps

Given S. 3650’s broad support across the aisles, in both chambers, and by Indian Country, NCUIH will continue to advocate for its swift passage in the next COVID-19 package, which the Senate is expected to take up later in July.

Background Information

 

Testimony

July 1, 2020

Senate Committee on Indian Affairs

Legislative Hearing to Receive Testimony on S. 3650

Testimony of Robyn Sunday-Allen, Vice President

National Council of Urban Indian Health (NCUIH)

 

My name is Robyn Sunday-Allen and I am the Vice President of the National Council of Urban Indian Health (NCUIH), which represents the 41 Urban Indian Organizations (UIOs) across the nation who provide high-quality, culturally-competent care to Urban Indians, constituting over 70% of all American Indians/Alaska Natives (AI/AN). I also serve as the Chief Executive Officer of the Oklahoma City Indian Clinic, a permanent program within the IHS direct care program and a UIO, which provides culturally sensitive health and wellness services including comprehensive medical care, dental, optometry, behavioral health, fitness, nutrition, and family programs to our patients. I would like to thank both Chairman Hoeven and Vice Chairman Udall for holding this legislative and oversight hearing during this unprecedented pandemic, which has especially impacted Indian Country. My testimony is regarding S. 3650, Coverage for the Urban Indian Health Providers Act, and how it would improve health care outcomes for Oklahoma City’s Urban Indian community.

S. 3650 will close a major disparate gap in the Indian Health Service (IHS) system by extending Federal Tort Claims Act (FTCA) coverage to UIOs. FTCA for UIOs was also included in President Trump’s FY 2021 budget and the Tribal Budget Formulation Workgroup’s FY 2021 and FY 2022 budget recommendations. Both in this esteemed Chamber and in the House of Representatives, the Coverage for Urban Indian Health Providers Act has enjoyed broad support, both geographically and across political parties. This extensive support shows that one thing is clear across the board: FTCA coverage must be extended to UIOs, especially at a time when it is needed most.

At the Oklahoma City Indian Clinic, we spend approximately $200,000 annually on malpractice insurance, money which we would rather invest in our services. If UIOs were covered under the FTCA, we would put every one of these dollars back into services to include preventative care, such as: mammograms, pap smears, immunizations (adult and children), and dental sealants, among other services.

We are not alone in needing these funds even more during the COVID-19 pandemic. Many UIOs fear for our staff and have been forced to institute hiring freezes as we stretch every dollar as far as it will go. In fact, 83% of UIOs initially reported they had been forced to reduce their services, and 9 UIOs have reported hiring freezes.

Extending FTCA coverage to UIOs is a simple legislative fix, but the benefits would be significant. A single UIO may pay as much as $250,000 annually in medical malpractice insurance, funds which could instead be used to invest in better health outcomes for their communities or to prepare for public health emergencies like the one we are currently facing. By freeing up federal funding for UIOs, they would be better able to serve their communities with high-quality health care. For instance, some UIOs have reported to NCUIH that they are hesitant to hire additional providers or provide additional services as they cannot cover the costs of additional medical malpractice insurance, even as they are prepared to cover the new salaries and related costs. This directly and substantially limits the services UIOs can provide to their patients as the cost of adding providers or new services to malpractice insurance policies can be the sole prohibition to service expansion.

The federal government maintains a trust obligation to tribes and AI/ANs, which originates in treaties wherein the U.S. promised certain duties to Native populations in exchange for the lands which make up this great Nation; included among these duties is the provision of health care services. The Indian Health Care Improvement Act recognized that the federal trust responsibility to provide health care to AI/AN people does not end at the borders of a reservation and that it extends to AI/ANs who reside in urban areas. It was also under this Act that Congress formally recognized UIOs as the entities to further the fulfillment of the federal government’s responsibilities to Urban Indians. UIOs are an integral component of the IHS system, which facilitates the provision of essential health care services through its three components: Indian Health Service facilities, Tribal Health Programs, and UIOs, commonly referred to as the “I/T/U” system. Each component of the I/T/U system has a significant role to play in providing AI/ANs with high-quality, culturally-competent care. UIOs not only offer a wide range of critical services, which include clinical and behavioral health services, but they are also often the only places in urban settings where Urban Indians can receive traditional care services and function as centers for cultural activities in inter-tribal settings.

Although UIOs are an integral component of the IHS system, UIOs still have to fight to receive parity with the other two components of the I/T/U system. If UIOs are not explicitly included in Indian health care legislation, they are most often implicitly excluded, with the ultimate result that UIOs do not receive the resources they need to provide care to their communities. This is a failure of the trust responsibility.

As it stands, all employees and eligible contractors at IHS and tribal facilities are treated as federal employees for the purpose of medical malpractice liability. This is true for Community Health Center employees and volunteers as well. Unlike these similarly-situated health centers, UIOs must use their limited federal funding to purchase expensive medical malpractice insurance out-of-pocket.

Even absent the current Public Health Emergency, UIOs face disproportionate hardship as they attempt to stretch every dollar to care for a population with higher risks of chronic disease. AI/ANs face significant health disparities, including diabetes, cancer, and heart disease.[1]  Many of these disparities place AI/ANs at a higher risk for serious COVID-19 complications. With over 70% of AI/ANs living in urban areas, and with the highest rates of COVID-19 taking place in areas of high population density, many UIOs are the central care delivery sites for communities with compounded risks.  UIOs receive direct funding from only one line item – and are not eligible for other critical IHS funding, including Health Care Facilities, Sanitation, Purchased/Referred Care, and Equipment, to name a few. Facing a pandemic with decades of underfunding made it clear in the earliest stages of the pandemic that UIOs would need a substantial amount of emergency resources in order to meet the needs of Urban Indians. Congress acted swiftly to support UIOs and the entire IHS system through emergency supplemental appropriations. We are grateful for the support, and cannot emphasize enough how essential these resources have been to positive health outcomes for Urban Indians.

In order to both maximize the value of the money Congress has appropriated to UIOs, and to ensure other critical needs are met, it is imperative that UIOs have access to critical cost-saving measures like FTCA coverage. UIOs have reported that they would use their medical malpractice savings for additional Personal Protective Equipment, infrastructure improvements to ensure proper distancing between patients and staff, hiring additional providers, and expanding available services. All of these are imperative to help UIOs prevent and treat COVID-19 among their patients and communities, while preparing for future Public Health Emergencies.

We thank Congress for your support of UIOs during this Public Health Emergency and we urge you to keep FTCA coverage for UIOs front of mind as your work diligently on the next COVID-19 package. We are grateful for the Committee’s continued support of Urban Indians and dedication to improving the health outcomes of Indian Country.

[1] National Center for Health Statistics. Health, United States, 2015: With Special Feature on Racial and Ethnic Health Disparities. Hyattsville, MD. 2016.

Senators Udall and Smith Highlight Need for Parity for Urban Indian Health in Remarks on Senate Floor

Remarks from Senators Tom Udall and Tina Smith

July 1, 2020

Today, Senators Tom Udall and Tina Smith spoke on the Senate floor about the importance of providing parity for urban Indian health and providing resources for all of Indian Country

Excerpt from Senator Udall

Watch Clip

70 percent of Native Americans live in urban settings. Yet the Medicaid reimbursement rate for urban Indian health facilities is lower than the federal reimbursement rate. We need to balance the scales and help the 41 urban Indian health facilities across the nation expand their services.

Full Remarks from Senator Udall

We here in Congress must focus our work on helping these communities. We must take on the long standing systemic reasons that these communities entering this crisis are entering at a greater risk and we must enact real reform so that the next time when the next pandemic or economic downturn hits. It’s not these same communities that once again bear the brunt of the disaster.

Today, Mr. President, I want to focus our attention on American Indian and Alaska Native communities, communities where infection and mortality rates are much higher than the overall U.S. population. Communities that can’t escape the economic hardships this pandemic has caused. We already knew that pandemics like this take an awful toll on native communities. This was true 100 years ago during the 1918 flu pandemic when Native Americans died at four times the rate of rest of the country.

This was true a decade ago during the 20, 19, H1N1 outbreak. When Native Americans died at the same high rates, it’s unforgivable that the administration was not better prepared. The underlying reasons that native peoples, whether living on tribal lands, urban settings or elsewhere, are at risk are multifaceted, but they are all rooted in historic, systemic injustice.

First and foremost, many Native Americans do not have ready access to quality health care despite the federal government’s trust and treaty obligations to provide it. Trust and treaty obligations take on taken on by this government in exchange for millions of acres of land and countless lives lost on the large rural reservations and remote Alaskan Native villages, the nearest health care facility might be hours away. And when you get there, if you can get there, they often — there aren’t often doctors enough or nurses or hospital beds enough, these logistical barriers are compounded by the chronic history.

Native communities also face the highest rates of underlying conditions like diabetes, heart and lung disease, asthma and obesity. That result in worse culvert 19 outcomes. Battles over water rights and underinvestment and tribal infrastructure have compounded the problems.

We all know that washing our hands is a critical measure to prevent the spread of culvert 19, yet tribal communities are three point — seven times more likely to lack complete indoor plumbing than other U.S. households. On the Navajo Nation, which is confronting one of the worst corona virus outbreaks in the nation. 18 percent of households don’t have complete indoor plumbing. And so again, it’s no surprise that researchers have already found that covered 19 cases are more likely to occur in tr ibal communities with a higher proportion of homes lacking indoor plumbing.

We also know that social distancing is key to preventing spread of the virus. Yet almost one in six native households are overcrowded, making social distancing not just difficult but physically impossible for many families. All these institutional barriers create and combine to create a perfect storm.

These barriers aren’t the result of chance. They’re the result of policy. It is these institutional barriers that we must acknowledge and finally address so that this pandemic is not one more example of the United States failure to meet our obligations.

This time must be different. We must meet our responsibilities and help build a more just and equitable society. Throughout this crisis.

Native communities have fought back, they are resilient. They have fought back hard. For example in my home state of New Mexico and in Arizona and Utah. The Navajo Nation has imposed strict curfews to spread.

To prevent the spread, they’ve ramped up testing despite the complete lack of testing supplies in the beginning and they have now as of today, tested about 25 percent of their population compared to 10 percent nationally, but tribal responses to the pandemic have been repeatedly. Underfunding of the Indian Health Service, which many of us have fought for years to correct, and while we’ve made progress, the IHS budget still only covers an estimated 16 percent of need and as a result of centuries of discriminatory land, agricultural and environmental policies, Native communities also Face the highest rates of underlying conditions like diabetes, heart and lung disease, asthma and obesity that result in worse culvert 19 outcomes. Battles over water rights and underinvestment and tribal infrastructure have compounded the problems.

We all know that washing our hands is a critical measure to prevent the spread of culvert 19, yet tribal communities are three point — seven times more likely to lack complete indoor plumbing than other U.S. households. On the Navajo Nation, which is confronting one of the worst corona virus outbreaks in the nation. 18 percent of households don’t have complete indoor plumbing. And so again, it’s no surprise that researchers have already found that covered 19 cases are more likely to occur in tr ibal communities with a higher proportion of homes lacking indoor plumbing.

We also know that social distancing is key to preventing spread of the virus. Yet almost one in six native households are overcrowded, making social distancing not just difficult but physically impossible for many families. All these institutional barriers create and combine to create a perfect storm.

These barriers aren’t the result of chance. They’re the result of policy. It is these institutional barriers that we must acknowledge and finally address so that this pandemic is not one more example of the United States failure to meet our obligations.

This time must be different. We must meet our responsibilities and help build a more just and equitable society. Throughout this crisis.

Native communities have fought back, they are resilient. They have fought back hard. For example in my home state of New Mexico and in Arizona and Utah. The Navajo Nation has imposed strict curfews to spread.

To prevent the spread, they’ve ramped up testing despite the complete lack of testing supplies in the beginning and they have now as of today, tested about 25 percent of their population compared to 10 percent nationally, but tribal responses to the pandemic have been repeatedly. I’ve fought hard for funding targeted for tribes when the administration offered nothing for tribes. We secured over 10 billion in the care sector. When the administration fumbled distribution of tribal funding?

Missing the statutory deadline for distribution by almost two months Congress and the tribes pushed back because tribes are in crisis days matter. It took a lawsuit in a federal court order for tribes to get their share of the 8 billion set aside for them under the care Sec. And today, the Senate Indian Affairs Committee will hold an oversight hearing on implementation of federal programs to support tribal culvert, 19 prevention containment and response efforts. Tribal witnesses will testify tha t policies and practices at FEMA. The CDC herself and a number of other federal agencies have made tribal access to federal culvert 19 resources much harder, whether it’s denying tribes access to corona virus surveillance data, creating a confusing business team bureaucracy for requesting emergency medical supplies or delaying access to grant funds.

This administration continually makes the decisions that disadvantage Native communities. Decisions that threaten native lives and prolong this country’s legacy of systematic, systemic injustice, the administration must do better and Congress must do much more. Each day, we fail to act to advance policies.

To address the disparities faced by Indian Country is the day we fail to uphold our oath of office. The Republican Senate majority has delayed far too long infections are on the rise. The U.S. has surpassed every other nation in the world in the spread and death and destruction of this virus.

20 million Americans are out of work, the highest unemployment level since the Great Depression. State, local and tribal. Governments and health care systems across the nation are shuttering essential services and furloughing essential workers. None of this should come as news to the Republican majority inaction in the face of this disaster is unconscionable.

This body must get down to business that we’re here and we’re elected to do. It’s long past time we pass another. Hamstrung by this administration and Congressional inaction as vice chair of the Senate Indian Affairs Committee. I’ve fought hard for funding targeted for tribes when the administration offered nothing for tribes.

We secured over 10 billion in the care sector when the administration fumbled distribution of tribal funding. Missing the statutory deadline for distribution by almost two months Congress and the tribes pushed back because tribes are in crisis days matter. It took a lawsuit in a federal court order for tribes to get their share of the 8 billion set aside for them under the care Sec. And today, the Senate Indian Affairs Committee will hold an oversight hearing on implementation of federal program s to support tribal culvert, 19 prevention containment and response efforts.

Tribal witnesses will testify that policies and practices at FEMA. The CDC and a number of other federal agencies have made tribal access to federal culvert 19 resources much harder, whether it’s denying tribes access to corona virus surveillance data, creating a confusing business team bureaucracy for requesting emergency medical supplies or delaying access to grant funds. This administration continually makes the decisions that disadvantage Native communities. Decisions that threaten n ative lives and prolong this country’s legacy of systematic, systemic injustice, the administration must do better and Congress must do much more.

Each day, we fail to act to advance policies. To address the disparities faced by Indian Country is the day we fail to uphold our oath of office. The Republican Senate majority has delayed far too long infections are on the rise.

The U.S. has surpassed every other nation in the world in the spread and death and destruction of this virus. 20 million Americans are out of work, the highest unemployment level since the Great Depression. State, local and tribal. Governments and health care systems across the nation are shuttering essential services and furloughing essential workers.

None of this should come as news to the Republican majority inaction in the face of this disaster is unconscionable. This body must get down to business that we’re here and we’re elected to do. It’s long past time we pass another.

We must infuse IHS with additional funding for tribal healthcare and ensure it has parity in accessing federal programs. We must provide tribal governments with the resources they need to keep their communities up and running safely. By providing 20 billion in additional targeted funding within the Treasury’s corona virus Relief Fund, the Senate should pass bills I’ve introduced that have already been adopted by the House of Representatives and its heroes package which was passed over six weeks ago.

We must make our strategic stockpile available to tribes. Tribes should be able to access PPE ventilators and other necessary medical equipment just as states can. We must make sure that tribes have equal access to the Centers for Disease Control and their resources to prepare for public health emergencies like this pandemic.

70 percent of Native Americans live in urban settings. Yet the Medicaid reimbursement rate for urban Indian health facilities is lower than the federal reimbursement rate. At other IHS facilities, we need to balance the scales and help the forty three urban Indian health facilities across the nation expand their services and as so much of our lives move to the Internet.

We must make sure that native schools, health care facilities and government services are not left on the wrong side of the digital divide. All tribes must have access to high speed broadband. Mr. President, this public health and economic crisis has hit us all hard, but we shouldn’t deny that some communities have been hit harder. We need to send immediate relief to those communities that have been so severely hurt, including Native communities and we need to set our sights on genuinely taking on this systemic and institutional barriers these communities have faced for far too long.

We can — we should — we must do better. Mr. President, I yield the floor and notice absence of a quorum.

Full Remarks from Senator Smith

I rise today with my colleague, the Senator from New Mexico, Tom Udall to call for urgent action by Congress to respond to the needs of tribal nations and urban Indigenous communities. During the COVID-19 pandemic, we have not done enough.

We have not lived up to our shared trust and treaty obligations and in this moment, we are called upon to respond to the historic injustice and systems of oppression and institutional violence that are harming communities of color and Indigenous people. Over the last month, people in Minnesota and across our country have focused our attention on the deep, systemic inequities that black and brown and indigenous people face, and this injustice is not new. It is as old as the colonization of our country by colleagues.

This is a unique moment. This public health crisis presents us with an opportunity to show that we are serious about repairing the damage done by our broken promises to sovereign, tribal nations and urban Indigenous communities. Some have said that COVID-19 is the great equalizer, but we know that covered hits hardest.

Those without a safe place to call home, those struggling with low wages and poverty and lack of health care and black brown and indigenous people living with the trauma of having their identity and their very humanity called into question even before this virus spread. The impact of covered on Native communities has been devastating. Native people have been hospitalized for COVID-19 it at five times the rate of white people.

In mid-May, the Navajo Nation reached a higher per capita infection rate than any other hotspot in the country. So why is it that cove? It is hitting tribal nations so hard well, despite repeated calls from tribal leaders and urban Indigenous leaders.

Over the past few decades, the federal government has stood by and allowed the budget for Indian health services to dwindle. We’ve neglected Indian housing programs and we’ve ignored growing health inequities. The federal institutions dedicated to serving Indian Country are not broken.

Unfortunately, these institutions have never been adequate to live up to our trust and treatment responsibilities and they represent a broken promise. The federal government’s failure has life and death consequences for native people, for their health and for their. Think of this striking statistic, unemployment in the Indigenous community in the Twin Cities is at a terrible Forty seven percent higher than any other group in our state. Within tribal nations, the economic impact of the corona virus is equally devastating. Early this spring, tribal governments in Minnesota and all around the country made the difficult decision to voluntarily close tribal enterprises in order to protect public health.

As a result, they lost significant government revenue and also experienced massive unemployment not only for their members, but for members. From the surrounding communities and this lost revenue meant that tribal governments were forced to scale back essential services like nutrition assistance, nutrition assistance for elders public safety and education programming. So in the cares act, Congress agreed to eight billion dollars in emergency relief to help tribes respond to coated even after Congressional action though tribal governments have had to continue fighting to get their fair share of those dollars, the Trump administration argued that some of this relief Should go to for profit, Alaska native corporations.

And then it took the Treasury Department 40 days to distribute just the first 60 percent of the funds to tribes and not until two weeks ago, almost three months after passage of the CARES Act did tribal governments receive the rest. To be clear, these funds cannot be used to replace lost revenue. So Mr. President, we have so much work to do to fulfill our commitment to Indigenous people and the simple proposition that Native families should have equal access to health care and housing and opportunity.

As white Americans when I speak to tribal leaders in my state about this cycle of historic underinvestment and inequity and broken promises, I mean, I share their frustration. I don’t know how anybody couldn’t.

Indigenous leaders in Minnesota know that a lack of housing on tribal lands leads to overcrowding, which increases the risk of contracting covered and tribes have asked over and over again for sufficient funding for an enhanced housing programs and they shouldn’t have to ask any more indigenous leaders Know a lack of access to health care and substance abuse disorder treatment leads to chronic health conditions like diabetes and heart disease and asthma, which worsen covered symptoms. Tribes have asked over and over again for sufficient funding to address these health inequities and they shouldn’t have to ask anymore. Indigenous leaders know that a lack of access to credit and capital prevents urban Indigenous households and folks living on tribal land from building wealth like their white neighbors who can more easily.

Therefore, weather the storm of unemployment Native communities have asked over and over again to enforce fair lending laws and to ensure act. Thank you Mr. President, I yield the floor.