IHS Pauses Johnson & Johnson COVID-19 Vaccine

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On Tuesday, April 14, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) announced that they are recommending a pause on the Johnson & Johnson/Janssen (J&J) COVID-19 vaccine while they review data involving six reported U.S. cases of a rare and severe type of blood clot in individuals receiving the vaccine product. Per this recommendation, the Indian Health Service (IHS) has paused all J&J vaccine administration.

IHS has three vaccine safety monitoring systems in place. To date, there have been no reported cases of the rare and severe type of blood clot seen in some individuals who have received this vaccine. The J&J vaccine makes up approximately 1.5% percent of IHS’s recorded shots in arms to, and IHS does not expect this pause to affect the agency’s goal of fully vaccinating 44% of its active adult patients by the end of April.

IHS employees have been advised to offer Pfizer and Moderna vaccines when available to patients that are scheduled to receive the J&J vaccine and will work to ensure that all vaccination sites have adequate stock of these vaccine products.

For more information, you may also visit the FDA YouTube site to hear the FDA and CDC press conference held this morning to answer questions about this pause in Johnson & Johnson/Janssen vaccine administration.

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Sixth Amendment to HHS Declaration on COVID-19 Vaccine Efforts Adds Flexibility

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On February 16, the HHS issued its latest amendment to its Declaration that provides immunity from liability for COVID-19 vaccine administration and other countermeasures during this Public Health Emergency (PHE). Since the pandemic emergency started back in late January 2020, HHS has issued the declaration and six amendments to it.

The Public Emergency and Emergency Preparedness Act (PREP Act) authorizes HHS Secretary to issue such a declaration to insulate from liability, except for willful misconduct. The flexibility inherent in the PREP Act and in the HHS agency actions, has afforded expanded protections for UIOs, as well as increase the number of interventions and categories of people able to administer vaccines.

On April 10, 2020, the former Secretary Alex M. Azar II, amended the Declaration under the PREP Act to extend liability immunity to countermeasures authorized under the CARES Act (85 FR 21012, Apr. 15, 2020). On June 4, the former Secretary further amended the Declaration to clarify that covered countermeasures under the Declaration include qualified countermeasures that limit the harm “COVID–19 might otherwise cause” securing further liability from tort claims. (85 FR 35100, June 8, 2020). On August 19, the next amendment approved additional categories of Qualified Persons authorized to prescribe and dispense the covered countermeasures.

The last amendment posted February 10, 2021, authorizes any health care provider authorized or licensed in any state to administer vaccines in any other state or territory (physician, registered nurse, practical nurse whose license expired in last 5 years and was in good standing to administer in any state or territory). The health care provider is required to complete CDC vaccine training.

In another turn of great advocacy by NCUIH staff in Congressional Relations, all the difficulties experienced by IOUs wanting to test for COVID-19, and interaction with the various federal agencies during the course of the COVID-19 emergency, served to lay the ground work and arguments for introducing the Congressional bill that for the first time extended protections in the Federal Torts Claim Act to urban Indian health providers, becoming Public Law 116-313 on January 5, 2021! See our FTCA bill, H.R. 6535, 116th Congress (2019-2020), deeming an urban Indian organization and its employees to be part of the Public Health Service for purposes of certain claims of personal injury.

Biden Administration Resumes White House Council on Native American Affairs

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The first White House Council on Native American Affairs (WHCNAA) meeting of the Biden-Harris administration will be held by Secretary of the Interior Deb Haaland and Domestic Policy Advisor Susan Rice on April 23, 2021. Secretary Haaland will serve as the Council’s Chair.

In a press release from the U.S. Department of Interior, Secretary Haaland stated, “Addressing the systemic inequities that impact Indigenous peoples is the responsibility of every federal agency that will require an all-of-government approach across the Administration.”

President Obama signed an executive order on June 26, 2013, establishing the WHCNAA to bring together federal leaders and Indian Country. The convening of the WCHNAA comes as the Biden-Harris administration has prioritized getting resources out to Tribal communities to address the impacts of climate change, racial equity, economic recovery, and COVID-19 response.

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NATIONAL NATIVE ORGANIZATIONS CALL FOR BOLD ACTION, INCLUSION OF URBAN INDIANS IN INFRASTRUCTURE PACKAGE

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On April 13, 2021, the National Council of Urban Indian Health (NCUIH) and several other American Indian and Alaska Native (AI/AN) organizations signed a joint letter urging Congress to address Indian Country’s infrastructure priorities in the upcoming legislative package. The letter includes several requests for infrastructure investments into Urban Indian Organizations (UIOs).

There are 41 UIOs operating in 77 health facilities across 22 states that provide high-quality, culturally competent care to urban Indian populations. Tribal leaders advocated to Congress for the creation of UIOs after the Relocation Era in recognition that the trust obligation for healthcare follows Indians off reservations. Unfortunately, there are significant parity issues experienced by UIOs as compared to other federally funded healthcare systems, which greatly impact their services and operations. For example, the IHCIA prohibits UIOs from making even minor renovations to their facilities using their annual appropriations. This provision was intended to help UIOs maintain or attain accreditation with grants, but instead has hamstrung UIOs from using their already limited funding for any infrastructure needs.

Further, unlike other parts of the Indian health system, UIOs do not receive any funding for facilities infrastructure, which has made repairs, renovations, and remediation extremely difficult. The pandemic has made it even harder for UIOs as they now must make updates for no-contact services, socially distanced waiting rooms, and increased security to adhere to COVID-19 safety guidelines. The time is long overdue for investment into UIO infrastructure for this vital prong of the Indian health system.

The letter includes the following priorities for UIO infrastructure:

Infrastructure for UIOs

  • Amend the IHCIA to remove restrictions on using UIO funds for making facility renovations.
  • At least $100 million for Urban Indian Health IT (25 U.S.C. § 1660h).
  • At least $749.3 million for Urban Indian Health.
  • At least $3 million for Urban Indian Health Community Health Representatives (25 U.S.C. § 1660f).
  • Extend Full (100 percent) Federal Medical Assistance Percentage (FMAP) to services provided at UIOs permanently.
  • Establish an Urban Confer Policy for HHS.

Health Care Facilities Construction

  • At least $21 billion for Healthcare Facilities Construction, including but not be limited to, support for new and current planned projects, the Small Ambulatory Health Center Program, UIOs, the Joint Venture Construction Program, and innovative approaches to addressing unmet construction needs for health facilities as described in 25 U.S.C. §1631(f).

Public Health Infrastructure

  • Allow I/T/U providers to be reimbursed for services provided outside of the four walls of their clinic, just as they would if they were provided in the clinic.
  • Establish a Native Behavioral Health Program for I/T/U and fund through FY26 at $200 million annually with annual increases for medical inflation, and funding available through contracts/compacts for Title I and Title V Tribes.

Tribal Health Workforce Development

  • Fully fund the Community Health Aide Program for implementation in all states and for UIOs.

READ THE LETTER

NCUIH Submits Written Testimony to House Interior Appropriations with FY22 Budget Requests for UIOs

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On April 14, the National Council of Urban Indian Health (NCUIH) CEO, Francys Crevier, submitted public witness written testimony to the House Appropriations Subcommittee on Interior, Environment, and Related Agencies regarding Fiscal Year (FY) 2022 funding for Urban Indian Organizations (UIOs).

UIOs provide culturally competent health care to some of the 70% of American Indians and Alaska Natives (AI/AN) living in cities and are primarily funded by a single line item in the annual Indian health budget, which constitutes less than 1% of the total Indian Health Service (IHS) annual budget. The devastating impact of the COVID-19 pandemic on Indian Country proved the dire need for increased funding and resources for UIOs, who have continuously provided services in the hardest hit urban areas during the entire pandemic.

In the testimony, NCUIH requested the following:

  • $200.5 million for Urban Indian Health for FY22
  • Include report language to allow use of facilities funding to UIOs
  • Advance appropriations for IHS
  • UIOs be insulated from unrelated budgetary disputes through a spend faster anomaly so that critical funding is not halted

These requests are essential to ensure that urban Indians are properly cared for and moves us closer to fulfilling the federal government’s trust responsibility to AI/ANs.

NEXT STEPS:

The testimony will be read and considered by the subcommittee as the appropriations process goes forward for Fiscal Year 2022.

Read the Full Testimony

PRESS RELEASE: Senate Hearing Highlights Importance of Urban Indian Health as COVID-19 Rages On

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FOR IMMEDIATE RELEASE

Policy Contact: Meredith Raimondi, mraimondi@NCUIH.org

Press Contact: Sara Williams, swilliams@NCUIH.org

NCUIH President Walter Murillo testified on the critical work of urban Indian health. 

Washington, D.C. (April 14, 2021) – Today, the President of the National Council of Urban Indian Health (NCUIH) testified before the Senate Committee on Indian Affairs for an oversight hearing on “Examining the COVID-19 Response in Native Communities: Native Health Systems One Year Later.” Walter Murillo (Choctaw), CEO of Native Health in Phoenix, joined representatives from the Indian Health Service (IHS), National Indian Health Board, Papa Ola Lokahi, and Alaska Native Medical Center for the virtual hearing.

“Because the Indian health care system and UIOs have never been properly funded, we started from an extreme deficit when the pandemic hit,” Murillo said. He continued, “UIOs only receive $672 per patient for the year – this is unacceptable. The past 12 months have reminded us how resilient our people are and highlighted how critical our Indian health care system is to the lives of American Indians and Alaska Natives. Tragically, we have planned many funerals and lost far too many members of our communities.” 

Native health systems “started the rollout of some of the most successful vaccine campaigns in the country, and they continue to work every day to keep native communities safe. It really is remarkable how native health systems have overcome long odds, considering how under-resourced they were to begin,” said Chair Brian Schatz (D-HI) in his opening statement.

Senators from both sides of the aisle emphasized the importance of the federal government’s trust responsibility to provide health care for all Native people and key fixes needed to improve urban Indian health. Senator Tina Smith (D-MN) said, “We need to make sure that Congress is providing sufficient resources directly for the urban Indigenous.”  Senator Lankford (R-OK) who championed legislation to extend the Federal Tort Claims Act (FTCA) to UIOs applauded the IHS for swift implementation of that provision which passed as a standalone bill last year.

Hot Topic: 100% FMAP for UIOs

Senator Maria Cantwell (D-WA) pushed for the enactment of a permanent 100% Federal Medical Assistance Percentage (FMAP) for services provided by Urban Indian Organizations (UIOs). “There’s no reason to distinguish between an IHS, Tribal, or UIO facility. They all should get full 100% FMAP reimbursement. Urban Indian health is suffering, and there is no reason not to give them parity,” said Senator Cantwell. Mr. Murillo, who has been fighting for full FMAP for 20 years, explained how parity would help equalize serious funding shortages experienced by urban Indian organizations.

Hot Topic: Facilities

Infrastructure was another key topic of the hearing discussion with both Senator Smith and Senator Lankford inquiring about restrictions faced by UIOs with regards to facilities upgrades. In his written testimony, Mr. Murillo requested the Committee support $21 billion for Indian health infrastructure inclusive of UIOs and the support of removing restrictions on UIOs. Senators learned about how UIOs cannot access any infrastructure funds under the IHS facilities line item and the need for the American Jobs Plan to include avenues for improvements for urban Indian health facilities.

Next Steps

The Senate Committee on Indian Affairs will take the recommendations from today into consideration as they prepare their legislative priorities for this Congress related to responding to COVID-19.

More Information 

Read Written Testimony Watch Testimony

NCUIH Testifying Before Senate Committee on Indian Affairs on COVID-19 (4/14)

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NCUIH President and CEO of Native Health in Phoenix, AZ, Walter Murillo (Choctaw) has been invited to testify before the Senate Committee on Indian Affairs on the COVID-19 impacts in Indian Country. The Senate Committee on Indian Affairs, led by Chair Brian Schatz (D-HI) and Vice-Chair Lisa Murkowski (R-AK), will also hear from the National Indian Health Board and Papa Ola Lokahi.

Watch the Hearing

Senate Hearing Highlights Importance of Urban Indian Health as COVID-19 Rages On

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NCUIH President Walter Murillo testified on the critical work of urban Indian health. 

Washington, D.C. (April 14, 2021) – Today, the President of the National Council of Urban Indian Health (NCUIH) testified before the Senate Committee on Indian Affairs for an oversight hearing on “Examining the COVID-19 Response in Native Communities: Native Health Systems One Year Later.” Walter Murillo (Choctaw), CEO of Native Health in Phoenix, joined representatives from the Indian Health Service (IHS), National Indian Health Board, Papa Ola Lokahi, and Alaska Native Medical Center for the virtual hearing.

“Because the Indian health care system and UIOs have never been properly funded, we started from an extreme deficit when the pandemic hit,” Murillo said. He continued, “UIOs only receive $672 per patient for the year – this is unacceptable. The past 12 months have reminded us how resilient our people are and highlighted how critical our Indian health care system is to the lives of American Indians and Alaska Natives. Tragically, we have planned many funerals and lost far too many members of our communities.” 

Native health systems “started the rollout of some of the most successful vaccine campaigns in the country, and they continue to work every day to keep native communities safe. It really is remarkable how native health systems have overcome long odds, considering how under-resourced they were to begin,” said Chair Brian Schatz (D-HI) in his opening statement.

Senators from both sides of the aisle emphasized the importance of the federal government’s trust responsibility to provide health care for all Native people and key fixes needed to improve urban Indian health. Senator Tina Smith (D-MN) said, “We need to make sure that Congress is providing sufficient resources directly for the urban Indigenous.”  Senator Lankford (R-OK) who championed legislation to extend the Federal Tort Claims Act (FTCA) to UIOs applauded the IHS for swift implementation of that provision which passed as a standalone bill last year.

Hot Topic: 100% FMAP for UIOs

Senator Maria Cantwell (D-WA) pushed for the enactment of a permanent 100% Federal Medical Assistance Percentage (FMAP) for services provided by Urban Indian Organizations (UIOs). “There’s no reason to distinguish between an IHS, Tribal, or UIO facility. They all should get full 100% FMAP reimbursement. Urban Indian health is suffering, and there is no reason not to give them parity,” said Senator Cantwell. Mr. Murillo, who has been fighting for full FMAP for 20 years, explained how parity would help equalize serious funding shortages experienced by urban Indian organizations.

Hot Topic: Facilities

Infrastructure was another key topic of the hearing discussion with both Senator Smith and Senator Lankford inquiring about restrictions faced by UIOs with regards to facilities upgrades. In his written testimony, Mr. Murillo requested the Committee support $21 billion for Indian health infrastructure inclusive of UIOs and the support of removing restrictions on UIOs. Senators learned about how UIOs cannot access any infrastructure funds under the IHS facilities line item and the need for the American Jobs Plan to include avenues for improvements for urban Indian health facilities.

Next Steps

The Senate Committee on Indian Affairs will take the recommendations from today into consideration as they prepare their legislative priorities for this Congress related to responding to COVID-19.

More Information 

Read Written Testimony 

Watch Testimony

PRESS RELEASE: NCUIH and Native American Lifelines Announce DMV Vaccines for Natives

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FOR IMMEDIATE RELEASE

Policy Contact: Meredith Raimondi, mraimondi@NCUIH.org

Press Contact: Sara Williams, swilliams@NCUIH.org

National Council of Urban Indian Health and Native American Lifelines Announce DMV Vaccines for Natives

After months of barriers, urban Indians in the DMV will finally be able to get vaccinated.

 Washington, D.C. (April 13, 2021) – The National Council of Urban Indian Health (NCUIH) and Native American Lifelines (NAL) are pleased to announce the availability of COVID-19 vaccinations for urban Indians in the D.C., Maryland, and Virginia metropolitan area. In partnership with the Indian Health Service and University of Maryland – Baltimore, registration is now available for appointments in Baltimore beginning on Wednesday, April 14.

“For months, we have fought tooth and nail to get vaccines for urban Indians in Maryland, D.C., and Virginia. The pandemic has wrought many challenges on urban Indians but getting a vaccine shouldn’t have been one of them. Any member of the hardest hit population shouldn’t have had to wait months for this lifesaving opportunity. This is also not what the trust responsibility for healthcare is supposed to be. As we are also serving record patients to address increased needs in behavioral health and domestic violence, we are glad to finally be able to vaccinate our community. We are grateful for partners like NCUIH, IHS, and the University of Maryland, Baltimore, who helped make this happen,” said Kerry Hawk-Lessard, Executive Director.

“As the only national organization focused on the health of urban Indians, we are pleased to finally announce that vaccines for Natives in the DMV are now available. It is disappointing that the population dying at the highest rates of COVID-19 worldwide is only just gaining access to vaccines in the DMV five days before the entire country will be eligible. This experience has highlighted a long-standing inequity faced by urban Indians and forced countless Natives to risk additional exposure when flying to reservations to receive a vaccine. As we’ve buried far too many relatives in the past year, we hope that this Administration and Congress will realize that it is now time to fully fund Urban Indian Organizations (UIOs) and Indian Health Service as we fight our way to the end of this horrific pandemic,” said NCUIH CEO Francys Crevier (Algonquin).

Vaccine Distribution to Urban Indians

Since last fall, NCUIH and NAL have pushed for inclusion of the 65,000 Natives in the Washington, DC, Maryland, and Virginia Metropolitan Area. As Natives are dying from COVID-19 at the highest rates worldwide, NCUIH has advocated to the federal government to prioritize this population for vaccines.

UIOs across the country have highly successful vaccine rollouts that have been touted in the national and local media. After a recent study in January from the Urban Indian Health Institute showed that nearly 75% of Natives would get vaccinated, UIOs are seeing record patients and regularly hosting mass vaccination clinics with hundreds of participants. Because of the success of vaccine administration by UIOs, local and other non-profit organizations have partnered with UIOs. While there is much talk of vaccine equity on a national scale, no state nor the District of Columbia, has prioritized Natives or any other race for vaccines, so UIOs have filled a vital role. For example, one UIO in Montana vaccinated 180 teachers who work with Native students, while many others are sharing their vaccines with the NAACP and LatinX organizations to reach other highly vulnerable groups.

NCUIH created an online petition to urge HHS to provide vaccines to DMV Natives and sent a letter to Administration officials to request vaccines. The Indian Health Service has also assisted the past several months, trying to coordinate vaccines for urban Indians in the area. Several Urban Indian Organizations (UIOs) in other states even offered to fly their staff to the DMV to administer vaccines. Finally, urban Indians in the area will have access to vaccines through Native American Lifelines due to the hard work of NAL’s staff and the advocacy of NCUIH.

Vaccine Clinic Information

In partnership with the University of Maryland, Baltimore the clinic will be open to anyone 16 years of age and older who is eligible. Appointments will be available starting Wednesday, April 14. They will be scheduled on Wednesdays, Fridays, Saturdays, and Sundays in the coming weeks. Because this will be an IHS-sponsored clinic, the following groups are deemed eligible as per Native American Lifelines vaccine plan: tribal citizens and descendants, non-Native family members, partners, or caregivers of tribal citizens and descendants, non-Native individuals working in Native-serving organizations (e.g., NCUIH, NCAI, NACA, NARF, NIGA, NIHB, BIA, BIE, IHS, HHS, Interior, etc.)

If you are unable to schedule your appointment online, in need of transportation assistance, please call Jessica or Bri at Native (410) 837 – 2258 (x102 for Jessica and x106 for Bri).

UMB Vaccine Clinic:
Address: 601 W. Lombard St., Baltimore, Md. 21201
Parking: Pratt and Penn Garages

  • Pratt Garage: 646 W. Pratt St.
  • Penn Garage: 120 S. Penn St.
  • Handicap or Mobility Assistance Parking:
    • Pratt Garage, 3rd floor

Hours of Operations: Wednesday-Saturday 10 a.m. – 6 p.m. EST

If you have already received one dose of Pfizer and need a second dose, please call the number above to schedule a second dose if you do not see the time available online.

About NCUIH and NAL

Native American Lifelines (NAL) is one of 41 Urban Indian Organizations (UIOs) funded by the Indian Health Service. Native Americans Lifelines operates two outreach and referral clinics in two states but is recognized as only one facility by the Indian Health Service. NAL receives less than $1 million to serve all urban Indians in Baltimore (including Washington, DC) and Boston. The mission of Native American Lifelines is to promote health and social resiliency within Urban American Indian communities. Native American Lifelines applies principles of trauma informed care to provide culturally centered behavioral health, dental, outreach and referral services.

The National Council of Urban Indian Health 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 living in urban areas. NCUIH strives to improve the health of all AI/ANs, including the over 70% of the AI/AN population that lives in urban areas, supported by quality, accessible health care centers.
NCUIH was recently named a founding member of the President’s COVID-19 Community Corps. 

To Schedule Your Appointment and Learn More Visit NCUIH.org/Vaccine

  • Schedule an appointment
  • Volunteer at a clinic
  • Learn more about NCUIH’s advocacy efforts

NCUIH Testifying Before Senate Committee on Indian Affairs on COVID-19

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NCUIH President and CEO of Native Health in Phoenix, AZ, Walter Murillo (Choctaw) has been invited to testify before the Senate Committee on Indian Affairs on the COVID-19 impacts in Indian Country. The Senate Committee on Indian Affairs, led by Chair Brian Schatz (D-HI) and Vice-Chair Lisa Murkowski (R-AK), will also hear from the National Indian Health Board and Papa Ola Lokahi.

Watch the Hearing