PRESS RELEASE – NCUIH Testifies at House and Senate Hearings Highlighting Need for Urban Indian Health Infrastructure Fix

Washington, D.C. (July 22, 2021) – This week, the National Council of Urban Indian Health (NCUIH) testified before the House Natural Resources Subcommittee for Indigenous Peoples of the United States (SCIP) and the Senate Committee on Indian Affairs (SCIA) in support of the Urban Indian Health Facilities Provider Act (H.R. 3496 / S. 1797). On Tuesday, Sonya Tetnowski (Makah Tribe), NCUIH President-Elect and Chief Executive Officer of the Indian Health Center of Santa Clara Valley, testified before SCIP. On Wednesday, Robyn Sunday-Allen (Cherokee), NCUIH Vice President and CEO of the Oklahoma City Indian Clinic, testified before SCIA. Tetnowski and Sunday-Allen spoke in support of the NCUIH-endorsed Urban Indian Health Providers Facilities Improvement Act, which will pave the way for increased investment in the renovation and construction of Urban Indian Organization (UIO) facilities. It will amend Section 509 of The Indian Health Care Improvement Act (IHCIA) (25 U.S.C. § 1659) to permit UIOs to access existing avenues for Indian Health Services (IHS) facilities renovation funding. This bipartisan amendment of prior legislation will not otherwise affect federal facilities funding for IHS or Tribally operated programs through existing Indian Health Service appropriations for improvements and renovations.

Read Full NCUIH SCIP Testimony              Watch Full SCIP Hearing

Read NCUIH’s Full SCIA Testimony               Watch Full SCIA Hearing


Leaders from the House Natural Resources Committee Expressed Support for the Bill

Subcommittee Chair Leger Fernandez supported the bill and Chair Grijalva said “Mr. Gallego’s bill is particularly important as a follow-up to the COVID pandemic and to the follow-up on the disparity with regard to the healthcare that Indigenous people receive. It’s a really good piece of legislation, very timely given all of the other discussions that are going on right now in terms of reconciliation, etc.” Ranking Member Young also expressed support for H.R. 3496 and suggested it be moved forward. ​

“Making sure UIOs can use their limited resources on the projects they know will most benefit patients is how we ensure that these vulnerable populations receive the best care possible. That’s why my bipartisan bill simply removes this obsolete provision of law and allows UIOs to spend their money where it will be most effective for patients,” said Rep. Ruben Gallego (D-AZ-07).

Several Members of Congress from both sides of the aisle demonstrated a strong interest in expanding resources in urban Indian health and followed up with Ms. Tetnowski about the implications of the legislation. For example, Chair Leger Fernandez asked about the impacts of any changes on accreditation processes for the 41 UIOs, and Ms. Tetnowski explained the legislation will have no effect on accreditation statuses for UIOs.
In a hearing last month, IHS also reiterated the law is archaic and there is no reason to retain this provision that ultimately impedes health care for urban AI/ANs.

Senate Hearing Highlights Urgency for Parity for Urban Indian Health

Senator James Lankford (R-OK) introduced Robyn Sunday-Allen and the bill of which he is the primary sponsor, “I strongly believe that more must be done to achieve parity for the UIOs within the Indian Health System umbrella.” In addition to support from Chair Schatz and Vice Chair Murkowski, IHS Deputy Director for Management Operations, Randy Grinnell testified that providing UIOs with broader authority “to improve their health care facilities will assist in providing the high quality, safe, and culturally relevant health care for the urban Indian population.”

Several other parity issues for urban Indian health were raised by the Senators, including Native Behavioral Health and the need for 100% FMAP for UIOs. Senator Cantwell asked IHS, “How long will it take for us to get full FMAP for Urban Indian Health?” IHS said they would have to follow up with a response and was unable to provide any timeline for when resources would reach urban Indian organizations. To date, UIOs have not received any benefits from the 100% FMAP for UIOs included in the American Rescue Plan Act passed in March of this year.

The Senate hearing also covered the Native American Child Protection Act. The bill includes the following updates for UIOs that were advocated for by NCUIH and noted by Heidi Todacheene:

  • Includes the establishment of a 12-member Advisory Board appointed by the Secretary of the Interior that will consist of representatives from Indian tribes, Tribal organizations, and urban Indian organizations with expertise in child abuse and child neglect.
  • Includes development of training and technical assistance materials on the prevention, identification, investigation, and treatment of incidents of family violence, child abuse, and child neglect for distribution to Indian tribes, Tribal organizations, and urban Indian organizations.

We at NCUIH would like to thank SCIP and SCIA for scheduling hearings for testimony from stakeholders in Indian health regarding infrastructure expansion in Indian Country. These hearings are an important first step for bringing UIOs and the urban AI/AN patients whom they serve into parity with beneficiaries served at IHS or Tribal health facilities.

SCIP and SCIA will take the requests from Tetnowski’s and Sunday-Allen’s testimonies this week into consideration as its members prepare their legislative priorities in deciding which bills may be included in the upcoming bipartisan infrastructure framework proposal. NCUIH will request markups by both Committees.


UIOs lack access to facilities funding under the general IHS budgetary scheme, meaning there is no specifically allocated funding for UIO facilities, maintenance, sanitation, or medical equipment, among other imperative facility needs. While the whole IHS system has made the transition to telehealth, negative pressurizing rooms, and other facility renovations to safely serve patients during the pandemic, restrictions in the relevant statutory text did not allow UIOs to make those transitions. Section 509 currently permits the IHS to provide UIOs with funding for minor renovations and only in order to assist UIOs in meeting or maintaining compliance with the accreditation standards set forth by The Joint Commission (TJC).

These restrictions on facilities funding under Section 509 have ultimately prevented UIO facilities from obtaining the funds necessary to improve the safety and quality of care provided to American Indian/Alaska Native (AI/AN) persons in urban settings. Without such facilities funding, UIOs are forced to draw from limited funding pools, from which they must also derive their limited funding for AI/AN patient services. This lack of facility funding for UIOs is a breach of the federal trust obligation to AI/AN health care beneficiaries, necessitating congressional action to include UIOs in future legislative measures for IHS facility funding.


House Appropriations Committee Approves Labor-HHS Bill with Funding Increases for Indian Country

On July 15, 2021, the House Appropriations Committee approved its fiscal year (FY) 2022 Labor, Health and Human Services, Education, and Related Agencies funding bill by a 33-25 vote. The bill authorizes $119.8 billion for the Department of Health and Human Services (HHS)— an increase of $22.9 billion above the FY 2021 enacted level and $129 million below the president’s FY 2022 budget request. Other key provisions include a $15 million set-aside for IHS facilities/Tribally-Operated Health Programs/Urban Indian Health Programs under the National Health Service Corps (NHSC) Loan Repayment Program, increased funding for the Centers for Disease Control and Prevention (CDC)— including an increase for the Good Health and Wellness in Indian Country (GHWIC) program, increased funding for the Substance Abuse and Mental Health Services Administration (SAMHSA), and increased American Indian/Alaska Native (AI/AN) set-aside funding for Zero Suicide grants. A more detailed analysis follows below.

Bill Highlights


  • Bill Report: “The Committee recommendation for the Centers for Disease Control and Prevention (CDC) program level includes $9,612,761,000 in discretionary budget authority, $55,358,000 in mandatory funds under the terms of the Energy Employees Occupational Illness Compensation Program Act, and $903,300,000 in transfers from the Prevention and Public Health (PPH) Fund.” The bill funds the CDC at $10.6 billion, an increase of $2.7 billion above the FY2021 enacted level.


  • Bill Report: “The Committee’s recommended level includes an increase of $5,000,000 for Good Health and Wellness in Indian Country.”

Read More

American Indians have the highest COVID vaccination rate in the US

American Indians have the highest COVID vaccination rate in the US | PBS


According to CDC data, Indigenous people are getting vaccinated quicker than any other group. Here are the successes—and challenges—of getting vaccines to urban Native American communities.

Before getting vaccinated against COVID-19 was an option, Francys Crevier was afraid to leave her Maryland home.

She ordered all of her groceries and limited her time outside, knowing that each venture would put both herself and her immunocompromised mother, with whom Crevier shares her home, at risk. Knowing she could provide for Mom was “a blessing, for sure,” Crevier says. After all, American Indians and Alaska Natives were hospitalized and died from COVID-19 at a higher rate than any other racial group in America throughout the pandemic, says Crevier, who’s Algonquin.

“As a Native woman, I didn’t know if I was going to make it through this,” she says.

Indeed, the U.S. Indigenous population had more than 3.5 times the infection rate, more than four times the hospitalization rate, and a higher mortality rate than white Americans, reports the Indian Health Service (IHS), a federal health program for American Indians and Alaska Natives. Official data reveal that the Navajo Nation, the largest tribe in the U.S., has been one of the hardest-hit populations, reporting one of the country’s highest per-capita COVID-19 infection rates in May 2020, the Navajo Times reports

Read More

NCUIH Endorses UIO-inclusive Bill for Virtual Peer Behavioral Health Support Services

The Virtual Peer Support Act of 2021 (H.R. 2929/S. 157) seeks to expand virtual peer support services for “Tribal communities” alongside community-based providers through federal grant allocations. UIOs are included within the definition of “Tribal communities,” making this an inclusive effort to legislate for Indian health with UIO needs in mind.

Read More