Customer Service Executive Order to Streamline Tribal Grant Application Process

On December 13, 2021, President Biden signed a new Executive Order (EO 14058) directing Government leaders to consider the public experience when seeking government services. This order, Transforming Federal Customer Experience and Service Deliver to Rebuild Trust in Government, includes 36 customer experience improvement commitments across 17 agencies which aim to improve service delivery and the lives of individuals.

Through this EO, agencies, especially those identified as High-Impact Service Providers, commit to centering their customers in all that they do; modernizing programs, reducing administrative burden and piloting new online tools and technologies. These customer service updates will impact the majority of Americans, especially those who are taxpayers, retirees, veterans, and many more. Included within the fact sheet is an update as to what this EO means for Tribal communities:

“Tribal communities will be able to expect more streamlined and integrated grants application processes, rather than having to provide information over and over again to the Federal Government and navigate across multiple agency websites.”

For the full text of the EO, visit the NCUIH regulation tracker at Updated every other week, the regulation tracker collects all federal agency and Administration publications to the Federal Registrar. This tracker is an easily searchable resources for you to use on your own, or you can download a PDF copy to your own server.

NCUIH Submits Comments to DOI on Boarding School Initiative and the Lasting Impact on Urban Indian Health

On December 23, 2021, the National Council of Urban Indian Health (NCUIH) submitted comments to the Department of the Interior (DOI) regarding the agency’s Federal Boarding School Initiative (Initiative). NCUIH reiterated its ongoing support for the Administration’s efforts to address the legacy of boarding school programs, while urging the Administration to use the Initiative to address the public health impact of boarding schools on urban American Indian and Alaskan Natives (AI/ANs). NCUIH emphasized the importance of studying not only the impact of boarding school programs for survivors, but also the lasting impact of the intergenerational trauma caused by boarding schools within urban AI/AN communities.


On June 22, 2021, DOI Secretary Haaland issued a memorandum directing DOI to prepare a report addressing the “intergenerational trauma, cycles of violence and abuse, disappearance, premature deaths, and other undocumented bodily and mental impacts.” This Initiative came weeks after the discovery of 215 Indigenous children’s remains were found at a boarding school site in Canada. Secretary Haaland noted that to “promote spiritual and emotional healing in [AI/AN] communities, we [DOI] must shed light on the unspoken traumas of the past…no matter how hard it will be.”

Boarding schools and residential schools are a tragic thread in history that the United States and Canada share: The United States Government Indian Boarding School Policy authorized the forced removal of hundreds of thousands of Native children, as young as 5 years old, relocating them from their homes in Tribal communities to one of the 367 Indian Boarding Schools across 30 States. Between 1869 and the 1960s, the United States federal government stole Native children from their families to destroy their indigenous identities, beliefs, and traditional languages to assimilate them into white American culture through federally funded Christian-run schools.

NCUIH’s Role

Following Secretary Haaland’s memorandum, NCUIH issued a statement commending Secretary Haaland for beginning the process of holding the United States to account for the effects of its boarding school policy.  NCUIH also reiterated its support of the Initiative’s ability to address Indian Country’s historical trauma. NCUIH recognizes the deeply sensitive and emotional impact that federal boarding schools have on the AI/AN community at large, including the continued impact on the many UIOs we serve and their constituents. NCUIH exists, in part, because of the historic oppression of the AI/AN population including federal boarding schools that resulted in the growing AI/AN populations in cities.

Additionally, NCUIH endorsed the Truth and Healing Commission on Indian Boarding School Policies in the United States Act. This bill would create a Truth and Healing Commission on Indian Boarding School Polices in the United States. The Commission will provide a space for AI/AN people to speak about their personal experiences in government-run boarding schools and allow them to provide recommendations to the government. NCUIH is in full support of this Commission and hopes to see DOI establish a similar commission in the Initiative that includes a UIO representative to represent AI/ANs who reside in urban settings.

Importance of Including Urban Indians in the Initiative

In its comments, NCUIH urged DOI and the Administration to address the ongoing effects of Indian boarding schools on AI/AN health.  Specifically, NCUIH requested that DOI incorporate the following items into the Initiative:

  • Partner with AI/AN organizations, including UIOs, to fully study and understand the impact of boarding school trauma and assist survivors in healing from this trauma.
  • Study the lasting impact of boarding school policies, including intergenerational trauma, on the social determinants of health of contemporary AI/AN communities, including those in urban areas
  • Include the UIOs representing the seventy percent (70%) of AI/ANs living in urban areas in DOI’s process through urban confer
    • NCUIH’s comments recognized the importance of Tribal sovereignty and the government-to-government relationship as vital to the Initiative, but noted failure to include UIOs in consultation will leave a significant portion of the AI/AN population without a voice
  • Ensure a comprehensive assimilation of data by making all AI/AN communities true partners in the Initiative.

The DOI report on the investigation is scheduled to be finished in April 2022. NCUIH will remain close to the investigation and monitor for updates. NUCIH will also continue to advocate for the inclusion of UIOs in the process and encourage DOI to incorporate a study of the impact of the boarding schools on urban AI/AN health into the Initiative.

Senator Cantwell Highlights Urban Indian Organizations in Senate Committee on Indian Affairs Oversight Hearing on VAWA

On December 8, 2021, the Senate Committee on Indian Affairs (SCIA) held an oversight hearing on “Restoring Justice: Addressing Violence in Native Communities through VAWA Title IX Special Jurisdiction.” Focusing on the successes and challenges of Title IX of the 2013 Violence Against Women Act (VAWA 2013), the hearing coincided with the committee’s release of the Reauthorization draft text.

When Congress passed VAWA 2013, it included a provision for Indian Tribal governments to exercise criminal jurisdiction over certain non-Indians who commit domestic violence against Indian victims on Tribal lands or violate qualifying protection orders. Although VAWA 2013 has been instrumental in these cases, there remain impactful jurisdictional gaps such as, being able to prosecute crimes against children, dating violence, sex trafficking, as well as co-occurring crimes such as assault on a law enforcement officer or DUI.

During the hearing, Senator Maria Cantwell (D-WA) brought to light the work of urban Indian organizations (UIOs) regarding Missing and Murdered Indigenous People (MMIP). Many UIOs conduct home visits and are at the front-line to identify domestic violence and other risk factors for MMIP. The National Council of Urban Indian Health (NCUIH) has been advocating for MMIP efforts and urban Indians to be included in the VAWA reauthorization to strengthen these critical services provided at UIOs for AI/ANs.

VAWA Hearing on Heels of Recent EO from Biden on MMIP

On November 15, 2021, President Biden signed Executive Order 14053 (E.O.) on Improving Public Safety and Criminal Justice for Native Americans and Addressing the Crisis of Missing and Murdered Indigenous People (MMIP) during the White House Tribal Nations Summit. NCUIH is pleased to see that the E.O. specifically mentions the Department of Health and Human Services (HHS) and the Secretary of the Interior conferring with UIOs on developing a comprehensive plan to support initiatives related to MMIP. We are also pleased to see that the E.O. highlights the need for improved data surrounding this crisis as it relates to urban Indian communities. NCUIH has voiced the importance of gathering more data on these communities, specifically on Missing and Murdered Indigenous Women.

CDC strengthens COVID-19 Booster Guidance

On November 29, CDC strengthened its recommendations on who should aim to complete a booster dose of the COVID-19 vaccine. This new recommendation urges that everyone ages 18 and older should receive a booster at least 6 months post completion of a 2-dose regimen, or 2 months post a single dose inoculation.

With the emergence of the Omicron variant, the importance of vaccination, and the use of boosters, as a prevention method is even more important. CDC Director, Dr. Rochelle Walensky also encouraged those who are unvaccinated to change that as soon as possible. Dr. Walensky also highlighted the importance of getting tested should you experience symptoms.

For more information, the Coronavirus Resources Center on the NCUIH website includes links to any recent guidance  or updates from federal agencies about COVID-19.

NCUIH Thanks Julia Dreyer for Her Service

NCUIH would like to thank Julia Dreyer, the Vice President of Public Policy, for her service to Indian Country as she moves on to her next endeavor! For the past four years, Julia has tirelessly advocated on behalf of American Indians and Alaska Natives living in urban settings. During Ms. Dreyer’s tenure, NCUIH has thrived and achieved significant wins for American Indian and Alaska Native health (AI/AN) care, such as more agency engagement on pressing issues, fighting against work requirements for AI/ANs, 100% FMAP for 8 quarters for services at Urban Indian Organizations (UIOs), UIO inclusion within every COVID-19 relief bill, and the amendment to the Indian Health Care Improvement Act to allow UIOs to use their line item funds for facilities related spending. Please join NCUIH in thanking Julia!

Julia Dreyer, NCUIH Vice President of Public Policy (Left) and Francys Crevier, NCUIH CEO (Right)

FY 2022 Update on IHS Special Diabetes Program for Indians: SDPI Funding Levels Reduced and 1-Year Extension of Current Grant Cycle

On November 15, 2021, the Indian Health Service (IHS) sent out a Dear Tribal Leader and Urban Indian Organization Leader letter (DULL) that discussed the Special Diabetes Program for Indians (SDPI) for fiscal year (FY) 2021 and the upcoming changes for the program in FY 2022. As a grant program inclusive of all three components of the Indian Health Service/Tribal Health Program/Urban Indian Organization (I/T/U) system, SDPI has been a resounding and demonstrable success in reducing diabetes and diabetes-related illnesses in Indian Country.


In 2004, Congress established the SDPI Demonstration Projects to translate research-based interventions for diabetes prevention and cardiovascular disease (CVD) risk reduction into AI/AN community-based programs and health care settings. In total,  The SDPI Demonstration Projects successfully translated diabetes science and reduced the risk of diabetes in high risk individuals, and reduced CVD risk factors in people with diabetes. In 2010, the SDPI Demonstration Projects transitioned into the SDPI Initiatives to continue their prevention work and begin disseminating the strategies and lessons learned to other I/T/U health programs.

Since the inception of SDPI, it has achieved real, demonstrable success, with a 50% reduction in diabetic eye disease rates,drops in diabetic kidney failure, and a 54% decline in End Stage Renal Disease.Given the high rates of diabetes and diabetes-related illnesses AI/ANs face, it is imperative that SDPI is administered in a way that continues to reduce these rates – and in a manner that is inclusive of UIOs. AI/ANs have the highest diabetes prevalence rates of all racial and ethnic groups in the United States, with AI/AN adults almost three times more likely than non-Hispanic white adults to be diagnosed with diabetes.According to 2018 data from the Centers for Disease Control and Prevention, AI/ANs were 2.3 times more likely than non-Hispanic whites to die from diabetes and twice as likely to be diagnosed with end stage renal disease than non-Hispanic whites. SDPI is therefore a critical program to address the disparate high rates of diabetes among AI/ANs.

SDPI has directly enabled UIOs to provide critical services to their AI/AN patients, in turn significantly reducing the incidence of diabetes and diabetes-related illnesses among urban Indian communities. funding. Facilities use these funds to offer a wide range of diabetes treatment and prevention services, including but not limited to exercise programs and physical activity, nutrition services, community gardens, culinary education, physical education, health and wellness fairs, culturally-relevant nutrition assistance, food sovereignty education, group exercise activities, green spaces, and youth and elder-focused activities. To continue the path of success in reducing the rate of diabetes in Indian Country, IHS must continue to provide this essential funding to UIOs.

NCUIH has long advocated for an increase in SDPI funds.  NCUIH


FY 2022 Changes and Updates

Starting in FY 2022, SDPI funding will reduce from $150 million to $147 million each year. This reduction is due to a mandatory sequester which reflects a required 2% reduction continuing through 2023 under current law. While the SDPI grant cycle was due to end on December 31, 2021, IHS learned of the time intensive requirements and IHS has determined that FY 2022 will constitute a 1-year extension of the current grant cycle, extending it to a seventh year. IHS believes this extension will allow more time to work on the notice of funding opportunity and decrease some of the administrative burden for SDPI grantees.

Tribal Leaders Diabetes Committee Meeting Held on December 8, 2021

On December 8, 2021, IHS held a Tribal Leader Diabetes Committee (TLDC) meeting to discuss the current SDPI Funding Distribution. This funding includes $130.2 million in Tribal and IHS grants. A portion of that total will go to 14 IHS grants as well as Technical Assistance services for 8 IHS areas.  Urban Grants will receive $8.5 million in funding with $100k going to Technical Assistance. The SDPI Funding Formula is used to determine how much of the $130.2 million goes to each Area for Tribal/IHS grants. This formula includes information about diabetes prevalence, user population (AI/ANs who have used IHS services at least once in the past 3 years), and the tribal size adjustment. The meeting also announced a new Notice of Funding Opportunity (NOFO) which allows for new and open competition. Urban Indian health programs operated by UIOs are eligible for this NOFO pursuant to a grant or contract with IHS.


The TLDC meeting also outlined a FY 2023 SDPI timeline and issues for consideration, including the potential risk for a decrease in annual SDPI grant amounts due to the open competition, how grantees can be held harmless under the current situation, whether there will be a change in the SDPI funding formula, and what the Tribal Consultation/Urban Confer process will look like moving forward.

NCUIH-Endorsed Protecting Moms Who Served Act Enacted

On November 30, 2021, President Biden signed the Protecting Moms Who served Act (H.R. 958/S. 796) into law. This bipartisan legislation introduced by Representative Lauren Underwood (D-IL-14) and Senators Susan Collins (R-ME) and Tammy Duckworth (D-IL) is the first of 12 bills in the historic Momnibus Act to be enacted. This bill addresses the maternal mortality crisis among Veterans by:

  • Investing $15 million in maternity care coordination programs at the Department of Veterans Affairs facilities; and
  • Commissioning the first-ever comprehensive study of maternal mortality, morbidity, and disparities among Veterans.
    • The report on maternal morbidity and mortality includes an assessment on the barriers to determining the data and recommendations for improvements in tracking maternal health outcomes among pregnant and postpartum veterans who are eligible to use the Indian Health Service, Tribal health programs, or urban Indian health organizations.

The National Council of Urban Indian Health has tirelessly advocated for improving the health of American Indian and Alaska Native (AI/AN) Veterans and is pleased to endorse Rep. Underwood, Sen. Collins, and Sen. Duckworth’s legislation which advances maternal healthcare for Veterans with a focus on racial and ethnic disparities.

Rep. Bacon Recognizes 35th Anniversary the Nebraska Urban Indian Health Coalition

On November 2, 2021, Representative Don Bacon (R-NE-02) rose to the floor to honor the 35th anniversary of the Nebraska Urban Indian Health Coalition (NUIHC) in recognition of National Native American Heritage Month.

In his three-minute speech, Rep. Bacon highlighted both the work of NUIHC and Dr. Donna Polk, NUIHC’s Chief Executive Officer.

In recognition of the Nebraska Urban Indian Health Coalition, we shine a spotlight on 35 years of helping elevate the health status and eliminating disparities of urban Indians and other underserved populations in Nebraska and Iowa through education, collaboration, advocacy, and health service delivery. Congratulations to Dr. Polk and her team for 35 years of excellence and serving our great community.” – Rep. Bacon

NUIHC has been serving the urban Indian community of the greater Omaha metropolitan area, Lincoln-Lancaster metropolitan area, and Sioux City, Iowa since 1986. NUIHC’s mission is to elevate the health status of urban Indians and other underserved populations through their culturally and linguistically appropriate health care services, substance abuse and behavioral health treatment programs, and community outreach services.

Upcoming Urban Confer to Discuss ARPA and BBBA Funding for IHS Programs

On November 22, 2021 IHS sent a Dear Urban Tribal Organizational Leader letter (DULL) that outlines an additional $210 million for Public Health Workforce Activities from the U.S. Department of Health and Human Services through the American Rescue Plan Act (ARPA). The DULL also outlines the Build Back Better Act (BBBA) that includes $2.35 billion in additional resources for several Indian Health Service (IHS) programs. Currently, the BBBA is up for consideration in Congress and includes funding for several prioritized IHS programs.

ARPA and BBBA’s IHS Program Impact

Directed funding of the ARPA and BBBA are a result of the disproportionate impact the COVID-19 pandemic has had on American Indian/Alaska Native (AI/AN) communities. The proposed funding emphasizes the urgent need for preparatory action to handle the exacerbated inequalities across the nation.

The allocation of $210 million to IHS is a significant amount of funding that would enable the creation and enhancement of community level programs that are equity focused and results driven. The directed dollars have the capacity to boost public health responses and increase the professional volume that is dedicated to the work in IHS, Tribal, and urban Indian health programs.

Additionally, the BBBA includes $2.35 billion in additional funding for several IHS programs, including, $1 billion to address the 1993 Health Care Facilities Construction Priority List; $945 million for Maintenance and Improvements; $124 million for behavioral health services, including necessary facilities improvements; and $100 million for Urban Indian Organization construction. NCUIH supports the BBBA funding and its planned disbursement to the prioritized IHS programs.

Next Steps

NCUIH will be holding a prep call on Wednesday, December 15, 2021 from 12:00 p.m. – 1:00 p.m. (EST). Join NCUIH’s prep call here. During this meeting, we will review potential talking points and provide a shareable document prior to the IHS Urban Confer Session.

The virtual Urban Confer session will take place to discuss the additional funds on Wednesday, December 15, 2021 from 2:00 p.m. – 4:00p.m. (EST). Join the meeting by clicking here. Written comments are also encouraged on the two funding sources. The deadline to submit written comments is December 23, 2021.