NCUIH-Endorses Bill to Elevate the Health Care Needs of Native Americans Within the Federal Government

On January 13, 2022, Representative Greg Stanton (D-AZ) and Representative David Joyce (R-OH) introduced the Stronger Engagement for Indian Health Needs Act (H.R. 6406). This bill would elevate the Indian Health Service Director to Assistant Secretary for Indian Health within the Department of Health and Human Services (HHS), increasing their authority within the federal government on the health care needs of the American Indian and Alaska Native (AI/AN) population. The National Council of Urban Indian Health (NCUIH) worked closely with Representatives Stanton and Joyce on this legislation and supports their effort to bring better representation for the health needs of AI/ANs.

“The health of our people has suffered due to the failure of the government to uphold the trust responsibility of providing health care to all American Indians and Alaska Natives. The pandemic, which continues to devastate Indian Country, has made it clear that it’s time for the Administration to recognize the importance of Indian health by elevating the position of the Director of the IHS to Assistant Secretary,” said Walter Murillo (Choctaw), President of NCUIH and Chief Executive Officer of Native Health, which is based in Phoenix, Arizona. “We applaud Representatives Greg Stanton and David Joyce for their longstanding leadership to improve health outcomes for Native people and hope this change will usher in a new era where Indian health is a priority and not an afterthought.”

The bill has been endorsed by leading Native American advocacy groups—including the National Congress of American Indians, National Indian Health Board, and NCUIH. The bill was referred to the Committee on Natural Resources and the Committee on Energy and Commerce. It currently awaits consideration.


NCUIH-Endorsed Comprehensive Addiction Resources Emergency (CARE) Act Includes Funding for Urban Indian Organizations

On December 16, 2021, Senator Warren (D-MA) and Representative Maloney (D-NY) reintroduced the Comprehensive Addiction Resources Emergency (CARE) Act (S. 3418/H.R. 6311). The CARE Act addresses the substance use epidemic by providing state and local governments with $125 billion in federal funding over ten years, Of the nearly $1 billion, the CARE Act sets aside $150 million a year in funding to Native non-profits and clinics, including to urban Indian organizations, Native Hawaiian organizations, and projects designed to test innovative service delivery and culturally informed care models to tackle addiction.

NCUIH worked closely with Congressional leaders to ensure the inclusion of urban Indians in this important legislative response to the Nation’s substance use epidemic and is pleased to endorse this bill. The bill was originally introduced in 2018 and is currently endorsed by over 175 national, local, and tribal organizations. In the Senate it was referred to the Committee on Health, Education, Labor, and Pensions. In the House it was referred to the Committee on Energy and Commerce, in addition to the Committees on Natural Resources, the Judiciary, and Oversight and Reform. It currently awaits further consideration.

“Many times, critical funding, even when appropriated in equitable amounts, does not reach across AI/AN urban communities, largely in part because when urban Indians are not specifically mentioned in legislative language they are most often excluded or forced to prove their eligibility under the intent of the laws created. NCUIH appreciates that the CARE Act has detailed specific language that ensures urban Indian organizations are listed as an eligible entity in this important legislative act,” wrote Francys Crevier (Algonquin), CEO of the National Council of Urban Indian Health (NCUIH).


Additional Information about the CARE Act

Additional funds from the $1 billion include $790 million per year for grants to Tribal governments to help fight this crisis and invest in substance use prevention and treatment; $7.5 million in additional funding for Tribal nations and regional tribal epidemiology centers to improve data collection on overdoses; and 50 million a year to Tribal Colleges and Universities, Indian Health Service-funded organizations, and medical training programs that partner with Tribal nations and Tribal organizations to train Native health professionals to improve substance use disorder treatment services. This Act also provides $1 billion per year to expand access to the overdose reversal drug, Naloxone, to states to distribute to Tribal nations, first responders, public health departments, and the public.



to the Indian Health Service, the opioid crisis and COVID-19 pandemic are intersecting with each other and presenting unprecedented challenges for American Indian and Alaskan Native (AI/AN) families and communities. Because of the pandemic, substance and opioid use and fatalities have significantly increased in low-income communities.

AI/ANs continue to be deeply impacted by the opioid crisis and continue to see an overwhelming increase of deaths, addiction, and overdoses above the National average. AI/ANs had the second-highest rate of opioid overdose out of all U.S. racial and ethnic groups in 2017, and the second and third highest overdose death rates from heroin and synthetic opioids, respectively, according to the Centers for Disease Control and Prevention.

Since 1974, AI/AN adolescents have consistently had the highest substance abuse rates than any other racial or ethnic group in the U.S. Staggering statistics such as these do not happen overnight, they are the direct result of intergenerational trauma caused by adverse childhood experiences such as alcoholism, drug abuse and domestic violence in a family, emotional neglect, incarceration of a family member, and physical or sexual abuse— which are known to lead to a higher risk of addiction and other behavioral and mental health problems later in life.

Unfortunately, the majority of the nation’s AI/ANs living on and off reservations have limited access to substance abuse services due to transportation issues, lack of health insurance, poverty, inadequate healthcare facilities and a shortage of appropriate treatment options in their communities. Some of the disparities in treatment that occur within the AI/AN population can be resolved through increased availability of culturally sensitive treatment programs. Studies have shown that cultural identity and spirituality are important issues for AI/ANs seeking help for substance abuse, and these individuals may experience better outcomes when traditional healing approaches (such as powwows, drum circles, and sweat lodges) are incorporated into treatment programs.

NCUIH-Endorsed Bill Reintroduced to Improve Access to Critical Medical Supplies for American Indians and Alaska Natives

On January 4, 2022, Senator Elizabeth Warren (D-MA) and Representatives Ruben Gallego (D-AZ) and Tom Cole (R-OK) reintroduced the Tribal Medical Supplies Stockpile Access Act (S. 3444/H.R. 6372). This bipartisan, bicameral legislation would guarantee that the Indian Health Service (IHS), tribal health authorities, and urban Indian organizations (UIOs) have access to the Strategic National Stockpile, a federal repository of drugs and medical supplies that can be tapped if a public health emergency could exhaust local supplies. The National Council of Urban Indian Health (NCUIH) welcomes the reintroduction of this important legislation to provide critical resources to UIOs amid the current pandemic and future public health emergencies.


“We are encouraged by the leadership of Senator Warren, Representative Gallego, and Representative Cole to increase health care access for American Indians and Alaska Natives through the Strategic National Stockpile. As the coronavirus continues to have greater impacts, Congress must do everything possible to uphold its trust responsibility to Indian Country by providing appropriate resources. The stockpile is designed for those who need it most in times of emergency and Indian Country should not be left behind,” said Francys Crevier (Algonquin), Chief Executive Officer, NCUIH.


NCUIH supported the original legislation that was introduced in March 2020 by Senator Warren and remains unchanged in the reintroduction. Other organizations that support the bill include the National Indian Health Board, the National Congress of American Indians, United South and Eastern Tribes Sovereignty Protection Fund, Seattle Indian Health Board, and the Friends Committee on National Legislation. This bill was referred to the Senate Committee on Health, Education, Labor, and Pensions and currently awaits further consideration.




Currently, Indian Country’s access to the Strategic National Stockpile is limited and is not guaranteed in the statute. NCUIH has advocated for UIOs to have access to the National Strategic Stockpile in light of the COVID-19 pandemic. In April 2020, NCUIH and other National Native organizations sent a letter to Members of both chambers of Congress outlining a joint COVID-19 recovery legislative proposal which included a request to include Tribal and UIO access to the Strategic National Stockpile.


On June 18, 2020 the Center for American Progress, a Washington DC based think tank, released a report on the COVID-19 response in Indian Country and included recommended policy solutions for better funding and supporting IHS, such as providing all Indian Health Service/Tribal Health Program/UIO facilities access to the Strategic National Stockpile and Public Health Emergency Fund.

Updated CDC Guidance for Pfizer-BioNTech COVID-19 vaccination

On Tuesday, January 4, the Centers for Disease Control and Prevention (CDC) issued two new recommendations on guidance on the administration of the COVID-19 vaccine technology from Pfizer-BioNTech. This guidance follows after the Food and Drug Administration (FDA) gave similar recommendations. The updated recommendations include the following: recommendations include the following:

  • Those who received the Pfizer-BioNTech COVID-19 vaccine as their primary series are not recommended to get a booster after 5 months.
  • Children 5-11-years-old who are moderately or severely immunocompromised should received an additional primary dose of the Pfizer-BioNTech vaccine 28 days after their second shot.

Additionally, following a recent Advisory Committee on Immunization Practices (ACIP) meeting, CDC is endorsing ACIP’s recommendation that people 12-17 years old should receive a booster shot 5-months after their initial Pfizer-BioNTech vaccination series. Currently, this vaccine is the only COVID-19 vaccine authorized for adolescents aged 12-17.