EPA Seeks Applications from Underserved Communities to Address Drivers and Environmental Impacts of Energy Transitions

On January 18, 2022, the Environmental Protection Agency (EPA) initiated an application process seeking applicants proposing community-engaged research that will address drivers and environmental impacts of energy transitions in underserved communities. The EPA defines “underserved communities” as “populations sharing a particular characteristic, as well as geographic communities, that have been systematically denied a full opportunity to participate in aspects of economic, social, and civic life, including people of color, low income, rural, tribal, indigenous, and other populations that may be disproportionately impacted by environmental harms and risks.”

 

The Science to Achieve Results (STAR) Program is seeking applicants who can provide research that addresses the following research areas:
  1. Understanding how air quality, the environment, and public health in underserved communities might be improved through the transformations of the energy sector (e.g., wide-spread adoption of renewable energy sources and energy efficient technologies, electrification of transportation services and household energy use) while minimizing potential negative impacts;
  2. Identifying approaches or strategies to ensure that energy transitions provide air quality benefits and reduce environmental risks while meeting the energy and mobility needs of underserved communities;
  3. Understanding how socioeconomic, cultural, behavioral, institutional, and systems factors drive individual and household decisions regarding the adoption of renewable energy sources, energy-efficient technologies and building modifications, and new transportation modes in underserved communities;
  4. Understanding how socioeconomic, organizational, and institutional factors affect decisions at the organizational, governmental, and community levels regarding the adoption and diffusion of renewable energy sources, energy-efficient technologies, building modifications, and new transportation modes in underserved communities; and,
  5. Identifying and evaluating potential multi-pollutant and/or multi-sectoral approaches to achieve climate, air quality, and other environmental goals while maximizing potential positive impacts as well as minimizing potential negative impacts to underserved communities arising from large-scale energy systems transformation

Awards and Application Eligibility

The EPA anticipates awarding eleven grants or cooperative agreements totaling $10 million. Eligible applicants include public and private nonprofit institutions/organization and certain hospitals.  Profit-making firms and individuals are not eligible to apply.

 

 The application period closes April 28, 2022.

IHS Issues Final Rule Implementing “Buy Indian Act”

On January 13, 2022, the Indian Health Service (IHS) announced publication of the final rule implementing the Buy Indian Act (“Final Rule”).  This rule supplements the Federal Acquisition Regulation (FAR) and the Department of Health and Human Services Acquisition Act (HHSAR). The rule will become effective March 14, 2022.  Once the rule is effective, IHS will update the Indian Health Manual, Part 5, Chapter 5, Section 6-1 Buy Indian Policy.

The Buy Indian Act provides the IHS with authority to set-aside procurement contracts for Indian-owned and controlled businesses.  The Buy Indian Act rule has been in development at the Indian Health Service (IHS) since 2016, in collaboration with the Health and Human Services (HHS) and the Assistant Secretary for Financial Resources (ASFR). Over the course of four (4) public consultation sessions, comments were received, reviewed, addressed, and incorporated into the final rule.

The Final Rule is intended to encourage procurement relationships with Indian labor and industry.  It formalizes the administrative procedure by which IHS carries out acquisition activities with the intent of ensuring uniformity for offers submitted by Indian labor and industry under solicitations set-aside under the Buy Indian Act and the Final Rule.

According to IHS Acting Deputy Director Elizabeth Fowler, this rule aims to improve business processes that support value-based purchasing and standardized management strategies in contracts. IHS hopes that the Rule advances the IHS mission and supports economic sustainability and development across Indian Country. Dr. Fowler also indicated that IHS intends to use the rule to set-aside for Indian Economic Enterprises a significant portion of the $1 billion in commercial contract dollars it currently obligates per year.

As identified by IHS, the final rule has capacity to:

  • alleviate unnecessary regulatory burden on Indian Economic Enterprises
  • expand application of the Buy Indian Act to all construction including the planning, design and construction of health care facilities, personnel quarters, and water supply and waste disposal facilities;
  • better adhere to the language of the Buy Indian Act;
  • strengthen oversight of the Buy Indian Act to reduce the potential for fraud and abuse;
  • and clarify the preference for Indian Economic Enterprises;

IHS has committed to providing support during the implementation phase of incorporating the new strategies and is dedicated to improving compliance, training, and reporting in respect to the Buy Indian Act.

Indian-owned and controlled businesses which are interested in competing for IHS Buy Indian Act set-aside acquisitions will be required to fill out an IHS Indian Economic Enterprise self-certification form. The form will be attached to all IHS solicitations set-aside under the Buy Indian Act.  Completed and signed forms must be submitted with a quote/proposal in response to the specific IHS solicitation.  Potential offerors can also reach out to any IHS Contracting Officer to obtain a copy of the form.  Once IHS has updated the Indian Health Manual the form will also be made available on the IHS Division of Acquisition Policy webpage.

Potential offerors with additional questions, can contact Santiago Almaraz, IHS head of contracting activity at santiago.almaraz@ihs.gov or Ken Truesdale, acting director-division of acquisition policy, at kenneth.truesdale@ihs.gov.

For technical questions concerning this rule contact: Carl Mitchell, Director, Division of Regulatory Policy Coordination (DRPC), Office of Management Services (OMS), IHS, 301-443-6384, carl.mitchell@ihs.gov; or Santiago Almaraz, Acting Director, OMS, IHS 301-443-4872, santiago.almaraz@ihs.gov.

DOJ Consultation Meeting on the Public Safety and Criminal Justice Needs of Native Americans

On January 14, 2022, the U.S. Department of Justice (DOJ) Office of Tribal Justice (OTJ) issued a Dear Tribal Leader letter inviting Tribal leaders to a two-day government-to-government consultation on March 16 and 17, 2022. The purpose of this two-day consultation is to discuss “DOJ’s efforts to address the unacceptably high rate of violent crime in Native communities, including the rates of missing or murdered indigenous persons.” Deputy Attorney General Lisa Monaco directed this consultation in her November 15, 2021  memorandum establishing the DOJ’s Steering Committee to address the crisis of missing and murdered indigenous persons (MMIP). The OTJ is also welcoming written comments via email to OTJ@usdoj.gov until April 15, 2022. The meetings will be held from 3:00 p.m. – 4:30 p.m. EST on both days.

On November 15, 2021, during the White House Tribal Nations Summit, President Biden signed Executive Order 14053 (E.O.) “Improving Public Safety and Criminal Justice for Native Americans and Addressing the Crisis of Missing or Murdered Indigenous People,” which directed the Administration to work together with Tribes to “build safe and healthy Tribal communities and to support comprehensive law enforcement, prevention, intervention, and support services.”  The E.O. also recognizes that because “approximately 70 percent of American Indian and Alaska Natives live in urban areas and part of this epidemic of violence is against Native American people in urban areas, we must continue that work on Tribal lands but also build on existing strategies to identify solutions directed toward the particular needs of urban Native Americans.”  To that end, in her November 15, 2021 memorandum, Deputy Attorney General Monaco directed DOJ’s Steering Committee to seek and consider the views of stakeholders including Urban Indian Organizations.

Meeting of the Advisory Committee on Infant and Maternal Mortality

On March 15 and 16, 2022, the Health Resources and Services Administration (HRSA) Advisory Committee on Infant and Maternal Mortality (ACIMM) will be hosting a public meeting to discuss Federal program updates; COVID-19 updates; race-concordant care; health of Indigenous mothers and babies; and the impact of violence on infant and maternal mortality. During this two-day meeting, members of the public will have the opportunity to provide written or oral comments. Requests to submit a written statement or make oral comments to ACIMM should be sent to Anne Leitch at SACIM@hrsa.gov. at least 3 business days prior to the meeting. The meeting will be held from 12:00 p.m. to 4:00 p.m. EST both days.

Background

Formed in 1991, the ACIMM advises the Secretary of Health and Human Services (HHS) on department activities, partnerships, policies, and programs directed at reducing infant mortality, maternal mortality and sever maternal morbidity, and improving the health status of infants and women before, during, and after pregnancy. The ACIMM consists of public and private members and provides advice on how to coordinate governmental efforts to improve infant mortality, related adverse birth outcomes, and maternal health, as well as influence similar efforts in the private and voluntary sectors. With its focus on underlying causes of the disparities and inequities seen in birth outcomes for women and infants, the ACIMM advises the Secretary on the health, social, economic, and environmental factors contributing to the inequities and proposes structural, policy, and/or systems level changes.

AI/AN Infant and Maternal Mortality

According to HHS Office of Minority Health American Indian and Alaska Natives (AI/AN) have almost twice the infant mortality rate as non-Hispanic whites. AI/AN infants are also 2.7 times more likely than non-Hispanic white infants to die from accidental deaths before the age of one year and AI/AN infants are 50 percent more likely to die from complications related to low birthweights as compared to the same group. AI/AN mothers are also disproportionately represented in maternal mortality. In 2019, AI/AN mothers were almost three times as likely to receive late or no prenatal care as compared to non-Hispanic white mothers.

Bureau of Indian Education Hosting Two-Day Meeting to Discuss Mandates of the Individuals with Disabilities Education Act of 2004 for Indian Children with Disabilities

On March 9-10, 2022, the Bureau of Indian Education (BIE) Advisory Board for Exceptional Children will host an online meeting open to the public to discuss the Individuals with Disabilities Education Act of 2004 (IDEA) and its impact on Indian children with disabilities.  The Advisory Board will consider agenda items regarding special education topics from the:

  • BIE Central Office
  • BIE/Division of Performance and Accountability (DPA)/Special Education Program
  • BIE Office of Sovereignty in Indian Education
  • Four Public Commenting Sessions will be provided during both meeting days.

The meeting will be from 8:00 a.m. to 4:00 p.m. Mountain Standard Time both days.  For more information on the upcoming meeting, please visit: Federal Register :: Advisory Board of Exceptional Children

Background

The goal of IDEA is to ensure that students with a disability are provided with free appropriate public education that is tailored to their individual needs, with the overall goal to provide children with disabilities the same opportunity for education as those students who do not have a disability. The Advisory Board was established under IDEA to advise the Secretary of the Interior, through the Assistant Secretary of Indian Affairs, on the needs of Indian children with disabilities.  According to the Office of Special Education Programs, in school year 2018-2019, “20.1% of American Indian or Alaska Native children with disabilities served under IDEA, Part B were in Oklahoma, 9% in Arizona, 7.6% in BIE, 5.9% in New Mexico, 5.9% in California, 5.5% in Alaska, 3.9% in New York, and 4.1% in Minnesota.”

According to a recent report by the U.S. Census Bureau, American Indian and Alaska Native (AI/AN) children represent the highest rate of disability among U.S. children. In 2019, more than 3 million children in the U.S. had a disability, with  5.9 percent of AI/AN children having a disability. Various social factors impact the disproportionate number of AI/AN children with a disability, including household income, as well as lack of access to high quality-health care services.

CMS Commits Over $49 Million to Reduce Uninsured Rate Among Children and Boost Medicaid Enrollment Among Parents, and Pregnant People

On January 27, the Centers for Medicare & Medicaid Services (CMS) announced that it will commit $49.4 million in cooperative agreements in an effort to fund organizations that can connect more eligible children, parents, and pregnant individuals to health care coverage through Medicaid and Children’s Health Insurance Program (CHIP). Eligible awardees include state and local governments, tribal organizations, federal health safety net organizations, and non-profits, as well as schools and other organizations. Each awardee may receive $500,000 up to an anticipated $1,500,000 over a three-year award period.  Awardees must use the funding to reduce the number of uninsured and advance Medicaid and CHIP enrollment and retention. Application proposals are due on March 28, 2022.  The anticipated award issuance date for these awards is July 1, 2022.

Background

The Connecting Kids to Coverage HEALTHY KIDS 2022 Outreach and Enrollment Cooperative Agreements provide funding opportunities to reduce the number of children who are eligible for, but not enrolled in, CHIP and to improve retention of eligible children who are enrolled.  According to CMS, the rate of uninsured children increased to 5.2 percent in 2019, meaning that around 4 million children are uninsured.  In addition, Medicaid and CHIP participation rates have declined, indicating that a greater proportion of eligible children are not accessing the health benefits that Medicaid and CHIP provide.  CMS estimates that among the 4 million uninsured children, 2.3 million children are eligible for Medicaid and CHIP and CMS further estimates that AI/AN children continue to experience the highest uninsured rate at 11.8 percent.

Funded organizations will provide enrollment and renewal assistance to children and their families, as well as pregnant people—a new optional target population in this year’s award announcement.  Applicants will be encouraged to consider a range of activities, including:

  • Engaging schools and other programs serving young people;
  • Bridging racial and demographic health coverage disparities by targeting communities with low coverage rates;
  • Establishing and developing application assistance resources to provide high-quality, reliable enrollment and renewal services in local communities;
  • Using social media to conduct virtual outreach and enrollment assistance; and
  • Using parent mentors and community health workers to assist families with enrolling in Medicaid and CHIP, retaining coverage, and addressing social determinants of health.

How to Apply

Applicants must submit their application electronically through the grants.gov website.  The following forms must be completed with an electronic signature and enclosed as part of the application:

  1. Project Abstract Summary
  2. SF-424: Official Application for Federal Assistance
  3. SF-LLL: Disclosure of Lobbying Activities
  4. Project Site Location Form(s)

In addition, Applicant’s must provide the following information with their application

  1. Application cover letter or cover page (optional)
  2. Project Narrative
  3. Data Collection and Reporting Plan
  4. Work Plan and Timeline
  5. Budget Narrative
  6. Evaluation Plan
  7. Staffing Plan
  8. Business assessment of applicant organization

All applications must be submitted electronically and be received through www.grants.gov by 3:00 pm, Eastern Time, on March 28, 2022.  More information on this funding opportunity as well as application materials, can be found  here.

Study Shows Native Children Disproportionately Experience Orphanhood Due to COVID-19

On October 7, 2021, the American Academy of Pediatrics published a study on caregiver deaths by race and ethnicity. The study highlights stark COVID-19 disparities in American Indian/Alaska Native (AI/AN) communities.

According to the study, 1 of every 168 AI/AN children experienced orphanhood or death of caregivers due to the pandemic compared to 1 of every 310 Black children, 1 of every 412 Hispanic children, 1 of every 612 Asian children, and 1 of every 753 white children experienced orphanhood or death of caregivers. AI/AN children were 4.5 times more likely than white children to lose a parent or grandparent caregiver.

Native communities face some of the harshest disparities in health outcomes of any population in the U.S. and are disproportionately impacted by the COVID-19 pandemic.

Download Graphic


About the Study

The study was a collaboration between the Centers for Disease Control and Prevention (CDC), Imperial College London, Harvard University, Oxford University, and the University of Cape Town, South Africa. Published in the Oct. 7 issue of the journal Pediatrics, it was jointly led by CDC’s COVID Response and Imperial College London, and partly funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health (NIH), as well as Imperial College London.

Read More

Padilla, 13 Other Senators Call on Biden Administration to Establish Advisory Group for Urban Indians

On February 3, 2022, Senators Alex Padilla (D-CA), Catherine Cortez Masto (D-NV), Tina Smith (D-MN), Dianne Feinstein (D-CA), Elizabeth Warren (D-MA), Ed Markey (D-MA), Mark Kelly (D-AZ), Amy Klobuchar (D-MN), Patty Murray (D-WA), Tammy Baldwin (D-WI), Chris Van Hollen (D-MD), Jacky Rosen (D-NV), Jeff Merkley (D-OR), and Jon Tester (D-MT) sent a letter to the Biden Administration requesting the establishment of an Urban Indian Interagency Work Group to identify the needs and develop strategies to better serve urban American Indian/Alaska Native (AI/AN) populations. The National Council of Urban Indian Health (NCUIH) worked closely with Senator Padilla on this letter and supports the effort to bring better representation for the needs of American Indians and Alaska Natives who do not reside on Tribal land.

 

“In light of the goals you outlined in the Biden-Harris Plan for Tribal Nations, specifically to ensure that urban AI/ANs receive ‘quality health care, culturally relevant education, adequate and affordable housing, and other needed resources,’ we urge the administration to form an Urban Indian Interagency Work Group to identify the critical needs of urban AI/AN populations and develop strategies to implement real change that uplifts urban AI/ANs,” wrote the Senators.

 

The Work Group would help identify federal funding strategies to better address the needs of urban AI/ANs, advance the development of a wellness centered framework to inform health services, strengthen support for practice-based traditional healing approaches, improve Urban Confer policies at Health and Human Services and associated agencies, and ensure that Urban Indian Organizations can regularly meet with federal agencies to address relevant topics of concern.

 

Tribal Leaders Highlight Need for Increased Urban Indian Health Funding in Fiscal Year 2024 Area Reports

On January 26-27, 2022, the Indian Health Service (IHS) held their Area Report Presentations Webinar for Fiscal Year (FY) 2024 where Tribal leaders from 12 IHS Areas and leaders from three Native organizations, including the National Council of Urban Indian Health (NCUIH), presented on their budget requests. Many Tribal leaders spoke about the need to increase urban Indian health funding and establish designated funding for urban Indian health facilities and infrastructure.  Many Areas also highlighted mental health and substance abuse needs, Health IT modernization, and permanent authorization of the Special Diabetes Program for Indians (SDPI). As part of the trust responsibility to provide health care to all American Indians and Alaska Natives, Tribal Leaders present their funding needs each year to the Secretary of HHS and the Director of the Office of Management and Budget. The recommendations are formed through the Tribal Budget Formulation Work Group and serve as a framework for the Administration in setting budget amounts for their annual requests to Congress. This process ensures the federal government has the resources to provide health care to all American Indians and Alaska Natives in fulfillment of the trust responsibility.

 

Tribal Leaders Highlight the Need for Increased Urban Indian Health Funding

Urban Indian health was a priority in the Area report presentations. IHS Oklahoma Area Representative and President of the Wichita and Affiliated Tribes, Terri Parton, advocated for $509.963 million in funding for urban Indian health, citing that “Although 78% of AI/ANs reside in urban areas, the IHS funding allocation for urban Indian health only reflects close to 1% of the total annual IHS budget,” and “There are inadequate levels of funding to address the rising urban Indian population.”

 

Several Areas featured the work of UIOs in their presentations and advocated for increased allocation of funding and resources for urban Indian health.

  • IHS Phoenix Area recommended a $18.86 billion funding increase for Health Care Facilities Construction with $2 billion for urban Indian health facility renovation. The Phoenix Area Representative also highlighted that the urban Indian health program increase of $92.6 million identified in the FY 2023 budget recommendations remains a top concern in FY 2024, and recommended increased funding for Tribal and Urban Community Health Representative services.
  • IHS Bemidji Area stressed that UIOs are underfunded and rely heavily on grants which can be unstable and recommended $477 million for urban Indian health in FY 2024.
  • IHS Portland Area recommended approximately $1.8 billion in funding for the FY 2024 urban Indian health line item.
  • IHS Tucson Area listed urban Indian facilities renovations in their top health priorities and Wavalene Saunders, Vice Chairwoman of the Tohono O’odham Nation, highlighted Tucson Indian Center’s collaboration with the Pascua Yaqui Tribe and Tohono O’odham Nation to address COVID-19 vaccine and testing efforts.
  • The IHS Billings Area Representatives highlighted two Billings UIO success stories. Lane Spotted Elk, Councilman of Northern Cheyenne Tribal Council, highlighted the Billings Urban Indian Health and Wellness Center’s student mental health and suicide prevention efforts though collaboration with schools. The Indian Family Health Clinic’s food pantry efforts was also highlighted for receiving 5000 pounds of donated food and providing food boxes to patients, primarily seniors, during the pandemic.

 

NCUIH supports the average of the 12 IHS Areas recommendation of $1 billion for urban Indian health funding for FY 2024.

 

Meredith Raimondi, NCUIH’s Interim Vice President of Public Policy, presented the following urban Indian organization (UIO) funding priorities for FY 2024 during the Area Report Webinar:

  1. Urban Indian health funding amount of approximately $1 billion, which reflects the average of the Area budget formulation recommendations.
  2. Availability of funds for UIOs to spend on facilities and infrastructure needs (these funds would be exclusive to UIOs and would not impact the IHS facilities accounts).
  3. Behavioral health funding for UIOs.
  4. SDPI reauthorization and increase to at least $200 million.
  5. Community Health Representatives fund of $3 million for UIOs.

In addition to budget priorities, Raimondi highlighted several “hot topics” for urban Indian health:

  1. Safeguard IHS funding through advance appropriations and exception apportionment across the entire IHS/ Tribal/UIO system.
  2. Permanent increase in Medicaid dollars for Indian health through the permanent extension of 100% Federal Medical Assistance Percentage (FMAP) to UIOs and increased reimbursement rates.
    1. The American Rescue Plan Act authorized a temporary two-year extension of 100% FMAP to UIOs beginning April 1, 2021, however, UIOs have not received a single dollar of increased funding.
  3. Urban confer: establish a mechanism for dialogue and input between the Department of Health and Human Services agencies overseeing UIO programs and UIOs.

 

Next Steps

IHS will hold their FY 2024 National Tribal Budget Formulation Work Group on February 10-11, 2022. NCUIH will continue to advocate for $1 billion in funding for urban Indian health and increased resources for UIOs.

VA Advisory Committee on Tribal and Indian Affairs Meet for the First Time

Urban Indian Organization Representative Sonya Tetnowski named co-chair of the Veterans Health Administration Subcommittee

On January 25, 2022, the U.S. Department of Veterans Affairs (VA) Advisory Committee on Tribal and Indian Affairs (Committee) met for the first time and held a three-day long session to advise the VA on matters relating to Native American veterans.  The Committee is made up of 15 veterans, representing the 12 Indian Health Service (IHS) service areas, the Native Hawaiian veteran community, and Urban Indian Organizations (UIOs).  From January 25 – 27, the Committee provided advice and guidance to VA Secretary Dennis McDonough on matters related to Native Veteran healthcare services, COVID-19 efforts, homelessness and affordable housing initiatives, Indian Health Service (IHS) and urban Indian health, benefit access including memorial services, and the Vet Center program, among other items.  The National Council of Urban Indian Health (NCUIH) played a key role in the creation of the Committee and Sonya Tetnowski (Makah), NCUIH’s President-Elect and CEO of the Indian Health Center for Santa Clara Valley, currently serves as one of its members.

UIO Representation and Meeting Highlights

During the first meeting of the Committee, Ms. Tetnowski quickly established herself as a strong advocate for Native Veterans from all areas, including those living in urban areas. As an Army veteran, member of a rural tribe, and current executive of a UIO, Ms.Tetnowski highlighted many of the barriers AI/AN Veterans face in accessing health care and other benefits they earned from the United States.  She elevated urban Indian health priorities and issues throughout the conversations with the VA.  She reminded the VA that they have yet to fully implement the VA-IHS Memorandum of Understanding (MOU) for UIO reimbursements and that a VA Urban Confer Policy has yet to be executed.  Additionally, Ms. Tetnowski inquired about the rollout of the reimbursement agreement program (RAP) template for UIOs and how communications for that were to proceed.

Ms. Tetnowski also highlighted the importance of looking at the whole person and making sure that their needs are being met. She also brought forth potential subcommittees, including unhoused urban Veterans, Native Healer utilization and Behavioral Health and Substance Use.  At the end of the three-day meeting, Sonya volunteered to be, and was selected to be, Chair of the Veterans Health Administration (VHA) subcommittee within the TAC.

NCUIH is incredibly proud of Ms. Tetnowski and her extraordinary advocacy throughout this initial meeting of the Committee.  NCUIH will continue to support Ms. Tetnowski in her work on the Committee in addition to its ongoing advocacy work for UIOs before the VA.

Background

The advisory committee was created by Congress in 2020 and members were officially appointed to their roles in October 2021.  NCUIH played a critical role in getting this legislation passed in 2020 and in nominating an urban Indian Organization (UIO) representative to the Committee.  The purpose of the Committee is to advise the Secretary on all matters relating to Indian Tribes, tribal organizations, Native Hawaiian organizations, and Native American Veterans. This includes advising the Secretary on the administration of healthcare services and benefits to American Indians and Alaska Native Veterans; thereby assessing those needs and whether VA is meeting them.

 

On October 30, 2019, the House Committee on Veterans’ Affairs, Subcommittee on Health conducted an oversight hearing in which NCUIH’s then Board Vice President, Sonya Tetnowski, testified.  In her testimony, Ms. Tetnowski highlighted that “most AI/AN veterans live in urban areas and would benefit from the culturally competent care provided at UIOs.”

 

Additionally, NCUIH signed onto a December 4, 2020 letter with other National Native organizations regarding the VA Technical Advisory Committee bill.  In the letter, NCUIH emphasized the importance of UIOs in the healthcare delivery system, especially when addressing Native Veteran access to culturally competent care. Thanks to NCUIH’s advocacy, the legislation creating the Committee requires it to have a sitting member represent UIOs and be nominated by a national UIO.

NCUIH also provided testimony on Native Veterans Suicide Prevention to the House Committee on Veterans Affairs on September 21, 2022.  Again, Ms. Tetnowski testified on behalf of NCUIH and reiterated the importance of culturally competent health care provided to Native veterans.  She highlighted how UIOs offer several culturally centered mental health care services to Native Veterans, including operating residential substance use disorder (SUD) programs with inpatient treatment.

NCUIH nominated its President-Elect and CEO of Indian Health Center of Santa Clara Valley, Sonya Tetnowski to the Committee and she was selected as a member.   Ms. Tetnowski is a Makah Tribal Member and a Veteran of the U.S. military, having served in the Army as a Paratrooper.  She was deployed multiple times during her service in the Army and has tirelessly advocated on behalf of health equity for American Indians, including Native Veterans, through Congressional testimony and leadership at NCUIH.

About Native Veterans

According to a VA report, 140,507 Veterans identify themselves as American Indian or Alaska Native (AI/AN), and a higher percentage of AI/AN Veterans served in the Pre-9/11 period (17.7%) compared to Veterans of all other races (14.0%).  The report also showed that significant disparities between AI/AN veterans and other veterans including that:

  • AI/AN Veterans had lower personal incomes than Veterans of other races, ($29,847 v $38,792).
  • AI/AN Veterans were more likely to have some college compared to Veterans of other races (44.3% vs. 37.4%, respectively) but less likely to hold a bachelor’s degree (13.7% and 16.9%, respectively).
  • The percentage of AI/AN Veterans who were unemployed was higher than the percentage of Veterans of other races who were unemployed (5.5% vs. 3.4%, respectively).
  • AI/AN Veterans were more likely to lack health insurance than Veterans of other races (7.4% vs. 2.9%).
  • AI/AN Veterans were more likely to have a service-connected disability than Veterans of other races (30.0% vs. 23.0%, respectively).

AI/AN Veterans used Veterans Benefits Administration (VBA) benefits or services at a lower percentage than Veterans of other races (41.6% vs. 52.7%) in FY 2017.