On April 5, 2023, Health Resources & Services Administration’s (HRSA) Office of Intergovernmental and External Affairs (IEA) will host a tribal listening session on understanding historical trauma and its impacts on the American Indian/Alaska Native (AI/AN) workforce. HRSA’s goal is to advance tribal health systems and resources, partnering with federal agencies and other organizations to increase access to HRSA programs aimed to advance healthcare. Working with the tribal communities, HRSA aims to increase opportunities to access and optimize the quality and performance of the tribal health system increasing the capacity of Indian Country to respond to the impact of negative health outcomes among AI/AN communities. To help tribal organizations maximize the impact of key government programs, HRSA has prioritized increasing urban Indian health participation in the Health Center Program.

Background

The mission of HRSA IEA is to provide accessibility and awareness of HRSA programs designed to increase healthcare access and address emerging public health issues. HRSA IEA serves as the principal Agency lead on intergovernmental and external affairs, regional operations, and tribal partnerships.  HRSA IEA extends the reach of its programs by leveraging knowledge of national and regional contact located in various states, tribes, and territories. HRSA IEA also maintains partnerships across federal, state, and tribal networks to promote Department of Health and Human Services (HHS) policy priorities.

AI/AN Historical Trauma

Historical trauma is the cumulative psychological and emotional wounding across generations. For Tribal nations and the AI/AN community, historical trauma began during the eras of colonization, forced removal, and government sponsored boarding schools aimed to destroy AI/AN people and culture. Today, the impact of historical trauma  is manifested in many ways among AI/ANs including high rates of chronic diseases, suicides, domestic violence, alcoholism, and other social problems such as the lack of culturally competent care often leading to poor communication between physicians and patient that increase rick of misdiagnosis and loss of public trust. These ailments are negatively attributed across social determinants of health thereby impairing the ability to readily participate in the workforce.

NCUIH’s Role

NCUIH has advocated extensively for policy related to healing and reconciliation of historical trauma which continues to afflict AI/AN communities. For example, 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 where impacts and ongoing effects of Indian Boarding School Policies are examined. The Commission will also 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.

Dear Urban Indian Health Advocates,

We need your help contacting Congress to support increased healthcare resources for urban Native communities.

Representatives Ruben Gallego (D-AZ-3) and Raúl Grijalva (D-AZ-7) are again leading a letter to the Chair and Ranking Member of the Appropriations Subcommittee on Interior, Environment, and Related Agencies. This subcommittee appropriates funding for the Indian Health Service (IHS) and Urban Indian Organizations (UIOs).

The letter requests an increase for the urban Indian health line item to $973.59 million for Fiscal Year 2024 and retaining appropriations for IHS. Adequate funding for urban Indian health is necessary to fulfill the federal government’s trust responsibility to all American Indians and Alaska Natives.  The proposed amount is determined by the Tribal Budget Formulation Workgroup (TBFWG) as part of the request for full funding for IHS at $51.4 billion.

We encourage you to contact your Member of Congress and request that they sign the Gallego-Grijalva Urban Indian Health Letter by the deadline of March 17.

You can use the text below as a template to call and/or email to email your Member of Congress. You can find your representative here.

Sincerely,

The National Council of Urban Indian Health (NCUIH)

---

STEPS TO CONTACT CONGRESS 

• Step 1: Copy the email below.
• Step 2: Find your representative here.
• Step 3: Paste the email into the form and send. Please contact Lycia Maddocks (LMaddocks@ncuih.org) with questions.

---

Email to Your Member of Congress

Dear Representative,

As an urban Indian health advocate, I respectfully request you sign on to the Gallego-Grijalva letter to the Chair and Ranking Member of the Appropriations Subcommittee on Interior, Environment, and Related Agencies. The letter requests an increase for the urban Indian health line item to $973.59 million for Fiscal Year 2024 and retaining appropriations for IHS. Adequate funding for urban Indian health is necessary to fulfill the federal government’s trust responsibility to all American Indians and Alaska Natives.  The proposed amount is determined by the Tribal Budget Formulation Workgroup (TBFWG) as part of the request for full funding for IHS at $51.4 billion.

It is the policy of the United States “to ensure the highest possible health status for Indians and urban Indians and to provide all resources necessary to effect that policy.” This requires that funding for Indian health must be significantly increased if the federal government is to finally fulfill its trust responsibility. At a minimum, funding must be maintained and protected as budget-cutting measures are being considered.

We respectfully ask that you join this year to help honor the federal trust obligation and support the overall health and well-being of American Indians and Alaska Natives.

To sign on to the letter, please contact Emma Reidy (Emma.Reidy@mail.house.gov) from Gallego’s office by this Friday, March 17.

Thank you for your leadership and commitment to upholding the United States’ trust and treaty responsibility.

Sincerely,

[YOUR NAME]