NCUIH 2023 Policy Priorities Released

NCUIH worked with UIOs to identify policy priorities in 2023 under three themes: upholding the highest health status of all American Indians and Alaska Natives, parity in the Indian Health System, and improving the IHS.

The National Council of Urban Indian Health (NCUIH) is pleased to announce the release of its 2023 Policy Priorities document, which outlines a summary of urban Indian organization (UIO) priorities for the Executive and Legislative branches of the government for 2023. These priorities were informed by NCUIH’s 2022 Policy Assessment.

NCUIH hosted five focus groups to identify UIO policy priorities for 2023, as they relate to Indian Health Service (IHS)- designated facility types (full ambulatory, limited ambulatory, outreach and referral, and outpatient and residential). NCUIH worked with UIOs to identify policy priorities in 2023 under three themes: upholding the highest health status of all American Indians and Alaska Natives, parity in the Indian Health System, and improving IHS.

2023 Policy Priorities:

Upholding the Highest Health Status for All American Indians and Alaska Natives

Fully Fund the Indian Health Service (IHS) and Urban Indian Health at the Amounts Requested by Tribes

• Support the Tribal Budget Formulation Work Group request of $51.42 billion for IHS and $973.59 million for the Urban Indian Line Item for FY 2024.
• Support Participation and Continued Inclusion of UIOs in the IHS Budget Formulation Process.

Improving Behavioral Health for All American Indians and Alaska Natives

• Appropriate $80 Million for Behavioral Health and Substance Use Disorder Resources for Native Americans.
• Ensure Critical Resources and Funding Opportunities Related to Behavioral Health and Substance Use Disorder are Inclusive of Urban Native Communities and the UIOs that Help Serve Them.

Protect Funding for Native Health from Political Disagreements 

• Maintain Advance Appropriations for IHS to Insulate the Indian Health Service from Government Shutdowns and to Protect Patient Lives.
• Transition IHS from Discretionary to Mandatory Appropriations.

“Nothing About Us Without Us”: Improving Health Outcomes Through Dialogue and Action

• Increase Federal Agency Engagement with UIOs through Urban Confer Policies.
• Identify the Needs of and Develop Strategies to Better Serve Urban Native Populations.

Improving Health Outcomes Through Traditional Healing and Culturally-Based Practices

• Improve Funding Access for UIOs to Expand traditional Healing and Culturally Based Practices

Improving Native Veteran Health Outcomes

• Establish an Urban Confer Policy at the Department of Veterans Affairs (VA).
• Engage with UIOs to Successfully Implement the Interagency Initiative to Address Homelessness for Urban Native Veterans.
• Increase Urban Native Access to VA Resources that Address Social Determinants of Health (SDOH).

Healing from Federal Boarding Schools

• Support Federal Initiatives to allow the Indian Health Service to Support Healing from Boarding School Policies.
• Study and Incorporate Findings of the Public Health Impact of Indian Boarding Schools on Urban Natives Today.

Fulfilling the Trust Responsibility 

• Support Native Communities by Fully Honoring the Federal Trust Responsibility to Provide Healthcare to Native People.
• Permanently Reauthorize and Increase Funding for the Special Diabetes Program for Indians (SDPI) at a Minimum of $250 Million Annually.

Tackling the Stigma and Advancing HIV Support Efforts in Native Communities

• Increase Innovative Resources to Reduce Stigma and Fear around HIV in Native Communities and Increase Behavioral Health Support Resources at UIOs for Natives Living with HIV.

Improving Food Security for Urban American Indians and Alaska Natives

• Increase access to U.S. Department of Agriculture (USDA) Resources and Funding Opportunities for Urban Native Communities and the UIOs that Help Serve Them.
• Increase UIO access to fresh produce and other traditional foods for AI/ANs through the IHS Produce Prescription Pilot Program.

Ending the Epidemic of Missing or Murdered Indigenous Peoples (MMIP)

• Reauthorize the Family Violence Prevention and Services Act (FVPSA) and Pass the BADGES for Native Communities Act.
• Honor Executive Order 14053: Improving Public Safety and Criminal Justice for Native Americans and Addressing the Crisis of Missing or Murdered Indigenous People by Including UIOs in Prevention and Intervention Efforts.

Improving Native Maternal and Infant Health 

• Include a Tribal and UIO Health Provider Representative on the Advisory Committee on Infant and Maternal Mortality to Complement the Work of the Standing IHS Ex-officio Member.
• Increase the Health Resource Services Administration’s Engagement with UIOs through Urban Confer and UIO Listening Sessions Regarding the Provision of Healthcare to Native Mothers and Infants.

Achieving Parity in the Indian Health System

Increasing Resources to Support More Comprehensive Care for Medicaid-IHS Beneficiaries

• Enact the Urban Indian Health Parity Act to Ensure Permanent Full (100%) Federal Medical Assistance Percentage (FMAP) to Expand Services Provided at UIOs.

Improving the Indian Health Workforce

• Inclusion of UIOs in National Community Health Aide Program (CHAP).
• Improve the Medicaid workforce through the Inclusion of UIOs in the VA’s Pilot Program on Graduate Medical Education and Residency Program (PPGMER).
• Permit U.S. Public Health Service Commissioned Officers to be Detailed to UIOs.

Improving the Indian Health Service

Accurately Account for Provider Shortages

• Engage with the Health Resources and Services Administration (HRSA) so that UIOs receive Health Professional Shortage Area (HPSA) Scores that Accurately Reflect the Level of Provider Shortage for UIO Service Areas.

 Data is Dollars: Improving Data in Indian Health 

• Re-Introduce the Tribal Health Data Improvement Act.
• Improve Reporting for UIO Data.
• Improve Health Information Technology /Electronic Health Records.

Continuity in UIO Support from the Indian Health System

• Improve Area Office Consistency with Respect to Oversight and Management.
• Improve Communication at the IHS Area Level.

Elevate the Health Care Needs of American Indians and Alaska Natives Within the Federal Government

• Re-Introduce the Stronger Engagement for Indian Health Needs Act to elevate the IHS Director to Assistant Secretary for Indian Health.