IHS Releases Office of Urban Indian Health Strategic Plan, Incorporates NCUIH Suggestions to Improve Data Accuracy and Facilitate Communication Efforts with Federal Partners and UIOs

On June 5, 2023, the Office of Urban Indian Health Program (OUIHP) under the Indian Health Service (IHS) published a Dear Urban Leader Letter, regarding the release of the final 2023-2027 5-Year Strategic Plan (Plan). Prior to this release, the National Council of Urban Indian Health (NCUIH) submitted comments to the OUIHP on December 15, 2022, regarding the upcoming Plan. Several of NCUIH’s comments were reflected in the Plan. OUIHP hosted several Urban Confers and Tribal Consultations starting in December 2021 seeking input and recommendations from UIOs for revisions to the 2017-2021 OUIHP Strategic Plan.

Background

In 2017, the IHS developed an OUIHP Strategic Plan 2017-2021, pursuant to the Consolidated Appropriations Act, which described what the Agency hoped to achieve over the next 5 years.  The 2017-2021 Plan was based on the participation and feedback received from UIO Leaders, IHS staff, and other stakeholders. In fiscal year (FY) 2022, IHS evaluated the existing OUIHP Strategic Plan and made revisions and modifications to the new Plan for FY 2023-2027. According to the OUIHP, the Plan will be centered on five Strategic Pillars:

• Provide effective, timely, and transparent communication;
• Improve OUIHP’s operational oversight and management;
• Leverage partnerships to expand UIO resources;
• Improve data quality; and
• Expand the infrastructure and capacity of UIOs.

NCUIH’s Role

NCUIH submitted a total of 4 comments to OUIHP regarding feedback on drafting of the Plan. NCUIH appreciates OUIHP for its efforts to meet various goals and objectives of the 2017-2021 Plan, for hosting several Urban Confers seeking UIO feedback on the new Plan, and for sharing each draft iteration of the new plan. However, NCUIH noted in each comment that there remains significant unmet goals and objectives from the 2017-2021 Plan which need continued attention and action.

NCUIH reiterated previous comments submitted in response to each draft of the Plan and also recommended that OUIHP include several key goals from the 2017-2021 Plan. Some recommendations NCUIH made in the 2023-2027 Plan included:

• Improve communication at the Area Level
• Improve area office consistency concerning oversight and management
• Support equitable reporting of individuals who are visiting multiple sites within the I/T/U system as well as proper reporting of UIO patient identity
• Review and modify the Implementation Plan annually
• Include specific actionable items and timelines
• Include UIOs to establish an annual on-site review process across IHS Areas through training and development
• Ensure action items include actions to achieve the corresponding objective
• Ensure that UIOs will be conferred within the process of evaluating the expansion of UIOs

NCUIH is pleased that OUIHP incorporated several of these recommendations into the development of the Plan across the different Strategic Pillars. For example, NCUIH’s recommendation on improving data accuracy by using appropriate data metrics to better reflect the effective use of federal funding was reflected in the Plan’s Strategic Pillar 4 to “Improve data quality” through the Strategic Pillar 4, Goal 2 that states that OUIPH “Partners with UIOs and other urban stakeholders to improve data accuracy and quality.” The Plan also includes the following two objectives: “Partner with NCUIH data workgroup and Tribal Epidemiology Centers to improve UIO data reporting; Work with UIOs to achieve 100% data mapping to the National Data Warehouse.” The Plan additionally includes NCUIH’s recommendation that OUIHP keep Strategic Pillar 1, Goal 3, Objective 3 from draft 2 “Facilitate communications with federal partners and UIOs on Urban Indian issues.”

NCUIH strongly believes that the Plan is an important vehicle to articulate leadership priorities, provide direction for program management functions, engage external partners and entities, and measure OUIHP’s progress towards meeting the goals and objectives contained in the Plan. NCUIH will continue to participate in the implementation and exercise of the Plan and inform UIOs of upcoming opportunities related to implementation of OUIHP’s Plan.