20 Senators Request Increased Resources and Stable Funding for Urban Indian Health in FY 2025

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On May 14, 2024, 20 Senators requested up to $965.3 million for urban Indian health in Fiscal Year (FY) 2025 and advance appropriations for the Indian Health Service (IHS).

Sen. Tina Smith (D-MN) and 19 other Senators sent a letter to Chairman Jeff Merkley (D-OR) and Ranking Member Lisa Murkowski (R-AK) of the Senate Interior Appropriations Committee requesting up to $965.3 million for urban Indian health as part of the Tribal Formulation Workgroup’s topline request of $53.85 billion for IHS in FY 2025. The letter also requests the Appropriations Committee maintain advance appropriations for IHS for FY26. The letter emphasizes the critical role that Urban Indian Organizations (UIOs) play in the health care delivery to American Indian and Alaska Native patients and the importance of providing UIOs with the necessary funding to continue to provide quality, culturally competent care to their communities. On May 1, 2024, a group of 52 Representatives sent a letter to the House Interior Appropriations Committee with the same requests.

The letter also notes that chronic underfunding of IHS and urban Indian health has contributed to the health disparities among American Indian and Alaska Native people living in urban areas that suffer greater rates of chronic disease, infant mortality, and suicide compared to other populations.

This letter sends a clear and powerful message to Chairman Merkley and Ranking Member Murkowski and the members of the Senate that funding for urban Indian health must be significantly increased to fulfill the federal government’s trust responsibility to provide quality healthcare to all American Indian and Alaska Native people.

NCUIH is grateful for the support of the following Senators:

  1. Tina Smith
  2. Tammy Baldwin
  3. Maria Cantwell
  4. Ben Luján
  5. Edward Markey
  6. Alex Padilla
  7. Jack Rosen
  8. Jon Tester
  9. Chris Van Hollen
  10. Elizabeth Warren
  11. Amy Klobuchar
  12. Catherine Cortez Masto
  13. Laphonza Butler
  14. Kyrsten Sinema
  15. Ron Wyden
  16. Mark Kelly
  17. Kirsten Gillibrand
  18. Richard Blumenthal
  19. Tammy Duckworth
  20. Michael Bennet

Full Letter Text

Dear Chairman Merkley and Ranking Member Murkowski,

We write to thank you for your proven commitment to the Indian health system, including Urban Indian Organizations (UIOs), and to request you continue your support by funding urban Indian health at the highest level possible, up to $965.3 million, and retaining advanced appropriations for the Indian Health Service (IHS) in the Fiscal Year (FY) 2025 Interior, Environment, and Related Agencies Appropriations Act.

These requests reflect the full need for urban Indian health determined by the Tribal Budget Formulation Workgroup, which is comprised of Tribal leaders representing all twelve IHS service areas. The Workgroup recommended this funding amount for urban Indian health as a part of a $53.85 billion topline recommendation for the Indian Health Service.

UIOs are an important part of the IHS, which oversees a three-prong system for the provision of health care: Indian Health Service, Tribal Programs, and Urban Indian Organizations (I/T/U).UIOs are on the front lines in working to provide for the health and well-being of American Indians and Alaska Natives living outside of Tribal jurisdictions. They serve patients from over 500 federally recognized Tribal Nations in 38 urban areas across the country. UIOs are not eligible for other federal line items that IHS and Tribal facilities are, like hospitals and health clinics, money, purchase and referred care dollars, or IHS dental services dollars. Therefore, this funding request is essential to providing quality, culturally-competent health care to AI/AN people living in urban areas.

Chronic underfunding of IHS and urban Indian health has contributed to the health disparities among AI/AN people. Additionally, AI/AN people living in urban areas suffer greater rates of chronic disease, infant mortality, and suicide compared to all other populations. Urban Native populations are less likely to receive preventive care and are less likely to have health insurance. Additional funding is critical to addressing this disparity.

In order to fulfill the federal government’s trust responsibility to all AI/AN people to provide quality healthcare, funding for urban Indian health must be significantly increased. It is also imperative that such an increase not be paid for by diminishing funding for already hard-pressed IHS and Tribal providers. The solution to address the unmet needs of urban Native and all AI/AN people is an increase in the overall IHS budget.

Thank you for your continued support of urban Indian health and your consideration of this important request.

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Indian Health Service Report Finds that Urban Indian Organization Staff Must Increase by 136% to Meet Patient Demand by 2032

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On April 23, 2024, the Indian Health Service (IHS) Office of Urban Indian Health Programs (OUIHP) released the Urban Indian Organization (UIO) Infrastructure Study Report to Congress Fiscal Year 2023 (“UIO Infrastructure Study”). The report establishes future facility needs for the majority of the 41 UIOs and estimates the operational resources needed to serve each UIO Service Area’s future urban American Indian and Alaska Native population.

Key Findings

Some key findings address UIOs’ future services, staffing needs, operational budget, and facility requirements.

Regarding future services provided at UIOs, the UIO Infrastructure Study stated that “the majority of UIOs emphasize primary medical care services and aspire to be the culturally appropriate medical home for their patient population and community.” UIOs that offer primary care and provided data plan to have staff and resource capacity to support approximately 1,376,000 primary care visits in 2032, an increase from the current rate of approximately 463,000 provider visits per year. “Most UIOs see themselves offering a broader spectrum of outpatient services in the future to provide their patients with a one-stop shop of services.”

To reach the UIOs’ 2032 goals, the 39 UIOs that provided staffing data would need to grow from 3,420 Full-Time Equivalents (FTEs) to 6,275 FTEs, which is a 78% increase. “For overall patient service demand, the number of FTEs would need to grow to 8,083.” To fund the 2032 vision, IHS “contract and grant funding provided annually would need to increase by $1.37 billion for the Urban Indian population portion and overall would need to increase by $1.81 billion.” Lastly, UIOs need an additional 2.75 million building gross spare feet (BGSF) which would require $2.95 billion for facility design and construction and $4.4 billion to replace the entire inventory of UIOs’ space.

Background

In 2021, Congress allocated $1 million in funds for IHS to conduct an Urban Indian Infrastructure study through the Consolidated Appropriations Act, 2021. The purpose of the Infrastructure Study is to further understand the most critical deficiencies facing UIOs. IHS contracted with The Innova Group, a healthcare consultancy entity, to conduct the Infrastructure Study. On March 15, 2022, Congress provided $800,969 in additional funding to IHS for the Infrastructure Study through the Consolidated Appropriations Act, 2022.

NCUIH’s Advocacy

On August 23, 2022, NCUIH submitted comments to IHS in response to the June 16, 2022, Dear Urban Indian Organization Leader letter regarding the use of funding available for the Urban Indian Infrastructure Study.

NCUIH continues to advocate for transparency in the process of the UIO Infrastructure Study and greater support to address the critical infrastructure needs at UIOs. NCUIH will continue to keep UIOs informed as more information is made available from IHS.

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New Medicaid Rule Emphasizes Mandate that States Must Consult with Tribes and UIOs

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On May 10, 2024, the Centers for Medicare and Medicaid Services (CMS) issued a final rule regarding ensuring access to Medicaid services. This final rule addresses access to care, quality and health outcomes, and better addressing health equity issues in the Medicaid program across fee-for-service (FFS), managed care delivery systems, and in home and community-based services (HCBS) programs. While the final rule was not responsive to comments submitted by the National Council of Urban Indian Health (NCUIH), CMS stated that states with one or more urban Indian organizations (UIOs) that furnish health care services must consult with the UIO(s) on a regular, ongoing basis. UIOs are also eligible to be on states’ Medicaid Advisory Committees (MACs).

Background

On May 3, 2023, CMS issued the proposed rule on ensuring access to Medicaid services. The proposed rule included both proposed changes to current requirements and newly proposed requirements that would advance CMS’s efforts to improve access to care, quality, and health outcomes, and better promote health equity for Medicaid beneficiaries across FFS and managed care delivery systems, including for home and community-based services provided through those delivery systems. These proposed requirements were intended to increase transparency and accountability, standardize data and monitoring, and create opportunities for states to promote active beneficiary engagement in their Medicaid programs.

NCUIH’s Advocacy and CMS’ Response

On July 3, 2023, NCUIH submitted written comments and recommendations to CMS Administrator, Chiquita Brooks-LaSure, in response to the May 2, 2023, request for comment on the CMS proposed rule regarding ensuring access to Medicaid services. In its comments, NCUIH asked that CMS:

  • Ensure UIO and American Indian and Alaska Native representation on each state Medicaid Advisory Committee (MAC) and Beneficiary Advisory Group (BAG)—now called the Beneficiary Advisory Council (BAC).
  • Ensure the rule does not impose additional burdensome reporting requirements on providers.
  • Engage with the Tribal Technical Advisory Committee (TTAG) to consider regulations or guidance to enforce the state consultation and confer requirements.
  • Support 100% Federal Medical Assistance Percentage (FMAP) for Medicaid services provided at UIOs to ensure American Indian and Alaska Native Medicaid beneficiaries receive appropriate, quality culturally competent care.

NCUIH will continue to advocate for CMS to ensure UIO American Indian and Alaska Native beneficiaries have continued access to Medicaid services.

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May Policy Updates: Highlights from the Annual Conference, Congressional Testimony, Upcoming Events, and More!

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In this Edition:

📸 Annual Conference & Hill Day Recap: View photos and key updates from Annual Conference and Hill Day activities.

🏢 Federal Agency Roundtables: Insights from CMS, SAMHSA, HRSA, CDC, and SSA, plus IHS listening sessions.

🏛 Federal Addresses: Updates from OMB, CMCS, DOJ, and DOI.

📆 Upcoming Events: Key dates like the VA Urban Confer, IHS Strategic Plan Urban Confer, and more.

💬 NCUIH in Action: Highlights from our representation at the NIHB Tribal Leaders Reception and the Taskforce on Maternal Mental Health launch.

📝 Federal Agency Comments: NCUIH’s advocacy on the CMS Traditional Healing Framework, VA-UIO Reimbursement Program, and more.

🔜 Consultations & Comment Opportunities: Participate in upcoming consultations on the IHS HIT Modernization Program and ICWA.

📅 Significant Dates: Track events like the NIHB National Tribal Health Conference and the NCAI Mid-Year Conference.

NCUIH Annual Conference and Hill Day

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The NCUIH Annual Conference crescendoed with a Capitol Hill Advocacy Day, where the National Council of Urban Indian Health and leaders from Urban Indian Organizations visited 53 Congressional offices. This event was significant as it provided a platform for these leaders to directly engage with policymakers, amplifying the voice of Urban Indian Organizations and highlighting their priorities. This direct interaction helps ensure that their unique needs and challenges are understood and considered in legislative decision-making.

We are also proud to have hosted 5 Federal Agency Roundtables:

  • Centers for Medicare & Medicaid Services (CMS)
  • Substance Abuse and Mental Health Services Administration (SAMHSA)
  • Health Resources and Services Administration (HRSA)
  • Centers for Disease Control and Prevention (CDC)
  • Social Security Administration (SSA)

3 Listening Sessions:

  • Indian Health Service (IHS)
  • Indian Health Service Division of Behavioral Health (IHS DBH)
  • Indian Health Service HIV Program

and 1 Urban Confer with the VA on the Reimbursement Agreement Program: 

  • Department of Veterans Affairs (VA)

Sonya Tetnowski (Makah), MBA-F, Former NCUIH Board President, and The Honorable Denis Richard McDonough, Secretary of Veterans Affairs.

Sonya Tetnowski (Makah), MBA-F, Former NCUIH Board President, and The Honorable Denis Richard McDonough, Secretary of Veterans Affairs.

Featured Federal Agencies:

  • Office of Management and Budget (OMB)
  • Center for Medicaid & CHIP Services (CMCS)
  • Department of Justice (DOJ)
  • Department of the Interior (DOI)

Rori Collins, JD, Esq. (Nenana Native Village) NCUIH Public Policy Counsel, Walter Murillo (Choctaw), NCUIH Board President, Alexandra Payan, JD, NCUIH Federal Relations Manager, Daniel Tsai, Deputy Administrator and Director of CMCS, Francys Crevier (Algonquin), NCUIH CEO, Kitty Marx, CMS Division of Tribal Affairs.

Rori Collins, JD, Esq. (Nenana Native Village) NCUIH Public Policy Counsel, Walter Murillo (Choctaw), NCUIH Board President, Alexandra Payan, JD, NCUIH Federal Relations Manager, Daniel Tsai, Deputy Administrator and Director of CMCS, Francys Crevier (Algonquin), NCUIH CEO, Kitty Marx, CMS Division of Tribal Affairs.

Rori Collins, JD, Esq. (Nenana Native Village) NCUIH Public Policy Counsel, Meredith Raimondi, NCUIH VP of Policy and Communications, Bryan Newland (Ojibwe), Assistant Secretary of the Interior or Indian Affairs.

Rori Collins, JD, Esq. (Nenana Native Village) NCUIH Public Policy Counsel, Meredith Raimondi, NCUIH VP of Policy and Communications, Bryan Newland (Ojibwe), Assistant Secretary of the Interior or Indian Affairs.


NCUIH Requests Full Funding for the Indian Health System for FY 2025

Todd Wilson (Crow), Executive Director of Helena Indian Alliance-Leo Pocha Clinic Testifies during American Indian and Alaska Native Public Witness Day.

Todd Wilson (Crow), Executive Director of Helena Indian Alliance-Leo Pocha Clinic Testifies during American Indian and Alaska Native Public Witness Day.

NCUIH Testimony at House Interior Appropriations Subcommittee American Indian and Alaska Native Public Witness Hearing

On May 8, 2024, Todd Wilson (Crow), Executive Director of Helena Indian Alliance-Leo Pocha Clinic and NCUIH board member, was NCUIH’s witness for the House Appropriations Committee’s AI/AN Witness Day.

  • Go deeper: Testimony advocated for full funding for IHS at $53.8 billion and Urban Indian Health line item at $965.3 million for Fiscal Year (FY) 2025 (as requested by the Tribal Budget Formulation Workgroup), maintaining advance appropriations for IHS until mandatory funding is authorized, and protecting IHS from sequestration.

Congressional Dear Colleague Letters

NCUIH helped draft the Dear Colleague Letters requesting the TBFWG’s FY 2025 requests for the Urban Indian Health line item ($965.3 million) and IHS ($53.85 billion).

Advocacy Highlights: CMS Traditional Healing Framework & VA-UIO Reimbursement Agreement Program

NCUIH

On April 29, NCUIH submitted comments to CMS on the Traditional Healing Framework Section 1115 Demonstrations.

  • The bottom line: NCUIH requested that CMS include Traditional Healing services provided at UIOs in the Proposed Framework; allow Tribes, UIOs, and States the flexibility to develop a solution that serves all American Indian and Alaska Native beneficiaries; ensure the Proposed Framework reflects the requests of Tribes and UIOs; ensure the Proposed Framework does not create inequities in care; respect confidentiality for Traditional Healers and Traditional Healing practices; and engage with UIOs by hosting an urban confer and continue to engage with Tribes.

On May 15, NCUIH submitted comments to the VA on the VA-UIO Reimbursement Agreement Program. Urban confer was held on May 1, 2024, at the NCUIH conference.

  • The bottom line: NCUIH requested that the VA continue to engage with and provide updates to UIO on the revised agreement through its development; improve the UIO reimbursement rates under the revised agreement; ensure Changes to the Scope of Services Include Services Provided at UIOs; and provide technical assistance to UIOs to support UIO participation.

Upcoming Federal Comment Opportunities: 

June 7 – IHS Health Information Technology (HIT) Modernization Program: Deployment and Cohort Planning

  • IHS held a Tribal Consultation and Urban Confer on May 9 providing information and updates on the EHR implementation process.
  • IHS is seeking comments on the topic of EHR deployment and cohort planning.

June 14 – DOJ, DOI, HHS – Strengthening ICWA

  • DOJ, DOI, and HHS held a joint Tribal Consultation on May 14, 2024.
  • The agencies are seeking feedback on ICWA and what steps the agencies can take to promise federal protections for Indian children and their parents and caregivers.

June 28 – IHS Urban Confer regarding IHS’ Strategic Plan for FY 2024-2028

  • IHS will host a virtual Urban Confer on May 30.
  • The draft IHS Strategic Plan for FYs 2024-2028 will establish the Agency’s direction for the next 5 years.
  • IHS is seeking input to establish goals, objectives, strategies, and performance measures to improve Agency operations, strengthen Tribal partnerships, and deliver quality health care to American Indians and Alaska Natives in urban communities.

July 1 – USDA Dietary Guidelines for America

  • USDA is seeking public comment as the 2025 Dietary Guidelines Advisory Committee conducts its scientific review process.

July 10 – VHA-IHS MOU Operational Plan for FY24 and Joint Tribal Consultation and Urban Confer

  • The VA and IHS sent a Dear Tribal and Urban Leader Letter seeking feedback on the VHA-IHS MOU Operational Plan for FY 2024.
  • VA and IHS are tentatively planning to host an Urban Confer the week of June 10, 2024.

NCUIH in Action: Partner Advocacy, Democracy is Indigenous, and Medicaid Unwinding

Meredith Raimondi, NCUIH VP of Policy and Communications, Anthony (A.C.) Locklear, JD, Federal Relations Director at National Indian Health Board, and Mary Jomia, NCUIH Public Policy Manager.

Meredith Raimondi, NCUIH VP of Policy and Communications, Anthony (A.C.) Locklear, JD, Federal Relations Director at National Indian Health Board, and Mary Jomia, NCUIH Public Policy Manager.

Meredith Raimondi, NCUIH VP of Policy and Communications, Anthony (A.C.) Locklear, JD, Federal Relations Director at National Indian Health Board, and Mary Jomia, NCUIH Public Policy Manager.On May 7, NCUIH represented UIOs at the National Indian Health Board (NIHB) Tribal Leaders Reception with HHS Secretary Tribal Advisory Committee (STAC) members.

NCUIH Interim Director of Congressional Relations Jeremy Grabiner, Urban Indian Center of Salt Lake Specialist Ralyn Montoya, National Urban Indian Family Coalition Executive Director Janeen Comenote, Kansas City Indian Center's Executive Director Gaylene Crouser and Coordinator Jason Swartley, at the Democracy is Indigenous Mid-Year Gathering.

NCUIH Interim Director of Congressional Relations Jeremy Grabiner, Urban Indian Center of Salt Lake Specialist Ralyn Montoya, National Urban Indian Family Coalition Executive Director Janeen Comenote, Kansas City Indian Center’s Executive Director Gaylene Crouser and Coordinator Jason Swartley, at the Democracy is Indigenous Mid-Year Gathering.

On May 14 and 15, NCUIH attended the National Urban Indian Family Coalition’s Democracy is Indigenous Mid-Year Meeting. NCUIH and partner Urban Indian Organizations shared the work they are doing to address voting access as social determinant of health. NCUIH also shared resources for voting which can be found at NCUIH.org/Vote.

Carolyn Kowalyk, NCUIH Public Health Associate, at SAMHSA’s Taskforce on Maternal Mental Health Launch of the National Strategy and Report to Congress event.

Carolyn Kowalyk, NCUIH Public Health Associate, at SAMHSA’s Taskforce on Maternal Mental Health Launch of the National Strategy and Report to Congress event.

On May 14, NCUIH represented UIOs at the SAMHSA Taskforce on Maternal Mental Health Launch of the National Strategy and Report to Congress. Attendees heard from task force co-chairs and members, women with lived experience, HHS leaders, Congressional leaders, and others dedicated to addressing the maternal health crisis in the U.S.

  • Did you know?: The Taskforce on Maternal Mental Health is a subcommittee of the SAMHSA Advisory Committee on Women’s Services.

Meredith Raimondi, NCUIH VP of Policy and Communications, presenting at a Medicaid Unwinding panel discussion at the NIHB 2024 Tribal Health Conference.

Meredith Raimondi, NCUIH VP of Policy and Communications, presenting at a Medicaid Unwinding panel discussion at the NIHB 2024 Tribal Health Conference.

From May 19-23, NCUIH is attending the NIHB National Tribal Health Conference in Rapid City, SD. On May 21, NCUIH Vice President of Policy and Communications, Meredith Raimondi joined the American Cancer Society Cancer Action Network (ACSCAN), NIHB, and Georgetown Center for Children and Families in a panel discussion about the impact of the Medicaid unwinding and terminations on Native American communities. With 2.7 million Native people relying on Medicaid, the federal government must fulfill its trust obligation and safeguard their coverage.

Upcoming Events and Important Dates

Calendar with events on it

Recent Dear Tribal Leader Letters (DTLLs) and Dear Urban Leader Letters (DULLs)

Upcoming Events:

  • May 19-23: NIHB National Tribal Health Conference in Rapid City, SD
  • May 24: OUIHP-Urban Program Executive Directors/Chief Executive Officers Monthly Conference Call
  • May 29: White House Council on Native American Affairs (WHCNAA) Homeless Veterans Initiative Workgroup meeting.
  • May 30: IHS Urban Confer on the Development of the Strategic Plan for FYs 2024-2028. Join the meeting here.
  • June 1-6: National Congress of American Indians (NCAI) Mid Year Conference in Cherokee, NC. Register here.
  • June 11-12: Tribal Leaders Diabetes Committee in Scottsdale, AZ
  • June 11: MMPC Monthly Meeting

ICYMI:

Sonya Tetnowski (Makah), CEO of Indian Health Center of Santa Clara Valley presenting before the VA Advisory Committee on Tribal and Indian Affairs.

Sonya Tetnowski (Makah), CEO of Indian Health Center of Santa Clara Valley presenting before the VA Advisory Committee on Tribal and Indian Affairs.

On May 8-9, NCUIH represented UIOs at the HHS STAC meeting. Sonya Tetnowski (Makah), CEO of the Indian Health Center of Santa Clara Valley, presented about the VA Advisory Committee on Tribal and Indian Affairs

  • What’s next: The next VA TAC meeting will likely be in Washington D.C. around August-September 2024.
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NCUIH Endorsed Tribal Border Crossing Parity Act Protects Tribal Sovereignty and Ends Blood Quantum Rule for Border Crossings

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On March 27, 2024, Representative Fulcher and Representative Kilmer introduced the National Council of Urban Indian Health (NCUIH)-endorsed Tribal Border Crossing Parity Act. This bill would simplify the process for American Indian and Alaska Native people crossing the United States-Canada border and uphold Tribal sovereignty. If passed, the bill would allow Tribal members to use their Tribe-issued IDs as proof of citizenship in a federally recognized Tribe to cross the border, rather than having to provide proof of 50% blood quantum.

Currently, Tribally enrolled citizens who have shown proof of blood quantum and been issued a certificate from the Department of Interior, can freely cross the U.S.-Canadian border. While this policy dates back to the Jay Treaty of 1794, which allowed Native Americans to cross the border freely, without blood quantum requirements, Congress changed that requirement during the Termination Era. In 1952, the Immigration and Nationality Act required a 50% blood quantum and proof from the Department of Interior to cross freely. This creates an undue burden on Tribal members and violates Tribal sovereignty, as the blood quantum requirement infringes on the sovereignty of federally recognized Tribes to determine their own membership.  Tribal identification should be fully recognized as the best form of identification. The Tribal Border Crossing Parity Act will protect Tribal Sovereignty and ensure American Indian and Alaska Native people can freely exercise their treaty rights.

“The Tribal Border Crossing Parity Act is a healing step forward for the U.S. federal government toward truly honoring the trust and treaty obligation to Tribal Nations” said Francys Crevier, Chief Executive Officer at NCUIH. “The Jay Treaty of 1794 supported Indigenous People of North America to travel freely despite newly created colonizer lines, but during the Termination Era in 1952, Congress implemented a racist blood requirement that violated Tribal Sovereignty, the government-to-government relationship, and the original intent and spirit of the Jay Treaty, infringing on the rights of Tribal citizens. This legislation will correct some of the wrongs of the past and eradicate a racist law created in an attempt to terminate Tribal sovereignty.”

This bill is endorsed by the National Congress of American Indians, Kootenai Tribe of Idaho, and Prairie Band Potawatomi Nation.

Background

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Bipartisan Group of 52 Congressional Leaders Request Full Funding for Indian Health Service and Increased Resources for Urban Indian Health

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On May 1, 2024, 50 Congressional leaders joined Representatives Gallego and Grijalva in their letter to Chairman Simpson and Ranking Member Pingree of the House Interior Appropriations Committee requesting up to $53.85 billion for the Indian Health Service and $965.3 million for Urban Indian Health in FY25 and maintaining advance appropriations for IHS until authorizers move IHS to mandatory funding. The letter emphasizes that the federal government has a trust responsibility to provide federal health services to maintain and improve the health of American Indian and Alaska Natives.

The bipartisan group of 52 Congressional leaders reiterated their support for the Appropriations Committee’s work on the historic inclusion of advance appropriations in the FY23 and FY24 omnibus. Previously, IHS was the only federal health care provider funded through annual appropriations. Without advance appropriations, IHS is subject to the negative impacts of government shutdowns and continuing resolutions that can lead to serious disruptions in UIO’s ability to provide critical patient services. The inclusion of advance appropriations is a crucial step toward ensuring long-term stable funding for IHS.

This letter sends a powerful message to Chairman Simpson and Ranking Member Pingree, and members of Congress that in order to fulfill the federal government’s trust responsibility to all Natives to provide safe and quality healthcare, funding for the Indian Health Service must be significantly increased.

NCUIH is grateful for the support of the following Representatives:

  1. Ruben Gallego
  2. Raul M. Grijalva
  3. Dusty Johnson
  4. Sharice Davids
  5. Mary Sattler Peltola
  6. Teresa Leger Fernandez
  7. Raul Ruiz, M.D.
  8. Melanie Stansbury
  9. Gwen S. Moore
  10. Salud Carbajal
  11. Doris Matsui
  12. Shontel Brown
  13. Steven Horsford
  14. Greg Casar
  15. Grace F. Napolitano
  16. Nanette Diaz Barragan
  17. Pramila Jayapal
  18. Gabe Vasquez
  19. Katie Porter
  20. Adam Schiff
  21. Andrea Salinas
  22. Brittany Pettersen
  23. Earl Blumenauer
  24. Jared Huffman
  25. Mark Takano
  26. Jasmine Crockett
  27. Ro Khanna
  28. Jonathan L Jackson
  29. Julia Brownley
  30. Mike Levin
  31. Jimmy Panetta
  32. Ilhan Omar
  33. Lisa Blunt Rochester
  34. Jared Golden
  35. Chris Deluzio
  36. Jamaal Bowman
  37. Veronica Escobar
  38. Adam Smith
  39. Haley M. Stevens
  40. Cori Bush
  41. Val Hoyle
  42. Zoe Lofgren
  43. Jahana Hayes
  44. Steve Cohen
  45. Andre Carson
  46. Diana DeGette
  47. Kim Schrier
  48. Greg Stanton
  49. Jared Moskowitz
  50. Stephen F. Lynch
  51. Darren Soto
  52. Jesus G. “Chuy” Garcia
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NCUIH Recommends NIH Collaboration with Urban Indian Organizations for Future HIV Research Initiatives

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On March 28, 2024, the National Council of Urban Indian Health (NCUIH) submitted a response to a request for information (RFI) from the National Institutes of Health (NIH) Office of AIDS Research (OAR) to inform the development of the Fiscal Year (FY) 2026-2030 NIH Strategic Plan for HIV and HIV-Related Research (“Strategic Plan”). As part of its response, NCUIH urged NIH to prioritize research efforts that address the specific needs and challenges faced by American Indian and Alaska Native communities and requested that NIH partner with urban Indian organizations (UIOs) to improve research implementation.

Background

NIH OAR oversees and coordinates all HIV research activities across NIH, including both extramural and intramural research, research training, program evaluation, and HIV research infrastructure and capacity development. NIH supports a comprehensive portfolio of research representing a broad range of basic, clinical, behavioral, social, translational, and implementation science on HIV and associated coinfections and comorbidities. The Strategic Plan provides a framework for developing the NIH HIV research budget, articulates HIV research priorities, and provides information about NIH HIV research priorities to the scientific community, Congress, HIV-affected communities, and the public at large. The current strategic Plan is for FY 2021-2025.

The RFI requested responses to the FY 2026-2030 Strategic Plan’s four goals:

  • Goal 1: Enhance discovery and advance HIV science through fundamental research.
  • Goal 2: Advance the development and assessment of novel interventions for HIV prevention, treatment, and cure.
  • Goal 3: Optimize public health impact of HIV discoveries through translation, dissemination, and implementation of research findings.
  • Goal 4: Build research workforce and infrastructure capacity to enhance sustainability of HIV scientific discovery.

NCUIH’s Recommendations

In its response to OAR’s RFI, NCUIH requested that NIH:

  • Prioritize research efforts that address the specific needs and challenges faced by American Indian and Alaska Native communities in combating HIV.
  • Partner with UIOs to reach urban American Indian and Alaska Native populations.
  • Support the development of a diverse and inclusive HIV research workforce by recruiting and retaining American Indian and Alaska Native researchers.
  • Host UIO listening sessions as it develops the Strategic Plan

NCUIH will continue to monitor the development of the FY 2026-2030 NIH Strategic Plan for HIV and HIV-Related Research.

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NCUIH Urges Direct Engagement with Urban Indian Organizations in CMS Quality Improvement Program

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On March 20, 2024, the National Council of Urban Indian Health (NCUIH) submitted comments to the Centers for Medicare and Medicaid Services (CMS) Centers for Clinical Standards and Quality Deputy Director, Jean Moody Williams, regarding the American Indian Alaska Native CMS Quality Improvement (AIANHQI) Program 13th Scope of Work (2024-2029). In its comments, NCUIH requested that CMS engage directly with urban Indian organizations (UIOs) as CMS considers UIO inclusion in the AIANHQI Program.

Background

CMS’ Quality Improvement Organization (QIO) Program is one of the largest federal programs dedicated to improving the quality of health care at the community level. AIANHQI is a strategic partner of the QIO Program that advances this mission through partnerships with tribal communities and Medicare-certified Indian Health Service (IHS)-managed hospitals, including rural and critical access hospitals. AIANHQI initiatives complement IHS strategic priorities and goals. The QIO Program and the AIANHQI collaborate with IHS and tribal nations to help solve the most pressing AIAN health care challenges.

Click here to learn more about the AIANHQI.

NCUIH’s Recommendations

In its comments, NCUIH recommended that CMS:

  • Host Urban Confers or UIO Listening Sessions to engage directly with UIOs.
  • Ensure the Quality Improvement Organization has expertise in working with UIOs.

NCUIH will continue to monitor the possible UIO inclusion in the AIANHQI and provide updates on developments.

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PRESS RELEASE: NCUIH Honors Representatives Raul Ruiz, M.D. and Don Bacon, Senators Markwayne Mullin and Ben Ray Luján

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NCUIH recognized the Members of Congress for their work in advancing the health of Native people.

FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (May 8, 2024) –  The National Council of Urban Indian Health (NCUIH) presented four Congressional Urban Indian Health Champion Awards to Members of Congress for their efforts to advance urban Indian health during its 2024 Annual Conference: Sustaining Traditions: Culture, Identity, Health.

Representative Raul Ruiz, M.D. (D-CA-25), Representative Don Bacon (R-NE-02), Senator Markwayne Mullin (R-OK), and Senator Ben Ray Luján (D-NM), were recognized as Members of Congress who have demonstrated outstanding commitment and leadership in advocating for the advancement and improvement of urban Native health and health care. These individuals have gone above and beyond in their efforts to champion legislation, policies, and initiatives that promote the health, welfare, and rights of urban Native peoples, and have a proven track record of collaboration, bipartisan cooperation, and effectiveness in advancing legislative agendas that address critical issues relating to urban Native health. NCUIH thanks the awardees for their dedication to upholding the federal trust and treaty obligation to provide healthcare services to all American Indian and Alaska Native people, regardless of where they reside.

Pictured: Representative Raul Ruiz, M.D. with NCUIH CEO Francys Crevier, and UIO Representatives from California.

Pictured: Homles Whalen, Senior Counsel for Senator Markwayne Mullin with NCUIH CEO Francys Crevier, CEO of the Indian Health Care Resource Center Carmelita Skeeter, and NCUIH President-Elect Robyn Sunday-Allen.

Pictured: Calli Shapiro, Senior Policy Counsel for Ben Ray Luján with NCUIH Board Member Dr. Linda Son-Stone, and NCUIH CEO Francys Crevier.

Pictured: Representative Don Bacon with Cheryl Carlberg, Omaha Clinic Director at the Nebraska Urban Indian Health Coalition, and NCUIH Staff.

About NCUIH

The National Council of Urban Indian Health (NCUIH) is a national representative advocating for the 41 Urban Indian Organizations contracting with the Indian Health Service under the Indian Health Care Improvement Act. NCUIH is devoted to the support and development of quality, accessible, and culturally competent health and public health services for American Indians and Alaska Natives living in urban areas.

NCUIH respects and supports Tribal sovereignty and the unique government-to-government relationship between our Tribal Nations and the United States. NCUIH works to support those federal laws, policies, and procedures that respect and uplift Tribal sovereignty and the government-to-government relationship. NCUIH does not support any federal law, policy, or procedure that infringes upon or in any way diminishes Tribal sovereignty or the government-to-government relationship.

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NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org, 202-417-7781

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NCUIH to Testify During American Indian and Alaska Native Public Witness Day

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Todd Wilson (Crow), Executive Director of the Helena Indian Alliance Leo-Pocha Clinic and National Council of Urban Indian Health (NCUIH) Board Member

On Wednesday, May 8, 2024, at 11:20 AM EST, Todd Wilson (Crow), Executive Director of the Helena Indian Alliance Leo-Pocha Clinic and National Council of Urban Indian Health (NCUIH) Board Member, will testify on behalf of NCUIH before the House Interior Appropriations Subcommittee hearing as part of American Indian and Alaska Native Public Witness Days (May 7 and 8, 2024).

Mr. Wilson’s testimony will advocate for full funding for the Indian Health Service (IHS) and Urban Indian Health line item at the amounts requested by the Tribal Budget Formulation Workgroup for Fiscal Year 2026, maintaining advance appropriations for IHS until mandatory funding is authorized, and protecting IHS from sequestration.

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