In this Edition:

🧰 New Toolkit: NCUIH releases a step-by-step guide to help UIOs invite Members of Congress to visit their clinics.

⚠️ Government Shutdown: Congress fails to pass a Continuing Resolution; IHS operations continue through advance appropriations—IHS funding for UIOs is protected.

📢 Rapid Response: The Coalition for Tribal Sovereignty coordinated a joint letter to the Office of Management and Budget and an Action Alert for UIOs to advocate for Tribal-serving federal employees.

⚖️ Parity & Partnerships: Urban Indian Health Parity Act reintroduced; NCUIH urges bipartisan support.

🏥 Graduate Medical Pilot: VA launches PPGMER program—UIOs eligible; applications due Nov. 28.

🏛️ Federal Engagement: NCUIH meets with HHS Secretary Kennedy; STAC raises hiring freeze, staffing, and 340B concerns.

🧠 Behavioral Health: SAMHSA Native Connections grants released; NCUIH pushes for $30M funding increase in FY 2026.

🌾 Rural Health Transformation: CMS opens $50B RHTP funding for states; applications due Nov. 5.

📅 Event Updates: IHS UIO and Partner Summit postponed; NCUIH Congressional Briefing on SUD/Overdose prevention tentatively Oct. 27.

📊 FY 2028 Budget Formulation: Area consultations begin this month; NCUIH provides PowerPoint templates and TA for UIO participation.

FY 2028 Area Budget Formulation: Preparation and Tools

Why Participation Matters

• Area consultations directly shape recommendations for national funding priorities. Each Area’s input helps determine the Urban Indian Health line item, which is averaged from regional proposals.

UIO engagement ensures that urban needs are accurately reflected in IHS budget planning.

How NCUIH is Supporting UIOs

• Each UIO will receive an Area-specific PowerPoint template with highlighted sections to customize for your clinic and region.
• NCUIH offers technical assistance and can help review slides or testimony before submission.

📅 Upcoming Area Consultations

• Nashville: October 29 (Virtual)
• Oklahoma City: November 5–6 (Hybrid)
• Bemidji: November 18–19 (Wisconsin Dells, WI)
• Phoenix: December 2–3 (Hybrid)
• California: December 10
• If your area is not listed, we have not received any information yet. Please let us know if you have heard an announcement for your area.

To schedule a prep session, contact policy@ncuih.org.

Appropriations and the Government Shutdown

When Congress failed to pass a continuing resolution by September 30, the federal government entered a shutdown.

• IHS operations mainly continued thanks to advance appropriations.
• On October 1, NCUIH convened a rapid response call with UIOs and issued a press release to Capitol Hill.
• Together with CTS, NCUIH sent a letter to OMB requesting an exemption for federal employees serving Tribal Nations during any shutdowns.
• A CTS Action Alert was shared with UIOs, including a template letter, talking points, and list of federally funded Tribal accounts.

New Resource: Toolkit on Inviting Members of Congress to Visit Your Urban Indian Organization

NCUIH released a new toolkit designed to help Urban Indian Organization (UIO) leaders invite members of Congress to visit their clinics.
The guide includes:

• Step-by-step instructions and best practices for scheduling a congressional visit.
• Template email language to help connect with congressional schedulers.
• Tips for highlighting the impact of UIOs and issues facing Native communities in urban areas.

These visits serve as powerful opportunities to build relationships and raise awareness of Urban Indian health needs.

Legislative Updates

Urban Indian Health Parity Act (H.R. 4722) 

• Reintroduced by Reps. Ruiz (CA-25) and Bacon (NE-02), this bipartisan bill would ensure UIOs receive parity in health program funding.

👉 Action for UIOs: Email Republican offices to sign on as co-sponsors.

New VA Pilot Program on Graduate Medical Education and Residency (PPGMER) – UIOs Eligible 

This new program supports physician rotations at IHS, Tribal, and UIO facilities.

• Applications are due by November 28, 2025.

NCUIH encourages UIOs to apply for eligibility under this program to strengthen urban Native clinical training capacity.

Federal Engagement: STAC and HHS Updates

At the HHS Secretary’s Tribal Advisory Committee (STAC) meeting (Sept. 23–25): 

• NCUIH met with HHS Secretary Kennedy, advocating for continued support for Urban Indian health, the end of the federal hiring freeze and increased IHS staffing.
• IHS reported over 1,000 vacancies since January, despite adding 70 Commissioned Corps officers.
• STAC members requested:
• A Native representative on the new HHS Healthcare Advisory Committee.
• A Tribal exemption from HRSA’s 340B rebate pilot program.
• Litigation continues to prevent HHS from implementing its proposed reorganization.

Grant and Funding Update

SAMHSA Native Connections Grant 

Several UIOs faced grant delays this year, prompting NCUIH to elevate the issue to HHS and provide STAC talking points.

• All FY 2025 grants have now been released.

For FY 2026:

• Senate proposal: Maintain current $23.67M level.
  House proposal: Increase funding to $30M.
• NCUIH continues to advocate for the higher House amount.

SAMHSA leadership reaffirmed the program’s importance:

“This program is so impactful for Tribal communities.” — Arthur Kleinschmidt, SAMHSA Principal Deputy Assistant Secretary, Sept. 24

CMS Rural Health Transformation Program (RHTP)

• On October 8, CMS held an All-Tribes webinar on the $50 Billion Rural Health Transformation Program under the One Big Beautiful Bill Act.
• State applications due: November 5, 2025
• The program aims to strengthen rural and Tribal health systems through innovative funding models.

Highlighted Action from the Coalition for Tribal Sovereignty

► Coalition for Tribal Sovereignty (CTS) 

CTS Action Alert to reach out to OMB and Members of Congress– shared with all UIOs​

• Includes template letter, talking points, and a list of funded accounts with Tribal implications.

About CTS: The Coalition for Tribal Sovereignty (CTS) is a collaborative alliance that serves as a powerful unifying voice of regional and national inter-tribal policy-oriented, non-profit organizations to engage with federal policymakers on critical issues affecting the sovereign interests, rights, and authorities of Tribal Nations, tribal citizens, and community members across the United States.

Upcoming Events and Meetings

Postponed: IHS UIO and Partner Federal Agencies Summit

• Originally planned for October 21–22, now postponed due to the shutdown.
• The UIO Caucus (October 20) has also been canceled.
• New dates will be announced once federal operations resume.

Upcoming Events 

• November 3: NIHB MMPC meeting ahead of CMS Tribal Technical Advisory Group (TTAG)
• November 12–13: CMS TTAG Quarterly Meeting (DC)
• November 16–21: NCAI Annual Convention & Marketplace (Seattle, WA)
• November 19: NCUIH Monthly Policy Workgroup (Virtual)

About NCUIH

The National Council of Urban Indian Health (NCUIH) is a national representative 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 high quality and accessible health and public health services for American Indian and Alaska Native people 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.