PRESS RELEASE: National Council of Urban Indian Health Announces 2026-2028 Board of Directors Leadership

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FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (May 28, 2026) – The National Council of Urban Indian Health (NCUIH) proudly announces the 2026-2028 board members. The elections occurred on April 28, during NCUIH’s Annual Conference.

NCUIH Executive Officers
Position Member Organization
Board President Robyn Sunday-Allen Oklahoma City Indian Clinic
Board President-Elect | 2028-2030 Sonya Tetnowski Indian Health Center of Santa Clara Valley
Board Vice-President Walter Murillo Native Health
Board Secretary Dr. Linda Son-Stone First Nations Community HealthSource
Board Treasurer Adrianne Maddux Denver Indian Health and Family Services
NCUIH Board Members By Region
Region Member Organization
1 Kerry Hawk-Lessard Native American LifeLines of Baltimore
2 a Dr. Patrick Rock Indian Health Board of Minneapolis
2 b Dr. Albert Mensah American Indian Health Services of Chicago
3 Vacant –
4 Todd Wilson Helena Indian Alliance-Leo Pocha Clinic
5 Toni Lodge The NATIVE Project
6 a Sonya Tetnowski Indian Health Center of Santa Clara Valley
6 b Natalie Aguilera Native American Health Center
7 a Dr. Linda Son-Stone First Nations Community HealthSource
7 b Walter Murillo Native Health
7 c Robyn Sunday-Allen Oklahoma City Indian Clinic
8 Adrianne Maddux Denver Indian Health and Family Services
About the Board Members

Our new board members are distinguished leaders in Native health care administration, passionate advocates for community health, and committed to culturally competent care. Their expertise will significantly influence our strategies and programs, enhancing health outcomes across American Indian and Alaska Native communities. Learn more on our website.

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.

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

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NCUIH Submits Comments to DEA Urging Inclusion of Urban Indian Organizations in Telemedicine Prescribing Rule

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On May 8, 2026, the National Council of Urban Indian Health (NCUIH) submitted written comments to Drug Enforcement Administration (DEA) Administrator Terrance C. Cole in response to the agency’s consultation on Special Registrations for Telemedicine and Limited State Telemedicine Registrations (Docket No. DEA-407, 90 FR 6541, January 17, 2025). NCUIH’s comments urge DEA to ensure that Urban Indian Organizations (UIOs) are explicitly included in the final rule’s special registration framework, and that administrative requirements do not create barriers that effectively prohibit UIO participation.

Background

The DEA’s proposed final rule would establish a permanent special registration framework for practitioners seeking to prescribe controlled substances, including medications for opioid use disorder (MOUD) such as buprenorphine, via telemedicine. The rule is consequential for UIOs because the current COVID-era telemedicine flexibilities expire on December 31, 2026, and UIOs have no existing statutory pathway to prescribe controlled substances via telemedicine. Federal law provides an existing telemedicine exception for IHS and Tribal practitioners, but that exception was designed as a rural access provision and is unavailable to UIO practitioners, who serve urban populations by definition. When COVID-era flexibilities lapse, UIO practitioners will have no pathway to initiate new patients on controlled substances via telemedicine. The special registration framework DEA is now creating represents the right and potentially only vehicle to establish a permanent solution.

NCUIH holds the urban Indian seat on the CMS Tribal Technical Advisory Group (TTAG) and has engaged on this rulemaking since the 2023 proposed rules on telemedicine prescribing. NCUIH’s comments address the distinct legal and regulatory circumstances of the urban Indian health system.

Current Action

When the COVID-era telemedicine flexibilities expire on December 31, 2026, an urban AI/AN patient who is ready to begin opioid use disorder treatment but cannot make an in-person appointment will have nowhere to turn. Unlike patients seen at IHS or Tribal facilities, UIO patients cannot fall back on a statutory alternative. They simply go without care. For many, loss of telemedicine prescribing flexibility would not redirect them to in-person care. It would drive them out of treatment entirely.

American Indian and Alaska Native people have the highest rate of fatal opioid overdoses of any population in the United States. Opioid overdose deaths among AI/AN people doubled between 2019 and 2021. UIOs serve these communities as primary care, behavioral health, and overdose prevention and treatment providers and they are located in counties at the center of the crisis. NCUIH’s 2024 CDC-commissioned needs assessment found that UIOs are located in counties that averaged 2,056 overdose mortalities in the first half of 2023, compared to a national county average of 209. Despite this, only 20 percent of UIOs offer medication-assisted treatment on-site, 60 percent reported legal or financial barriers to MAT provision, and 60 percent expressed interest in offering MAT but lacked the resources to do so, a direct consequence of the regulatory gap the final rule has an opportunity to close.

NCUIH’s comments make four key recommendations to DEA:

  1. Explicitly include UIO practitioners in any exemption or accessible special registration pathway established by the final rule, and recognize that IHS-eligible patients receiving care at UIOs are covered by any such pathway.
  2. Ensure administrative requirements do not effectively prohibit UIO participation, including the nationwide Prescription Drug Monitoring Program (PDMP) check requirement that was widely criticized across the 35,454 public comments submitted to the formal docket. UIOs are small, under-resourced organizations serving highly mobile, multi-state patient populations, and they lack the administrative infrastructure to absorb requirements designed for large health systems.
  3. Permit audio-only telemedicine for all OUD treatment encounters where audio-video is unavailable or not accepted by the patient, consistent with the accommodation already established in the DEA-948 final rule. Prior to the expiration of COVID-era flexibilities, IHS patients used audio-only telehealth 60 percent of the time. Restricting OUD prescribing to audio-video encounters would exclude patients without reliable internet access or video technology from tele-MOUD access.
  4. Apply continuity-of-care supply limits under the Special Registration framework sufficient to support sustained treatment for patients who face significant barriers to in-person follow-up, including transience, housing instability, and transportation barriers.

NCUIH will continue to monitor DEA’s telemedicine prescribing rulemaking and engage with federal partners to ensure that UIOs and the urban AI/AN communities they serve are not excluded from policies that expand access to life-saving SUD treatment.

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NCUIH May Policy Update: 2026 Annual Conference and HIll Day Recap, Special Diabetes Program for Indians, and Indian Health Service Funding updates and more!

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In this Edition:

  • 💰 Notice of Funding Opportunities
  • 🏛️ NCUIH 2026 Annual Conference and Hill Day Recap
  • 📜 Public Health Service Access Act (S. 4416) Introduced
  • 💰 FY 2027 Funding Updates: House Proposes Increased Funding for IHS
  • 🏛️ 21 Senators Support Indian Health Service and Urban Indian Health Funding
  • 🩺 Special Diabetes Program for Indians Updates
  • 💊 Federal Medical Assistance Percentage Updates
  • 📅 FY 2028 Department of Health and Human Services Annual Tribal Budget Consultation and Secretary’s Tribal Advisory Committee Recap
  • 💉 NCUIH Submits Comments to Health Resources and Services Administration on 340B Rebate Pilot Program
  • 💻 NCUIH Comments on Telehealth Prescribing Flexibility,
  • 🏛️Center for Indigenous Innovation and Health Tribal Advisory Committee Accepting Nominations
  • 📅 Upcoming Events and Policy Dates
  • 📝 ICYMI: Recent NCUIH Policy Blog Posts

Current Funding Opportunities

SAMHSA | Now Live – Garrett Lee Smith State/Tribal Suicide Prevention and Early Intervention Due: June 15, 2026

VA | Staff Sergeant Fox Suicide Prevention Grant Program Due: June 12, 2026

  • Funds community-based organizations to provide or coordinate non-clinical suicide prevention services for Veterans, Active-Duty Service Members, and their families.
  • Award: $100,000 – $750,000 · Total program funding: $111M
  • Full details: https://www.mentalhealth.va.gov/ssgfox-grants/

IHS | Phase 2 Produce Prescription Pilot Program (P4) Due: June 22, 2026

  • Supports produce prescription programs in Tribal communities, including UIOs, enabling AI/AN individuals to receive produce prescriptions redeemable for nutritious foods through approved community organizations or health care providers. UIOs are eligible. Up to 18 awards expected.
  • Award: $200,000 – $250,000 · Total pool: $3.5M
  • Full details: https://www.grants.gov/search-results-detail/362483

IHS | IHS FY 2026 Urban Emergency Fund (UEF) Due: No fixed deadline — submit as soon as reasonably practicable after an emergency occurs.

  • Helps UIOs address costs associated with one-time, non-recurring emergencies and disaster relief efforts.
  • Award: Up to $250,000 (subject to availability of appropriations; not guaranteed)
  • Full details: Submit a written request to the applicable IHS Area Director, with copies to the Area Chief Contracting Officer and the UIO’s Contracting Officer Representative.

NCUIH’s 2026 Annual Conference – Recap

NCUIH held its 2026 Annual Conference in Washington, D.C., from April 27–30, marking the 50th anniversary of the Indian Health Care Improvement Act. Key highlights from this year’s conference included:

  • Rep. Pingree
  • Department of Health and Human Services updates
  • Substance Abuse and Mental Health Services Administration updates
  • Centers for Medicare and Medicaid Services video presentation

NCUIH’s 2026 Hill Day – 60 Visits!

NCUIH’s 2026 Hill Day was a major success, with 60 congressional office visits. Attendees urged Congress to take action on key policy priorities, including:

  • Urban Indian Health Funding
  • 100% Federal Medical Assistance Percentage for Urban Indian Organizations
  • Substance Abuse and Mental Health Services Administration Grants

NCUIH Bi-Partisan Legislation Introduced to Strengthen Urban Indian Organization Workforce

Public Health Service Access Act (S. 4416)

The Public Health Service Access Act is a legislative amendment to the Public Health Service Act that would authorize the Indian Health Service to detail U.S. Public Health Service Commissioned Officers directly to Urban Indian Organizations.

  • Introduced on April 28 by Sen. Murkowski (R-AK), Sen. Murray (D-WA), Sen. Tillis (R-NC), and Sen. Cortez Masto (D-NV)
    Public Health Service Access Act (S. 4416)

Next Steps: The bill has been referred to the Senate Committee on Health, Education, Labor and Pensions.

[Read more on NCUIH’s blog]

FY 2027 Funding Updates: House Proposes Increased Funding for IHS, Congressional and Federal Support for UIOs

On May 20, The House released their FY 2027 Interior Appropriations Bill which proposes:

  • $8.69 billion for Fiscal Year 2027 for the Indian Health Service, which is an increase of $639.8 million above the Fiscal Year 2026 enacted level.
  • $6.06 billion in Fiscal Year 2028 advance appropriations.

NCUIH submitted written testimony to House and Senate Interior and Labor-HHS Appropriations Subcommittees, requesting increased funding for urban Indian health and protection of key Indian Country programs.

FY 2027 Appropriations discussions are underway:

  • House Interior Subcommittee Markup was held on 5/21/2026 and the full Committee markup is scheduled for June 3.
  • House Labor-HHS subcommittee and full committee markups are scheduled for June 5th and 9th.

21 Senators Support Indian Health Service and Urban Indian Health Funding

On April 15, 21 U.S. Senators signed a dear-colleague letter to Senate Interior Appropriations Committee leadership for FY 2027 funding. NCUIH conducted outreach to Members of Congress in support of this effort, which included requests for

  • Full funding for Urban Indian Health and the Indian Health Service
  • Maintaining Advance Appropriations for the Indian Health Service

Read more on NCUIH’s Policy Resource Center.

Indian Health Service Chief of Staff Clayton Fulton highlights importance of UIOs at House Interior Appropriations Subcommittee budget hearing to examine the IHS Fiscal Year 2027 Budget Request

“Our urbans do incredible work for the amount of dollars that we provide them each year. They do incredible access, and we work very diligently with them and the National Council on urban Indian health to make sure that they are well accessed, whether that’s creating access to our grant programs like behavioral health, additional grants that we have in urban programs and securing them so that has been primarily our partnership, and continue to work with them.”

— Indian Health Service Chief of Staff Clayton Fulton, April 30 Indian Health Service Budget Hearing

Special Diabetes Program for Indians Updates: Funding Status, Budget Context, and Congressional Implications

The Special Diabetes Program for Indians received $200 million in FY 2026 — the highest funding level in the program’s history, representing a 25% increase. Key updates include:

  1. FY 2026 Funding: $200 million enacted; highest level in Special Diabetes Program for Indians history (+25% increase). Current authorization expires December 31, 2026.
  2. FY 2027 President’s Budget: The $49.4 million reflected in the FY 2027 President’s Budget represents approximately one quarter of the annual $200 million level — roughly three months of funding before the authorization expires — minus $1 million in automatic sequestration cuts.
  3. Program Risk: No funding authority after January 1, 2027, without reauthorization. 31 UIOs receive SDPI grants. A lapse in authorization would cut off diabetes prevention and treatment services at tribal and urban Indian programs.

Pending Legislation:

  • Special Diabetes Program Reauthorization Act of 2025 (S.2211) – Introduced by Senators Collins and Shaheen on July 8, 2025, to reauthorize both the Special Diabetes Program for Type 1 Diabetes and the Special Diabetes Program for Indians.
  • House companion bill, H.R. 5461, was also introduced.

Congress must act to pass S. 2211 or comparable reauthorization legislation before December 31, 2026, to prevent a lapse in program authority.

Read more on NCUIH’s blog.

FY 2028 Department of Health and Human Services Annual Tribal Budget Consultation – Recap

On April 24, NCUIH submitted formal comments to the FY 2028 HHS Annual Tribal Budget Consultation. Key requests included:

  • Funding for Urban Indian Health and IHS at the full amount requested by Tribes
  • Mandatory appropriations for the Indian Health Service and exemption of HHS Indian Country funding from sequestration
  • UIO inclusion in budget formulation
  • Legislative fix to set FMAP at 100% for Medicaid services provided at UIOs.

The FY 2028 HHS Annual Tribal Budget Consultation was held April 21-22 in Washington, D.C. Support was shown for urban Indian health as HHS leadership highlighted their visits to UIOs and Tribal leaders raised that the proposed decrease for Urban Indian Health in the FY 2027 President’s Budget threatens UIOs and supported 100% Federal Medical Assistance Percentage (FMAP) for UIOs.

Department of Health and Human Services Secretary’s Tribal Advisory Committee Meeting – Recap

On April 23, NCUIH attended the HHS Secretary’s Tribal Advisory Committee (STAC) meeting.

Key highlights include:

  1. Secretary Kennedy named Urban Indian Organizations — including Native Health, Native American Connections, and Oklahoma City Indian Clinic — as models for traditional food integration and traditional healing-based substance use treatment.
  2. NCUIH acknowledged the Secretary for his support of 100% FMAP for UIOs, which he committed to working with Senator Cantwell on at an April 22 Senate Finance committee Hearing.

SAMHSA Issues Updated Harm Reduction Funding Guidance – What Can and Cannot Be Supported

SAMHSA has issued updated guidance clarifying what supplies and services can and cannot be supported with SAMHSA funding.

We encourage UIOs to review the Dear Colleague letter to assess any implications for your specific grants.

NCUIH Submits Comments to Health Resources and Services Administration Supporting Indian Health Care Provider Exemption from 340B Rebate Pilot Program

On April 20, NCUIH submitted comments to the Health Resources and Services Administration (HRSA) in response to its Request for Information on the 340B Rebate Model Pilot Program, which poses significant administrative and financial burdens for UIOs.

  • Requests include tribal consultation/urban confer and exemption for IHS, Tribal, and UIO providers from any rebate-based 340B pilot model.

NCUIH and CMS Tribal Technical Advisory Group Support Flexibility in Telehealth Prescribing for Urban Indian Organizations

The Drug Enforcement Administration (DEA) is conducting Tribal consultation on a framework for prescribing controlled substances via telemedicine and is seeking input on the unique healthcare access challenges facing urban American Indian and Alaska Native communities.

  • May 8 – NCUIH submitted comments to the DEA highlighting the statutory exclusion of UIOs from the existing Indian health telemedicine exception.
  • May 7 – NCUIH worked with UIOs and the CMS Tribal Technical Advisory Group (TTAG) in sending a letter to DEA, which included urban American Indian and Alaska Native patient access barriers, the critical role of audio-only telehealth, and the need for telehealth flexibilities for patient treatment.

HHS is Accepting Nominations for the Center for Indigenous Innovation and Health Tribal Advisory Committee

The HHS Office of Minority Health is accepting nominations for the Center for Indigenous Innovation and Health Tribal Advisory Committee (CIIH TAC).

  • TAC Membership: 3 delegates from IHS geographic areas and 3 National At-Large Member positions (must be nominated by an elected Tribal leader).
  • Nomination accepted until roles filled

Learn more on the Federal Register Notice.

Upcoming Events and Policy Dates

  • May 27 — Department of Veterans Affairs I/T/U Reimbursement Agreement Webinar (link)
  • June 2 — Indian Health Service Tribal Leaders Diabetes Committee Quarterly Meeting (virtual)

Recent NCUIH Policy Blogs

NCUIH Policy Blog

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.

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Special Diabetes Program for Indians Faces Funding Cliff Without Congressional Reauthorization

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The Consolidated Appropriations Act, 2026 (P.L. 119-75), signed into law in February 2026, reauthorized the Special Diabetes Program for Indians (SDPI) at $200 million per year — a 25% increase and the highest funding level in program history. The law also sets the stage for a critical decision point: SDPI’s authorization expires December 31, 2026, and without further Congressional action, the program will lose all funding authority on January 1, 2027.

SDPI is authorized under Section 330C of the Public Health Service Act. The $49.4 million reflected in the FY 2027 President’s Budget represents approximately one quarter of the annual $200 million level — roughly three months of funding before the authorization expires — minus $1 million in automatic sequestration cuts. The Office of Management and Budget (OMB) also elected not to include any mandatory program funding projections across the government in this year’s budget submission, which further contributes to SDPI appearing as a reduction.

Thirty-one Urban Indian Organizations (UIOs) receive SDPI grants. A lapse in authorization would cut off diabetes prevention and treatment services at tribal and urban Indian programs.

Congressional Action

At the April 21, 2026, Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies (LHHS) hearing on the FY 2027 HHS budget, Senator Jeanne Shaheen (D-NH) raised SDPI as part of a broader statement on the administration’s proposed cuts to diabetes prevention and research. Noting that 42 million Americans are currently living with diabetes and that American Indian and Alaska Native communities face disproportionately high rates of the disease, Senator Shaheen highlighted the apparent 75% reduction to SDPI alongside the elimination of CDC diabetes education programs and the termination of a major diabetes and dementia research study. Senator Shaheen, along with Senator Susan Collins (R-ME), led the bipartisan effort that secured the most recent SDPI reauthorization and the $200 million funding level enacted in February 2026.

Pending Legislation

On July 8, 2025, Senators Collins and Shaheen introduced S. 2211, the Special Diabetes Program Reauthorization Act of 2025, to reauthorize both the Special Diabetes Program for Type 1 Diabetes and the Special Diabetes Program for Indians. The bill was referred to the Senate Committee on Health, Education, Labor, and Pensions (HELP), where it remains pending. A House companion bill, H.R. 5461, was also introduced. The legislation has drawn bipartisan support, with 11 cosponsors across both parties. Congress must pass reauthorization legislation before December 31, 2026, to prevent a lapse in program authority.

Background

SDPI was established to address the disproportionately high rates of diabetes among American Indian and Alaska Native populations. The program funds prevention, treatment, and education initiatives at tribal and urban Indian health programs across the country. As a mandatory appropriation, SDPI requires periodic Congressional reauthorization to continue — it does not renew automatically each year like discretionary programs.

Next Steps

Congress must act to pass S. 2211 or comparable reauthorization legislation before December 31, 2026, to prevent a lapse in program authority. NCUIH will continue to monitor SDPI reauthorization efforts and advocate for continuation of the program at the full $200 million funding level.

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IHS Announces SDPI Grant Supplements, Consultation and Confer

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On May 21, 2026, the Indian Health Service (IHS) issued a Dear Tribal Leader and Urban Indian Organization Leader letter announcing two significant actions related to the Special Diabetes Program for Indians (SDPI): administrative grant supplements for all current grantees and a commitment to Tribal Consultation and Urban Confer on additional funding. The letter was signed by IHS Chief of Staff Clayton Fulton.

Background

The Consolidated Appropriations Act, 2026 (P.L. 119-75), signed into law in February 2026, reauthorized SDPI at $200 million per year — a $41 million increase above the prior funding level and the highest authorization in program history. The law also provided $50 million for the first three months of FY 2027, extending authorization through December 31, 2026.

SDPI is authorized under Section 330C of the Public Health Service Act. Unlike discretionary programs, SDPI requires periodic Congressional reauthorization to continue and does not renew automatically. Thirty-one Urban Indian Organizations (UIOs) are among the 310 current SDPI grant recipients. SDPI grants are awarded on a calendar year cycle, distinct from the federal fiscal year appropriations cycle.

IHS Actions

Administrative supplements. IHS will distribute 25 percent administrative supplements to all 310 current SDPI grant recipients, drawing on one-time unobligated carryover SDPI funding. Remaining CY 2026 annual grant funding will be made available to recipients on or before June 30, 2026.

Tribal Consultation and Urban Confer. IHS announced its intention to conduct Tribal Consultation and Urban Confer regarding the use of additional SDPI funds resulting from the FY 2026 reauthorization increase. Details on the process will be forthcoming.

TLDC Engagement

The IHS Tribal Leaders Diabetes Committee (TLDC) is charged under IHS Circular 25-11 with making recommendations to the IHS Director on the distribution of SDPI funds and broad-based policy and advocacy priorities related to diabetes in American Indian and Alaska Native (AI/AN) communities. The TLDC has been actively engaged with IHS on SDPI funding administration. NCUIH serves as a technical advisor to the TLDC, representing the interests of urban AI/AN communities and the UIOs that serve them.

Next Steps

NCUIH will continue to monitor developments related to SDPI reauthorization, the forthcoming Tribal Consultation and Urban Confer process, and IHS’s administration of SDPI funding.

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NCUIH Honors Senator Tina Smith for Her Leadership and Legacy in Urban Indian Health

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FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (May 20, 2026) – The National Council of Urban Indian Health (NCUIH) presented the Urban Indian Health Champion Award to Senator Tina Smith (D-MN) during NCUIH’s 2026 Annual Conference.

For years, Senator Smith has shown up for urban Indian health in ways that matter. In 2020, she co-introduced the bipartisan Coverage for Urban Indian Health Providers Act, which extended Federal Tort Claims Act (FTCA) coverage to Urban Indian Organizations (UIOs), a concrete win for UIOs and the communities they serve. That victory is just one example of the impactful change Senator Smith has worked to deliver for Indian Country.

From Left to Right: Dr. Patrick Rock CEO Indian Health Board of Minneapolis (IHB) (Leech Lake Band of Ojibwe), Senator Tina Smith, Joni Buffalohead, Chairwoman (Sisseton Wahpeton Oyate), Mike Goze, IHB Board member (Ho-Chunk Nation of Wisconsin)

Year after year, Senator Smith has also led the Senate Dear Colleague letter to the Interior Appropriations Subcommittee, which requested the maximum funding for urban Indian health and advance appropriations for the Indian Health Service. It is a consistent, reliable act of leadership that UIOs across the country depend on.

As Senator Smith prepares to conclude her Senate service at the end of her term, this award also celebrates her legacy. Over the course of her tenure, she has helped transform how Congress thinks about urban Indian health. We are deeply grateful for everything she has done for urban Indian communities and honored to recognize her with this award.

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.

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

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Urban Indian Organizations’ Programming Profile

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Urban Indian Organizations (UIOs) provide critical health care services to AI/AN people living in their service areas. UIOs play a vital role in upholding the federal trust responsibility that the United States (U.S.) Government holds with Tribes and American Indian/Alaska Native (AI/AN) people, as the large majority of AI/AN people live in urban areas. Currently, 41 UIOs are contracted with the Indian Health Service (IHS) under Title V of the Indian Health Care Improvement Act (IHCIA), representing 38 different urban areas within the U.S. These 41 UIOs consist of four different program types:

  • Full ambulatory facilities (24)
  • Limited ambulatory facilities (seven)
  • Residential and inpatient treatment facilities (five)
  • Outreach and referral facilities (five)

In 2025, the National Council of Urban Indian Health (NCUIH), reviewed all UIO services and programs provided as described on UIO websites, social media, and federal grant funding information databases. This overview of services demonstrates the wide range of multi-disciplinary programming that UIOs bring to their communities, with 80 percent of UIOs offering care for all four programming types: medical services, behavioral health services, social services, and traditional health practices.

Medical Services

All UIOs offer immunizations, healthy lifestyle programming, and chronic disease prevention programming.  Outside of those fundamentals, 85 percent of UIOs provide direct primary care services such as chronic disease management, regular physicals, urgent care, screenings, lab services, , and pregnancy and postpartum care.  The Special Diabetes Program for Indians (SDPI) is at 78 percent of UIOs, an embodiment of the unique care that UIOs provide their patients that utilizes strengths within Indigenous communities to promote wellness while also managing existing chronic diseases like diabetes. SDPI allows for indigenized diabetes care, so programs not typically allowed from standard grant sources like Indigenous food cooking classes to help manage A1C levels, community gardens, traditional dancing classes for fitness, and culturally based youth groups all are incorporated into diabetes prevention and management programs. When programs are specifically tailored to the communities they serve and incorporate community and culture, this can increase participation and patient buy in (National Council of Urban Indian Health, 2024).

Some UIOs with advanced service providers provide specialty care for their patients with many sites offering services such as nutritionists/dietician visits, dental care, optometry, and minor surgeries in house.  Several UIOs even include their own pharmacy, increasing accessibility and affordability for patients, which allows for supportive pharmacy-assisted chronic disease monitoring. Novel medical programs at UIOs include food prescription programs and mobile health vans increasing accessibility to care and promoting the inclusion of larger social drivers of health in healthcare programming.

Figure 1. Urban Indian organizations with a nutritionist or dietician on staff.

Interestingly, a little under half of UIOs provide cancer-related prevention services (49 percent) for their community members, which includes breast and cervical cancer screenings.  An uncovered unmet need is in identifying colorectal cancer in urban AI/AN people, as the ability to test is only at 12 percent of UIOs.  These services are less common because they are underfunded, not because they are not needed, and more funding and partnerships would bring more access to this area.

Figure 2. Urban Indian organizations’ cancer-related services offered

 

UIO providers emphasize the importance of their facilities offering care in house rather than referring out to ensure patient continuity of care, maintaining and strengthening patient relationships, and ensuring that care is culturally relevant for their patients. These medical services support all generations within these UIO communities bolstering much needed disease treatment and preventative care.

Figure 3. Commonality of medical services offered at urban Indian organizations

Behavioral Health Services

Behavioral health services are fundamental care at UIOs. All UIOs offer general counseling, with an emphasis on substance use disorders, and care for domestic violence/sexual assault victims. Counseling services vary in structure, with some offering family counseling, individualized counseling, and more. Other popular behavioral health services include consultation and assessment for diagnosis, support groups, intensive outpatient care, community education, and youth programs focused on promoting positive mental health practices for prevention.

Social Services

Figure 4. Urban Indian organizations with case workers or social workers available

With a holistic approach to health, non-medical factors must also be addressed to provide the best care for patients. UIOs offer a variety of social services to ensure all the needs of their patients are met. This approach to care is exemplified by the 85 percent of UIOs that employ social workers or case workers for their patients. Other popular social services at UIOs include assistance with insurance enrollment, transportation to care, support with housing and other necessities, and elder programs. While not as common, a few UIOs are able to offer housing for their community, directly addressing the larger non-medical needs of their patients that impact health and wellness.

Figure 5. Commonality of social services offered at urban Indian organizations

Traditional Healing

UIOs are set apart from standard health organizations as seen through the culturally relevant care they provide to their community. Many Urban Native people are unable to participate in traditional healing or ceremony due to living away from their Tribal communities, but almost all UIOs (95 percent) offer different ways to reconnect their patients with Traditional Healing as part of their programming. This programming highlights the significance of UIOs within their communities, providing culturally relevant care that is grounded in Indigenous concepts and practices of wellness. Talking circles are the most common traditional practice, with 61 percent of UIOs offering this practice. Traditional healing-based substance use treatment programs (i.e. Wellbriety), traditional drumming, traditional medicines, traditional arts, and Indigenous foods are also common traditional healing-based programs and practices that UIOs provide for their patients.

As shared by UIO staff in NCUIH’s 2023 report, traditional healing is in high demand within UIO communities (National Council of Urban Indian Health, 2023b). It offers a mechanism to combat social isolation, strengthen community and cultural connection, and promote wellness (National Council of Urban Indian Health, 2023b). However, many of these programs, as well as standard health services, are underfunded at UIOs, making it difficult for UIOs to fully meet the needs of the communities they serve (National Council of Urban Indian Health, 2023b).

Funding

It is vital that UIOs receive stable and sustained funding for their work to maintain their work in promoting healthier communities and providing life-saving care. Outside of IHS, Medicaid and the Children’s Health Insurance Program (CHIP) are the largest sources of funding for UIOs (National Council of Urban Indian Health, 2023a). Medicaid and CHIP reimbursement supplement the chronically low congressional appropriations to UIOs. Increased ability for Centers for Medicare & Medicaid Services (CMS) to reimburse for UIO services, like applying 100 percent federal medical assistance (FMAP) percentage would better support the work UIOs do to combat health disparities.

Many UIO programs and services are also funded through grants, but sustainability and relevance of grant opportunities do not always match the needs of AI/AN communities. Grants should adapt to better suit the Native communities they wish to support by extending grant life cycles, allowing funding for cultural activities and priorities, and increasing focus on preventative health programming (National Council of Urban Indian Health, 2023b).

UIO leaders outlined their priorities for 2026 with NCUIH with the top items emphasizing funding:

  • increasing congressional funding for Urban Indian Health
  • securing 100 percent federal medical assistance percentage (FMAP)
  • increasing general behavioral health funding (National Council of Urban Indian Health, 2025)

Despite the limited funding allocated to them, UIOs are integral parts of the AI/AN communities they serve and do much with the fraction of need provided. With more AI/AN people living away from Tribal lands, and thus Tribal health and IHS facilities, it is necessary that funding for AI/AN healthcare reflects the need for greater urban funding to uphold the trust responsibility to urban AI/AN people. By embracing an Indigenous holistic approach to care, UIOs uplift Urban AI/AN people when they most need it.

To cite information about UIO services and programming as detailed in this blog post, please use the following citation:

National Council of Urban Indian Health (2026). Urban Indian Organizations’ Programming Profile. https://ncuih.org/2026/05/18/urban-indian-organizations-programming-profile/

Citations:

National Council of Urban Indian Health. (2023a). An Overview of the Impact of Medicaid on Health Care for American Indians and Alaska Natives. https://ncuih.org/wp-content/uploads/Impact-Medicaid_NCUIH_D329_F2.pdf

National Council of Urban Indian Health. (2023b). (rep.). Recent Trends in Third Party Billing: Thematic Analysis of Traditional Healing Programs at Urban Indian Organizations and Meta-Analysis of Health Outcomes. Retrieved from https://ncuih.org/wp-content/uploads/03.25.24-FINAL-design-of-2023-TH-Report.pdf.

National Council of Urban Indian Health. (2024). (rep.). Recent Trends in Third Party Billing: Thematic Analysis of Traditional Food Programs at Urban Indian Organizations and Research on Traditional Healing. Retrieved 2026, from https://ncuih.org/wp-content/uploads/Traditional-Food-Report-NCUIH-D507_F2.pdf.

National Council of Urban Indian Health. (2025, November). Summary of NCUIH Policy Priorities Survey for 2026.

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Murkowski, Tillis, Murray, and Cortez Masto Introduce Bipartisan Bill to Strengthen Urban Indian Organization Workforce

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U.S. Senators Lisa Murkowski (R-AK), Patty Murray (D-WA), Thom Tillis (R-NC), and Catherine Cortez Masto (D-NV) have introduced bipartisan legislation to allow U.S. Public Health Service Commissioned Corps officers (PHSCOs) to be detailed directly to Urban Indian Organizations (UIOs).

Recently, Secretary Kennedy assigned 70 officers to Indian Health Service facilities to help stabilize staffing needs. Allowing PHCSOs to be detailed directly to UIOs is a longstanding priority that would improve capacity to serve patients and families.

“UIOs provide far more than a place for an annual check-up; they deliver culturally grounded care that reflects the needs and values of the communities they serve,” said Senator Murkowski. “All Native people deserve access to quality health care, whether they live in a city or a rural community. Ensuring these facilities are adequately staffed will strengthen health outcomes for American Indian and Alaska Native communities nationwide and help fill a critical gap in care.”

“Nevada’s Urban Indian health facilities are chronically understaffed,” said Senator Cortez Masto. “Even the best doctors and nurses can’t provide patients with the quality of care that they need if there simply aren’t enough of them. This commonsense fix gives the Department of Health and Human Services the flexibility it needs to ensure that Tribal communities across the Silver State can get the health care they need.”

“We are grateful to Senators Murkowski, Murray, Tillis, and Cortez Masto for championing this bipartisan effort to allow U.S. Public Health Service Commissioned Officers to be detailed directly at urban Indian organizations. Due to limited funding, Urban Indian Organizations continue to face significant challenges in recruiting and retaining skilled health care professionals, and detailing Commissioned Officers help them address workforce shortages and increase collaboration across the federal health care system. We urge Congress to pass this legislation swiftly so that Urban Indian Organizations can benefit from this vital workforce support.” — Francys Crevier (Algonquin), CEO of NCUIH

Background

The Public Health Services for Advancing Care and Creating Efficient Support Systems in Underserved Communities Act, or the PHS ACCESS Act, would amend Section 214 of the Public Health Service Act to formally authorize the Health and Human Services (HHS) Secretary to detail PHCSOs to UIOs to perform work related to the functions of HHS. Detailing officers to UIOs would help address persistent workforce shortages at UIOs, bring skilled, federally-supported clinicians and public health professionals into urban Indian health settings, and strengthen coordination across the broader Indian health system.

Next Steps

The bill has been referred to the Senate Committee on Health, Education, Labor, and Pensions. The bill will need to be passed out of the Committee before receiving full consideration from the Senate.

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NCUIH 2026-2027 Policy Priorities Released: Need for Full and Stable IHS Funding, Medicaid Parity for UIOs, and Investments in Native Behavioral Health Programs

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The National Council of Urban Indian Health (NCUIH) is pleased to announce the release of its 2026-2027 Policy Priorities document, which outlines a summary of urban Indian organization (UIO) priorities for the Executive and Legislative branches of the government. These priorities were informed by NCUIH’s 2025 Policy Assessment.

NCUIH hosted five focus groups and conducted a nationwide survey to identify and rank UIO policy priorities for 2026, as they relate to Indian Health Service (IHS)-designated facility types (full ambulatory, limited ambulatory, outreach and referral, and outpatient and residential). The result is a focused, member-driven agenda. NCUIH worked with UIOs to identify five top policy priorities for 2026-2027:

  • Increasing Funding for IHS and the Urban Indian Health Line Item
  • Establishing Permanent Full (100%) FMAP for Medicaid Services at UIOs
  • Increasing Behavioral Health Funding
  • Stability in Federal Grants
  • Health Information Technology and Electronic Health Record Improvement
Read the 2026-2027 Policy Priorities

2026-2027 Policy Priorities:

FULLY FUND THE INDIAN HEALTH SERVICE (IHS) & URBAN INDIAN HEALTH AT THE AMOUNTS REQUESTED BY TRIBES

Implement Tribal Funding Priorities for the Indian Health Service and Urban Indian Health

  • Support the Tribal Budget Formulation Work Group request of $73 billion for IHS and $1.09 billion for the Urban Indian Line Item for FY 2027.
  • Maintain Advance Appropriations for the Indian Health Service to Insulate the Indian Health System from Government Shutdowns and to Protect Patient Lives.
  • Reclassify Contract Support Costs and 105(l) Leases to Mandatory Appropriations.

MEETING THE TRUST OBLIGATION FOR IHS-MEDICAID BENEFICIARIES RECEIVING SERVICES AT URBAN INDIAN ORGANIZATIONS

Uphold the Trust Obligation for IHS-Medicaid Beneficiaries Receiving Services at Urban Indian Organizations

  • Provide 100% Federal Medical Assistance Percentage (FMAP) for Services at UIOs and Ensure Proper Implementation of Medicaid Obligations for Services Provided at Urban Indian Organizations under H.R. 1.
  • Pass the Urban Indian Health Parity Act to Ensure Permanent Full (100%) FMAP for Services Provided at UIOs.
  • Ensure that HHS and CMS Issue Binding Guidance to States to Automatically Exempt American Indian and Alaska Native Beneficiaries from H.R. 1 Work Requirements and Cost-Sharing.

IMPROVING BEHAVIORAL HEALTH FOR ALL AMERICAN INDIAN AND ALASKA NATIVE PEOPLE

Increase Funding for Behavioral Health and Substance Use Disorder Resources for American Indian and Alaska Native People

  • Appropriate $80 Million for Behavioral Health and Substance Use Disorder Resources for Native Americans.
  • Reintroduce and Co-Sponsor the Native Behavioral Health Access Improvement Act.
  • Protect Critical Programs Such as Native Connections from Any Funding Delays or Disruptions.

STABILIZE AND PROTECT FEDERAL GRANT FUNDING PATHWAYS

Stability in Federal Grants

  • Reduce Barriers to Access to Ensure Timely Distribution of Grant Funding.

HEALTH INFORMATION TECHNOLOGY AND ELECTRONIC HEALTH RECORD IMPROVEMENT

Bridging the Gap: Enhancing Patient Care by Advancing Health Information Technology

  • Appropriate Dedicated Funding for UIO and Tribal Health Care Providers to Offset HIT Modernization Costs, Including Costs Associated with Transitioning to or Achieving Interoperability with the New IHS Enterprise EHR System.
  • Ensure the PATH EHR is Fully Interoperable with the Diversity of COTS EHR Systems Currently in Use at UIOs and Tribal Facilities.
  • Develop a Pathway and Funding for UIOs Who Use COTS EHR Systems to Implement the PATH EHR If They Choose to Do So.
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CMS Releases Guidance to States on Implementation of the One Big Beautiful Bill Act 6-Month Medicaid Redeterminations – Includes AI/AN Exemption

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The Centers for Medicare and Medicaid Services (CMS) recently released a State Medicaid Director letter (SMDL) on implementing the eligibility redeterminations in Section 71107 of the One Big Beautiful Bill Act, which is also known as the “Working Families Tax Cut Legislation.” The SMDL includes a summary of the exemptions for American Indian and Alaska Native people from the 6-month renewal requirement (see page 4). NCUIH continues to urge CMS to continue to consult with Tribes to ensure proper implementation of exemptions for American Indian and Alaska Native people.

Additional Information

On July 4, 2025, the President signed the One Big Beautiful Bill Act (OBBBA) into law. The OBBBA is a major bill that delivers many elements of President Trump’s legislative agenda, including new requirements for access to Medicaid and SNAP. Fortunately, Indians, Urban Indians, California Indians, and individuals determined eligible as an Indian for the Indian Health Service under regulations promulgated by the Secretary are exempted from the Medicaid requirements in the OBBBA and included in exemptions for the Supplemental Nutrition Assistance Program (SNAP) work requirements.

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