In this Edition:

Questions for UIOs: Request for Input and Feedback
Urban Indian Health Hill Day 2026 Review
Mark Cruz Nominated as Indian Health Service Director
NCUIH Co-Chairs Health Subcommittee at NCAI 2026 Mid-Year Convention
Special Diabetes Program for Indians (SDPI) Updates
Fiscal Year 2027 Appropriations Status and Updates
Centers for Medicare & Medicaid Services Interim Final Rule on H.R. 1 Implementation
Office of Management and Budget Regulation for Federal Financial Assistance Rule
Department of Health and Human Services Request for Comment on the Chronic Disease of Addiction
Upcoming Events, Policy Dates, and Funding Opportunities

Questions for UIOs: Request for Input and Feeback

IHS Special Diabetes Program for Indians (SDPI):

The IHS Tribal Leaders Diabetes Committee is creating a data-driven presentation on SDPI to highlight the successes of the program to HHS leadership. If you have data examples from your UIO’s SDPI program that are yielding great results (e.g., nutrition- or activity-related programming, pharmacy work, or anything that demonstrates the success of your SDPI program) that you would like included in the presentation, please share the information with NCUIH.

On December 29, 2025, the Centers for Medicare & Medicaid Services awarded all 50 states Rural Health Transformation Fund (RHTF) money. More information on the Rural Health Transformation Fund is available on the NCUIH Policy Resource Center Webpage.

NCUIH requests that Urban Indian Organizations let NCUIH know if their organization receives funding.

UIO Listening Session with IHS Division of Behavioral Health (DBH):

NCUIH is facilitating a virtual UIO listening session with IHS DBH in September. To ensure DBH’s remarks are responsive to UIOs’ needs, please let us know any questions you have for DBH, behavioral health challenges and successes at your UIO, and any topics you want covered during the listening session.

Data request:Please share with NCUIH any data that you have on the number of Alaska Native patients served at your UIO.

Responses can be sent to policy@ncuih.org

Urban Indian Health Hill Day 2026 Review

On April 30, 2026, NCUIH and Urban Indian Organizations (UIOs) leaders from across the country gathered in Washington, D.C. for a Capitol Hill Day. UIO leaders, staff, and members of the community participated in NCUIH’s in-person Training ahead of Hill Day, arriving prepared and equipped to increase awareness of urban Indian health needs and carried those messages directly to Capitol Hill.

[Access the Full Report on NCUIH’s Policy Resource Center Webpage]

Mark Cruz Nominated as Indian Health Service Director

On June 1, 2026, President Trump submitted the appointment of Mark Cruz, a citizen of the Klamath Tribes, as the Director of the Indian Health Service (IHS). Cruz currently serves as Senior Advisor to Secretary of Health and Human Services Robert F. Kennedy Jr., as one of the highest-ranking Native officials within HHS. Cruz holds a Bachelor of Arts in Political Science from Pepperdine University and a Master of Arts in Urban Education Policy from Brown University.

What’s Next: The Senate Committee on Indian Affairs will hold a confirmation hearing on June 24, 2026, at 10 AM.

[Read the full Blog Post]

NCAI 2026 Mid-Year Convention and Marketplace

NCUIH’s co-chaired the Health Subcommittee and considered Health resolutions.

Resolutions were adopted on:

Supporting reimbursement for Commercial Off-The-Shelf EHR Systems and for ongoing annual appropriations – UIOs added
Implement administrative safeguards for Third Party Billing – UIOs added
Addressing the opioid crisis in Indian Country
Protecting and increasing Sanitation Facilities Construction funding

IHS Announces SDPI Grant Supplements, Consultation and Confer

In a May 21 Dear Tribal/Urban Leader Letter, the Indian Health Service (IHS) announced that it will distribute 25% administrative supplements to all 310 current SDPI grant recipients, drawing on one-time unobligated carryover SDPI funding.

IHS also announced its intention to conduct Tribal Consultation and Urban Confer regarding the use of additional SDPI funds resulting from the Fiscal Year 2026 reauthorization increase of $50 million, on a date to be determined.

Fiscal Year 2027 Appropriations Status and Updates: Proposed Increases for Urban Indian Health and Key Indian Country Programs

The House Interior bill proposes a $10.57 million increase for Urban Indian Organizations in Fiscal Year 2027

The House Interior, Environment, and Related Agencies Subcommittee held its markup on May 21, and the Full Committee held its markup on June 3; NCUIH submitted written testimony to the House on March 11 and to the Senate on May 16.

The proposed funding includes:

Urban Indian Health at: $105.992 million, a $10.57 million increase from FY 2026 enacted amount;
the Indian Health Service at $8.69 billion, a $60 million increase;
Advance Appropriations at $6.06 billion;
the Produce Prescription Pilot Program, for which Urban Indian Organizations are eligible, at $7 million;
and Tribal Epidemiology Centers at $45 million, a $5.57 million increase.

Next Steps: The House will now need to schedule a floor vote on the Interior, Environment, and Related Agencies spending bill. The legislation is not expected to become law in its current form. House leadership will need to work with Senate Leadership to negotiate a final bill text for passage in both chambers.

[Read NCUIH’s full analysis on Policy Resource Center Webpage]

The House Labor HHS bill proposes to protect key Indian Country programs in Fiscal Year 2027

The House Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) Subcommittee held its markup on June 5, and the Full Committee held its markup on June 9; NCUIH submitted written testimony to the House on April 16 and to the Senate on May 22.

The following table summarizes the proposed Fiscal Year 2027 House Labor, Health and Human Services funding for key Indian Country programs.

Line Item	Fiscal Year 2026 Enacted	Fiscal Year 2027 President Request	Fiscal Year 2027 House Proposed
Good Health and Wellness in Indian Country	$27 million	Eliminated	$30 million
Improving Native American Cancer Outcomes	$9 million	Eliminated	$15 million
Ryan White HIV/AIDS Program	$2.57 billion	$2.50 billion	$2.35 billion
Minority HIV/AIDS Fund	$56 million ($6 million tribal set-aside)	Eliminated	$20 million ($6 million tribal set-aside)
Tribal Behavioral grants (Native Connections)	$26.25 million	Eliminated; created a new behavioral health program under the Administration for a Healthy America (AHA)	$30 million

Next Steps: House Leadership will now work with Senate Leadership to develop the final Labor-HHS appropriations spending bill. The Senate has not yet released their Labor-HHS appropriations bill. As a final appropriations bill is produced, NCUIH will continue to work to protect funding for Indian Country and maintain maximum funding levels.

[Read NCUIH’s full analysis on our Policy Resource Center Webpage]

Centers for Medicare & Medicaid Services Interim Final Rule on H.R. 1 Implementation

On June 1, the Centers for Medicare & Medicaid Services (CMS) issued an interim final rule on H.R. 1 implementation.

The rule includes an American Indian and Alaska Native exemption from Medicaid requirements, but it does not include language mandating that states engage in Tribal Consultation or Urban Confer.
The comment period closes July 31.
The CMS Tribal Technical Advisory Group (TTAG) is working with CMS to publish specific American Indian and Alaska Native exemption guidance for states.

NCUIH continues to request that CMS and state Medicaid programs ensure Medicaid exemptions are inclusive of all American Indian and Alaska Native beneficiaries, regardless of where they live.

On May 21, NCUIH submitted a comment to the Utah Department of Health and Human Services on Utah’s Medicaid Reform 1115 Demonstration, 2027–2032 Renewal
June 10, NCUIH submitted a comment to CMS on the Arkansas Health and Opportunity for Me (ARHOME) Renewal Demonstration.

Office of Management and Budget Regulation for Federal Financial Assistance Rule

On May 29, the Office of Management and Budget (OMB) issued a proposed Regulation for Federal Financial Assistance.

This proposed revision will impact how nearly all grant awards are administered and overseen,
And it would expand federal agency authority to terminate or suspend discretionary awards that are determined to no longer serve the program goals, agency priorities, or the federal government interest.

The Office of Management and Budget stated that it will initiate formal Tribal consultation before a final rule is promulgated.

NCUIH is reviewing the rule, and comments are due July 13.

Department of Health and Human Services Request for Comment on the Chronic Disease of Addiction

On June 10, the Department of Health and Human Services issued a request for information (RFI) and is inviting public comment on the research, development, programs, and policies that have been most successful in improving the availability of and access to effective prevention, treatment, and recovery interventions for addiction, mental illness, and co-occurring substance use and mental disorders.

The request for information seeks to identify successful research, programs, and policies and to recommend novel policy ideas and gaps in research that can be addressed and implemented using existing funding.

Comments are due July 5.

Center for Indigenous Innovation and Health Tribal Advisory Committee Nominations

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

Committee membership consists of 3 delegates from Indian Health Service geographic areas and 3 national at-large member positions, which must be nominated by an elected Tribal leader.
The Office of Minority Health will continue to receive nominations until all CIIH TAC primary and alternate delegate positions are filled.

[Learn more on the Federal Register Notice]

Coalition for Tribal Sovereignty

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. Subscribe to updates on their website at www.coalitionfortribalsovereignty.org.

Upcoming Events and Policy Dates

July 7: National Indian Health Board (NIHB) Medicare, Medicaid and Health Reform Policy Committee (MMPC) July Face-to-Face Meeting, held ahead of the Centers for Medicare & Medicaid Services Tribal Technical Advisory Group meeting
July 8: Centers for Medicare & Medicaid Services Tribal Technical Advisory Group Face-to-Face Quarterly Meeting
July 15: NCUIH Monthly Policy Workgroup (virtual)
July 28–30: Tribal Self-Governance Advisory Committee (TSGAC) Advisory Committee Meeting
July 27–31: Centers for Medicare & Medicaid Services Tribal Technical Advisory Group July 2026 Hill Day

Current Funding Opportunities

Visit the NCUIH Website to apply and explore our Full List of Opportunities

Tribal Behavioral Health Substance Use Prevention (Native Connections)

Urban Indian Organizations are eligible.
The award is up to $350,000 per year per award, for up to 5 years.
The application deadline is July 13, 2026.

Indian Health Service Phase 2 Produce Prescription Pilot Program (P4)

Urban Indian Organizations are eligible.
The award ranges from $200,000 to $250,000.
The application deadline is June 22, 2026.

Health Resources and Services Administration (HRSA) HIV Technical Assistance for Indian Country

Urban Indian Organizations are eligible.
The award is up to $1,500,000 per award, with 3 awards expected.
The application deadline is July 10, 2026.

Department of Justice (DOJ) Office for Victims of Crime (OVC) Fiscal Year 2026 Increasing Services for American Indian and Alaska Native Victims of Human Trafficking in Urban Centers Program

Urban Indian Organizations are eligible.
The award is up to $450,000.
The application deadline is July 23, 2026.

Indian Health Service Fiscal Year 2026 Urban Emergency Fund (UEF)

The purpose of this fund is to help Urban Indian Organizations address costs associated with one-time, non-recurring emergencies and disaster relief efforts.
The award is a limited discretionary fund, with up to $250,000 available.
The application deadline is as soon as reasonably practicable after the emergency occurs.

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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