NCUIH Urges CMS to Approve CalAIM Renewal to Continue Access to Traditional Health Care Practices

On June 25, 2026, the National Council of Urban Indian Health (NCUIH) submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to CMS’s request for public comment on California’s Advancing and Innovating Medi-Cal (CalAIM) Renewal Demonstration. NCUIH also provided Urban Indian Organization (UIO) leaders with a comment template to support UIO engagement on the renewal.

The CalAIM Renewal includes continued coverage of traditional health care practices, also known as Traditional Healing services, for substance use disorder treatment for American Indian and Alaska Native people. NCUIH urged CMS to approve the renewal, including the provision providing access to traditional health care practices for American Indian and Alaska Native people in California.

This decision matters because the CalAIM Renewal will determine whether Indian Health Care Providers in California, including UIOs, can continue providing traditional health care practices for substance use disorder treatment. NCUIH emphasized that continued access to these services is consistent with the federal trust responsibility to provide health services to American Indian and Alaska Native people, including those living in urban areas.

NCUIH also noted that the United States owes this trust obligation to American Indian and Alaska Native people no matter where they live and contracts with the 41 UIOs to help fulfill this obligation for Native people living in urban areas. Traditional health care practices are provided through the Indian health system to eligible American Indian and Alaska Native people under the Indian Health Care Improvement Act. This framework is grounded in the political relationship between the United States and Tribal Nations.

NCUIH highlighted the continued need for access to traditional health care practices for substance use disorder treatment. Substance use disorder remains a serious health concern among the American Indian and Alaska Native people served through the Indian health system, and traditional health care practices are an established part of the care the United States provides to meet its trust obligation.

Approving the CalAIM Renewal would allow Indian Health Care Providers in California, including UIOs, to continue providing traditional health care practices to treat substance use disorder and better serve American Indian and Alaska Native communities. NCUIH further noted that these services were recently recognized by the U.S. Department of Health and Human Services Secretary during the April 2026 meeting of the Secretary’s Tribal Advisory Committee.

CMS is now reviewing public comments on the CalAIM Renewal. NCUIH will continue to monitor the demonstration renewal and engage as needed to support continued access to traditional health care practices through Indian Health Care Providers in California, including UIOs. CMS approval is needed before the current demonstration authority expires so these services can continue without interruption.

As CMS considers the CalAIM Renewal, NCUIH continues to urge approval of the provision supporting access to traditional health care practices for American Indian and Alaska Native people in California. Continuing this coverage is necessary to preserve access to care through the Indian health system and uphold the federal trust responsibility to Native people, including those living in urban areas.