PRESS RELEASE: NCUIH Testifies at Two Congressional Hearings Regarding Critical Funding for Urban Indian Health

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Congressional leaders emphasized the need to increase resources for urban Indian health and provide opioid funding for urban Indian communities.

FOR IMMEDIATE RELEASE

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

WASHINGTON, D.C. (April 5, 2022) – The National Council of Urban Indian Health (NCUIH) President-Elect and CEO of the Indian Health Center of Santa Clara Valley, Sonya Tetnowski (Makah Tribe), testified before the House Interior Appropriations Subcommittee as part of American Indian and Alaska Native (AI/AN) Public Witness Day hearing regarding Fiscal Year (FY) 2023 funding for Urban Indian Organizations (UIOs). Maureen Rosette (Chippewa Cree Nation), NCUIH board member and Chief Operating Officer of NATIVE Project, testified before the House Natural Resources Oversight & Investigations Subcommittee for a hearing entitled, “The Opioid Crisis in Tribal Communities.” In their testimonies, NCUIH leaders highlighted the critical health needs of urban Indians and the needs of the Indian health system.

NCUIH thanks the members of the subcommittees for the opportunity to testify on the needs of urban Indians and encourages Congress to continue to prioritize urban Indian health in FY 2023 and years to come.

House Appropriators Demonstrate Strong Commitment to Indian Health

NCUIH President-Elect Tetnowski testified before the House Appropriations Subcommittee along with Ms. Fawn Sharp for the National Congress of American Indians, Mr. Jason Dropik for the National Indian Education Association, and Mr. William Smith for the National Indian Health Board. The House Appropriations Committee uses testimony provided to inform the FY 2023 Appropriations decisions.

NCUIH requested the following:

  • $49.8 billion for the Indian Health Service (FY22 Enacted: $6.6 billion) and $949.9 million for Urban Indian Health (FY22 Enacted: $73.4 million) for FY 2023 as requested by the Tribal Budget Formulation Workgroup
  • Advance appropriations for the Indian Health Service (IHS)
  • Support of mandatory funding for IHS including UIOs

Full Funding for the Indian Health System a Priority for Congress

Many Members of Congress on both sides of the aisle noted the need to increase resources for Indian health in order to meet the trust responsibility. “The federal trust obligation to provide health care to Natives is not optional and must be provided no matter where they reside,” said Ms. Tetnowski in her testimony, “Funding for Indian health must be significantly increased if the federal government is, to finally, and faithfully, fulfill its trust responsibility.”

Ranking Member David Joyce (R-OH-14) agreed with Ms. Tetnowski, “There is still much to do to fulfill the trust responsibility.” Representative Mike Simpson (R-ID-02), also emphasized that more must be done so “there’s not disparity between Indian Health Services and other health services delivered by the federal government.”

President Sharp stated, “This subcommittee’s jurisdiction includes some of the most critical funding for Indian Country. As detailed in the 2018 Broken Promises Report, chronically underfunded and inefficiently structured federal programs have left some of the most basic obligations of the United States to tribal nations unmet for centuries. We call on this subcommittee in Congress to get behind the vision of tribal leaders for right these wrongs by providing the full and adequate funding for Indian country.”

The Case for Mandatory and Advance Appropriations for IHS

The Indian health system, including IHS, Tribal facilities and UIOs, is the only major federal provider of health care that is funded through annual appropriations. For example, the Veterans Health Administration at the Department of Veterans Affairs receives most of its funding through advance appropriations. If IHS were to receive advance appropriations, it would not be subject to government shutdowns, automatic sequestration cuts, and continuing resolutions (CRs) as its funding for the next year would already be in place. According to the Congressional Research Service, since FY 1997, IHS has once (in FY 2006) received full-year appropriations by the start of the fiscal year.

“During the most recent 35-day government shutdown at the start of FY 2019, the Indian health system was the only federal healthcare entity that shut down. UIOs are so chronically underfunded that several UIOs had to reduce services, lose staff, or close their doors entirely, forcing them to leave their patients without adequate care. Advance appropriations is imperative to provide certainty to the IHS system and ensure unrelated budget disagreements do not put lives at stake,” said Ms. Tetnowski.

Many Members of Congress were interested in hearing more about the differences between mandatory and advance appropriations. In her opening remarks, Chair Pingree pointed out that the mandatory funding proposal, if implemented, would remove the jurisdiction from the Appropriations Committee to the authorizing committees. Both NCAI President Sharp and NIHB Chair Smith also expressed support for the mandatory funding proposal from President Biden. Mr. Smith testified the President’s proposal is “a bold vision to end chronic underfunding and building a comprehensive Indian health care system. We urge Congress to support the request and work together with administrations and the tribes to see that as passed into law.”

Rep. Simpson sought to clarify whether both Advance Appropriations and Mandatory Appropriations remain priorities for Indian Country. President Sharp explained that “both [advance and mandatory funding] are critically important” in fulfillment of the trust responsibility while noting that basic health should be a mandatory expenditure of the United States government. President-Elect Tetnowski also stated that, “Advance appropriations would ensure that we weren’t shut down during any type of government closure. IHS is currently the only health care [provider] in the Federal government that does not have advanced appropriations.”

Resources

Congressional Leaders Express Support for Expanding Opioid Funding to Urban Indians

“Opioid overdose deaths during the pandemic increased more in Native American communities than in communities for any other racial or ethnic group,” said Representative Katie Porter (D-CA-45), “to address this crisis, we need to provide more resources for tribal governments and urban Indian health organizations to treat the opioid epidemic.” 

Urban Indians Left out of Opioid Grant Funding

Funding to assist AI/AN communities to address the opioid crisis have repeatedly left out urban Indians. UIOs were not eligible for the funding designated to help Native communities in the State Opioid Response (SOR) Grant reauthorization included in the recently passed FY 2022 Omnibus (H.R. 2471) despite inclusion of UIOs in the SOR bill (H.R. 2379) that passed the House on October 20, 2021. The final language in the omnibus (H.R. 2471) did not explicitly include “Urban Indian Organizations” as eligible and did not use the language from H.R. 2379. While this was likely a result of legislative text being copied from previous legislation, this prohibits urban Indian health providers from being able to access the critical funding needed to combat the opioid crisis.

“During the last government shutdown, one UIO suffered 12 opioid overdoses, 10 of which were fatal. This represents 10 relatives who are no longer part of our community,” Ms. Rosette emphasized, “These are mothers, fathers, uncles, and aunties no longer present in the lives of their families. These are tribal relatives unable to pass along the cultural traditions that make us, as Native people, who we are.”

Responding to a question from Rep. Stansbury (D-NM-01) on what the committee can do to help support UIO’s work on the ground to address the opioid crisis in Native communities, Ms. Rosette reiterated, “Funding is always an obstacle for us. Grants, like the state opioid response grant, would allow us to provide culturally appropriate treatment to our community, but we were not included. You have to specifically say “urban” along with “tribal” otherwise we are not allowed to get the funding.”

Opioid Epidemic in AI/AN Communities

Since 1974, AI/AN adolescents have consistently had the highest substance abuse rates than any other racial or ethnic group in the U.S. Urban AI/AN populations are also at a much higher risk for behavioral health issues than the general population. For instance, 15.1% of urban AI/AN persons report frequent mental distress compared to 9.9% of the general public.

Additionally, the opioid crisis and COVID-19 pandemic are intersecting with each other and presenting unprecedented challenges for AI/AN families and communities. On October 7, 2021, the American Academy of Pediatrics published a study on caregiver deaths by race and ethnicity. According to the study, 1 of every 168 AI/AN children experienced orphanhood or death of caregivers due to the pandemic and AI/AN children were 4.5 times more likely than white children to lose a parent or grandparent caregiver. Unfortunately, this has exacerbated mental health and substance use issues among our youth. In the age group of 15-24, AI/AN youth have a suicide rate that is 172% higher than the general population in that age group.

Resources

Next Steps

NCUIH will continue to advocate for full funding of Indian Health Service and urban Indian health at the amounts requested by Tribal leaders as well as for additional resources for the opioid response for Native communities.

Native American Heritage Month UIO Spotlight: All Nations Health Center

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Native American Heritage Month is more than just a 30-day celebration, it’s a reminder that important work is happening every day to ensure Native communities everywhere have equitable access to services and representation.

NCUIH would like to introduce an Urban Indian Organization (UIO) and NCUIH member, All Nations Health Center in Missoula, Montana, who are at the frontlines of this important work and are representative of the imperative efforts of over 40 Urban Indian Organizations across the country.

We asked Executive Director, Skye McGinty (Little Shell Chippewa), MA, MBA, a few questions about their experiences in the UIO community, through the lens of All Nations, and what are some important things to keep in mind during Native American Heritage Month for both Native and Non-Native community members.

A picture of the All Nations team at their 3rd Annual 5K Fun Run and Walk.

 

Q: What do you wish the public knew about your services? Are there any misconceptions?

A: In late 2020, we changed our name from Missoula Urban Indian Health Center to All Nations Health Center to better reflect the culture of our clinic and our mission to provide holistic health services to the communities who live in and around Missoula. The biggest misconception in our community is that our services are only for Native people. While we do have an Indigenous perspective on the delivery of health services and our primary focus is on the Native population, we serve non-Natives, too. We hear time and time again from our non-Native clients that the kinds of services we provide and the way we deliver them is special and different compared to what you might experience in a Western medicine setting. If we could clear up any misconceptions, it’s that we provide services to truly all nations, and our Indigenous providers and services are for everyone.

 

Q: Why do you think organizations specific to serving Native communities are important?

A: It’s vital that Native people have access to services where their lived experiences are honored, they are reflected in the makeup of the staff, and strengthening their resiliency is at the top of the list of priorities. Native organizations provide that safety and honoring in ways that other organizations can’t. Good allyship from non-Native organizations is critical to moving the needle on issues that most deeply impact our Indigenous communities, but Native organizations already have the knowledge to reach our communities and make lasting, positive impacts. It’s imperative that we as Native people are leading the services that we provide to our communities.

 

Q: What’s the biggest challenge you face as an organization?

A: Aside from the obvious answer of COVID, our organization struggles with consistent levels of federal and state funding. Like many UIOs, our budget largely consists of a patchwork of different federal, state, and local grant initiatives. It’s hard to plan for sustainability when continuation applications, reporting requirements, and new grants are all due. Combined with the fact that UIOs have largely been left out of language in legislation that impacts our ability to be self-sustaining, finding reliable funding sources remains our largest challenge.  

 

Q: What excites you about the future of your facility?

A: I am most excited about having a truly integrated model of care for our patients in our new facility. Right now, our services are spread out among three facilities, and with the launch of our capital campaign, we’ll be able to consolidate all services in one brand new patient-centered medical home. I’m excited to bring on new providers to complement our current service offerings and to expand into new services that are comprehensive, holistic, and informed by Indigenous knowledge.

 

NCUIH is excited to share the experience of All Nations and recognize the many other essential UIOs providing vital services to their communities across the country. You can check out the full list of UIO NCUIH Members here. We hope this Native American Heritage Month, we can all re-center the needs of our urban Native communities across Indian Country. Sharing challenges, celebrating how far we’ve come, and looking forward to the future are all incredible ways to stay involved this month and always.

 

Looking for a way to engage with NCUIH and help raise awareness and much-needed funds towards social health equity? Register today for the #MoveWithNCUIH Native American Heritage Month Virtual 5k! Together we will walk, run, bike, swim (or however you choose to move) from a safe distance and celebrate our efforts virtually with one another.

 

Sign-up to #MoveWithNCUIH today!

PRESS RELEASE: Bipartisan Padilla-Moran-Lankford NCUIH Amendment for Urban Indian Health Passes Senate

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The technical fix will be critical to improving health infrastructure for off-reservation American Indians and Alaska Natives.

FOR IMMEDIATE RELEASE – 8.2.21

Media Contact: National Council of Urban Indian HealthMeredith Raimondi, Director of Congressional Relations MRaimondi@ncuih.org 202-417-7781

Washington, D.C. (August 2, 2021) – On Monday, the Senate voted on amendments to the bipartisan infrastructure package including the Padilla-Moran-Lankford Urban Indian Health Amendment, which passed 90-7. The National Council of Urban Indian Health (NCUIH) has worked closely on a bipartisan basis for the past year on this technical legislative fix to support health care for tribal members who reside off of reservations. This amendment would allow existing resources to be used to fund infrastructure projects within the Indian health system.

“We applaud Senators Padilla, Moran, Lankford, Rounds, Smith, Feinstein, Schatz, and Schumer for their steadfast and tireless leadership on behalf of Indian Country. This technical fix will be critical to expanding health care infrastructure for Native communities who have been devastated by the COVID-19 pandemic. We also thank the National Congress of American Indians for their partnership in advocating for improved outcomes for all of Indian Country,” said Francys Crevier (Algonquin), CEO of NCUIH.

Next Steps

The Senate will continue to debate amendments to the bipartisan infrastructure plan. In the meantime, NCUIH will continue to advocate for $21 billion for Indian health infrastructure in the budget reconciliation package from the a joint letter led by the National Congress of American Indians (NCAI) on April 13, 2021.

Background

“Urban Indian Organizations (UIOs) are a lifeline to Native Americans living in urban areas across California,” said Senator Alex Padilla (D-CA). “Yet, UIOs are prohibited from using Indian Health Service funding for facilities, maintenance, equipment, and other necessary construction upgrades. During the pandemic, many UIOs couldn’t get approval for ventilation upgrades, heaters, generators, and weatherization equipment. Removing this unjust burden on UIOs is a commonsense fix and would allow them to improve the quality of the culturally competent care that they provide.”

“Oklahoma has the second-largest Urban Indian patient population and is proudly served in both Tulsa and Oklahoma City clinics. We should continue to improve health care access for our Urban Indian population and broaden the flexibility for Urban Indian Organizations’ use of facilities renovation dollars, in addition to those for accreditation, to meet patient needs,” said Senator James Lankford (R-OK).

“The impacts of COVID-19 will be with our Native communities for a long time to come. It is critical that the Indian Health Care Center of Santa Clara Valley and other UIOs be able to provide a safe environment for the families and patients we serve. We are extremely grateful for Senator Padilla’s leadership in rectifying a longstanding barrier preventing us from using existing funding to make urgent upgrades,” said Sonya Tetnowski (Makah), CEO of Indian Health Care Center of Santa Clara Valley, President of California Consortium for Urban Indian Health (CCUIH), and President-elect of NCUIH.

“It is time to live out this Country’s commitment to each other to live with respect for one another and in community. With this legislation, Friendship House in San Francisco will build a home village site for our urban Native Americans, so that our people may contribute to saving and enriching our homeland, which we must now all share and care for or lose. We greatly appreciate Senator Padilla’s leadership on this issue,” said Abby Abinanti (Yurok), President of the Friendship House Association of American Indians Board of Directors.

UIOs lack access to facilities funding under the general IHS budgetary scheme, meaning there is no specifically allocated funding for UIO facilities, maintenance, sanitation, or medical equipment, among other imperative facility needs. While the whole IHS system has made the transition to telehealth, negative pressurizing rooms, and other facility renovations to safely serve patients during the pandemic, restrictions in the relevant statutory text did not allow UIOs to make those transitions. Section 509 currently permits the IHS to provide UIOs with funding for minor renovations and only in order to assist UIOs in meeting or maintaining compliance with the accreditation standards set forth by The Joint Commission (TJC).

These restrictions on facilities funding under Section 509 have ultimately prevented UIO facilities from obtaining the funds necessary to improve the safety and quality of care provided to American Indian/Alaska Native (AI/AN) persons in urban settings. Without such facilities funding, UIOs are forced to draw from limited funding pools, from which they must also derive their limited funding for AI/AN patient services. This lack of facility funding for UIOs is a breach of the federal trust obligation to AI/AN health care beneficiaries, necessitating congressional action to include UIOs in future legislative measures for IHS facility funding.

In May, Congressman Ruben Gallego (D-AZ) and Congressman Don Bacon (R-NE) introduced the Urban Indian Health Facilities Provider Act (H.R. 3496) in the House of Representatives which expands the use of existing IHS resources under Section 509 of the Indian Health Care Improvement Act (IHCIA) (25 U.S.C. § 1659) to increase the funding authority for renovating, constructing, and expanding Urban Indian Organizations (UIO). Senators Alex Padilla (D-CA), James Lankford (R-OK) along with co-sponsors Moran (R-KS), Feinstein (D-CA), and Smith (D-MN) on the Senate Indian Affairs Committee introduced the identical Senate bill (S. 1797).

Last month, NCUIH testified before the House Natural Resources Subcommittee for Indigenous Peoples of the United States (SCIP) and the Senate Committee on Indian Affairs (SCIA) in support of the Urban Indian Health Facilities Provider Act (H.R. 3496 / S. 1797). Sonya Tetnowski (Makah Tribe), NCUIH President-Elect and Chief Executive Officer of the Indian Health Center of Santa Clara Valley, testified before SCIP and Robyn Sunday-Allen (Cherokee), NCUIH Vice President and CEO of the Oklahoma City Indian Clinic, testified before SCIA.

This fix is broadly supported in Indian Country and the National Congress of American Indians passed a resolution in June to “Call for Congress to Amend Section 509 of the Indian Health Care Improvement Act (IHCIA) to Remove Facility Funding Barriers for Urban Indian Organizations”.

American Indians have the highest COVID vaccination rate in the US

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American Indians have the highest COVID vaccination rate in the US | PBS

 

According to CDC data, Indigenous people are getting vaccinated quicker than any other group. Here are the successes—and challenges—of getting vaccines to urban Native American communities.

Before getting vaccinated against COVID-19 was an option, Francys Crevier was afraid to leave her Maryland home.

She ordered all of her groceries and limited her time outside, knowing that each venture would put both herself and her immunocompromised mother, with whom Crevier shares her home, at risk. Knowing she could provide for Mom was “a blessing, for sure,” Crevier says. After all, American Indians and Alaska Natives were hospitalized and died from COVID-19 at a higher rate than any other racial group in America throughout the pandemic, says Crevier, who’s Algonquin.

“As a Native woman, I didn’t know if I was going to make it through this,” she says.

Indeed, the U.S. Indigenous population had more than 3.5 times the infection rate, more than four times the hospitalization rate, and a higher mortality rate than white Americans, reports the Indian Health Service (IHS), a federal health program for American Indians and Alaska Natives. Official data reveal that the Navajo Nation, the largest tribe in the U.S., has been one of the hardest-hit populations, reporting one of the country’s highest per-capita COVID-19 infection rates in May 2020, the Navajo Times reports…

Read More

NCUIH Partners with Native American Lifelines to Provide COVID-19 Vaccine

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After months of tireless advocacy, the National Council of Urban Indian Health (NCUIH) has partnered with Native American Lifelines (NAL), the University of Maryland, Baltimore, and the Indian Health Service (IHS) to bring the COVID-19 vaccine to urban Indians in the Washington, DC, Maryland, and Virginia metropolitan area. Vaccine appointments are being held at the University of Maryland, Baltimore, can be scheduled online, and are open to DMV metropolitan Natives (ages 16+) as well as non-Native individuals who work in organizations serving the Native community.

Read more about this new development from local news outlets:

University of Maryland, Baltimore opens COVID vaccine clinic for Indigenous peoples

UMB opens first regional COVID-19 clinic exclusively for Native Americans

COVID-19 Vaccine Available for Native Americans at UMB

UMB News: COVID-19 Vaccine Available for Native Americans at UMB

Vaccine clinic for Native Americans opens in Baltimore

Local clinic aims to get vaccinations to Native American community

PRESS RELEASE: NCUIH and Native American Lifelines Announce DMV Vaccines for Natives

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FOR IMMEDIATE RELEASE

Policy Contact: Meredith Raimondi, mraimondi@NCUIH.org

Press Contact: Sara Williams, swilliams@NCUIH.org

National Council of Urban Indian Health and Native American Lifelines Announce DMV Vaccines for Natives

After months of barriers, urban Indians in the DMV will finally be able to get vaccinated.

 Washington, D.C. (April 13, 2021) – The National Council of Urban Indian Health (NCUIH) and Native American Lifelines (NAL) are pleased to announce the availability of COVID-19 vaccinations for urban Indians in the D.C., Maryland, and Virginia metropolitan area. In partnership with the Indian Health Service and University of Maryland – Baltimore, registration is now available for appointments in Baltimore beginning on Wednesday, April 14.

“For months, we have fought tooth and nail to get vaccines for urban Indians in Maryland, D.C., and Virginia. The pandemic has wrought many challenges on urban Indians but getting a vaccine shouldn’t have been one of them. Any member of the hardest hit population shouldn’t have had to wait months for this lifesaving opportunity. This is also not what the trust responsibility for healthcare is supposed to be. As we are also serving record patients to address increased needs in behavioral health and domestic violence, we are glad to finally be able to vaccinate our community. We are grateful for partners like NCUIH, IHS, and the University of Maryland, Baltimore, who helped make this happen,” said Kerry Hawk-Lessard, Executive Director.

“As the only national organization focused on the health of urban Indians, we are pleased to finally announce that vaccines for Natives in the DMV are now available. It is disappointing that the population dying at the highest rates of COVID-19 worldwide is only just gaining access to vaccines in the DMV five days before the entire country will be eligible. This experience has highlighted a long-standing inequity faced by urban Indians and forced countless Natives to risk additional exposure when flying to reservations to receive a vaccine. As we’ve buried far too many relatives in the past year, we hope that this Administration and Congress will realize that it is now time to fully fund Urban Indian Organizations (UIOs) and Indian Health Service as we fight our way to the end of this horrific pandemic,” said NCUIH CEO Francys Crevier (Algonquin).

Vaccine Distribution to Urban Indians

Since last fall, NCUIH and NAL have pushed for inclusion of the 65,000 Natives in the Washington, DC, Maryland, and Virginia Metropolitan Area. As Natives are dying from COVID-19 at the highest rates worldwide, NCUIH has advocated to the federal government to prioritize this population for vaccines.

UIOs across the country have highly successful vaccine rollouts that have been touted in the national and local media. After a recent study in January from the Urban Indian Health Institute showed that nearly 75% of Natives would get vaccinated, UIOs are seeing record patients and regularly hosting mass vaccination clinics with hundreds of participants. Because of the success of vaccine administration by UIOs, local and other non-profit organizations have partnered with UIOs. While there is much talk of vaccine equity on a national scale, no state nor the District of Columbia, has prioritized Natives or any other race for vaccines, so UIOs have filled a vital role. For example, one UIO in Montana vaccinated 180 teachers who work with Native students, while many others are sharing their vaccines with the NAACP and LatinX organizations to reach other highly vulnerable groups.

NCUIH created an online petition to urge HHS to provide vaccines to DMV Natives and sent a letter to Administration officials to request vaccines. The Indian Health Service has also assisted the past several months, trying to coordinate vaccines for urban Indians in the area. Several Urban Indian Organizations (UIOs) in other states even offered to fly their staff to the DMV to administer vaccines. Finally, urban Indians in the area will have access to vaccines through Native American Lifelines due to the hard work of NAL’s staff and the advocacy of NCUIH.

Vaccine Clinic Information

In partnership with the University of Maryland, Baltimore the clinic will be open to anyone 16 years of age and older who is eligible. Appointments will be available starting Wednesday, April 14. They will be scheduled on Wednesdays, Fridays, Saturdays, and Sundays in the coming weeks. Because this will be an IHS-sponsored clinic, the following groups are deemed eligible as per Native American Lifelines vaccine plan: tribal citizens and descendants, non-Native family members, partners, or caregivers of tribal citizens and descendants, non-Native individuals working in Native-serving organizations (e.g., NCUIH, NCAI, NACA, NARF, NIGA, NIHB, BIA, BIE, IHS, HHS, Interior, etc.)

If you are unable to schedule your appointment online, in need of transportation assistance, please call Jessica or Bri at Native (410) 837 – 2258 (x102 for Jessica and x106 for Bri).

UMB Vaccine Clinic:
Address: 601 W. Lombard St., Baltimore, Md. 21201
Parking: Pratt and Penn Garages

  • Pratt Garage: 646 W. Pratt St.
  • Penn Garage: 120 S. Penn St.
  • Handicap or Mobility Assistance Parking:
    • Pratt Garage, 3rd floor

Hours of Operations: Wednesday-Saturday 10 a.m. – 6 p.m. EST

If you have already received one dose of Pfizer and need a second dose, please call the number above to schedule a second dose if you do not see the time available online.

About NCUIH and NAL

Native American Lifelines (NAL) is one of 41 Urban Indian Organizations (UIOs) funded by the Indian Health Service. Native Americans Lifelines operates two outreach and referral clinics in two states but is recognized as only one facility by the Indian Health Service. NAL receives less than $1 million to serve all urban Indians in Baltimore (including Washington, DC) and Boston. The mission of Native American Lifelines is to promote health and social resiliency within Urban American Indian communities. Native American Lifelines applies principles of trauma informed care to provide culturally centered behavioral health, dental, outreach and referral services.

The National Council of Urban Indian Health is the national non-profit organization 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 strives to improve the health of all AI/ANs, including the over 70% of the AI/AN population that lives in urban areas, supported by quality, accessible health care centers.
NCUIH was recently named a founding member of the President’s COVID-19 Community Corps. 

To Schedule Your Appointment and Learn More Visit NCUIH.org/Vaccine

  • Schedule an appointment
  • Volunteer at a clinic
  • Learn more about NCUIH’s advocacy efforts

PRESS RELEASE: IHS Announces Medical Malpractice Coverage for Urban Indian Health Workers Following Enactment of NCUIH Legislation

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Washington, D.C. (March 26, 2021) – On Monday, March 22, the Indian Health Service (IHS) announced the successful implementation of the Federal Tort Claims Act (FTCA) to Urban Indian Organizations (UIOs) and their employees to the same extent and in the same manner as to Tribes and Tribal Organizations. The National Council of Urban Indian Health (NCUIH) has advocated for over 20 years for medical malpractice coverage for urban Indian health workers. With this essential change, a single organization can redirect up to $200,000 annually to patient care.

 

Congressional champions Reps. Ruben Gallego (D-AZ) and Markwayne Mullin (R-OK), along with Senators Tina Smith (D-MN), Tom Udall (D-NM), James Lankford (R-OK), and Martha McSally (R-AZ), worked tirelessly to ensure this important fix to expand resources for UIOs. NCUIH legislation to provide coverage for urban Indian health workers passed late last year as a standalone bill with broad bipartisan support.

 

“During the pandemic, every dollar makes a difference for these critical organizations providing care to urban Indians,” said NCUIH CEO Francys Crevier (Algonquin). “We applaud our Congressional advocates in helping stretch our limited resources to serve urban Indians at such a critical time. As Natives continue to have the highest death rates in the world, the federal government must uphold its trust responsibility and continue to provide every possible opportunity to increase access to care.” 

 

“Federal tort law currently omits coverage for UIOs, and especially during the coronavirus pandemic, UIOs, like other already covered Tribal health facilities, need to have the peace of mind that they can utilize their funds for care, not court cases,” said Senator Lankford.

 

“Oklahoma City Indian Clinic has spent hundreds of thousands of dollars each year on liability insurance for our providers,” said NCUIH Vice-President and CEO of Oklahoma City Indian Clinic Robyn Sunday-Allen. “With this parity, we can now put every cent back into services. We applaud the leadership of Senator Lankford on helping redirect our limited resources back to patients and families who rely on our services now more than ever.”

PRESS RELEASE: NCUIH Testified Before House on COVID-19 Impacts in Indian Country

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FOR IMMEDIATE RELEASE

Policy Contact: Meredith Raimondi, mraimondi@NCUIH.org

Press Contact: Sara Williams, swilliams@NCUIH.org

Washington, D.C. (March 23, 2021) – National Council of Urban Indian Health CEO Francys Crevier (Algonquin) testified before the Subcommittee for Indigenous Peoples of the United States, led by Chair Teresa Leger Fernández (D-NM). The hearing is addressed the “Emerging Coronavirus Impacts in Indian Country.”

“Urban Indian Organizations have continuously provided services in the hardest hit urban areas during the entire pandemic,” said Crevier. “There have been vast improvements from where we were a year ago with regards to the availability of supplies, tests, and vaccines, but that will never make up for the sheer number of Native lives lost. Unfortunately, despite improvements, the situation facing Natives has not relented. The bottom line is that what little data exists for Natives shows a stark reality: COVID-19 is killing Native Americans at a faster rate than any other community.”

Rep. Ruben Gallego (D-AZ), an urban Indian health champion, requested additional information about why Urban Indian Organizations (UIOs) cannot make any facilities-related upgrades using federal funds. Ms. Crevier explained that the Indian Health Care Improvement Act contains unnecessary limitations on UIOs and urged for a legislative fix to allow UIOs to use federal funds for facilities. Rep. Chuy Garcia (D-IL) discussed the long-standing inequities experienced by UIOs due to lack of full funding.

“Structural deficiencies led to the devastating impact of COVID-19 on Native American communities,” Said Rep. Leger Fernandez. “We must also identify ways to address the root causes of the impacts. I heard over and over in today’s testimony about the need for full funding as is required by the trust responsibility.”

House Natural Resources Chairman Raul Grijalva (D-AZ) asked Francys Crevier about the importance of an urban confer process. She identified why it is critical for federal agencies like the Department of Health and Human Services (HHS) to have policies that address communicating with UIOs. Ranking Member Don Young (R-AK) discussed the re-introduction of the Rep. Betty McCollum advance appropriations bill for all of the Indian Health Service, including UIOs.

The hearing also included testimony from Chief William Smith, Chairperson and Alaska Area Representative, National Indian Health Board. In his testimony, Chief Smith highlighted the importance of extending permanent 100% Federal Medical Assistance Percentages to UIOs and the need for mandatory appropriations for the Indian Health Service, Tribal organizations, and UIOs.

Ranking Member Bruce Westerman (R-AR) acknowledged the disproportionality of the effect of COVID-19 on American Indian and Alaska Native (AI/AN) populations and that the current funding provided in the American Rescue Plan Act is commendable. Still, it is not sustainable for the needs and efficacy of combatting the historical health issues that plague AI/AN people. To reiterate Rep. Westerman’s request for increased funding, Rep. Young called for the subcommittee to introduce a historical “Native people only” bill to address funding and all the needs that impact AI/AN populations and Native people.

Watch Testimony Read Full Testimony

Small Native American Health Centers Face Vaccine Barriers

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This article was originally published on Law360 by Emma Whitford.

Law360 (March 12, 2021, 6:12 PM EST) — The Indian Health Service has reported administering more than 684,000 COVID-19 vaccine doses so far and delivering them to locations as remote as the bottom of the Grand Canyon, but some urban health centers say they’re not part of this early success.

IHS-funded clinics in cities like Phoenix have vaccinated thousands, expanding their eligibility requirements to administer doses to younger Native Americans in addition to elders and essential workers.

But a small organization that contracts with the IHS to serve Native Americans in Boston and Baltimore told Law360 it lacked the storage and staffing required to receive direct vaccine shipments from the IHS back in December. Staff say they have hundreds of potential vaccine patients in their regions but have yet to administer a single dose.

About 70% of Native Americans live in cities, but urban health centers don’t receive a proportional amount of IHS funding. All three IHS-funded urban centers on the East Coast — the third is in New York City — lack on-site medical services, focusing instead on referrals.

For advocates, this discrepancy shows the need to increase overall IHS funding and build up small urban health centers so that Native Americans can have comparable care options regardless of their ZIP code.

“I don’t have any way to store the vaccine, and I don’t have medical providers on site to administer the vaccine,” said Kerry Lessard, executive director of Native American Lifelines, which has locations in Boston and Baltimore providing services such as mental health care and disease prevention.

“When you leave the reservation or a large Native community, you’re penalized, essentially,” Lessard added. “You don’t have access to the services that are guaranteed to you. That is an abrogation of sovereignty.”

In a February resolution, the National Council of Urban Indian Health called on the U.S. Department of Health and Human Services to create an Emergency COVID-19 Urban Indian Task Force and provide “full resources, technical assistance and support” for vaccine distribution at all IHS-funded facilities, specifically mentioning Native American Lifelines of Baltimore and Boston.

While some of the smallest urban clinics, like the Tucson Indian Center in Arizona, are now close to establishing vaccine partnerships with local tribes and governments, NCUIH director Francys Crevier said it has been a heavy logistical burden on facilities that are stretched thin to begin with.

According to the council, there are 63,000 Native Americans and Alaska Natives living in the D.C. metropolitan area.

“If Congress really wants to make a difference, I think that has to start with full funding of IHS and a plan of service expansion to the areas that our population is [in],” Crevier said.

Lessard said she is currently working around the clock in Baltimore trying to leverage her existing relationships in state government and within the Indian Health Service.

In addition to trying to serve members of state-recognized tribes in Maryland that cannot contract directly with the IHS, like the Accohannock, she is fielding vaccine requests from federal workers in Washington, D.C., who are hearing vaccination success stories from friends and family who live on reservations.

Maryland established a Vaccine Equity Task Force this month. A spokesperson told Law360 that a visit with Lessard’s organization “will be scheduled as soon as possible,” and that the state can potentially provide staffing and space to administer vaccines.

By contrast, larger city-based clinics, like Native Health of Phoenix, are already deep into their vaccination programs after starting appointments in mid-December.

Native Health Phoenix Director Walter Murillo has a staff of more than 180 and three locations across the city. He told Law360 he was able to purchase an ultra-cold freezer last summer in anticipation of the vaccine rollout and already has more than 2,200 vaccines, expanding eligibility to people with underlying conditions like diabetes and hypertension who are not currently eligible under Maricopa County guidelines.

“Going through IHS was actually an absolute plus, a blessing to say that we could get those [doses] directly from distribution points from the federal government,” said Murillo, who is also president of the NCUIH. But he acknowledged that his smaller sister organizations are “starting from five steps back.”

In Boston, according to Lessard, Sen. Elizabeth Warren’s office helped broker an introduction between Native American Lifelines and the Massachusetts Department of Health, but so far it hasn’t been fruitful. Organizations like Native American Lifelines are “crucial providers of health care” and “all levels of government should work with them,” a spokesperson for Warren told Law360.

Massachusetts’ health department did not comment on the record to Law360, though the Boston Public Health Commission said by email it “would be happy to work with” Native American Lifelines.

But Zoë Harris, program assistant at Native American Lifelines in Boston, said it’s been a frustrating few months for her client base of about 100 people.

“Our client population was frustrated because they were seeing all their family members back home getting access, and they felt like they were being punished because they are no longer on the reservation,” Harris said.

There are also local state-recognized tribes, like the Herring Pond Wampanoag Tribe and Nipmuc Nation, which Harris said rely on the center.

A new pandemic relief bill passed by President Joe Biden on Thursday has $6.1 billion for IHS including “no less than $84 million for urban Indian health programs,” IHS told Law360, in addition to $160 million set aside for them in earlier relief packages.

“IHS supports expanding access to health care for urban Indians” and will “continue to work closely with [urban Indian organizations] on meeting the health care needs of urban Indian communities,” the agency said.

Meanwhile, Harris and her team in Boston are looking to partner with the National Guard or the state’s two federally recognized tribes, the Mashpee Wampanoag Tribe on Cape Cod and Wampanoag Tribe of Gay Head Aquinnah on Martha’s Vineyard.

Both tribes are currently receiving vaccines from IHS, but coordination is challenging, especially with the island-bound Aquinnah.

“For me personally, it sheds the light on needing a fully ambulatory clinic in the Boston area,” Harris said. “We are supposed to be serving the Greater Boston Area … and there are three people in our office. That’s literally a job that’s not possible.”