February Policy Updates: Budget Updates, Advocacy Efforts, and Legislative Anticipation

In this Edition:

 Don’t miss out on the latest updates and announcements regarding the 2024 NCUIH Annual Conference, registration, and award nomination details.

🔎 Dive into the latest updates on the FY 2024 budget and upcoming FY 2025 budget release, including advocacy efforts to protect IHS funding.

📋 Join us for our upcoming webinar on February 28: “Urban Voices Amplified: Empowering Native Votes” and explore Get Out the Vote resources.

🏛 Stay informed on NCUIH’s policy priorities for 2024, as outlined in the recently released Policy Assessment, and the key issues shaping advocacy efforts for urban Natives.

 Discover NCUIH’s active engagement in various events and initiatives, including representation at important receptions and legislative launches.

📆 Mark your calendars for crucial upcoming events, and federal agency comment opportunities, including consultations/confers on Native health care, behavioral health, and more.

2024 NCUIH Annual Conference Registration & UIO Award Nomination

NCUIH

Register now before rates go up in March!

Sponsorships: Several different sponsorship levels remain. If you are interested in sponsoring the conference, please see our sponsor guide.

Room Reservations: The negotiated room rate of $369 per night (plus tax) for single/double occupancy rooms is available until April 5, 2024. We encourage you to book your room soon to secure this special rate. To make your reservation at the Hilton Washington DC Capitol Hill, click here to access the room block.

NCUIH

As part of our commitment to uplifting Native excellence, NCUIH is seeking nominations for individuals and or organizations who have made remarkable contributions to the field of urban Indian health. We invite you to nominate candidates for the following prestigious awards:

  • UIO Staff Member of the Year Award;
  • UIO Visionary Award;
  • Urban Indian Legacy Award; and,
  • Tribal Leader Impact Award.

Awards will be presented during the NCUIH Annual Conference on April 29-May 2, 2024, in Washington, D.C. Visit the conference website for further details on the nomination process. The deadline for submissions is Friday, March 15, 2024.

Submit Nomination

Budget Update: FY 2024 Deal Reached, FY 2025 Anticipated Budget Release

An EKG line across a map of America.

Fiscal Year 2024 Budget Status:

  • On January 27, top Appropriators announced a deal had been reached on the allocation for FY 2024 spending bills.
  • On January 29, NCUIH sent a letter to Congressional leadership to request that IHS be protected from sequestration in the funding bill.
  • What’s next: Congress is in recess until February 28, and they will have three days to pass a CR or budget deal.

Fiscal Year 2025 Budget Status:

  • Release of President Biden’s FY 2025 Budget is anticipated between March 11-15.
  • NCUIH signed on to the Partners in Health and Association of American Indian Physicians letter to House and Senate Interior-Environment Appropriations Subcommittee Leadership in support of the inclusion of $30 million new funding to address chronic clinical staff shortages across Indian Country through Graduate Medical Education (GME) programming in the FY2025 Interior, Environment, and Related Agencies appropriations bills.

Urban Voices Amplified: Empowering Native Votes in Collaboration with the National Urban Indian Family Coalition

NCUIH

February 28, 2024 | 1:00 – 2:00 p.m. EST

Join us on February 28th, 2024, for a webinar hosted by the NCUIH Policy team.

  • In collaboration with the National Urban Indian Family Coalition (NUIFC) and UIO partners, we will delve into vital topics related to Get Out the Vote (GOTV) and mobilizing Native votes.
  • This event will focus on key strategies and information essential in an election year, addressing the significance of Native American civic participation.
  • Why it matters: Be part of an insightful discussion about voter registration, mobilization efforts, and the pivotal role Native voices play in shaping our communities during this important electoral season. Don’t miss out on this opportunity to engage in the dialogue that impacts us all.

Register to Attend

NCUIH Releases 2023 Annual Policy Assessment

NCUIH

On January 25, 2024, NCUIH released its 2023 Policy Assessment which includes findings from focus groups held with UIO leaders and helps set NCUIH’s policy priorities for 2024. Key findings include:

  • Funding is a Key Focus and Challenge
  • UIOs Need More Diverse Resources to Address Food Insecurity
  • Workforce Recruitment and Retention is a Concern Amid a Competitive Market

What else?: NCUIH hosted a Policy Preview Webinar for UIO leaders:

Watch the webinar to hear about the findings of NCUIH’s 2023 Policy Assessment and for a comprehensive understanding of the key issues shaping advocacy efforts and influencing the policy landscape for urban Native health in 2024.

NCUIH in Action: State of Indian Nations, Meetings on the Hill, HRSA Maternal Health & Mortality Initiative Launch, & More

NCUIH

Earlier this month, NCUIH attended the 2024 State of Indian Nations Address hosted by the National Congress of American Indians!

  • We were inspired by the powerful words of Tribal leaders, elders, and especially the passionate youth who spoke about their visions for a brighter and more equitable future.
  • Together, we’re committed to working towards unity, progress, and opportunity for all Native people.

On February 15th, NCUIH worked with the National Congress of American Indians & National Indian Health Board to facilitate and staff Congressional meetings for Tribal Leaders and provided talking points on the issue of 100% Federal Medical Assistance Percentage (FMAP) for UIOs.

NCUIH

NCUIH Policy Analyst, Emily Larsen, Representative Mary Peltola (D-AK), NCUIH VP of Policy and Communications, Meredith Raimondi.

NCUIH

Sean Gard, Rep. Moore Chief of Staff, Representative Gwen Moore (D-WI), NCUIH Policy Analyst, Emily Larsen.

On February 14, NCUIH represented UIOs at the National Native American Boarding School Healing Coalition (NABS)’s lunch & learn with Congressional Native American Caucus Co-Chairs, Reps. Tom Cole (Chickasaw) (R-OK-04) and Sharice Davids (Ho-Chunk) (D-KS-03) regarding the Truth and Healing Commission on Indian Boarding School Policies Act of 2024 (H.R. 7227).

Representative Cole (R-OK) and Representative Davids (D-KS)

Representative Cole (R-OK) and Representative Davids (D-KS)

NCUIH

  • Go deeper: Reps. Cole and Davids reintroduced this legislation to investigate, document, and report on the histories of Indian boarding schools, Indian boarding school policies, and long-term impacts on Native communities.

On February 8, the Senate Committee on Indian Affairs (SCIA) held a hearing that includes an NCUIH-endorsed bill, the IHS Workforce Parity Act (S.3022), which expands healthcare provider access to IHS scholarship and loan repayment programs.

Senate Committee on Indian Affairs (SCIA)

Senate Committee on Indian Affairs (SCIA)

  • What they’re saying: The Honorable Melanie Anne Egorin, Assistant Secretary of Legislation for HHS, testified that this legislation “builds capacity and it builds the ability to recruit and retain [health care providers], which is a critical need.”
  • What’s next: The bill awaits a full committee vote and NCUIH will continue to advocate for this bill to become law.

On January 25, NCUIH represented UIOs at the Health Resources & Services Administration (HRSA) Maternal Health & Mortality Initiative launch event.

NCUIH Public Policy Manager, Mary Jomia, Antigone Dempsey, Division of Policy and Data Director, HRSA/HHS, Acting Senior Advisor, Amelia Khalil.

NCUIH Public Policy Manager, Mary Jomia, Antigone Dempsey, Division of Policy and Data Director, HRSA/HHS, Acting Senior Advisor, Amelia Khalil.

  • Why it matters: The initiative will strengthen HRSA’s maternal health work and maximize the impact of HRSA grants and programs to address maternal health disparities, including in American Indian and Alaska Native communities.

On January 24, NCUIH represented UIOs at the Sanofi Health Equity Heroes reception.

NCUIH VP of Policy and Communications, Meredith Raimondi, NCUIH Public Policy Manager, Mary Jomia.

NCUIH VP of Policy and Communications, Meredith Raimondi, NCUIH Public Policy Manager, Mary Jomia.

IHS National Tribal Budget Formulation Workgroup Recommends $55.9 Billion for IHS in FY 2026

NCUIH President-elect Walter Murillo (Choctaw), CEO Francys Crevier (Algonquin), and NCUIH board member Maureen Rosette (Chippewa Cree)

NCUIH President-elect Walter Murillo (Choctaw), CEO Francys Crevier (Algonquin), and NCUIH board member Maureen Rosette (Chippewa Cree)

On January 24-25, IHS held its’ FY 2026 National Tribal Budget Formulation Workgroup Area Report Webinar where Tribal leaders from all 12 IHS Areas and leaders from Native organizations presented their budget priorities and hot issues for FY 2026. Meredith Raimondi, VP of Policy and Communications, presented on NCUIH’s priorities.

On February 12-13, NCUIH President-elect Walter Murillo (Choctaw), CEO Francys Crevier (Algonquin), and NCUIH board member Maureen Rosette (Chippewa Cree) joined the IHS National Tribal Budget Work Session where all of the Area’s budget recommendations are consolidated into a comprehensive set of national health priorities and budget recommendations. Mr. Murillo presented urban Indian health priorities.

  • Tribes drive the budget formulation process to ensure the IHS budget reflects the evolving health needs of American Indian and Alaska Native people and communities.
  • NCUIH always supports the Tribal Budget Formulation Workgroup budget request and advocates for full mandatory funding for IHS.
  • NCUIH is grateful for the Tribal Budget Formulation Workgroup’s advocacy for a fully funded Indian health care system, including Urban Indian Organizations.
  • The bottom line: Total Tribal recommendation for IHS for FY2026: $55.9 billion.
  • The bottom line: Total Tribal recommendation for Urban Indian Health for FY2026: $765.5 million, $195.9 million less than the FY2025 request.

Go deeper: Visit our Policy Blog to learn more about specific NCUIH and Area Recommendations.

Monitoring the Bench: Supreme Court Updates from NCUIH

Illustration of two gavels forming an x in front of the Supreme Court building

Becerra v. San Carlos Apache/Becerra v. Northern Arapaho Tribe (Consolidated)

  • Issue: Whether IHS must pay “contract support costs” not only to support IHS-funded activities but also to support the Tribe’s expenditure of income collected from third parties.
  • Relation to UIOs: No strong relation to UIOs because it relates to CSCs, but will affect Tribal healthcare facilities, and potentially restrict the scope of CSCs to cover services at Tribal facilities.
  • Case Status: Oral Argument set for March 25.
  • NCUIH Action: On February 14. NCUIH signed on to an amicus brief led by the National Indian Health Board in support of Respondent Tribes. The brief was submitted to the Court on February 19th.

Relentless, Inc. v. Department of Commerce and Loper Bright Enterprises v. Raimondo   

  • Issue: Whether the court should overrule Chevron v. Natural Resources Defense Council, or at least clarify that statutory silence concerning controversial powers expressly but narrowly granted elsewhere in the statute does not constitute an ambiguity requiring deference to the agency.
  • Relation to UIOs: Both cases have the potential to overturn Chevron deference, which would open up administrative agencies to more litigation and create discrepancies in how regulations are enforced.
  • Case Status: Oral Argument was held on January 17, 2024.
  • NCUIH Action: Monitoring.

Corner Post, Inc. v. Board of Governors of the Federal Reserve System

  • Issue: Whether a plaintiff’s Administrative Procedure Act claim “first accrues” under 28 U.S.C. § 2401(a) when an agency issues a rule — regardless of whether that rule injures the plaintiff on that date — or when the rule first causes a plaintiff to “suffer [] legal wrong” or be “adversely affected or aggrieved.”
  • Relation to UIOs: This would determine when an injury accrues, which impacts the amount of time a challenge could be made against an agency’s action.
  • Case Status: Oral Argument was held on February 20.
  • NCUIH Action: Monitoring.

NCUIH Advocates for Tribal Sovereignty and Cultural Sensitivity in HHS Proposed Rule on Grantmaking & SAMHSA Native Behavioral Health Program

Illustration of Congress with empty speech bubbles

On January 18, NCUIH submitted comments to the Department of Health and Human Services (HHS) Office of Civil Rights (OCR) regarding its Proposed Rule on HHS Grants Regulation.

  • The bottom line: NCUIH requested that HHS includes language in the proposed rule that clearly states that nothing in the rule will limit the ability of Tribes or UIOs to serve American Indian and Alaska Native people exclusively using HHS awards, and that OCR and HHS grant staff are properly trained on the unique political status of American Indian and Alaska Native people.

On January 31, NCUIH submitted comments to the Substance Abuse and Mental Health Services Administration (SAMHSA) Office of Tribal Affairs regarding its Behavioral Health and Substance Use Disorder Resources for Native Americans Program.

  • The bottom line: NCUIH recommended that SAMHSA ensures noncompetitive Program awards across the I/T/U system, accounts for administrative duties in the funding formula, respects Traditional Healing and Indigenous Knowledge in the funding formula, ensures program measures do not impose additional burdensome reporting requirements, ensures that all information related to program application is widely available, seeks additional expert feedback from Tribal Advisory Committees and Federal Agencies, and continues to engage with and incorporate UIO feedback in the Program’s development.

Upcoming Urban Confer Comment Opportunities

Laptop with an envelope as the screen

IHS Urban Confer on Fentanyl and Opioid Supplemental

  • On February 2, 2024, IHS held an Urban Confer seeking guidance and recommendations on the potential implementation of $250 million included in the Administration’s recent supplemental request to support funding for fentanyl and opioid programming.
  • IHS intends to make this funding available to the whole I/T/U system.
  • Written comments can be emailed to urbanconfer@ihs.gov, with the following subject line: Supplemental Request for Fentanyl and Opioid Abuse Funding.
  • The comment submission deadline for this Urban Confer is Monday, March 4, 2024.

IHS Urban Confer on Health IT Modernization

  • The first session was held on February 8 on Enterprise Collaboration Group (ECG). IHS provided an overview of the ECG, a body that gathers insights from subject matter experts who are end-users of the enterprise EHR. ECGs will be broken up into Domain Groups comprised of EHR users in the I/T/U. 60 Tribes and 14 UIOs have submitted a statement of interest (SOI) to indicate their interest in partnering with IHS on the shared enterprise solution.
  • Written comments are can be emailed within 30 days following each session to urbanconfer@ihs.gov – SUBJECT LINE: Health IT Modernization.
  • The comment submission deadline for this Urban Confer is March 8, 2024.

Upcoming Events and Important Dates

Calendar with events on it

Upcoming Events:

  • Feb 26 – 29– VA Advisory Committee on Tribal and Indian Affairs
  • Feb 27 – IHS National Tribal Advisory Committee (NTAC) on Behavioral Health Q1 Meeting
  • Feb 28 – NCUIH Webinar – Urban Voices Amplified: Empowering Native Votes
  • March 4 – Comments due for IHS Urban Confer on $250 Million Fentanyl and Opioid Programs
  • March 5 – MMPC Face-to-Face Meeting
  • March 5 – 6 – Tribal Leaders Diabetes Committee (TLDC) Meeting (hybrid)
  • March 6 – 7 – Centers for Medicare & Medicaid Services (CMS) Tribal Technical Advisory Group (TTAG) Face-to-Face Meeting (hybrid)
  • March 18 – 19 – American Academy of Pediatrics (AAP) Committee on Native American Child Health (CONACH) Meeting
  • March 19 – 21 – IHS 2024 National Combined Council Virtual Meeting

ICYMI:

  • On January 18, IHS hosted a Tribal Consultation on the Definition of Indian Tribe. Consulting on what definition of Indian Tribe should be included in the updated IHS Tribal Consultation Polic9 (List Act Definition (25 U.S.C. § 5130); or ISDEAA Definition (25 U.S.C. § 5304(e))).

Recent Dear Tribal Leader Letters (DTLLs) and Dear Urban Leader Letters (DULLs)

  • January 18: IHS DTLL/DULL – IHS – Tribal Consultation/Urban Confer on Health IT Modernization

    – This letter informs Tribal/UIO leaders about a series of four Tribal Consultation and Urban Confer sessions in calendar year 2024 on Health IT Modernization.

    -The first session was held on February 8 on Enterprise Collaboration Group (ECG).

    -Session 2: Deployment and Cohort Planning (virtual) will be held on May 9, 2024 from 1:30 p.m. – 3:00 p.m. ET. Register here.

    -Session 3: Multi-Tenant Domain Considerations (virtual) will be held on August 8, 2024 from 1:30 p.m. – 3:00 p.m. ET. Register here.

    -Session 4: Site Readiness and Training (hybrid) will be held on November 7, 2024 from 1:30 p.m. – 3:00 p.m. ET. Register here.

  • January 22IHS DULL – IHS Fiscal Year 2023 Budget to Support UIOs

    – The purpose of the FY23 Budget Report is to provide financial transparency and accountability for the Urban Indian Health Budget line. The report details the funds distributed by OUIHP and IHS Area Offices. View the budget report here.

    – The funds have been allocated for program administration, contract and grant awards, HIT, and Urban Indian Health initiatives.

  • January 22IHS DTLL/DULL – IHS Agency Accomplishments During the First Quarter of Fiscal Year 2024

    -The IHS FY 2024 First Quarter Performance Report was released. View the report here.

    -Some of the achievements included: IHS receiving its first-ever advance appropriations, progress to modernize HIT, and a breakthrough partnership with the U.S. Department of Veterans Affairs.

  • January 31: IHS DTLL/DULL – Director Writes to Communicate Key Leadership Changes

  • February 15 – IHS DTLL/DULL – The IHS Chief Medical Officer shares an update on efforts by the Agency to address the syphilis epidemic in Indian Country.

    -IHS data shows that syphilis screening in IHS facilities has increased by 98 percent from 2022 to 2023.

    -The letter includes resources and an STI toolkit for facilities to use to combat the syphilis epidemic.

One last thing, check out these upcoming funding opportunities:

  • National Institute of Food and Agriculture, U.S. Department of Agriculture – The Gus Schumacher Nutrition Incentive Program – Produce Prescription Program

    – Deadline: February 28, 2024 (Apply)

  • IHS – Indian Health Service Scholarship Program (IHSSP)

    -Deadline: February 28, 2024 (Apply)

  • AmeriCorps – Forest Corps Recruiting Native Youth for Opportunities to Support Cultural Resource Management Projects

    – Deadline: February 29, 2024 (Apply)

Veterans Save $2.5 Million Thanks to Department of Veteran Affairs Copay Exemption Championed by NCUIH and Native Partner Organizations

On February 13, 2024, the Department of Veterans Affairs (VA) announced that it has exempted or reimbursed more than 143,000 copayments totaling approximately $2.5 million for more than 3,800 eligible American Indian and Alaska Native Veterans.

This comes less than a year after the VA implemented a final rule, championed by the National Council of Urban Indian Health (NCUIH), that exempts eligible American Indian and Alaska Native Veterans to make copayments for health care and urgent care received through VA ― making VA health care more accessible and affordable. Under this policy, VA also reimburses for copayments paid on or after January 5, 2022.

Learn more about copayment exemptions for Native American and Alaska Native Veterans and VA benefits and programs for American Indian and Alaska Native Veterans.

Background

The copayment exemption is a significant step to upholding the federal government’s trust responsibility to “maintain and improve the health of the Indians.” American Indians and Alaska Natives serve in the military at one of the highest rates of any group in the United States and many Native veterans receive healthcare from the Veterans Health Administration, an agency within VA, in addition to utilizing IHS, Tribal, and UIO facilities. Unfortunately, American Indian and Alaska Native Veterans generally have a higher prevalence of mental health disorders compared with White veterans, and among all veterans, the prevalence of suicidal ideation is highest for those reporting a diagnosis of depression, anxiety, or post-traumatic stress disorder. Further, an estimated 86.2 percent of American Indian and Alaska Native Veterans that live in urban areas generally have higher unemployment, lower education attainment, lower income, higher VA-service connected disability, and generally live in poorer housing conditions than non-Native Veterans also living in urban areas.

On April 4, 2023, VA published a final rule in the Federal Register establishing the waiver process for Veterans to submit documentation to have their VA copays waived. This rule implements Section 3002 of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020 Public Law 116-315, signed into law on January 5, 2021, which prohibits collection of a health care copayment by the Secretary of Veterans Affairs from an American Indian and Alaska Native Veteran who meets the definitions of “Indian” or “urban Indian” under the Indian Health Care Improvement Act (IHCIA).

NCUIH’s Role

NCUIH has championed this copayment exemption and continues to advocate for Native Veterans living in urban areas to ensure that they have access to the high-quality, culturally competent care that the country owes to them for their service because of the federal trust responsibility. In February 2023, NCUIH submitted comments to the VA in response to the then proposed rule on the copayment exemption for American Indian and Alaska Native Veterans, stressing our support for this long overdue federal action and the need throughout Indian Country. Because the proposed rule only required VA to cover the first three urgent care visits in a calendar year, NCUIH and partnering Native organizations strongly urged the VA to cover all urgent care visits needed by Indian or urban Indian Veterans, which the VA adopted in the final rule. Moreover, NCUIH stressed that Native Veterans are entitled to the copayment exemption because of the federal government’s responsibility to provide and support services for Native Veterans in fulfilment of the trust responsibility for health care provisions for all American Indians and Alaska Native people.

NCUIH is encouraged to see the impact this rule has made in Indian Country and we will continue to engage with the VA on issues related to American Indian and Alaska Native Veterans living in urban areas.

Tribal Leaders Recommend Increased Urban Indian Health Funding in Fiscal Year 2026 Area Reports

On January 24-25, 2024, the Indian Health Service (IHS) held their Area Report Presentations Webinar for Fiscal Year (FY) 2026 where Tribal leaders from all 12 IHS Areas and leaders from Native organizations, including the National Council of Urban Indian Health (NCUIH), presented on their budget requests. Tribal leaders spoke about the need to increase urban Indian health funding.  Phoenix Area representative and Chairwoman of the Fallon Paiute-Shoshone tribe, Cathi Willams-Tuni, even noted that urban health line item has “…remained static for way, way too long.”

Common themes among Area reports were the need for increased funding for mental and behavioral health, electronic health records (EHR), permanent authorization of the Special Diabetes Program for Indians (SDPI), and permanent exemption from sequestration.

NCUIH always supports the Workgroup’s recommendation for the IHS budget and is grateful for Tribal Leaders’ support for increased funding in the urban health line item.

Area Report Highlights

Several Areas featured the work of UIOs in their presentations and advocated for increased allocation of funding and resources for urban Indian health.

The Bemidji Area stressed that UIOs are forced to use grants that are restrictive in nature leaving highly accessed urban sites financially unstable. They recommended an increase of $914 million above the FY2023 planning base for the Urban Indian Health line item for FY2026 and noted that increased funding would support authorized new programs and services for UIOs.

The Billings Area included urban Indian health as a top priority and recommended an increase of $1.3 billion over the FY2023 planning base for the Urban Indian Health line item for FY 2026.

The Oklahoma Area included a request to increase funding for the urban Indian health line item by $467.5 million above the FY 2023 recommendation as a priority for FY2026 in their Area report.

The Phoenix Area included urban Indian health funding as a top priority and recommended an increase of $103.7 million above the FY2023 planning base for FY2026. The Phoenix Area also noted that UIOs have many unmet construction, maintenance and improvement needs.

The Portland Area recommended a 2% increase over the FY 2023 planning base to the urban Indian health line item for FY 2026. The Area representative also noted that when UIOs are not sufficiently funded, tribal members will come to tribal clinics and get denied Purchase Referred Care (PRC) because they live in urban areas.

The Tucson Area highlighted the need for increased funding for the Urban Health line item and recommended $1.4 billion over the FY 2023 planning base for FY2026. The Tucson Area also included the need for 100% Federal Medical Assistance Percentage (FMAP) for Medicaid services at UIOs in their Area report. They also presented on the Tucson Indian Center’s successes such as celebrating 60 years of serving the Tucson American Indian community and launching primary care and behavioral health services in January 2024.

NCUIH Presents Priorities at Area Presentations Webinar

Meredith Raimondi, NCUIH’s Vice President of Public Policy and Communications, presented the top priorities for urban Indian health FY 2026 during the Area Report Webinar. NCUIH supports full funding for the IHS, Tribal, and urban Indian organization (UIO) (I/T/U) system.  We endorse a budget in which IHS, Tribal Facilities, and UIOs are all fully funded to improve health outcomes for all Native people no matter where they live.

  1. Maintaining the Tribal Budget Workgroup’s most recent request for Urban Indian health, with no cuts for sequestration.
    1. This funding is necessary to address health priorities for Native in urban areas, including:
        1. Ensuring Urban Indian Health funding keeps pace with population growth.
        2. Providing funding for UIO facilities and infrastructure.
        3. Expanding service offerings to Native patients in urban areas.
  2. Establishing Permanent 100% Federal Medical Assistance Percentages (FMAP) for services provided to Medicaid beneficiaries at UIOs
  3. Recruitment and Retention of Workforce
  4. SDPI reauthorization
  5. Increased funding and resources for Traditional Healing services, food and housing insecurity

Background on Area Budget Formulation

As part of the trust responsibility to provide health care to all American Indians and Alaska Natives, Tribal Leaders present their funding needs each year to the Secretary of HHS and the Director of the Office of Management and Budget. The recommendations are formed through the Tribal Budget Formulation Work Group and serve as a framework for the Administration in setting budget amounts for their annual requests to Congress. This process ensures the federal government has the resources to provide health care to all American Indians and Alaska Natives in fulfillment of the trust responsibility.

Next Steps

On February 13-14, 2024, IHS will host the FY 2026 National Tribal Budget Formulation Work Session.  This is a 2-day annual meeting where the two tribal representatives from each Area come together to review and consolidate all the Area’s Budget recommendations into a comprehensive set of national health priorities and budget recommendations. Work session activities include:

  • Tribal Caucus occurs where the tribal workgroup co-chairs are selected
  • Tribal representatives from each Area give a brief Area report presentation to the group
  • Discussion on determining priorities and budget recommendations
    • Discussions are made by consensus from workgroup members. Only the two tribal representatives that are part of the workgroup are allowed to partake in voting.
  • The workgroup will meet with the IHS Director and other IHS leadership to discuss health priorities and budget recommendations.
  • At least one tribal representative from each Area along with technical team members will coordinate to complete follow-up work on the budget recommendation and testimony that will be presented.

NCUIH Signs Letter of Support for John R. Lewis Voting Rights Act

On November 8, 2023, the National Council of Urban Indian Health (NCUIH) joined the Nonprofit Infrastructure Coalition, National Urban Indian Family Coalition, and 29 other nonprofit organizations in the effort to support voting rights in the United States, by signing a letter to Representative Terri Sewell (D-AL-07) expressing support for the John R. Lewis Voting Rights Advancement Act of 2023 (H.R 14). This legislation would protect voting rights in the United States and provide critical updates and modernizations to the Voting Rights Act of 1965 (VRA). Discriminatory voting policies adversely affect Native communities, and this bill would ensure state and local voting enforcements will be subject to increased oversight from the federal government and cannot enforce voting policies that target minority communities.

Background

In 1965, Congress passed the Voting Rights Act, a landmark piece of legislation that included numerous provisions aimed at ensuring minority voters had an equal opportunity to vote and prohibited racial discrimination in voting. In 2013, the United States Supreme Court in Shelby County v. Holder, overturned many key anti-discrimination provisions in the Voting Rights Act of 1965.  One of the key provisions overturned was an enforcement mechanism that prohibited states or political subdivisions, with a history of discriminatory practices, to make changes to voting laws and practices without clearance from federal officials first. In Shelby, the Supreme Court ruled that the formula determining a history of discriminatory voting practices was unconstitutional, removing significant oversight from the federal government.

The John R. Lewis Voting Rights Advancement Act would restore protections in the original Voting Rights Act of 1965 and strengthen legal protections against discriminatory voting practices. This includes key provisions to protect voting access in Indian Country, such as prohibiting changing jurisdiction boundaries, creating at-large districts, relocating voting locations, reducing in-person voting days or hours, or making changes to the voter registration list in areas where a single language minority represents 20% or more of the population on Indian lands in the state or political subdivision.

Biden Administration Announces Voter Registration Pilot Program at Indian Health Service Facilities

According to the Native American Voting Rights Coalition an estimated 1,000,000 eligible American Indian and Alaska Native voters are not currently registered to vote, with numerous obstacles preventing them from registering to vote and participating in elections. Some of these include lack of traditional addresses, lack of access to required identification forms, cultural and political isolation, and difficulties reaching the polls.

In an effort to improve voting access for American Indians and Alaska Natives, the Biden Harris Administration has transformed certain Indian Health System facilities into voter registration sites. On March 5, 2023, President Biden announced agency actions to make the voting process more accessible in alignment with recommendations made by the Native American Rights Fund (NARF). This included a new initiative at the Indian Health Service (IHS) piloting “high-quality voter registration services across five different IHS facilities before the end of 2023”. The first site announced in this initiative Native Health in Phoenix, Arizona.

Native Health has been active in voting rights and dedicated to increasing Native participation in the voting process. In 2022, they distributed Get Out the Vote information at various events, invited guests for voting related discussions on their podcast, Native Talk Arizona, and highlighted the importance of voter registration through social media. As part of this pilot program and being a National Voter Registration Act designated site, they will continue this work by ensuring anyone who steps into their clinic is provided with an opportunity to register to vote.

Indian Health Service Extends Recommended Dates for Maternal RSV Vaccine for Pregnant AI/AN People

The Indian Health Service Chief Medical Officer, Dr. Loretta Christensen, has extended the recommended dates for administration of maternal respiratory syncytial virus (RSV) Vaccine for pregnant American Indian and Alaska Native (AI/AN) people. This extension aims to protect newborn infants from RSV during the 2023-2024 respiratory virus season. Eligible AI/AN people who are 32-36 weeks pregnant should continue to be offered one dose of Pfizer’s bivalent RSVpreF vaccine (Abrysvo™) through the end of February 2024.

RSV is a common cause of respiratory infection in U.S. infants and is the leading cause of hospitalization among U.S. infants. The highest incidence of RSV-associated hospitalization occurs in infants aged <3 months. RSV prevention products focus on passive immunization of infants through maternal immunization or immunoprophylaxis with monoclonal antibodies.

Healthcare providers are encouraged to offer RSVpreF vaccine (Abrysvo™, Pfizer) to pregnant people during 32 weeks’ gestation through 36 weeks and 6 days’ gestation to prevent RSV-associated lower respiratory tract disease in infants. Either RSVpreF vaccination or nirsevimab (Beyfortus™) immunization for infants is recommended, but administration of both products is not needed for most infants.

In most of the continental U.S., pregnant people should receive RSV vaccine from September through January. However, RSV seasons can vary in different parts of the U.S. Local, state, and territorial health departments can determine the best times to start and stop administration of RSV vaccines in their jurisdictions.

NCUIH Selected as One of 11 Organizations for Pfizer Communities in Action for Health Equity Grant

We are excited to announce that we have received the Pfizer Communities in Action for Health Equity grant, enabling us to collaborate on advancing health equity for historically disregarded communities. This grant will support our efforts in providing crucial support and technical assistance to Urban Indian Organizations (UIOs), raising awareness of their health policy needs, and addressing the healthcare disparities faced by Native people in urban areas. Through engagement with stakeholders, we aim to drive meaningful policy changes for improved health and equitable healthcare delivery. At NCUIH, our commitment to culturally competent care drives us to find sustainable solutions, and over the next year, we will continue our project in “Addressing Urban Indian Health Disparities through Policy Change.” This initiative aligns with the Pfizer Multicultural Health Equity Collective and Pfizer’s Institute of Translational Equitable Medicine, which aim to dismantle the drivers of health inequity through the Communities in Action for Health Equity grant program.

“The Communities in Action for Health Equity grants program resulted from many candid discussions with health equity leaders about how we can move forward more equitable care and actually drive systemic change,” said Niesha Foster, Vice President, Global Health and Social Impact, Pfizer. “Our partners are truly at the forefront of this work and while we know this will be a multi-year effort, we feel Pfizer can play an important role in bringing multi-disciplinary leaders together and investing in the community-led solutions they helped identify.”

To learn more about our project and partners, visit https://www.pfizer.com/news/announcements/pfizer-awards-2m-nonprofit-organizations-addressing-systemic-health-inequities.

IHS Responds to NCUIH’s Request to Provide Clarity on the Health IT Modernization Implementation During Virtual Summit

On December 13, 2023, the Indian Health Service (IHS) held the Health Information Technology (HIT) Modernization Virtual Summit. IHS gave Tribal and urban Indian organization (UIO) leaders an update on the HIT Modernization Program and provided a forum to engage with IHS on the Program. The purpose of the Summit was to raise awareness of the new enterprise Electronic Health Record (EHR) solution and to give Tribal and UIO leaders an opportunity to engage in a conversation with IHS on the HIT Modernization Program. In providing updates on the HIT Modernization implementation process, IHS also responded to comments that the National Council of Urban Indian Health recently submitted to the agency regarding HIT Modernization on December 8.

For more information on the Summit, please click here.

NCUIH Requested IHS Provide Clarity on the HIT Modernization Implementation

On December 8, 2023, NCUIH submitted comments and requests to IHS Director, Roselyn Tso, in response to a Tribal Consultation and Urban Confer and request for input on the HIT Modernization Program. In its comments, NCUIH urged IHS to maintain transparency in the HIT Modernization process to ensure that UIOs stay informed on the progress of the complex, multi-year rollout for the new EHR.

In its comments, NCUIH requested that IHS:

  • Clarify the HIT Modernization implementation process. This includes providing clarity on the vendor’s scope of work, the data migration process, and the ways in which IHS will support all facility types.
  • Provide an update to the timeline for HIT Modernization implementation. Specifically, NCUIH seeks clarity on the multi-year rollout cohort identification process.
  • Provide frequent and regular updates to the IHS HIT Modernization webpage.
  • Communicate the status of the Enterprise Collaboration Group (ECG).
IHS Responds to NCUIH’s Request Regarding Focus Groups and the Enterprise Collaboration Group

In NCUIH’s recently submitted comments to IHS regarding HIT Modernization, NCUIH requested clarification on the differences between the Focus Group and the ECG. During the Summit, IHS provided more information on the entities’ role in the HIT Modernization process.

Focus Groups are for every facility regardless of which EHR they are choosing to utilize. The ECG will be comprised of subject matter experts from IHS as well as Tribes and UIOs who provided statements of interest. It will be a chartered entity with many committees that will facilitate structured conversations to help manage the system. The ECG is for entities that will use the new system.

Other Takeaways from the HIT Modernization Program Updates

Timeline

The contract with GDIT is a 10-year indefinite delivery, indefinite quantity (IDIQ) contract. Initial go-live(s) expected to occur late Fiscal Year 2025. IHS requested Tribes and UIO maintain their current HIT system and keep data up to date to support EHR replacement if desired.

Substance Use Disorder Treatment and the New EHR

The EHR will support substance abuse/alcohol abuse treatment centers. IHS stated that it is working to understand how to share patient information with a health information exchange (HIE) partner in compliance with 42 CFR Part 2 (Confidentiality of Substance Use Disorder Patient Records). Because there are limits on how patient information can be shared, IHS is discussing how to share the information effectively under the rules and doing so in the HIE environment.

Background on HIT Modernization

During the November 8, 2023, Tribal Consultation and Urban Confer on HIT Modernization, IHS announced that it selected General Dynamics Information Technology, Inc. (GDIT) to build, configure, and maintain a new IHS enterprise EHR system utilizing Oracle Cerner technology. The new EHR will replace the Resource and Patient Management System.

For more information about HIT Modernization implementation, please click here.

NCUIH Action

NCUIH has submitted several written comments to IHS on HIT Modernization:

NCUIH also submitted written testimony  to the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies regarding the Fiscal year (FY) 2024 funding for UIOs in which NCUIH requested increased funding for EHR Modernization. Specifically, NCUIH requested support for the IHS’ transition to a new EHR system for IHS and UIOs by supporting the President’s budget request of $913 million in FY 2024 appropriations.

NCUIH will continue to closely follow IHS’s progress and policies with HIT Modernization.

NCUIH Releases 2023 Annual Policy Assessment

The Policy Assessment informs urban Indian organizations policy priorities for 2024, identifies barriers to workforce recruitment and retention, and addresses critical funding needs.

The National Council of Urban Indian Health (NCUIH) is pleased to announce the release of its 2023 Policy Assessment. NCUIH hosted five focus groups to identify Urban Indian Organization (UIO) policy priorities for 2023, as they relate to the Indian Health Service (IHS) designated facility types (full ambulatory, limited ambulatory, outreach and referral, and outpatient and residential). The focus groups were held on October 3, 4, and 5, 2023.

Together these focus groups allow NCUIH to work with UIOs to identify policy priorities in 2024 and identify barriers that impact delivery of care to Native patients and their communities.  Of the 41 UIOs, 18 attended and participated in the focus group sessions. This is the fourth year that NCUIH has conducted the assessment via focus groups sessions.

Overview of the Policy Assessment

During the focus group sessions, UIO leaders had the opportunity to share their opinions on the successes and challenges they experienced in 2023 and provide input on the policy areas where they would like to see the greatest policy support from NCUIH. Some of the key policy priority areas identified included increasing funding for the Indian Health Service and urban Indian health line items, securing 100% FMAP for UIOs, passing the Urban Indian Health Confer Act, reauthorizing the Special Diabetes Program for Indians, and reimbursing UIOs for traditional healing services.

Key Findings from the Policy Assessment are as follows:

  • Funding Remains a Key Focus and Challenge
  • Workforce Recruitment and Retention Remains Key Concern Amid Competitive Market
  • Health Information Technology Modernization Challenges
  • Actions Taken to Address Missing and Murdered Indigenous Persons, Despite Absent Adequate Funding
  • Need for Increased HIV Prevention and Treatment Resources
  • Barriers to the Provision of Traditional Healing
  • Clear Need to Increase and Diversify Resources to Address Food Insecurity
  • Lack of Stable Housing for Native People

Next Steps

NCUIH will release a comprehensive document of the 2024 Policy Priorities in the coming weeks.

Past Assessments and Priorities

January Policy Updates: CR Passed, SDPI Update, and 2024 Policy Overview

Happy New Year! 🍇

In this Edition:

  • 🔎 Explore the latest on the government shutdown and a 2024 forecast, with a focus on Special Diabetes Program for Indians (SDPI) funding.
  • 🏛 Stay informed on crucial legal cases, including the Supreme Court’s consideration of issues impacting Native communities.
  •  Participate in upcoming federal agency comment opportunities, shaping policies on health, substance use disorder, and more.
  • 📆 Mark your calendars for key events, consultations, and legislative updates.
  • 📋 Join us next week to learn about NCUIH’s 2024 Urban Indian Health Policy Priorities and find out what’s on the horizon.
  •  Don’t miss the opportunity to register now for the 2024 NCUIH Annual Conference and stay updated on NOFOs.

Short-Term Reprieve: FY24 Continuing Resolution Temporarily Extends SDPI Authorization

An EKG line across a map of America.

Today, President Biden signed a short-term stopgap bill to avoid a government shutdown on January 20th.

  • The bill would continue the two-tiered system with new deadlines on March 1st and March 8th. The latest stopgap includes minimal changes to spending, mainly just continuing the current continuing resolution. ​
  • Most importantly, it will extend SDPI through March 8 at current funding levels.

H.R. 5378 – Lower Costs More Transparency Act​

  • This bill has passed the House and has been received in the Senate. This bill funds SDPI at $170 million for FY24-25 among other provisions.
  • Why it matters: The bill’s reauthorization of SDPI would allow for UIOs to continue to use grant funding to offer a wide range of diabetes treatment and prevention services, including but not limited to exercise programs and physical activity, nutrition services, community gardens, culinary education, physical education, health and wellness fairs, culturally relevant nutrition assistance, food sovereignty education, group exercise activities, green spaces, and youth and elder-focused activities. While the FY2024 Continuing Resolution re-authorizes SDPI, it is set to expire in March, making this legislation even more crucial to avoid lapses in critical diabetes research and care funding.

Monitoring the Bench: Supreme Court Updates from NCUIH

Illustration of two gavels forming an x in front of the Supreme Court building

Becerra v. San Carlos Apache/Becerra v. Northern Arapaho Tribe (Consolidated) 

Issue: Whether IHS must pay “contract support costs” (CSCs) not only to support IHS-funded activities but also to support the Tribe’s expenditure of income collected from third parties.

Relation to UIOs: No strong relation to UIOs because it relates to CSCs, but will affect Tribal healthcare facilities, and potentially restrict the scope of CSCs to cover services at Tribal facilities. ​

Case Status: Granted Cert by the Supreme Court, no Oral Argument date set yet.

Relentless, Inc. v. Department of Commerce and Loper Bright Enterprises v. Raimondo 

Issue: Whether the court should overrule Chevron v. Natural Resources Defense Council, or at least clarify that statutory silence concerning controversial powers expressly but narrowly granted elsewhere in the statute does not constitute an ambiguity requiring deference to the agency.

Relation to UIOs: Both cases have the potential to overturn Chevron deference, which would open up administrative agencies to more litigation and create discrepancies in how regulations are enforced.

Case Status: Oral Argument was held on January 17, 2024 .

IHS Hosting Urban Confer on Fentanyl and Opioid Programs & Health IT Modernization

IHS

On February 2, 2024, IHS is holding an Urban Confer on the potential implementation of $250 million to support funding for fentanyl and opioid abuse prevention, treatment, recovery services, and harm reduction interventions.

  • The confer will take place on Friday, February 2, 2024, from 1pm-2:30pm EST via Zoom.
  • NCUIH will hold a prep session on February 2, 2024 for UIO leaders.

On February 8, 2024, IHS is holding Tribal Consultation/Urban Confer. on Health IT Modernization Tribal Consultation/Urban Confer.

  • The confer will take place on Thursday Feb 8, 2024, at 1:30pm EST via Zoom. Register here.

Upcoming Federal Agency Comments: Grants Regulation, Traditional Knowledge, Resources for Native Americans

Illustration of Congress with empty speech bubbles

January 31 – Substance Abuse and Mental Health Services Administration (SAMHSA) – Behavioral Health and Substance Use Disorder Resources for Native Americans Program​

  • SAMHSA is seeking recommendations on this newly authorized program​.
  • What factors should be considered in determining non-competitive awards to eligible entities?​
  • What measures should be established to demonstrate outcomes and report data on the results of services?​
  • How can the administrative process be streamlined to capture program requirements and facilitate assisting application submission?​

February 23 – US Patent and Trademark Office (USPTO) – Tribal Consultation on World Intellectual Property Organization (WIPO) Genetic Resources, Traditional Knowledge, Traditional Cultural Expressions of Indigenous Peoples​. More Info.

  • The Tribal Consultation will consist of four national webinars: two for federally recognized Tribal Nations and their proxies, and two for state and non-recognized Tribes, Native Hawaiians, their representatives, and inter-Tribal organizations. ​
  • USPTO and the WIPO seek Tribal input on how best to protect genetic resources, traditional knowledge, and traditional cultural expressions of Indigenous Peoples.

Upcoming Events and Important Dates

Calendar with events on it

January 19- 23: US Patent and Trademark Office (USPTO) Online Listening Sessions. Register here.

January 24: Administration for Community Living (ACL) Tribal Consultation (hybrid).

January 24-25: FY 2026 National Tribal Budget Formulation Workgroup Area Report Webinars. Join day 1 here. Join day 2 here.

February 2: IHS Urban Confer on the proposed supplemental funding request to support fentanyl and opioid programs. Join here.

February 6: HHS Tribal Consultation: Draft Tribal and Tribal Epidemiology Center Data Access Policy. Register here.

February 8: IHS Health IT Modernization Tribal Consultation/Urban Confer. Register here.

February 12-15: National Congress of American Indians (NCAI) Executive Council Winter Session (ECWS) and 2024 State of Indian Nations Address (Feb. 12). Register here.

February 13-14: IHS FY 2026 National Tribal Budget Formulation Work Session (Hybrid). More info.

February 15: Urban Program Executive Directors/Chief Executive Officers Monthly Conference Call.

February 21: Next NCUIH Monthly Policy Workgroup meeting. Join here.

February 21: IHS Tribal Self-Governance Advisory Committee (TSGAC) Meeting. More info.

February 21-22: Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry Tribal Advisory Council (hybrid). Register here.

ICYMI: 

  • January 9, 11, 17, 18: IHS Tribal Consultation on the Definition of Indian Tribe.

    -Consulted on what definition of Indian Tribe should be included in the updated IHS Tribal Consultation Policy: List Act Definition (25 U.S.C. § 5130); or ISDEAA Definition (25 U.S.C. § 5304(e)).

    The ISDEAA definition includes Alaska Native Corporations (ANCs) and is currently utilized in the IHS Tribal Consultation Policy

  • January 18: NCUIH submitted comments to HHS Office of Civil Rights (OCR) on the Proposed Rule on HHS Grants Regulation.

    -NCUIH requested that the agency include language in the proposed rule that clearly states that nothing in the rule will limit ability of Tribes or UIOs to serve American Indian and Alaska Native people exclusively using HHS awards, and ensure OCR and HHS grant staff are properly trained on the unique political status of American Indian and Alaska Native people.

  • Dec. 21: IHS Direct Service Tribal Advisory Committee (DSTAC) Quarterly Meeting.

    -IHS Chief Medical Officer reported that IHS has reduced opioid prescribing by 75% and they continue to support low barrier access to naloxone.

    -IHS has put together an obstetrician readiness manual that can be used when birth is outside a formal labor and delivery office.

Recent Dear Tribal Leader Letters (DTLLs) and Dear UIO Leader Letters (DULLs)

  • January 16: IHS DTLL/DULL – Appointment of the new IHS Deputy Director for Quality Healthcare and Enterprise Risk Management.

    -IHS has appointed Ms. Michelle Boylan, RN, MA, MBA, CPHQ, as the new Deputy Director for Quality Healthcare and Enterprise Risk Management.

  • January 12: IHS DULL – Urban Confer on the proposed supplemental funding request to support fentanyl and opioid programs.

    -The confer will take place on Friday, February 2, 2024, from 1pm-2:30pm EST via Zoom.

  • January 11: White House DTLL – White House Tribal Consultation on Executive Order (EO) 14112.

    -Announcing January 22, 2024 Consultation to discuss EO 14112: “Reforming Federal Funding and Support for Tribal Nations to Better Embrace Our Trust Responsibilities and Promote the Next Era of Tribal Self-Determination.”

    -This EO does not address funding for UIOs.

  • January 10: HHS DTLL – HHS Tribal Data Policy.

    -Tribal Consultation is on February 6, 2024, to discuss the current draft of the HHS Tribal and Tribal Epidemiology Center (TEC) Data Access Policy.

    -2022 Government Accountability Office report recommended that HHS develop a policy clarifying the HHS data to be made available to TECs.

  • Dec. 21: IHS DTLL – Federal Register Notice for calendar year 2024 reimbursement rate.

    -Announces publication of the Federal Register Notice for CY 2024 reimbursement rates: Lower 48 Medicaid AIR is $719, Lower 48 Medicare AIR is $667.

    -New page on the IHS website explains the process for these rates.

NCUIH 2024 Urban Indian Health Policy Preview

NCUIH Policy Preview

Join us for an informative session as the NCUIH Policy Department explores 2024 Policy Priorities for American Indians and Alaska Natives. This engaging webinar promises a thorough exploration of key issues leading the charge in advocacy efforts, shaping the policy landscape for Native communities in the coming year.

Event Goal:

The goal is to share with participants a comprehensive understanding of the key issues shaping advocacy efforts and influencing the policy landscape for American Indians and Alaska Natives.

Objectives: 

  1. Develop a deeper understanding of the 2024 Policy Priorities driving American Indian and Alaska Native health initiatives.
  2. Gain valuable insights into the advocacy efforts aimed at advancing urban Indian health policies.

The session is open to only UIO staff and will be facilitated by Jeremy Grabiner, NCUIH’s Interim Director of Congressional Relations.

Register

Urban Voices Amplified: Empowering Native Votes in Collaboration with the National Urban Indian Family Coalition

NUIFC GOTV

As part of our commitment to empowering Native American communities, and in collaboration with the National Urban Indian Family Coalition (NUIFC), we’re thrilled to share our Get Out the Vote (GOTV) Social Media Toolkit with you. This toolkit includes five eye-catching graphics tailored to encourage Indian Country to register and vote.

NCUIH

Here you’ll find high-resolution graphics designed to be shared across Instagram, X (formerly Twitter), LinkedIn, and Facebook.

Together, let’s inspire Native Americans to exercise their right to vote and make a lasting impact on our communities.

Additionally, we’re excited to share a digital poster that you can download, print, and hang up in your community spaces. This poster serves as a visual reminder to encourage voter registration and participation.

2024 NCUIH Annual Conference – Early Bird Registration Open

AC24

Register now before rates go up in March!

Sponsorships: Several different sponsorship levels remain. If you are interested in sponsoring the conference, please see our sponsor guide.

Room Reservations: The negotiated room rate of $369 per night (plus tax) for single/double occupancy rooms is available until April 5, 2024. We encourage you to book your room soon to secure this special rate. To make your reservation at the Hilton Washington DC Capitol Hill, click here to access the room block.

One last thing, check out these upcoming funding opportunities:

  • Health Resources & Services Administration (HRSA) – Maternal and Child Health Improving Oral Health Integration Demonstration Projects

    – Deadline: January 22, 2024 (Apply)

  • IHS – Community Opioid Intervention Prevention Program

    -Deadline: February 7, 2024 (Apply)

  • U.S. Department of Justice Office on Violence Against Women (OVW) – OVW Fiscal Year 2024 Legal Assistance for Victims Grant Program

    – Deadline: February 13, 2024 (Apply)

  • Youth Homelessness System Improvement (Department of Housing and Urban Development)

    – Deadline: February 15, 2024 (Apply)

  • SAMHSA – Strategic Prevention Framework Partnerships for Success for Communities, Local Governments, Universities, Colleges, and Tribes/Tribal Organizations

    – Deadline: February 21, 2024 (Apply)

  • National Institute of Food and Agriculture, U.S. Department of Agriculture – The Gus Schumacher Nutrition Incentive Program – Produce Prescription Program

    – Deadline: February 28, 2024 (Apply)

  • IHS – Indian Health Service Scholarship Program (IHSSP)

    -Deadline: February 28, 2024 (Apply)

  • AmeriCorps – Forest Corps Recruiting Native Youth for Opportunities to Support Cultural Resource Management Projects

    – Deadline: February 29, 2024 (Apply)

NCUIH Urges Office of Management and Budget to Fully Fund IHS and Fund Critical Indian Health Programs

On September 29, 2023, the National Council of Urban Indian health (NCUIH) submitted comments to the Office of Management and Budget (OMB) Director, Shalanda Young, regarding the formulation of the President’s Fiscal Year (FY) 2025 Budget. In its comments, NCUIH made seven key recommendations to fully fund and support health services for urban Indian organizations (UIOs) and urban American Indian and Alaska Native (AI/AN) people.

Background

OMB serves as a clearinghouse for budget formulation by developing overarching presidential priorities, coordinating across agencies, and publishing the annual President’s Budget. For more information on OMB, please click here.

NCUIH’s Recommendations

In its comments, NCUIH recommended that the President’s FY2025 budget:

  • Fully fund the Indian Health Service (IHS) and the Urban Indian Health Line Item , as recommended by the Tribal Budget Formulation Workgroup. Full funding for IHS in the President’s FY 2025 Budget will address the following UIO priorities:
    • Infrastructure and facility needs
    • Food security
    • Traditional Healing
    • Health information technology and electronic health record modernization
  • Safeguard IHS and UIO funding by transitioning the IHS budget from discretionary funding to mandatory funding and exempting IHS funding from sequestration.
  • Propose setting the Federal Medical Assistance Percentage (FMAP) at 100% for Medicaid services provided at UIOs.
  • Request inclusion of $80 million for the Native Behavioral Health Resource Program (NBHRP).
  • Propose permanent reauthorization of the Special Diabetes Program for Indians (SDPI) at $250 million, if not reauthorized in the FY 2024 budget.
  • Request a legislative fix permitting the U.S. Public Health Service Commissioned Corps Officers to be detailed to UIOs

NCUIH will continue to monitor the FY 2025 budget formulation process and report developments across federal agencies and in Congress.