HHS Provides Update on Suspected Behavioral Health Treatment Center Fraud Targeting Native Americans in Arizona

/in /by

On November 14, 2023, the Department of Health and Human Services (HHS) sent a Dear Tribal Leader and Urban Indian Organization Leader Letter (DTLL/DULL) to provide an update on suspected behavioral health treatment center fraudulent activities in Arizona. The DTLL/DULL provided a list of resources to stay up to date on the matter and described a “whole of government” approach that the Indian Health Service (IHS), Tribal leaders, Urban Indian Health Program leaders, the Arizona Health Care Cost Containment System (AHCCCS), and the State of Arizona are working toward. Specifically, they have established mechanisms to help affected people receive care, transportation, and other needed services. HHS stresses the importance of staying vigilant in addressing this matter.

Background

Suspected fraudulent providers are believed to be targeting vulnerable American Indian and Alaska Native (AI/AN) people who are unsheltered and experiencing the impacts of substance use disorder (SUD) health conditions. Reports indicate the suspected fraudulent providers entice vulnerable individuals with food, money, shelter, and offer treatment and safe housing to lure them into facilities that do not provide treatment. Initially, suspected fraudulent providers focused on recruiting in reservation communities in Arizona and New Mexico, but more recently there are reports of recruitment efforts throughout Indian Country and direct solicitation to the IHS, Tribal Health Programs, and Urban Indian Health Programs in an effort to gain referrals.

On May 16, 2023, Arizona Governor Katie Hobbs and Attorney General Kris Mayes joined the AHCCCS Office of Inspector General (OIG) to announce payment suspensions against registered behavioral health providers of Medicaid services based on credible allegations of fraudulent billing activities. This first of many actions to stop these criminal activities was a coordinated effort by the Arizona Attorney General’s Healthcare Fraud and Abuse Section, the Federal Bureau of Investigation (FBI), HHS, the U.S. Attorney’s Office, and the Internal Revenue Service. The suspected false and fraudulent claims have been associated with unethical treatment practices, patient brokering, unnecessary services, and overcharging. These actions have led to the suspension of more than 100 unique registered behavioral health providers since the May 16 announcement, and the search for additional fraudulent providers continues.

Resources to Stay Up to Date

IHS will provide regular communication, new information, and additional details as they become available. Several resources are immediately available:

Should you have any questions, please contact your IHS Area Office directly.

Bureau of Indian Education Seeks Nominations for Membership on the Advisory Board for Exceptional Children

/in /by

On December 4, 2023, the Bureau of Indian Education (BIE) issued a notice seeking nominations of individuals to serve on the Advisory Board for Exceptional Children (Advisory Board). There will be three positions available to specifically serve in the areas of Indian persons with disabilities; or State education officials; or State Interagency Coordinating Councils (for States having Indian reservations). Applications are due Wednesday, January 31, 2024.

Eligibility and Nomination Information

Nominations may come from individuals, organizations, and federally recognized Tribes. Interested individuals may also self-nominate. Nominees should have expertise and knowledge of the issues and/or needs of American Indian children with disabilities. A summary of the candidates’ qualifications (resume or curriculum vitae) must be included with a completed nomination application form. Nominees must have the ability to attend Advisory Board meetings, carry out Advisory Board assignments, participate in teleconference calls, and work in groups.

Please submit nominations to Ms. Jennifer Davis, Designated Federal Officer (DFO), Bureau of Indian Education, Division of Performance and Accountability, 2600 N Central Ave., Suite 800, Phoenix, AZ 85004; email to jennifer.davis@bie.edu; or fax to (602) 265–0293. Please click here for the nomination application on BIE’s website.

Background

The Advisory Board was established under the Individuals with Disabilities Education Act of 2004 (IDEA) in an effort to advise the Secretary of the Interior, through the Assistant Secretary-Indian Affairs, on the needs of Indian children with disabilities. Members of the Advisory Board will provide guidance, advice, and recommendations with respect to special education and related services for children with disabilities in BIE-funded schools in accordance with the requirements of IDEA.

The Advisory Board will also:

(1) Provide advice and recommendations for the coordination of services within the BIE and with other local, State and Federal agencies;

(2) Provide advice and recommendations on a broad range of policy issues dealing with the provision of educational services to American Indian children with disabilities;

(3) Serve as advocates for American Indian students with special education needs by providing advice and recommendations regarding best practices, effective program coordination strategies, and recommendations for improved educational programming;

(4) Provide advice and recommendations for the preparation of information required to be submitted to the Secretary of Education under 20 U.S.C. 1411 (h)(2);

(5) Provide advice and recommend policies concerning effective inter/intra agency collaboration, including modifications to regulations, and the elimination of barriers to inter- and intra-agency programs and activities; and

(6) Report and direct all correspondence to the Assistant Secretary—Indian Affairs through the Director, BIE with a courtesy copy to the Designated Federal Officer (DFO).

Membership

Pursuant to 20 U.S.C. 1411(h)(6), the Advisory Board is composed of up to fifteen individuals involved in or concerned with the education and provision of services to American Indian infants, toddlers, children, and youth with disabilities. The Advisory Board composition reflects a broad range of viewpoints and includes at least one member representing each of the following interests:

  • American Indians with disabilities;
  • teachers of children with disabilities;
  • American Indian parents or guardians of children with disabilities;
  • service providers;
  • State education officials;
  • local education officials;
  • State interagency coordinating councils (for States having Indian reservations);
  • Tribal representatives or Tribal organization representatives; and
  • other members representing the various divisions and entities of BIE.

NCUIH Advocates for HHS Office of Minority Health to Address AI/AN Needs in Healthy People 2030 Leading Health Indicators Initiative

/in /by

On October 31, 2023, the National Council of Urban Indian Health (NCUIH) submitted written comments in response to the Department of Health and Human Services (HHS) Office of Minority Health’s (OMH) September 13, 2023, letter regarding the development of a Notice of Funding Opportunity (NOFO) entitled Healthy People 2030 Leading Health Indicators Initiative (LHII). In its comments, NCUIH urges OMH to consider the health needs of American Indian and Alaska Native people living in urban areas when developing the NOFO, in accordance with Congress’ directive in the Indian Health Care Improvement Act “to raise the health status of Indians and urban Indians to at least the levels set forth in the goals contained within the Healthy People 2010 initiative or successor objectives,” like Healthy People 2030. NCUIH highlighted particular leading health indicators (LHIs) which impact American Indians and Alaska Natives living in urban areas, such as maternal deaths, food insecurity, diabetes, behavioral health, substance use disorders, and drug overdose deaths, and also urged OMH to facilitate partnerships between grantees and UIOs to ensure American Indians and Alaska Natives can be served by the LHII no matter where they reside.

Background

Healthy People 2030 identifies public health priorities to help individuals, organizations, and communities across the United States improve health and well-being. Healthy People 2030, the initiative’s fifth iteration, builds on knowledge gained over the first four decades. The Healthy People 2030 LHII is intended to identify innovative adaptations of evidence based/evidence informed practices that improve health outcomes related to Healthy People 2030 LHIs among racial, ethnic, tribal and other disadvantaged communities.

LHIs are a small subset of high-priority Healthy People 2030 objectives selected to drive action toward improving health and well-being. Most LHIs address important factors that impact major causes of death and disease in the United States, and they help organizations, communities, and states across the nation focus their resources and efforts to improve the health and well-being of all people. Healthy People 2030 includes 23 LHIs that are organized by life stage: Infants, Children and Adolescents, Adults and Older Adults, and All Ages.

Projects funded under the LHII will implement public health improvement models intended to improve health for one to two Healthy People 2030 LHIs in geographic areas targeted by the recipients. OMH also expects the initiative will result in enhanced capacity of public health, community, and government entities to address and reduce health disparities in geographic areas targeted by the recipients.

Next Steps

NCUIH will continue to monitor the development of the Healthy People 2030 Leading Health Indicators Initiative and advocate on the inclusion of issues of importance to American Indians and Alaska Natives living in urban areas and the UIOs that serve them.

December Policy Updates: White House Tribal Nations Summit Updates, 100% FMAP, and More

/in /by

Happy New Year!

In This Edition: ….conference season is underway, and many more developments in urban Native health policy.

Have a safe and happy holiday season!

White House Tribal Nations Summit Updates

SD and FC

Rep. Sharice Davids (D-KS), joins NCUIH CEO Francys Crevier, JD (Algonquin), AIHEC’s VP of Congressional Relations Ahniwake Rose, and Tribal college students during the White House Tribal Nations Summit.

NCUIH CEO Francys Crevier had the opportunity to attend the 2023 White House Tribal Nations Summit on December 6 and 7 in Washington, D.C.

President Biden sign Exec Order

President Joseph Biden joins Tribal Leaders to sign Executive Order 14112.

President Biden Signs Executive Order on Reforming Federal Funding and Support for Tribal Nations to Better Embrace Our Trust Responsibilities and Promote the Next Era of Tribal Self-Determination (EO 14112) during the White House Tribal Nations Summit.

The Biden-Harris Administration also released a 2023 Progress Report for Tribal Nations, which outlines historic progress the Administration has made over the past year to address top Indian Country concerns.

  • Initiatives vital to urban Native communities were highlighted, including strategies for access to the Strategic National Stockpile in healthcare, HHS’s Comprehensive Missing and Murdered Indigenous People (MMIP) plan, Veteran’s Health exemptions, the Native American Veterans Homelessness Initiative, 988 Suicide Lifeline focus, Indian Health Service (IHS) Health Information Technology (HIT) Modernization, reproductive healthcare access at IHS, and SSA Native Language accessibility improvements.

MR

NCUIH’s Vice President Policy and Communications presented at the Tribal Leaders Briefing.

On December 5, NCUIH was honored to contribute as a presenter alongside many other Native organizations at the National Congress of American Indians (NCAI) Tribal Leaders Briefing ahead of the 2023 White House Tribal Nations Summit.

Federal Budget Updates
Congress dealing with surprise medical bills

On November 15, 2023, a full government shutdown was averted when Congress passed a two-tiered Continuing Resolution (CR) serving as a stopgap spending measure. The CR was signed into law by President Biden on November 16, 2023.

What is included: The CR includes two funding deadlines for the twelve appropriations accounts, January 19 and February 2.

The bottom line: Last year, Congress authorized $5.13 billion in advanced appropriations for IHS, insulating the majority of IHS programs from the worst effects of a government shutdown.

Go deeper: The CR re-authorized the Special Diabetes Program for Indians (SDPI) until January 19th at $25.89 million, and funds IHS accounts not receiving advanced appropriations at FY23 levels through February 2nd.

Did you know?: President Biden requested $250 million for IHS in emergency supplemental funding in response to the current opioid epidemic. Congress has not included this funding in this CR.

Urban Indian Health Priority Updates: SDPI Reauthorization & 100% FMAP for UIOs

Illustration of Congress with empty speech bubbles

Special Diabetes Program for Indians​ (SDPI):

The Lower Cost, More Transparency Act of 2023 (H.R. 5378) includes language reauthorizing SDPI for FY2025 and raises funding to $170 million. The bill passed the House on Monday, December 11, 2023.

  • What’s next: The bill will now be considered by the Senate with a vote expected in the New Year.

  • 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. The FY2024 Continuing Resolution (CR) re-authorized SDPI at $25.89 million and is set to expire on January 19, 2024, making this legislation even more crucial to avoid lapses in critical diabetes research and care funding.

100% Federal Medical Assistance Percentage (FMAP) for UIOs:

On Nov. 30, Representative Bacon (R-NE-2) and Representative Ruiz (D-CA-25) reintroduced the bipartisan Urban Indian Health Parity Act (H.R. 6553) which would amend the Social Security Act to set the FMAP at 100% for services provided to Medicaid beneficiaries at UIOs.

“We applaud Representatives Ruiz and Bacon for this bipartisan effort to ensure that the federal government honors its trust responsibility to Native people and improves health outcomes that are desperately needed. With broad support from Indian Country, we are hopeful that Congress will move forward with ending this inequity to expand resources for communities that benefit from the necessary services provided by urban Indian organizations and all Indian Health Care Providers,” said Francys Crevier, CEO of NCUIH.

  • What’s next: NCUIH is currently working to secure more cosponsors for the bill.

American Medical Association Adopts NCUIH-Supported Resolution on IHS Improvements, Includes 100% FMAP for UIOs:

  • On November 3, 2023, NCUIH submitted written testimony to the 2023 Interim Meeting of the American Medical Association (AMA) House of Delegates, held on November 10-14, 2023, regarding the proposed resolution “Federal Medical Assistance Percentage Extension for Urban Indian Organizations” as part of  a larger resolution, Resolution 812 (I-23), “Indian Health Service Improvements.”

  • What they’re saying: The Reference Committee noted that 100% FMAP would “lead to enhanced and directed advocacy of priorities as identified by American Indian/Alaska Native-serving health organizations and other important stakeholders.”

  • The bottom line: The AMA adopted the entire resolution, including the language in support of 100% FMAP for UIOs.

“RESOLVED, that our American Medical Association supports an increase to the Federal Medical Assistance Percentage (FMAP) to 100% for medical services which are received at or through an Urban Indian Organization that has a grant or contract with the Indian Health Service (IHS) and encourage state and federal governments to reinvest Medicaid savings from 100% FMAP into tribally-driven health improvement programs.”

  • Why it matters: Adoption of this resolution means that 100% FMAP will now be a priority of the AMA moving forward. Having the support of the largest physician advocacy organization is an additional advocacy tool NCUIH and other organizations can utilize, and it shows Congress the necessity of passing 100% FMAP legislation.

Screenshot of FMAP infographic title

NCUIH Infographic on 100% FMAP for UIOs

Our thought bubble: NCUIH recently released an infographic on the importance of setting the FMAP at 100% for services provided to Medicaid beneficiaries at urban Indian organizations.

NCUIH Releases Report on Recent Trends in Third-Party Billing at UIOs

NCUIH

On November 29, 2023, NCUIH published its report on the experience of UIOs enrolled in Medicaid and the Children’s Health Insurance Program as a primary care case manager (PCCM) or Indian Managed Care Entity (IMCE).  ​

Go deeper:

  • Overall UIOs reported a positive experience when operating as a PCCM and felt that it improved patient care​.

  • The sole UIO operating as an IMCE (providing PCCM services) also felt that it improved patient care.

  • Read the full report.

What else?:

  • This is one of two reports funded by NORC at the University of Chicago focusing on third-party billing that NCUIH released this year​.

  • Our second report concerning Traditional Healing will be published early in 2024​.

NCUIH Requests Updates on IHS Health IT Modernization & AI/AN Engagement in HHS Healthy People Initiative

IHS

On November 20, NCUIH submitted comments to the Department of Health and Human Services (HHS) Office of Disease Prevention and Health Promotion (ODPHP) regarding Healthy People (HP) Objectives​.

  • The bottom line: NCUIH recommended that the agency conduct Tribal Consultation and Urban Confer when developing new objectives, ensure ODPHP is engaging with the HHS Secretary’s Tribal Advisory Committee on HP 2030 additional Objectives, and ensure that an IHS representative is on each of the objective workgroups.​

On December 8, NCUIH submitted comments to IHS regarding HIT Modernization: The Path Forward​.

  • The bottom line: NCUIH requested that the agency clarify the HIT Modernization implementation process, provide an update to the timeline for HIT Modernization implementation, provide frequent and regular updates to the IHS HIT Modernization webpage, and communicate the status of the Enterprise Collaboration Group.

Upcoming Events and Important Dates

Calendar with events on it

Upcoming Events & Important Dates:

  • January 9, 11 & 17​, 2024 – IHS Tribal Consultation – Updating the IHS Tribal Consultation Policy on the definition of “Indian Tribe.”

  • January 16-18​, 2024 – U.S. Patent and Trademark Office, Department of Commerce Tribal Consultation: Genetic Resources, Traditional Knowledge, and Traditional Cultural Expressions​.

  • January 18, 2024 ​- Urban Program Executive Directors/Chief Executive Officers Monthly Conference Call​.

Upcoming Federal Agency Comments:

  • January 18 – HHS Office of Civil Rights (OCR) – Proposed Rule on HHS Grants Regulation​:

    – Provisions in the HHS grant regulations that would require grant recipients to comply with applicable federal statutory nondiscrimination provisions, require HHS compliance with applicable Supreme Court decisions in administering grants, and provide a religious exemption from certain provisions. ​

  • January 23 – Department of Veterans Affairs (VA)/IHS – Revised Reimbursement Agreement Program​:

    – VA and IHS have executed a revised agreement to facilitate reimbursement by VA to IHS for health care and related services provided by the IHS to eligible AI/AN Veterans. ​

  • February 2 – Centers for Medicare and Medicaid Services (CMS) – Enforcement of State Compliance with Reporting and Federal Medicaid Renewal​:

    – This interim final rule implements reporting requirements and enforcement authorities in the Social Security Act that were added by the Consolidated Appropriations Act, 2023. ​

    – New enforcement authorities include requiring States to submit a corrective action plan, suspending disenrollments from Medicaid for procedural reasons​, imposing civil money penalties (CMPs), & applying a reduction to the State-specific FMAP for failure to meet reporting requirements.

ICYMI:

  • On December 5-6, NCUIH attended the Tribal Leaders Diabetes Committee (TLDC) meeting in Portland, Oregon as a technical advisor.

    – Much of the discussion was around SDPI and the current CR reauthorizing SDPI through January 19, 2024. Full SDPI reauthorization is still pending.

    – The Native American Rehabilitation Association of the Northwest, Inc. presented on their UIO’s diabetes programing including their Saturday Diabetes Clinic which has been a resounding success in providing care for diabetic patients.

  • On December 13, IHS held their HIT Modernization Summit where NCUIH’s Director of Technical Assistance, Dr. Kimberly Fowler, led the UIO caucus and UIO leaders were able to openly share questions, concerns, and comments regarding the HIT modernization process and the selection of the new Electronic Health Record (EHR). These questions were then asked during the Discussion and Q&A portion of the virtual summit.

    – During the summit, IHS announced that they are updating their HIT Modernization website to provide more up to date information and access to event information regarding the modernization process.

  • On December 13-14, IHS Tribal Self-Governance Advisory Committee (TSGAC) held their meeting in Washington, DC.

    – Jillian Curtis, Director, Office of Finance and Accounting, shared that FY 2024 sequestration is possible, and the Fiscal Responsibility Act (FRA) would trigger an automatic 1% discretionary sequester if the government is still operating under a partial year continuing resolution past April 30. Congress could override the sequester or use other scorekeeping methods to avoid sequester. Congress also has flexibility to turn off sequester for certain activities in subsequent legislation. Under the FRA, the default application of the sequester would be across the board. It is not yet clear whether the sequester would apply to advance appropriations.

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

NCUIH in Action: DOI Holiday Celebration, IHS Award Ceremony

FC at IHS Awards

Pictured L to R: Andrea Palm, Deputy Secretary of the Department of Health and Human Services (HHS), Francys Crevier, NCUIH CEO, and Roselyn Tso, Director of the Indian Health Service.

On December 8, NCUIH CEO, Francys Crevier was awarded the IHS Director’s Special Recognition Award: Urban Leadership Award by IHS Director, Roslyn Tso and Department Secretary of HHS, Andrea Palm.

“I am grateful for the 2022 Director’s Special Recognition Award, which recognizes the tireless efforts of the National Council of Urban Indian Health in advocating for the health and rights of Indigenous communities. This award is not just a personal achievement but a symbol of the collective impact we can make when we work together. Our Urban Indian Organizations, Tribes, and Tribal organization partners have been integral to our movement. I share this honor with our partners, our dedicated team, and the entire Native community living in urban areas as we continue our mission to foster positive change and ensure equitable access to health care.” – NCUIH CEO Francys Crevier (Algonquin)

NCUIH at IHS Award w Helena Indian Alliance

Pictured: Mike Touchette, Helena Indian Alliance (HIA) board chair, Francys Crevier, NCUIH CEO, Todd Wilson, HIA executive director, Renee Parsley, HIA board vice chair, and Jason Smith, HIA board treasurer.

Alongside Francys Crevier, Todd Wilson (Crow), a NCUIH board member and Executive Director of the Helena Indian Alliance in Montana, accepted an Urban Leadership Award on behalf of the Helena Indian Alliance for its outstanding contributions to urban leadership. Mr. Wilson has played a pivotal role in advocating for the rights and well-being of Indigenous communities, demonstrating exceptional dedication to improving health care in Indian Country. His leadership at the Helena Indian Alliance showcases a commitment to improving health care for urban Native populations. Kevin Sandoval, HIM/IT coordinator at the Helena Indian Alliance, won an IHS Director’s Special Recognition Award.

MR and Sec. Haaland

United States Secretary of the Interior, Deb Haaland (Pueblo of Laguna) and Meredith Raimondi, Vice-President of Policy and Communications, NCUIH.

On December 12, NCUIH represented UIOs at the Department of Interior Holiday Celebration with Sec. Deb Haaland.

MR and MJ @ TTAG

On November 28-29, NCUIH staff represented UIOs at the HHS Secretary’s Technical Advisory Committee (STAC) meeting in Washington, D.C. Dan Tsai, Director for Medicaid and CHIP at CMS, gave updates on the Medicaid unwinding, four walls, and 1115(a) demonstrations:

  • 1115(a) Demonstration Wavier:​ AZ has not approved the waiver, but several states have come forward to advocate for this.​ CMS reiterated that the agency understands the importance of AZ’s waiver.​

  • Four Walls:​ Extended implementation of the policy to February 2025 to work through legal challenges​. CMS is taking a look at Medicaid clinic payment system and looking at chronically homeless individuals.

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/Alaska Native health initiatives

  2. Gain valuable insights into the advocacy efforts aimed at advancing urban Indian health policies.

Register

2024 NCUIH Annual Conference – Call for Proposals

NCUIH AC 24

We are accepting proposals from all American Indian and Alaska Native-serving organizations, with a priority for UIOs to present their capacity-building best practices, successes, and innovations at our 2024 annual conference, Sustaining Traditions: Culture, Identity, and Health, April 30 – May 1, 2024, at the Hilton Capitol Hill in Washington, D.C.

All presentation proposals and poster session submissions are due January 19, 2024. Selected break-out session presenters will receive a reduced registration to attend the conference. To learn more and submit a proposal, please view the form.

Other conference updates include sponsorships and room reservations.

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

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.

Should you have any questions or require additional information, please do not hesitate to contact NCUIH conference organizers at conference@ncuih.org.

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)

  • Substance Abuse and Mental Health Services Administration (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)

House Passes NCUIH-Endorsed Bipartisan Bill that Improves Home and Community-Based Services for Native Veterans, Includes Collaboration with Tribal Programs and Urban Indian Organizations

/in /by

On December 5, 2023, the House passed the National Council of Urban Indian Health (NCUIH)-endorsed legislation, the Elizabeth Dole Home-and Community-Based Services for Veterans and Caregivers Act of 2023 (H.R. 542) with a vote of 414-5. The bill has now been received in the Senate. The original sponsor, Rep. Julia Brownley (D-CA-26) reintroduced this bipartisan legislation on January 26, 2023, which would direct the Department of Veterans Affairs (VA) to expand options for long-term home and community services. The bill also directs the VA to collaborate with the Director of the Indian Health Service (IHS) and representatives from tribal health programs and Urban Indian Organizations (UIOs) to ensure the availability of home-and community-based services for Native American veterans, including Native American veterans receiving health care and medical services under multiple health care systems. The bill currently has 63 Democrat and 13 Republican co-sponsors.

Specifically, the bill expands existing Home and Community Based Services (HCBS):

  1. The Veteran Directed Care Program, which provides veterans a flexible budget to hire friends, family, and neighbors to help with activities of daily living, such as bathing, or instrumental activities of daily living, such as making meals.
    1. The bill directs the VA Secretary to ensure the availability of the program for eligible veterans who are Native American veterans receiving care and services furnished by the Indian Health Service, a tribal health program, an Urban Indian organization, or (in the case of a Native Hawaiian veteran) a Native Hawaiian health care system, to the extent practicable.
  2. The Homemaker and Home Health Aide Program, which allows VA to contract with a community partner that employs home health aides to care for veterans in their homes, providing skilled services, case management, help with daily living, or to ease caregiver burnout.
  3. The Home-Based Primary Care Program, which allows for a VA physician to supervise a health care team that provides care in the veteran’s home for a veteran who has difficulty traveling or is isolated.
  4. The Skilled Home Health Care Program, which allows for VA to contract with a community health agency to provide in-home care for veterans who have higher levels of need like wound care, speech therapy, or skilled nursing.

“Every veteran should have the right to a peaceful and dignified life after their service to our country, and every veteran should have the right to stay in their home and receive the care they need, the care they have earned, and the care they deserve.” – Congresswoman Julia Brownley (D-CA)

Background on Native Veterans

Native Veteran Disparities 

Native veterans have served in the United States military in every armed conflict in the Nation’s history and have traditionally served at a higher rate than any other population in the United States. Unfortunately, Native veterans suffer significant disparities when they transition to civilian life. For example, Native veterans are more likely to be uninsured and have a service-connected disability than other veterans. Native veterans suffer these disparities no matter where they live. Native veterans living in urban areas experience the same poor physical and mental health outcomes as Native veterans in rural areas. In addition, urban Native veterans generally have lower incomes, higher unemployment, lower education attainment, higher VA-service connected disability, and generally live in poorer housing conditions than non-Native urban veterans.

Urban Indian Organizations Provide Culturally Competent Care for Native Veterans

UIOs are essential partners in serving Native veterans and are vital to improve care and access to services for Native veterans because of their deep ties to the Native community in urban areas. UIOs currently serve seven of the ten urban areas with the largest Native veteran populations, including the following areas: Phoenix, Arizona; Los Angeles, California; Seattle, Washington; Dallas, Texas; Oklahoma City, Oklahoma; New York City, New York; and Chicago, Illinois.

UIOs are uniquely positioned to assist the VA in improving culturally competent healthcare access for Native people. As such, this partnership has the potential to improve the quality of care and well-being to Native veterans in urban areas, but it is also consistent with the United States’ trust responsibility to provide services and resources to improve the health of all Native people.

Next Steps

This bill has been received in the Senate. NCUIH will continue to monitor the bill’s progress.

PRESS RELEASE: NCUIH CEO and Helena Indian Alliance Honored with IHS Director’s Special Recognition Awards in Urban Leadership

/in , /by

FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (December 13, 2023) – On December 8, 2023, the Indian Health Service’s Director’s Award Committee honored the National Council of Urban Indian Health’s (NCUIH) CEO, Francys Crevier J.D. (Algonquin) and the Helena Indian Alliance with the 2022 Director’s Special Recognition Award in Urban Leadership.

Pictured L to R: Andrea Palm, Deputy Secretary of the Department of Health and Human Services (HHS), Francys Crevier, NCUIH CEO, and Roselyn Tso, Director of the Indian Health Service

Pictured L to R: Andrea Palm, Deputy Secretary of the Department of Health and Human Services (HHS), Francys Crevier, NCUIH CEO, and Roselyn Tso, Director of the Indian Health Service

“I am grateful for the 2022 Director’s Special Recognition Award, which recognizes the tireless efforts of the National Council of Urban Indian Health in advocating for the health and rights of Indigenous communities. This award is not just a personal achievement but a symbol of the collective impact we can make when we work together. Our Urban Indian Organizations, Tribes, and Tribal organization partners have been integral to our movement. I share this honor with our partners, our dedicated team, and the entire Native community living in urban areas as we continue our mission to foster positive change and ensure equitable access to health care.” – NCUIH CEO Francys Crevier (Algonquin)

The Urban Leadership Award recognizes Ms. Crevier’s dedication to advocating for the rights of Indigenous people, better health care in Indian Country, and previously representing Tribes as an in-house counsel. Francys has been instrumental in steering NCUIH’s mission forward for the betterment of health care in Indian Country and championing the rights of Indigenous communities to ensure a healthier seven generations. The award highlights the significance of urban Native advocacy and marks a milestone in the ongoing journey towards equitable health care and justice for Indigenous communities.

Alongside Francys, Todd Wilson (Crow), a distinguished NCUIH board member and executive director of the Helena Indian Alliance in Montana, accepted an Urban Leadership Award on behalf of the Helena Indian Alliance for its outstanding contributions to urban leadership. Mr. Wilson has played a pivotal role in advocating for the rights and well-being of Indigenous communities, demonstrating exceptional dedication to improving health care in Indian Country. His leadership at the Helena Indian Alliance showcases a commitment to improving health care for urban Native populations. Kevin Sandoval, HIM/IT coordinator at the Helena Indian Alliance, won an IHS Director’s Special Recognition Award.

Pictured: Mike Touchette, Helena Indian Alliance (HIA) board chair, Francys Creier, NCUIH CEO, Todd Wilson, HIA executive director, Renee Parsley, HIA board vice chair, and Jason Smith, HIA board treasurer

Pictured: Mike Touchette, Helena Indian Alliance (HIA) board chair, Francys Creier, NCUIH CEO, Todd Wilson, HIA executive director, Renee Parsley, HIA board vice chair, and Jason Smith, HIA board treasurer

Pictured: Kevin Sandoval, Health Information Management/ IT Coordinator at Helena Indian Alliance

Pictured: Kevin Sandoval, Health Information Management/ IT Coordinator at Helena Indian Alliance

This prestigious award follows the recognition bestowed upon Carmelita Skeeter, CEO of the Indian Health Care Resource Center of Tulsa, in 2018. NCUIH remains steadfast in its dedication to enacting positive change and advocating for the rights and well-being of urban Native populations across the United States.

The Director’s Special Recognition Award serves as both validation and inspiration, propelling NCUIH to continue its unwavering commitment to transformative advocacy and enhancing health care access for all Indigenous communities. NCUIH extends its congratulations to Ms. Crevier, Mr. Sandoval, and the Helena Indian Alliance for this well-deserved recognition and significant contributions to Indian country!

About NCUIH

The National Council of Urban Indian Health (NCUIH) 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 (AI/ANs) living in urban areas. NCUIH is a national representative advocating for the 41 Title V Urban Indian Organizations (UIOs) under the Indian Health Service (IHS) in the Indian Health Care Improvement Act (IHCIA). NCUIH strives to improve the health of the over 70% of the AI/AN population living in urban areas, by supporting their access to high-quality, culturally-competent care. 

###

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

American Medical Association Adopts NCUIH-Supported Resolution on IHS Improvements, Includes Key Medicaid Parity Provision for UIOs

/in /by

On November 3, 2023, the National Council of Urban Indian Health (NCUIH) submitted written testimony to the 2023 Interim Meeting of the American Medical Association (AMA) House of Delegates (HOD), held on November 10-14, 2023, regarding the proposed resolution “Federal Medical Assistance Percentage Extension for Urban Indian Organizations” as part of  a larger resolution, Resolution 812 (I-23), “Indian Health Service Improvements.” This testimony was read in support of the resolution and resulted in the adoption of the entire resolution by the AMA, with amendments, including the language in support of 100% Federal Medical Assistance Percentage (FMAP) for urban Indian organizations (UIOs).

In its testimony, NCUIH emphasized that “Congress must enact legislation to provide permanent 100% FMAP for Medicaid services provided at UIOs to ensure parity across the IHS healthcare system and further fulfill the federal trust obligation to provide healthcare to Native people.” NCUIH also shared examples of how the temporary extension of 100% FMAP in 2021 benefited UIOs in Washington and Montana and emphasized permanent 100% FMAP as a vehicle to provide UIOs with a much-needed source of supplemental income to support the continued provision of comprehensive and culturally competent health care.

The Reference Committee noted that 100% FMAP would “lead to enhanced and directed advocacy of priorities as identified by American Indian/Alaska Native-serving health organizations and other important stakeholders.” After discussion, the Committee recommended the entire resolution be adopted as amended. The House of Delegates adopted the resolution and its new language, which reads as follows:

“RESOLVED, that our American Medical Association supports an increase to the Federal Medical Assistance Percentage (FMAP) to 100% for medical services which are received at or through an Urban Indian Organization that has a grant or contract with the Indian Health Service (IHS) and encourage state and federal governments to reinvest Medicaid savings from 100% FMAP into tribally-driven health improvement programs.”

Adoption of this resolution means that 100% FMAP will now be a priority of the AMA moving forward. Having the support of the largest physician advocacy organization is an additional advocacy tool NCUIH and other organizations can utilize, and it shows Congress the necessity of passing 100% FMAP legislation.

Background on 100% FMAP for UIOs

Federal Medical Assistance Percentage (FMAP) refers to the percentage of Medicaid costs covered by the federal government, which will be reimbursed to the states. Congress first authorized 100% FMAP for the Indian healthcare system in 1976 because it recognized that “Medicaid payments are . . . a much-needed supplement to a health care program which has for too long been insufficient to provide quality health care to” Native people and because “the Federal government has treaty obligations to provide services to Indians, it has not been a State responsibility.” Unfortunately, UIOs were not included in this initial authorization and therefore, services provided at UIOs were not eligible for 100% FMAP.

In 2021, Congress amended the Social Security Act (SSA) to provide for eight fiscal quarters of 100% FMAP for UIOs. This amendment temporarily eased the financial burden on states by allowing states to be reimbursed by the federal government for the full cost of providing care to Medicaid beneficiaries at UIOs. As a result, some states were able to utilize the provision to increase funding to UIOs. Unfortunately, this provision expired on March 31, 2023, meaning that states once again are responsible for covering a portion of the cost of Medicaid services provided at UIOs.

About the AMA House of Delegates (HOD)

The House of Delegates (HOD) is the legislative and policy-making body of the American Medical Association. State medical associations and national medical specialty societies are represented in the HOD along with AMA sections, national societies such as American Medical Writers Association (AMWA), American Osteopathic Association (AOA) and the National Medical Association (NMA), professional interest medical associations, and the federal services, including the Public Health Service. At HOD Meetings, resolutions are referred to the Reference Committee for open discussion and to allow recommendations for HOD action. If adopted by the HOD, the resolution can become the foundation of a new AMA program, establish or modify policy on an issue, or become a new directive for action. Policies of the AMA House of Delegates are policy statements on health topics and are one of the cornerstones of the AMA as they define what the Association stands for as an organization. They provide the information and guidance that physicians and others seek from the AMA about health care issues.

The AMA Interim Meeting of the House of Delegates takes place in November every year. Materials presented at the 2023 Interim Meeting are generated by AMA delegates/delegations, the AMA Board of Trustees, AMA Councils and AMA Sections. The delegates will next meet in June for the 2024 AMA Annual Meeting in Chicago.

NCUIH Joins Tribal Partner Organizations in a Letter to Congress Expressing Support for $250 Million in Opioid Response Funding for the Indian Health Service

/in /by

On November 6, 2023,  the National Council of Urban Indian Health (NCUIH) joined the National Indian Health Board (NIHB), the National Congress of American Indians (NCAI), and the Self-Governance Communication and Education Tribal Consortium in sending a letter to House and Senate leadership expressing support for the President’s supplemental funding request of $250 million for the Indian Health Service (IHS), as part of a $1.55 billion total investment in the fight against opioid addiction in America. This investment is in the form of Opioid Response grants through the Substance Abuse and Mental Health Services Administration (SAMHSA), and includes a 16% set-aside of emergency opioid response funding for Tribes and Tribal organizations.

This funding request has no guarantees that Congress will include the supplemental spending for FY 2024, especially given that partisan disputes will continue with the impending 2024 election. Also, with the Fiscal Responsibility Act spending caps lasting through 2025, it is essential that this funding is determined as “emergency” supplemental spending in order to see any increases in FY24.

In order to save lives in all Native communities, a meaningful investment in opioid crisis is essential. It is the federal government’s  trust responsibility to provide “[f]ederal health services to maintain and improve the health of the Indians,” and this is a vital step in protecting Native lives.

Full Text of the Letter

Dear Speaker Johnson, Minority Leader Jeffries, Majority Leader Schumer, and Minority Leader McConnell:

On behalf of the undersigned organizations and the 574 sovereign Tribal nations we serve, we write in support of the President’s supplemental funding request of $250 million for the Indian Health Service (IHS), as part of a $1.55 billion total investment in the fight against opioids and addiction in America. This funding is urgently needed to help Tribal communities address the severe impacts of the opioid and fentanyl crisis.

Opioids are the latest face of a mental health and addiction crisis in America that is disproportionately impacting our Tribal communities. The Centers for Disease Control (CDC) data show that American Indians and Alaska Natives have experienced the highest age-adjusted overdose death rates of any group for the past decade. Most of these deaths are due to opioid use, including fentanyl and fentanyl-laced substances.

In August 2023, The Northwest Portland Area Indian Health Board, in partnership with NIHB, hosted the National Tribal Opioid Summit in Tulalip, Washington. This convening of Tribal leaders; federal, regional, and state decision-makers; and policy experts discussed the ongoing and increasing harm opioids have on Tribal communities, and the solutions for empowerment and healing throughout Indian Country. This investment will go a long way to making a meaningful investment in these solutions.

The mental health and addiction epidemic plagues all our communities and touches all our families, regardless of status, wealth, or beliefs. Tribes seek a formal commitment from Congressional leadership that Tribal governments are federally-recognized governments, Tribal jurisdiction is American jurisdiction, and Tribes must be provided funds and empowered, as sovereigns, in the fight against hate, sadness, and hopelessness.

The President’s proposal to address the Opioid Crisis is for the elected body of the People to provide $1.55 billion in additional funding to the Substance Abuse and Mental Health Services Administration (SAMHSA), including $250 million that would be transferred to the IHS and made available for two years.

Despite the clear need in Indian Country, few federal dollars have been solely dedicated for this purpose to Tribal nations. For example, in FY 2023, State Opioid Response (SOR) funding was $1.575 billion, and the Tribal Opioid Response Grants (TOR) were $55 million, which is roughly 3 percent of the total. Given the impact of the opioid crisis in Indian Country, $250 million will be a long overdue investment that will save lives for generations to come.

Despite these serious challenges, Tribal nations and Tribal health systems are innovating when it comes to behavioral health. By focusing on holistic care, traditional healing practices, and indigenous ways of knowing, we have seen remarkable results in Tribal communities for treatment of opioid use. Tribes have combined culturally centered prevention, treatment and recovery services with implementation of key evidenced-based practices, including Medication Assisted Treatment (MAT) clinics for opioid use disorder; syringe service programs; training, administration, and distribution of the life-saving overdose reversal medication naloxone; peer recovery support services; outpatient therapy and behavioral health integration.

Nearly 50 years of self-determination and self-governance policy have clearly demonstrated that empowering Tribes works and results in better outcomes at the same dollar-for-dollar investment. In simple terms, good governance. Additional funding will allow Tribes to improve and expand this programming that we know is effective.

Again, we reiterate our strong support for the inclusion of $250 million to IHS for opioid and fentanyl response. This funding could not be needed more urgently. If you have any questions, please do not hesitate to contact NIHB’s Director of Government Relations, Caitrin Shuy, at cshuy@NIHB.org.

Sincerely,

National Indian Health Board
National Congress of American Indians
Self-Governance Communication and Education Tribal Consortium
National Council of Urban Indian Health

Senate Hearing Emphasized the Need to Address Fentanyl Crisis in Tribal and Urban Native Communities

On November 8, 2023, the Senate Committee on Indian Affairs (SCIA) held an oversight hearing on examining fentanyl in Native communities, focusing on Native perspectives on addressing the growing crisis. During the hearing, recommendations to address both Tribal and urban Native communities were expressed to the committee.

“Fentanyl related deaths is on the rise in this country, and Native communities are being hit extra hard. From 2020-2021, American Indians and Alaska Natives are experiencing an alarming 3% rise in drug overdose deaths, the second biggest rise of all groups in the United States… These overdose death rates are nothing short of staggering… This growing crisis is rooted in long-standing structural inequities in Native communities such as lack of affordable housing, limited access to high-quality healthcare, and underfunded public safety programs compound fentanyl’s impact on Native communities.” – Chairman of  the Senate Committee on Indian Affairs, Senator Brian Schatz (D-HI)

Dr. A. Aukai Austin Seabury, Ph.D., Executive Director & Licensed Clinical Psychologist at I Ola Lāhui, Inc., shared the importance of incorporating traditional healing and the uptake of reimbursement by third-party funders, “Something that seems to be of real promise is in the use of cultural practice as part of healing and recovery. Those programs that have emphasized those things seem to have wonderful outcomes, and we have even seen third-party insurers inspire mentoring and experimenting with models on how to fund and find mechanisms for funding cultural practices as a vital aspect of healing our communities.”

It was pointed out that the crisis is especially troubling in urban Indian youth, and Dr. Claradina Soto, Ph.D. recommended to the committee that investments need to be made in harm reduction education, access to naloxone, mental health services, youth rehab programs, and a focus on family cohesion and culturally based treatment to improve the lives of Native youth.

Background

American Indians and Alaksa Natives experience high rates of behavioral health issues and SUD, and have the highest rates of suicide of any minority group in the United States and high rates of SUD. In fact, Native people experience serious mental illnesses at a rate 1.58 times higher than the national average. American Indians and Alaska Natives have some of the highest rates of behavioral health issues caused by several factors, including centuries of generational trauma, colonization, and forced assimilation policies from the United States government. According to a 2020 report from the Centers for Disease Control and Prevention, non-Hispanic American Indian and Alaska Native people had the highest rates of drug overdose deaths in both urban and rural counties, at 44.3 per 100,000 and 39.8, respectively.

In response to these chronic health disparities and the dire need for behavioral health resources for Indian health care providers, the House Energy and Commerce Committee drafted bipartisan legislation creating the Native Behavioral Health Resources Program. This legislation was included in the House-passed Restoring Hope for Mental Health and Well-Being Act (H.R.7666), and ultimately included in the Consolidated Appropriations Act, 2023. This provision authorized to be appropriated $80 million for the Native Behavioral Health Resources Program.

NCUIH supports increased resources to IHS to address this growing health disparity. On February 17, 2023, NCUIH signed onto a letter sent to the Director of the Office of Management and Budget, Shalanda Young, requesting that the Native Behavioral Health Resources Program be appropriated to combat the opioid epidemic and behavioral health crisis in Indian Country.

November Policy Updates: Area Budget Formulation Underway, Medicaid Unwinding Webinar

/in /by

Happy Native American Heritage Month!

NCUIH

In This Edition: Congress has passed its short-term funding bill, conference season is underway, and many more developments in urban Native health policy.

📰 November marks the observance of Native American Heritage Month, a time to honor and celebrate the rich cultures, histories, and contributions of Native American and Indigenous communities.

Why it matters: Native American Heritage Month serves as a reminder of the resilience and strength of Indigenous communities throughout history. The National Council of Urban Indian Health (NCUIH) channels this spirit into advocacy efforts aimed at influencing policies that impact the health and wellness of urban Indians. By actively engaging with policymakers, stakeholders, and partners, we strive to create an environment where health policies are inclusive and considerate of the unique challenges urban populations face. Read more about our policy priorities here.

Our thought bubble: Together, let us honor the resilience and contributions of Native American communities by continuing to advocate for their health and well-being.

Crisis Averted: President Biden to Sign Temporary Spending Bill to Fund U.S. Government Into the New Year

Biden

On November 15, 2023, a full government shutdown was averted when Congress passed a two-tiered Continuing Resolution (CR) serving as a stopgap spending measure. The CR was signed into law by President Biden on November 16, 2023.

What is included: The CR includes two funding deadlines for the twelve appropriations accounts, January 19 and February 2.

The bottom line: Last year, Congress authorized $5.13 billion in advanced appropriations for IHS, insulating the majority of IHS programs from the worst effects of a government shutdown.

Go deeper: The CR re-authorized the Special Diabetes Program for Indians (SDPI) until January 19th at $25.89 million, and funds IHS accounts not receiving advanced appropriations at FY23 levels through February 2nd.

Did you know?: President Biden requested $250 million for IHS in emergency supplemental funding in response to the current opioid epidemic. Congress has not included this funding in this CR.

Moving Forward: Congress will continue negotiating a final spending bill during this time and NCUIH will monitor for updates.

Policy Webinar: Medicaid Unwinding for Urban Indian Organizations

NCUIH

Join NCUIH for a webinar on Medicaid Unwinding for UIOs where we will provide an overview on Medicaid unwinding, updates on our partnership efforts and the effect this work has the urban Native community. We will also discuss best practices and share updates on changes around the unwinding.

Register Here

Federal Updates: Prep Session for Budget Formulation, CMS Application

Illustration of Congress with empty speech bubbles

ICYMI: On November 7, NCUIH held a Prep Session for IHS Budget Formulation. NCUIH provided a PowerPoint template and suggested Talking Points for UIO leaders to use during their IHS Area Budget Formulation meetings.

  • UIOs may email policy@ncuih.org to request a copy of the template and talking points, and to set up a 1:1 session to discuss directly.

CMS Releases New Resources for ‘Making Care Primary Model’ Application – Available in 6 States with UIOs

  • CMS has released a user-friendly Application Manual for the Making Care Primary (MCP) Model, supporting user registration, portal navigation, and application submission.

  • The 10.5-year model, launching on July 1, 2024, aims to enhance care management and coordination, empower primary care clinicians, and address health-related social needs.

  • CMS, collaborating with State Medicaid Agencies in CO, NC, NJ, NM, NY, MN, MA, and WA, invites organizations to apply for the model, fostering full care transformation across payers.

  • Applications, due by November 30, 11:59 PM, can be initiated early for tailored support.

  • For details, visit the Request for Applications (RFA) or contact MCP@cms.hhs.gov.”

Upcoming Events and Important Dates including Area Budget Formulation Meetings

Calendar with events on it

Upcoming events and important dates:

  • Nov 28– IHS Portland Area Budget Formulation Meeting

  • Nov 28-29 – HHS Secretary’s Tribal Advisory Committee (STAC) in Washington, DC

  • Nov 30 – IHS National Tribal Advisory Committee (NTAC) Quarterly Meeting

  • Der 5– IHS Phoenix Area Budget Formulation Meeting

  • Dec 5-6 – Tribal Leaders Diabetes Committee Quarterly Meeting in-person in Portland, Oregon and virtual

  • Dec 6-7 – White House Tribal Nations Summit

  • Dec 11-12 – Department of Interior Self-Governance Advisory Committee Meeting

  • Dec 12– IHS Alaska Area Budget Formulation Meeting

  • Dec 13– IHS California Area Budget Formulation Meeting

  • Dec 13, 11:00 am – 5:30 pm EST- IHS Virtual Health Information Technology Modernization Summit (Register)

Go deeper: The Indian Health Service Virtual Health Information Technology Modernization Summit on December 13, 2023 is an opportunity for Tribal and UIO leaders to learn more about the new Electronic Health Record (EHR) and engage in robust and meaningful conversations with the IHS on important issues impacting Tribal and urban Indian communities as a result of the HIT Modernization program. During the Virtual Summit, IHS will host a caucus allowing Tribal and UIO leaders the opportunity to independently exchange viewpoints and share information. View the Virtual Summit Agenda here.

  • Dec 13– Great Plains Area Budget Formulation Meeting

  • Dec 14– Nashville Area Budget Formulation Meeting

NCUIH in Action: NCAI 80th Annual Convention & Marketplace, FedBar Presentation

Pictured: Francys Crevier, JD (Algonquin) NCUIH CEO and Walter Murillo (Choctaw) NCUIH Board President-Elect

Pictured: Francys Crevier, JD (Algonquin) NCUIH CEO and Walter Murillo (Choctaw) NCUIH Board President-Elect

NCUIH leadership participated in the 80th Annual Convention & Marketplace in New Orleans, Lousiana, emphasizing our commitment to advancing Indigenous health initiatives.

The big picture: NCAI elections were held for the new 2023-2025 Executive Committee: Mark Macarro, Chairman of Pechanga Band of Luiseño Indians – President; Brian Weeden, Chairman of the Mashpee Wampanoag Tribe – Vice President; Nickolaus D. Lewis, Lummi Nation Council Member – Recording Secretary; David Woerz, Chickasaw Nation Legislator – Treasurer.

One big thing: On November 3rd, NCUIH CEO Francys Crevier (Algonquin), JD, presented at the Federal Bar DC Indian Law Conference on “The Fight for Equity in Indian Country.” In her speech, she highlighted how important full, stable funding is for Indian health.

NCUIH CEO Francys Crevier (Algonquin), JD presents at Federal Bar DC Indian Law Conference.

NCUIH CEO Francys Crevier (Algonquin), JD presents at Federal Bar DC Indian Law Conference.

 

Honoring Native Veterans: Bakersfield American Indian Health Project Organizes California’s First-Ever All Native American Honor Flight to Washington, DC

Pictured: Individuals wearing blue coats signify Native veterans who have served in the military.

Pictured: Individuals wearing blue coats signify Native veterans who have served in the military.

On November 3, 2023, Native Veterans gathered at the National Native American Veterans Memorial in Washington as part of Kern County Honor Flight #48, California’s first Honor Flight made up of all Native American Veterans.

Go deeper: NCUIH member organization, Bakersfield American Indian Health Project, helped to organize this important trip. CEO, Angel Galvez (Tarasco and Purepecha), and BAIHP Board Secretary, Laura Juarez (Comanche) chaperoned Native Veterans from Kern County Honor Flight and participated in the Kern Country Honor Flight to honor their relatives who served in the Korean War.

L to R: Bakersfield American Indian Health Project (BAIHP) CEO, Angel Galvez (Tarasco and Purepecha), and BAIHP Board Laura Juarez (Comanche)

L to R: Bakersfield American Indian Health Project (BAIHP) CEO, Angel Galvez (Tarasco and Purepecha), and BAIHP Board Laura Juarez (Comanche)

Army Veteran Sonya Tetnowski (Makah), NCUIH Board President and CEO of Indian Health Center of Santa Clara Valley

Army Veteran Sonya Tetnowski (Makah), NCUIH Board President and CEO of Indian Health Center of Santa Clara Valley

NCUIH would like to acknowledge the service of Sonya Tetnowski, NCUIH Board President and CEO of the Indian Health Center of Santa Clara Valley who served as an Army Paratrooper. Ms. Tetnowski also currently serves as a member of the Department of Veterans Affairs Advisory Committee on Tribal and Indian Affairs.

The bottom line: NCUIH honors all those who have served, especially the invaluable contributions of Native Veterans who have historically served at the highest rates among all Americans. We extend our deepest gratitude to Native Veterans and all Veterans for their selfless service and dedication to preserving the freedoms we hold dear.

Vice President Harris Applauds Urban Indian Organization, NATIVE HEALTH, as First Pilot Site for Indian Health Service Voter Registration Program

VP

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”.

On October 23, 2023, Vice President Kamala Harris announced that the first facility under this pilot program will be NATIVE HEALTH, located in Phoenix, Arizona.

Did you know? Voting as a Social Determinant of Health has been acknowledged by the American Medical Association (AMA), and was included in their resolution from  2022, “Support for Safe and Equitable Access to Voting.”

NCUIH

NCUIH Welcomes Not Invisible Act Commission Report to Congress and Administration

Sonya Quote

At the start of National Native American Heritage Month, the Not Invisible Act Commission released its report entitled “Not One More” urging Congress and the Biden Administration to take immediate action to address the related crises of Missing and Murdered Indigenous Persons (MMIP) and human trafficking of Indigenous persons (HT).

Did you know?: NCUIH endorsed and advocated for the passage of the legislation that created the Commission and NCUIH’s Board President, Sonya Tetnowski (Makah), served on the Commission.

What they’re saying: “It was an honor to serve on this commission with so many tribal leaders from across Indian Country.  We as a commission heard from over 260 survivors, families, advocates, government agencies, and law enforcement to understand the impact from as many perspectives as possible. This 200-plus page report should be the beginning of this process as we know that each recommendation will require specific work to accomplish,” said Ms. Tetnowski.

Why it matters: The Commission’s report is a resounding call to the United States to fulfill its trust responsibility to American Indians and Alaska Natives and address the public health and public safety in Native communities caused by centuries of policies designed to attack Tribal Nations and Native ways of living.

What else: The Commission specifically recognized the impact of federal policies on Native people living in urban areas, highlighting the testimony of one witness who told the Commission “We can’t forget the urban relocation programs in the 50s; I hope this Commission doesn’t forget those relatives that are living off rez.”

What’s next: The Not Invisible Act requires the Secretary of the Interior and the Attorney General to make publicly available and submit a written response to the recommendations within 90 days to the Commission and Congress.

New Report Estimates 400,000 Native Americans Terminated from Medicaid During Unwinding

The report is co-authored by the Asian and Pacific Islander American Health Forum, the Leadership Conference on Civil and Human Rights, NAACP, the National Council of Negro Women, the National Council of Urban Indian Health, the National Urban League, the Southern Poverty Law Center Action Fund, UnidosUS, the Coalition on Human Needs, and Protect Our Care. 

The report is co-authored by the Asian and Pacific Islander American Health Forum, the Leadership Conference on Civil and Human Rights, NAACP, the National Council of Negro Women, the National Council of Urban Indian Health, the National Urban League, the Southern Poverty Law Center Action Fund, UnidosUS, the Coalition on Human Needs, and Protect Our Care.

NCUIH Joined 8 Organizations in Issuing Report on Impacts of Medicaid Terminations

Five Key Findings from the Report:

  1. Medicaid losses during six months of unwinding already exceed history’s greatest two-year drop in Medicaid enrollment.

  2. States have terminated Medicaid for 10 million people, causing grave harm, especially in communities of color. This includes an estimate of more than 400,000 Native Americans.

  3. More than 70% of the people terminated from Medicaid may have been eligible.

  4. The depth of Medicaid loss varies by state, to an extraordinary degree.

  5. The states with the highest termination rates have not made the investments needed to operate functional Medicaid systems.

Our thought bubble: “The report highlights the disproportionate impact Medicaid unwinding is having on Native communities,” said Francys Crevier (Algonquin), NCUIH CEO. “Medicaid and CHIP coverage are critical to fulfilling the United States’ trust responsibility to maintain and improve Native health, as inadequate insurance coverage is a significant barrier to healthcare access for Native people. Eligible Native children and families are losing coverage for administrative reasons and the federal government has a trust obligation and must do more to protect them.”

Read the Report Here

One last thing, check out these upcoming funding opportunities:

  • Healthy Start Initiative – Eliminating Disparities in Perinatal Health (Health Resources & Services Administration)

    – Deadline: December 15, 2023 (Apply)

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

    – Deadline: January 22, 2024 (Apply)

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

    – Deadline: February 15, 2024 (Apply)

House Passes Interior Appropriations Bill, Includes $7.078 Billion for the Indian Health Service and Maintains Advance Appropriations

/in /by

On November 3, 2023, the House of Representatives voted to approve the Fiscal Year (FY) 2024 Department of Interior, Environment, and Related Agencies Appropriations Act with a vote of 213 to 203. The bill provides a discretionary spending total of $25.417 billion, which is $13.433 billion below the FY23 enacted level and $21.37 billion below the President’s Budget Request. Despite the sizeable cut to the Interior, Environment, and Related Agencies bill, the Indian Health Service (IHS) received a 2.2% increase.

The bill authorizes $7.078 billion for IHS— an increase of $149 million from FY23 but $2.6 billion below the President’s request. Advance appropriations for IHS were maintained for FY25 and increased from $4.9 billion in FY24 to $5.8 billion for FY25. The bill also authorizes $115 million for the Urban Indian Health line item, a $15 million increase from the FY23 enacted level. Other key provisions include: $3 million for generators at IHS/Tribal Health Programs/Urban Indian Organizations (UIOs), $6 million for the Produce Prescription Pilot Program for Tribes and UIOs to increase access to produce and other traditional foods, as well as $35 million for Tribal Epidemiology Centers (TECs).

Line Item FY23 Enacted FY24 TBFWG Request FY24 President’s Budget FY24 House Passed
Urban Indian Health $90,419,000 $973,590,000 $115,150,000 $115,150,000
Indian Health Service $6,958,223,000 $50,996,276 $9,700,000,000 $7,078,223,000
Advance Appropriations $5,129,458,000 $9,100,000,000 $5,129,458,000 $5,878,223,000

Next Steps

On November 15, 2023, Congress passed a Continuing Resolution (CR) that will keep the government funded through the beginning of 2024. Until the CR expires, the House and Senate will remain in negotiations to pass a bill that will fund the government through the rest of the fiscal year.  Although the House of Representatives passed their version of the bill, it is unlikely to pass through the Senate. NCUIH will continue to monitor the state of appropriations and advocate for House-level funding in any funding negotiations or Omnibus legislation. The Senate introduced a separate Interior Appropriations bill on July 27, 2023. This bill has passed out of the Senate Appropriations Committee and is awaiting a full Senate vote. A date for this vote has not been set.

Background

On July 18, 2023, the House Appropriations Subcommittee on Interior, Environment, and Related Agencies released the Committee Bill Report for the FY24 budget with $115,156,000 for Urban Indian health. The bill appropriates $25.4 billion for Interior, Environment, and Related Agencies, which is $13.4 billion below the fiscal 2023 levels and $21.3 billion below the Biden Administration’s request.  Despite the sizeable cut to the Interior, Environment, and Related Agencies bill and reducing funding for nearly every account to below FY23 enacted levels, the Indian Health Service (IHS) received a 2.2% increase.

The report and bill were approved by the House Subcommittee on Interior on July 13, 2023 and approved with amendments by the full House Appropriations Committee on July 19, 2023. The bill authorizes $7.078 billion for IHS— an increase of $149 million from FY23 but $2.6 billion below the President’s request. Advance appropriations for IHS was maintained for FY25 and received an increase to $5.8 billion from $4.9 billion in FY24.

On March 9, 2023, President Biden released his budget request for FY24 which included $9.7 billion for IHS and proposed mandatory funding for IHS from FY 2025 to FY 2033 to the amount of $288 billion over-ten years as well as exempting IHS from sequestration.