PRESS RELEASE: National Council of Urban Indian Health Calls for Protection of Indian Health System Funding

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FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (January 31, 2025) – The National Council of Urban Indian Health (NCUIH) today urged Congress, the Office of Management and Budget (OMB), and the Department of Health and Human Services (HHS) to exempt the Indian Health System from any future funding restrictions or pauses. This call to action comes in response to recent events that temporarily froze resources critical to the operation of Tribal health care and Urban Indian Organization (UIO) facilities. While the recent OMB memorandum (M-25-13) has been rescinded, NCUIH remains concerned about potential future impacts on the Indian health system. The organization emphasizes that any disruption to funding could have severe consequences for American Indian and Alaska Native communities.

Key points from NCUIH’s communications include:

  1. Federal Trust Responsibility: NCUIH stresses the U.S. Government’s legal obligation to provide health services to Native people, as established by the Indian Health Care Improvement Act.
  2. Preventing Service Disruptions: Recent funding uncertainties forced UIOs to consider staffing cuts, service suspensions, and even facility closures.
  3. Historical Context: Past experience shows any disruption in funding can have grave consequences on the Indian health system. During the 2019 government shutdown, funding disruptions led to reduced services and facility closures, resulting in tragic consequences including fatal opioid overdoses in some communities.
  4. Specific Exemption Request: NCUIH is calling for a specific exemption for the entire Indian Health System, including the Tribal organizations, and UIOs, from any future funding restrictions.

Walter Murillo (Choctaw), Board President of NCUIH stated, “Even a temporary halt in funding could immediately deprive Native communities of necessary health services. As leaders of Urban Indian Organizations, we’re on the front lines of providing essential healthcare to Tribal citizens. We’re calling for a specific exemption for the entire Indian Health System from any future funding restrictions or pauses. This isn’t just about honoring agreements; it’s about fulfilling the federal government’s trust responsibility to provide healthcare for Tribal citizens, regardless of where they live.”

NCUIH is actively engaging with Congress, the OMB, and HHS to secure this specific exemption and prevent any future disruptions to critical health care services for Tribal citizens. The organization has sent letters to both Congress and HHS detailing the critical need for uninterrupted funding to the Indian Health System.

About NCUIH

The National Council of Urban Indian Health (NCUIH) is a national representative for the 41 Urban Indian Organizations contracting with the Indian Health Service under the Indian Health Care Improvement Act. NCUIH is devoted to the support and development of high quality and accessible health and public health services for American Indian and Alaska Native people living in urban areas.

NCUIH respects and supports Tribal sovereignty and the unique government-to-government relationship between our Tribal Nations and the United States. NCUIH works to support those federal laws, policies, and procedures that respect and uplift Tribal sovereignty and the government-to-government relationship. NCUIH does not support any federal law, policy, or procedure that infringes upon or in any way diminishes Tribal sovereignty or the government-to-government relationship.

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

OMB Announces Temporary Pause on Federal Financial Assistance Programs: Implications for Urban Indian Organizations

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FOR IMMEDIATE RELEASE

Washington, D.C. (January 28, 2025)– On January 27, 2025, Matthew J. Vaeth, Acting Director of the Office of Management and Budget (OMB) at the Executive Office of the President released a memorandum addressed to all heads of Executive Departments and Agencies with the subject line “Temporary Pause of Agency Grant, Loan, and Other Financial Assistance Programs.” The memorandum requires that Agency leadership “to the extent permissible under applicable law…temporarily pause all activities related to obligation or disbursement of all Federal financial assistance.”

Each Agency must “identify and review all Federal financial assistance programs and supporting activities consistent with the President’s policies and requirements.” To determine whether such programs and supporting activities are “consistent with the President’s policies and requirements” Department and Agency heads should refer to the series of thirty-four (34) executive orders released by the President since he took office on January 20, 2025. Relevant topics “includ[e], but are not limited to, foreign aid, nongovernmental organizations, DEI, woke gender ideology, and the green new deal.” The temporary pause becomes effective today, January 28, 2025, at 5:00 p.m. There is presently no scheduled end date for the pause. All activities related to open Notice of Funding Opportunities are subject to the pause. OMB may “grant exceptions allowing Federal agencies to issue new awards or take other actions case-by-case basis.”

Application to Urban Indian Organizations and Next Steps

Urban Indian Organizations (UIOs) receive federal funding from various sources, some, if not all, of which will be affected by the pause. Urban Indian Organizations (UIOs) are advised to discuss the potential implications of this memorandum with their finance and legal departments. Please note that federal agencies may be unable to respond to inquiries or questions. The Department of Health and Human Services has issued a pause on issuing documents and public communications until February 1, 2025.

Additional Information

The memorandum requires Federal Agencies to:

  1. Immediately identify and notify OMB of any legally mandated actions or deadlines for assistance programs that will arise during the pause.
  2. Submit detailed information of any programs, projects, or activities subject to this pause no later than February 10,
  3. Carry out the following activities for each Federal financial assistance program:
    1. Assign responsibility and oversight to a senior political appointee to ensure Federal financial assistance conforms to Administration priorities;
    2. Review currently pending Federal financial assistance announcements to ensure Administration priorities are addressed, and, subject to program statutory authority, modify unpublished Federal financial assistance announcements, withdraw any announcement already published, and, to the extent permissible by law, cancel awards already awarded conflict with Administration priorities; and
    3. Ensure adequate oversight of Federal financial assistance programs and initiate investigations when warranted to identify underperforming recipients, and address identified issues up to and including cancellation of awards.

The memorandum defines “financial assistance program” as the term is defined in 2 CFR 200.1 meaning “assistance that recipients or subrecipients receive or administer in the form of:(i) Grants;(ii) Cooperative agreements;(iii) Non-cash contributions or donations of property (including donated surplus property);(iv) Direct appropriations; (v) Food commodities; and (vi) Other financial assistance,” but clarifies that the memorandum does not apply to Social Security benefits or Medicare.

Follow-up instructions provided by OMB on Federal Financial Assistance program analysis require all Federal agencies that provide Federal financial assistance complete a spreadsheet with information on any program that has funding or activities planned through March 15th. Agency heads must submit the completed spreadsheet to OMB no later than February 7th, 2025.

About NCUIH

The National Council of Urban Indian Health (NCUIH) is a national representative advocating for the 41 Urban Indian Organizations contracting with the Indian Health Service under the Indian Health Care Improvement Act. NCUIH is devoted to the support and development of quality, accessible health and public health services for American Indians and Alaska Natives living in urban areas.

NCUIH respects and supports Tribal sovereignty and the unique government-to-government relationship between our Tribal Nations and the United States. NCUIH works to support those federal laws, policies, and procedures that respect and uplift Tribal sovereignty and the government-to-government relationship. NCUIH does not support any federal law, policy, or procedure that infringes upon or in any way diminishes Tribal sovereignty or the government-to-government relationship.

 

HHS Responds to Not Invisible Action Commission Findings and Recommendations with Plan to Support Urban Indian Communities in Combating the Missing and Murdered Indigenous People Crisis

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On November 15, 2024, the U.S. Department of Health and Human Services (HHS) released HHS’ supplemental response to the Not Invisible Act Commission’s (“Commission”) findings and recommendations on how to combat the missing and murdered Indigenous people (MMIP) and human trafficking crisis. The Commission’s findings and recommendations and the supplemental response by HHS mention urban Indian organizations (UIOs) and urban American Indian and Alaska Native people and communities. Importantly, HHS states that the National Center for Child Fatality Review and Prevention—“which provides technical assistance to state and local entities in conducting child death reviews, inclusive of AI/AN populations”—plans to “engage experts at Urban Indian Health Centers to create and implement a plan for also engaging [American Indian and Alaska Native] families living off Tribal lands.”

Read the HHS Full Supplemental Response here.

Background on the Commission

The National Council of Urban Indian Health (NCUIH) along with other national Native organizations worked in support of the Not Invisible Act legislation, which was enacted in October 2020. The Act required the Secretary of the Interior, in coordination with the Attorney General to establish and appoint a joint commission on violent crime against American Indian and Alaska Native people. Secretary of the Interior Haaland was the lead sponsor of the Not Invisible Act when she served in Congress. The bill was passed unanimously by voice vote in both chambers of Congress.

Commissioner Sonya Tetnowski is a citizen of the Makah Tribe and CEO of the Indian Health Center of Santa Clara Valley. She currently serves as the President California Consortium of Urban Indian Health (CCUIH) and previously served as NCUIH’s Board President. Ms. Tetnowski works daily in support of the health and wellness services to American Indians and Alaska Natives living in urban areas. Violence against American Indians and Alaska Natives is a public health crisis and is considered a social determinant of health (SDOH). NCUIH is committed to the reduction of violence impacting Native communities.

NCUIH Resources:

NCUIH Calls for Improved EHR Training and Support for Urban Indian Organizations During IHS Health Information Technology Modernization Implementation

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On December 6, 2024, the National Council of Urban Indian Health (NCUIH) submitted written comments to the Indian Health Service (IHS) Director, Roselyn Tso, regarding IHS January 18, 2024, Dear Tribal Leader and Urban Indian Organization Leader letter (DTLL/DULL) and the November 7, 2024, joint Tribal Consultation and Urban Confer (TC/UC) session on Health Information Technology (HIT) Modernization Site Readiness and Training. In its comments, NCUIH recommended that IHS support Urban Indian Organizations (UIOs) pre- and post-go-live of the new electronic health record (EHR) by providing training that does not disrupt facilities’ operations and reflects real-life scenarios

Background on HIT Modernization

On November 8, 2023, TC/UC on HIT Modernization, IHS announced that it selected General Dynamics Information Technology, Inc. (GDIT) to build, configure, and maintain a new IHS EHR system utilizing Oracle Cerner technology. The new EHR, named Patients at the Heart (PATH), will replace the Resource and Patient Management System (RPMS).

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

NCUIH’s Requests

In its comments following the TC/UC, NCUIH submitted the following requests and recommendations to IHS:

  • Support UIOs pre- and post-go-live by providing training that does not disrupt facilities’ operations and reflects real-life scenarios
  • Ensure HIT Modernization implementation is equitable and inclusive for all facility types and sizes pre- and post-go-live
  • Continue to engage with UIOs through Urban Confer sessions to understand the site-level needs that IHS should consider when designing and deploying the PATH EHR
  • Continue to provide an updated timeline of the PATH EHR implementation

NCUIH Advocacy on HIT Modernization

NCUIH has previously submitted several 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 Requests SAMHSA Engage with Urban Indian Organizations in Redesign of Tribal Behavioral Health Grant Program

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On November 27, 2024, the National Council of Urban Indian Health (NCUIH) submitted written comments to the Substance Abuse and Mental Health Service Administration’s (SAMHSA) October 2024 Dear Tribal Leader Letter on redesigning the Tribal Behavioral Health (TBH) grant program to streamline the program and enable applicants to focus on priorities that align with their needs. In its comments to SAMHSA, NCUIH requested that SAMHSA engage with Urban Indian Organizations (UIOs) by hosting an Urban Confer or UIO listening session throughout the redesign process because UIOs are eligible for the TBH grant program through the Native Connections grant.

Background on the TBH Grant Program

The purpose of this program is to prevent and reduce suicidal behavior and substance use/misuse, reduce the impact of trauma, and promote mental health among American Indian and Alaska Native youth, up to and including age 24, by building a healthy network of systems, services, and partnerships that impact youth. In fiscal year 2023 and fiscal year 2024, 4 UIOs were awardees of the TBH grant program.

Indian Health Service Releases its Strategic Plan for Fiscal Years 2025-2029, Urban Indian Organizations Included in Key Health Care Goals

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On December 5, 2025, the Indian Health Service (IHS) published a Dear Tribal Leader and Urban Indian Organization (UIO) Leader letter (DTLL/DULL), regarding the release of the final IHS Strategic Plan for Fiscal Years (FYs) 2025-2029 (Strategic Plan). Prior to this release, the National Council of Urban Indian Health (NCUIH) submitted comments to IHS on June 28, 2024, regarding the Draft Strategic Plan. While IHS did not incorporate NCUIH’s suggestions, IHS does include Urban Indian Organizations (UIOs) in the Strategic Plan in sections concerning ensuring comprehensive, culturally respectful health care services; advancing data-driven/evidence-based decision-making; promoting proactive intergovernmental and external relationships; and respecting self-determination.

Background

The Strategic Plan will establish IHS’ direction for FY 2025-2029. It is developed based on feedback received from Headquarters Offices, the Strategic Plan Workgroup, and other stakeholders, and builds on the work of Headquarters Offices to determine appropriate measures. IHS hosted a virtual Tribal Consultation on May 29, 2024, regarding the Draft Strategic Plan following a May 2, 2024, DTLL. IHS hosted an Urban Confer on May 30, 2024 as it developed the Strategic Plan. The Strategic Plan includes four Goals with corresponding Strategic Objectives:

  • Strategic Goal 1: Be a leading health care organization
  • Strategic Goal 2: Ensure comprehensive, culturally respectful health care services
  • Strategic Goal 3: Optimize operations through effective stewardship
  • Strategic Goal 4: Promote proactive intergovernmental and external relationships

NCUIH believes that the Plan is an important vehicle to articulate leadership priorities, provide direction for program management functions, engage external partners and entities, and measure IHS’ progress towards meeting the goals and objectives contained in the Strategic Plan. NCUIH will continue to participate in the implementation and exercise of the Strategic Plan and inform UIOs of upcoming opportunities related to implementation of the Strategic Plan.

Scientific Report of the 2025 Dietary Guidelines Advisory Committee Discusses Importance of Foods and Beverages Integral to American Indian and Alaska Native People

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On December 11, 2024, the Scientific Report of the 2025 Dietary Guidelines Advisory Committee (Scientific Report) was officially submitted to the Secretaries of the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA). The Report includes NCUIH’s September 30, 2024, recommendation to incorporate research on Traditional Foods into the 2025-2030 Dietary Guidelines by conducting a simulation that analyzed expert-identified foods and beverages integral to and consumed by American Indian and Alaska Native people with positive results.

  • Read the full report here.

The DGAC is accepting written comments on the Scientific Report until Saturday, February 8, 2025. DGAC will also accept oral comments via virtual format on January 16, 2025, at 1 PM ET. Click here for more information on the comment opportunities on this Scientific Report.

Background

Under section 301 of Public Law 101-445 (7 U.S.C. 5341, the National Nutrition Monitoring and Related Research Act of 1990, title III), the Secretaries of HHS and USDA are directed to publish the Dietary Guidelines for Americans (Dietary Guidelines) jointly at least every five years. The law instructs that this publication shall contain nutritional and dietary information and guidelines for the general public; shall be based on the preponderance of scientific and medical knowledge current at the time of publication; and shall be promoted by each Federal agency in carrying out any Federal food, nutrition, or health program. The current edition of the Dietary Guidelines (2020-2025) provides guidance on the entire lifespan, from birth to older adulthood, including pregnancy and lactation. The Dietary Guidelines for Americans, 2025-2030 will continue to provide food-based dietary guidance across the entire lifespan to help meet nutrient needs, promote health, and reduce the risk of chronic disease. HHS and USDA appointed the 2025 Dietary Guidelines Advisory Committee (2025 DGAC) to conduct an independent scientific review that will help inform the Departments’ development of the next edition of the Dietary Guidelines.

Discussion of American Indian and Alaska Native Diets and Traditional Foods

The report conducted analyses for overall U.S. diets. The simulations considered foods and beverages that the CDC’s National Health and Nutrition Examination Survey reported as consumed. To be responsive to public comments that called for the Dietary Guidelines to be inclusive of American Indian and Alaska Native populations by considering American Indian and Alaska Native Traditional Foods, a separate simulation was conducted to simulate food and beverages identified by experts as included in select American Indian and Alaska Native diets.

The simulations “confirmed that nutrient requirements could be met using the foods identified as integral and included in those diets with limited exceptions; that finding was consistent across the U.S. population, not just the select American Indian and Alaska Native diets.” This positive news allows for the “inclusion of foods and beverages identified by experts as integral to and consumed by select American Indian and Alaska Native groups, who continue to experience significant health disparities.” The finding also advances the DGAC’s goals for health equity and “ensuring that the Dietary Guidelines are relevant and actionable across all segments of the U.S. population.” The Scientific Report states that more research is needed on the dietary patterns and preferences of American Indian and Alaska Native populations to address knowledge gaps regarding American Indian and Alaska Native diets.

NCUIH’s Role

In the September 30, 2024, comment to HHS, NCUIH:

  • Recommended that the 2025 DGAC incorporate research on Traditional Foods into the 2025-2030 Dietary Guidelines.
  • Requested HHS and USDA engage with American Indian and Alaska Native communities through Tribal Consultation and Urban Confer.

NCUIH will continue to monitor the development of the 2025-2030 Dietary Guidelines.

HHS Secretary Approves Final Data Access Policies for Tribes and Tribal Epidemiology Centers

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On December 6, 2024, the Secretary of the Department of Health and Human Services (HHS) approved the final HHS data access policies for Tribes and Tribal Epidemiology Centers (TECs)– Tribal Data Access Policy (TDA) and Tribal Epidemiology Center Data Access Policy (TECDA), respectively. The policies are located on HHS’ Tribal Data Homepage along with information on how to request data from each HHS Division, a frequently-asked-questions on Tribal and TEC data access policies, and previous policy drafts. The policies establish HHS-wide data policies and cover the data under the custody and control of HHS which includes data collected from Urban Indian Organizations (UIOs).

Tribal Data Access Policy

The purpose of the TDA Policy is to establish an HHS wide policy for how HHS will provide Tribes with data (both in general and when acting in their capacities as public health agencies), including the scope of data available, the process to obtain data, and the expected timelines for processing Tribal requests for data. It also establishes an HHS-wide expectation for responding to requests from Tribes for data in the custody and control of HHS and its Staff and Operating Divisions (collectively referred to as “Divisions”).

Tribal Epidemiology Center Data Access Policy

The purpose of the TECDA Policy is to establish an HHS-wide policy governing data access for TECs, including the scope of data available, the process to obtain data, and the expected timelines for processing TECs’ requests for data. It establishes an HHS-wide expectation for responding to requests from TECs acting in their capacities as Public Health Authorities (PHAs) for data in the custody and control of HHS and its Staff and Divisions.

Health Resources and Services Administration Publishes List of Health Professional Shortage Areas as of October 15, 2024, Includes Urban Indian Organizations

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On November 5, 2024, the Health Resources and Services Administration (HRSA) published a notice informing the public of the availability of the complete lists of all geographic areas, population groups, and facilities designated as primary medical care, dental health, and mental health professional shortage areas (HPSAs) in a designated status as of October 15, 2024. These lists include Urban Indian Organizations (UIOs). HRSA’s HPSA Find tool on the Health Workforce Shortage Areas webpage can be used to find data on the geographic, population, and facility HPSA designations throughout the United States.

For further information on the HPSA designations listed on the website or to request additional designation, withdrawal, or reapplication for designation, please contact Dr. Shelby Hockenberry, Branch Chief, Shortage Designation Branch, Division of Policy and Shortage Designation, Bureau of Health Workforce, HRSA, 5600 Fishers Lane, Rockville, Maryland 20857, sdb@hrsa.gov, (301) 443-1993.

Background

Section 332 of the Public Health Service (PHS) Act, 42 U.S.C. 254e, provides that the Secretary shall designate HPSAs based on criteria established by regulation. HPSAs are defined in section 332 to include (1) urban and rural geographic areas with shortages of health professionals, (2) population groups with such shortages, and (3) facilities with such shortages. Section 332 further requires that the Secretary annually publish lists of the designated geographic areas, population groups, and facilities. Using the statute and regulations, HRSA automatically designates UIOs as HPSAs.

HPSA designation offers access to potential federal assistance for healthcare facilities and providers. Public or private nonprofit entities are eligible to apply for assignment of National Health Service Corps personnel to provide primary medical care, mental health, or dental health services in or to these HPSAs. National Health Service Corps health professionals enter into service agreements to serve in federally designated HPSAs. Entities with clinical training sites located in HPSAs are eligible to receive priority for certain residency training program grants administered by HRSA’s BHW. Other federal programs also utilize HPSA designations.

NCUIH Advocacy

As part of its advocacy, the National Council of Urban Indian Health (NCUIH) engages with HRSA to ensure that UIOs receive HPSA scores that accurately reflect the level of provider shortage for UIO service. UIOs have particularly highlighted how they are negatively impacted by the way their HRSA HPSA scores affect their ability to hire and retain staff participating in various loan repayment programs. NCUIH continues to engage with HRSA regarding the need to develop HPSA scores which reflect the level of need in the Indian health care system, as opposed to general geographic data.

December Policy Updates: Continuing Resolution, Advocacy, and Key Updates for Urban Indian Health

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In this Edition:

📜 Appropriations Update: Continuing Resolution Signed Into Law with SDPI Extension.

💡 Legislative Updates: FMAP, Native Veterans, Lumbee Fairness Bill, MMIP, IHS Workforce, and Federal Boarding Schools.

⚖ Monitoring the Bench: Tennessee’s Ban on Gender Affirming Care for Minors.

🆕 New Releases: USDA 2025 Dietary Guidelines Advisory Committee Releases Scientific Report.

🎤Advocacy: NCUIH Provides Key Recommendations on Behavioral Health Funding, Health IT Modernization, National HIV/AIDS Strategy, and Proposed Reorganization of IHS Headquarters.

📬 ICYMI: House Oversight Hearing “Investigating the Crisis of Missing and Murdered Indigenous Women”, Recent Dear Tribal and Urban Leader Letters.

🏅 Awarding Native Health Allies: NCUIH Presents Good Medicine Awards to Outgoing Legislators Tester and Peltola.

🤝 NCUIH in Action: White House Tribal Nations Summit, National Congress of American Indians and Indian Gaming Association Tribal Leaders Meeting, and Holiday Receptions with Government Leaders and Partners.

🔍 Save the Date!: NCUIH 2025 Annual Conference (April 22 – April 25).

📆 Important Dates and Events: Upcoming Events, from IHS monthly Conference Call to FY 2027 National Tribal Budget Formulation Workgroup Area Report Webinar.

📋 Funding Opportunities: HRSA’s Behavioral Health Workforce Development Technical Assistance Program.

Appropriations Update: Continuing Resolution Passed

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Congress Enacts Continuing Resolution

On December 20, Congress passed a Continuing Resolution (CR) to extend government funding set to expire on December 20, 2024 until March 14, 2025, averting a government shutdown.

  • The CR contains several riders including funding for farming, disaster relief, and extension of several public health programs set to expire on December 31, 2024.
  • Read the bill text here.

Key Public Health Programs Extended:

  • The CR extends current funding for the Special Diabetes Program for Indians (SDPI) through March 31, 2025, at $39.3 million. The program was set to expire on December 31, 2024.
  • Extends Medicare telehealth flexibilities until March 31, 2025.
  • Extends current funding Community Health Centers, National Health Service Corps, teaching health centers that operate GME programs until March 31, 2025.

What’s Next: Congressional leaders work to pass a FY 2025 appropriations package before the extended deadline.

Legislative Updates: FMAP, Child Welfare, Native Veterans, Lumbee Fairness Act, MMIP, IHS Workforce, and Truth and Healing Commission

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Federal Medical Assistance Percentage (FMAP) Update:

On December 6, 2024, NCUIH and 35 health care advocates sent a letter to Congressional Leadership requesting the inclusion of 100% Federal Medical Assistance Percentage (FMAP) for UIOs to be included in the end-of-year public health extenders package.

 Native American Child Protection Act (H.R. 663)

  • On December 17, 2024, the Native American Child Protection Act passed the Senate and is set to become law.
  • What is it?: This bill would reauthorize and revise Programs to investigate and prosecute child abuse, child neglect, and family violence involving Native American children.
  • How does it impact UIOs? The bill makes UIOs eligible for the Indian Child Abuse Treatment Grant Program, creates a National Indian Child Resource and Family Services Center (the Center) that will provide technical assistance and training to Tribes, Tribal organizations, and UIOs, and allows UIO representatives with expertise in child abuse and child neglect to sit on a 12-member Advisory Board to advise and assist the Center.
  • Read NCUIH’s blog on H.R. 633 passage.

Elizabeth Dole Home Care Act of 2024 (S.141)

  • On December 16, 2024, the Elizabeth Dole Home Care Act of 2024 passed the House and is set to become law.
  • What is it?: The bill is a comprehensive package of bills that significantly expands and reforms the delivery of services at the U.S. Department of Veterans Affairs (VA) for veterans, service members, and their families.
  • How does it impact UIOs? This legislation directs the VA to collaborate with the Director of the Indian Health Service (IHS) and representatives from Tribal health programs and UIOs to ensure the availability of home-and community-based services for AI/AN Veterans.

Lumbee Fairness Act (H.R. 1101)

  • On December 17, 2024, the Lumbee Fairness Bill passed the House.
  • What is it?: This bill would extend full recognition by the US to The Lumbee Tribe of North Carolina, making the Tribe and its enrolled members eligible for benefits provided to federally recognized Tribes.
  • What is next? The bill did not pass the Senate and will need to be reintroduced in the next Congress.

Bridging Agency Data Gaps and Ensuring Safety (BADGES) for Native Communities Act (S. 465)

  • On December 16, 2024, the BADGES for Native Communities Act passed the Senate.
  • What is it?: This bill requires law enforcement agencies to report on cases of missing or murdered Native people.
  • How does it impact UIOs? UIOs are eligible entities for the missing or murdered response coordination grant program established by this bill.
  • What is next? The bill did not pass the House and will need to be reintroduced in the next Congress.

IHS Workforce Parity Act of 2024 (S.3022)

  • On December 17, 2024, the IHS Workforce Parity Act of 2024 passed the Senate.
  • What is it?: This bill allows recipients of Indian Health Professions Scholarships or the Indian Health Service Loan Repayment Program to fulfill their service obligations through half-time clinical practice.
  • What is next? The bill did not pass the House and will need to be reintroduced in the next Congress.

Truth and Healing Commission on Indian Boarding School Policies Act of 2023 (S.1723)

  • On December 20, 2024, the Truth and Healing Commission on Indian Boarding School Policies of 2023 Act passed the Senate.
  • What is it? This bill will establish a Commission to examine and investigate the impacts and ongoing effects of the Federal Indian Boarding School policies.
  • What is next? The bill did not pass the House and will need to be reintroduced in the next Congress.

Monitoring the Bench: Tennessee’s Ban on Gender Affirming Care for Minors

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United States v. Skrmetti

  • Issue: Whether Tennessee’s ban on gender affirming care for minors violates the equal protection clause of the 14th Amendment.
  • Relation to UIOs: If the ban is upheld, could impact how UIOs in states with similar bans or restrictions are able to provide or communicate information relating to gender affirming care with minor patients.
  • Case Status:
    • Oral argument was held on December 4th.
    • Conservative majority on the court seemed to support upholding the ban.
    • The decision could have a large impact as 25 states, including OK, MT, UT, AZ and TX, have similar bans in place.

USDA 2025 Dietary Guidelines Advisory Committee Releases Scientific Report

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On December 10, 2024, the Department of Health and Human Services (HHS) and US Department of Agriculture (USDA) 2025 Dietary Guidelines Advisory Committee (DGAC) released its Scientific Report.

  • NCUIH previously submitted comments to the DGAC recommendation the DGAC which included incorporating research on Traditional Foods in the 2025-2030 Dietary Guidelines
  • Go deeper: The Report discusses the importance of Traditional Foods for AI/AN people and states that more research is needed on the dietary patterns and preferences of AI/AN populations to address knowledge gaps regarding AI/AN diets. Read the full report here.
  • Deadline for Comments:
    • DGAC is accepting written comments on the report until Saturday, February 8, 2025. Submit comments electronically here.
    • Oral comments will be accepted at a virtual meeting on January 16, 2025, from 1-4:30pm ET. Register for the meeting here.

NCUIH Provides Key Recommendations on Behavioral Health Funding, Health IT Modernization, National HIV/AIDS Strategy, and Proposed Reorganization of IHS Headquarters

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On November 27, 2024, NCUIH submitted comments to the Substance Abuse and Mental Health Services Administration (SAMHSA) regarding its redesigning of the Tribal Behavioral Health (TBH) Grant Program Notice of Funding Opportunity (NOFO) to streamline the application process and allow Tribes to select from two prevention priorities: one NOFO focused on suicide prevention and one NOFO focused on substance use prevention

  • Go deeper: NCUIH requested that SAMHSA engage with UIOs by hosting an Urban Confer or UIO listening session

On December 6, 2024, NCUIH submitted comments to IHS regarding the Health Information Technology (HIT) Modernization Site Readiness and Training

  • Go deeper: NCUIH requested that IHS support UIOs pre- and post-go-live, provide training that does not disrupt facilities’ operations and reflects real-life scenarios; ensure HIT Modernization implementation is equitable and inclusive for all facility types and sizes pre- and post-go-live; continue to engage with UIOs through Urban Confer sessions to understand the site-level needs that IHS should consider when designing and deploying the PATH EHR; and continue to provide an updated timeline of the PATH EHR implementation.

On December 6, 2024, NCUIH submitted comments to HHS Office of Infectious Disease and HIV/AIDS Policy (OIDP) regarding their Request for Information (RFI) on the development of the 2026-2030 National HIV/AIDS Strategy and the National Strategic Plans for Sexually Transmitted Infections, Vaccines, and Viral Hepatitis

  • Go deeper: NCUIH requested HHS OIDP host regularly occurring Urban Confers or UIO listening sessions, include AI/AN people in the list of priority populations for the National HIV/AIDS Strategy, include Traditional Healing for AI/AN people when addressing HIV/AIDS and STI, prioritize efforts to address the specific needs and challenges faced by AI/AN communities in combating STI and access to vaccines, and continue to include AI/AN people as a priority population when addressing viral hepatitis.

On December 13, 2024, NCUIH submitted comments the Social Security Administration (SSA) regarding their Call to Action Plan.

  • Go deeper: NCUIH requested SSA ensure UIO representation on the Commissioner’s Tribal Advisory Committee and meaningfully engage with UIOs via Urban Confer or UIO listening session.

On December 16, 2024, NCUIH submitted comments IHS on its proposed reorganization of IHS Headquarters Office of the Director.

  • Go deeper: NCUIH requested IHS maintain a dedicated focus on urban Indian health by clarifying the role of the OUIHP Strategic Plan and the proposed Division of Urban Indian Affairs leader, protect the Urban Indian Health line item, ensure meaningful engagement with UIOs through Urban Confer throughout the reorganization process by hosting additional Urban Confers and extend the written comment deadline, and clarify a timeline and next steps for the reorganization.

Upcoming Federal Agency Comment Opportunities

Jan. 10 – CDC Maternal Health and Tribal Maternal Mortality Review

  • Overview: This comment opportunity follows a listening session where CDC sought feedback to inform a sustainable funding initiative for Tribes and Tribal serving organizations. CDC solicited feedback from the following areas of discussion:
    • Your experiences with promoting maternal health in the communities where you live and/or serve and opportunities you see for improvement.
    • Information and data about maternal health that you currently use and important gaps.
    • Considerations for conducting a review of deaths during or within one year of pregnancy in Tribal communities.
  • Comment Deadline: January 10, 2025. Email to tribalsupport@cdc.gov with the subject line “Maternal Health and Tribal Maternal Mortality Review Listening Session.”

ICYMI: House Oversight Hearing “Investigating the Crisis of Missing and Murdered Indigenous Women”, Recent Dear Tribal and Urban Leader Letters

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On November 20, the House Committee on Appropriations, Subcommittee on Interior, Environment, and Related Agencies held an Oversight Hearing on “Investigating the Crisis of Missing and Murdered Indigenous Women.”

Representative Jake Ellzey (R-TX-6) cited NCUIH data on the number of urban Indian people in his district during his testimony:

“I don’t have any tribes in my district, but we do have 20,000 urban tribal members in the Dallas Fort Worth area,” - Rep. Jake Ellzey (R-TX-6).

Representative Pingree (D-ME-01) called for better data collection and reporting on Urban Native women and people experiencing violence:

“The Bureau of Indian Affairs estimates that there are approximately 4,200 missing and murdered cases that have gone unsolved. […] even though approximately 71 percent of indigenous women live in urban areas, research is missing on the rates of murder and violence for these women,” – Rep. Pingree (D-ME-01).

Recent Dear Tribal and Urban Leader Letters (DTLL/DULL)

December 5, 2024, DTLL/DULL – The IHS announces the release of the IHS Strategic Plan for FYs 2025-2029.

  • Overview: The IHS Strategic Plan for FY 2025-2029 was released and has four strategic goals:
    • Be a Leading Health Care Organization
    • Ensure Comprehensive, Culturally Respectful Health Care Services
    • Optimize Operations Through Effective Stewardship and
    • Promote Proactive Intergovernmental and External Relationships
  • NCUIH is currently reviewing and analyzing the Strategic Plan.

December 12, 2024, DTLL/DULL – The IHS reaffirms IHS’ commitment to protecting IHS patients and improving the PRC program.

  • Overview: IHS is working with the Consumer Financial Protection Bureau (CFPB) to protect eligible PRC patients receiving IHS-approved medical services from being subjected to improper bills from medical providers and collection activities from debt collectors. IHS and the CFPB are communicating with providers, medical billers, and debt collectors through a joint letter. In the letter, the IHS is reiterating that the IHCIA prohibits them from holding approved PRC program patients liable for any costs or charges associated with the approved health care services.

NCUIH Presents Good Medicine Awards to Outgoing Legislators Tester and Peltola

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NCUIH staff and Representative Mary Sattler Peltola (D-AK).

On December 11, 2024, NCUIH presented two Good Medicine Awards to Members of Congress for their efforts to support IHS and efforts to improve health outcomes for Native communities during their tenure in Congress.

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NCUIH CEO Francys Crevier and Senator Jon Tester (D-MT).

Senator Jon Tester (D-MT) and Representative Mary Sattler Peltola (D-AK) were recognized for their outstanding contributions and demonstrated leadership in advancing Native health care. Throughout their tenure in Congress, these individuals have gone above and beyond in their efforts to champion legislation, policies, and initiatives that promote the health, welfare, and rights of Native peoples, and have a proven track record of collaboration, bipartisan cooperation, and effectiveness in advancing legislative agendas that address critical issues relating to Native health.

Read more in NCUIH’s press release.

NCUIH in Action

White House Tribal Nations Summit

NCUIH CEO Francys Crevier and and IHS Director Roselyn Tso

NCUIH CEO Francys Crevier (Algonquin) with IHS Director Roselyn Tso (Navajo) at the White House Tribal Nations Summit.

On December 9, 2024, NCUIH represented UIOs at the White House Tribal Nations Summit. The Tribal Nations Summit, established by Executive Order 13647, is the flagship annual convening of the Federal government and Indian Country, and reflects the Biden-Harris Administration’s commitment to strengthening Nation-to-Nation relationships.

National Congress of American Indians and Indian Gaming Association Tribal Leaders Meeting

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NCUIH Vice President of Policy and Communications Meredith Raimondi and the National Indian Health Board’s Congressional Relations Director Winn Davis and Director of Government Relations Caitrin Shuy.

On December 10, 2024, NCUIH represented UIOs at the National Congress of American Indians/Indian Gaming Association Tribal Leaders Meeting, where they discussed transition strategies for the new administration the advancements in Indian Country over the past four years.

NCUIH attends Vice President, Department of Interior, and Key Partner Holiday Receptions 

On December 6, 2024, NCUIH represented UIOs at Vice President Kamala Harris’ Holiday Reception.

On December 11, 2024, NCUIH represented UIOs at the PhRMA Holiday Reception.

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NCUIH staff pictured with Liz Mahar, Director of Advocacy and Strategic Alliances at PhRMA.

On December 12, 2024, NCUIH represented UIOs at the Department of Interior Holiday Reception with Secretary Deb Haaland.

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NCUIH CEO Francys Crevier (Algonquin) and Secretary of the Interior Deb Haaland (Pueblo of Laguna).

On December 13, 2024, NCUIH represented UIOs at the Native American Bar Association Holiday Reception.

Save the Date! NCUIH 2025 Annual Conference (April 22 – April 25)

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The annual conference provides a platform for UIOs, health care professionals, policymakers, community leaders, and advocates to come together and discuss critical issues related to urban Indian health. Please save the date and stay tuned for further details!

Conference Schedule Overview

  • Tuesday, April 22: Training for Urban Indian Organization Boards of Directors
  • Wednesday and Thursday, April 23 – 24: Conference Programming
  • Friday, April 25: Capitol Hill Visits for Urban Indian Organizations
    • Note: Hill Visits are for UIOs only.

Sponsorship Opportunities Are Available!
There are several different sponsorship levels to meet your needs. If you are interested in sponsoring our conference, please see our sponsor guide and contact Tyler Dougherty at tdougherty@ncuih.org.

Conference Location – Room Block Information Coming Soon!
Westin Washington, DC Downtown, 999 9th St NW, Washington, D.C. 20001

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

 Learn more: https://ncuih.org/conference/

 NCUIH Annual Conference Call for Proposals Due January 28

NCUIH is accepting proposals from American Indian and Alaska Native serving organizations, with a priority for UIOs to present their capacity-building best practices, successes, and innovations at our 2025  annual conference on April 22-24, 2025.  Selected proposal presenters will receive a reduced registration to attend the conference. To learn more and submit a proposal, please view the submission form. Interested individuals and organizations may request to present during one of the following options:

  • Concurrent 40-minute break-out session;
  • Poster presentation during conference reception; or,
  • 15-minute lightning presentations to share best practices.

Learn more: https://ncuih.org/conference/#Proposals

Upcoming Events and Important Dates

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January 15, 2025 – NCUIH Monthly Policy Workgroup

January 16, 2025 – Office of Urban Indian Health Programs (OUIHIP) Urban Program Executive Directors/Chief Executive Officers Monthly Conference Call

January 22-23, 2025 – IHS FY 2027 National Tribal Budget Formulation Workgroup Area Report Webinar

One last thing, check out this upcoming funding opportunity:
The Health Resources and Services Administration (HRSA) is accepting applications for its Behavioral Health Workforce Development (BHWD) Technical Assistance Program.

  • This program provides support to HRSA’s BHWD recipients to expand the number of highly trained behavioral health providers nationwide. Eligible programs include the Behavioral Health Workforce Education and Training Program for Professionals, Behavioral Health Workforce Education and Training Program for Paraprofessionals, and the Graduate Psychology Education program. Funding is expected to be multi-year, with an estimated award date of September 1, 2025.
  • Application Deadline Date: March 3, 2025. (Apply)