PRESS RELEASE: NCUIH Applauds the Invitation of Native Health Leaders at Joint Session of Congress

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FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (March 4, 2025) – The National Council of Urban Indian Health (NCUIH) proudly recognizes the invitation of two esteemed Native health leaders to attend the upcoming Joint Session of Congress in Washington, D.C. Dr. Linda Son-Stone, CEO of First Nations Community HealthSource, has been invited as a guest of Congresswoman Melanie Stansbury (NM-01), while Walter Murillo, CEO of Native Health Phoenix and NCUIH Board President, will attend as a guest of Congressman Greg Stanton (AZ-04). Both Stansbury and Stanton are members of the Native American Caucus. The Joint Session of Congress presents an opportunity to emphasize the importance of honoring the federal trust responsibility to provide adequate healthcare to Native people.Both leaders have dedicated their careers to advocating for the health and well-being of urban Native populations. Their invitations are a recognition of the key role of Urban Indian Organizations (UIOs) in providing healthcare to Native communities.

UIOs are nonprofit organizations funded by the Indian Health Service (IHS) to provide quality health care to Native Americans living in urban areas. Native Health, based in Phoenix, Arizona, delivers primary medical, behavioral health, and community wellness services to the urban Native population. First Nations Community HealthSource (FNCH), located in Albuquerque, New Mexico, is the state’s only Urban Indian Organization and serves as a critical healthcare provider for Native and other underserved communities.

Stanton Emphasizes Importance of Native Health in Serving People on Medicaid

Stanton Emphasizes Importance of Native Health in Serving People on Medicaid

Congressman Stanton emphasized the importance of Murillo’s attendance in light of proposed Medicaid cuts that would disproportionately impact Native communities.

“Walter and the team at Native Health work every day to provide quality, affordable health care to Arizona’s urban Native population, and as many as half of their patients rely on AHCCCS (Arizona Health Care Cost Containment System). I’m proud that Walter will be my guest at the President’s address to highlight why Congress should reject any budget that cuts Medicaid and takes away health care for Arizona families,” said Rep. Stanton.

Medicaid is the biggest source of funding for Urban Indian Organizations outside of the Indian Health Service (IHS). 37.4% of Native Arizonans are enrolled in Medicaid—including more than 53,000 Native Medicaid beneficiaries in Arizona’s Fourth Congressional District.

First Nations Community HealthSource: A Shining Light

First Nations Community HealthSource: A Shining Light

Similarly, Congresswoman Stansbury highlighted the innovative work of First Nations Community HealthSource as “the shining light of health care in New Mexico.” Stansbury, stated, “this clinic is a cornerstone of our community, providing holistic and wrap-around services that address the deep health disparities facing our Native populations. I am honored to have Dr. Linda Son-Stone, an extraordinary leader in urban Indian health, as my guest at the Joint Session of Congress” said Rep. Stansbury.

On February 27, Rep. Stansbury led 111 members of Congress in a letter urging the administration to reverse executive actions that are negatively impacting Tribal programs. Their support is particularly critical as proposed Medicaid cuts threaten the health care coverage of the 2.7 million Native Americans who rely on Medicaid.

The joint session airs tonight, March 4 at 9:00 pm ET, live on C-SPAN.

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

United States Government Accountability Office Continues to List Indian Health Service on High-Risk List, One Criterion for Removal from High-Risk List Met

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On February 25, 2025, the United States Government Accountability Office (GAO) updated GAO’s “High Risk List” by adding a new area on federal disaster assistance and released the report “Heightened Attention Could Save Billions More an Improve Government Efficiency and Effectiveness.” Importantly, GAO continues to list “Improving Federal Management of Program that Serve Tribes and Their Members” – including the Indian Health Service (IHS)- on the High-Risk List. Specifically, GAO states that IHS has met one criterion for removal from the High-Risk List- “Leadership Commitment”- but the four other criteria- “Capacity,” “Action Plan,” “Monitoring,” and “Demonstrated Progress”- are partially met and still need attention. Progress to meet these criteria will include consistently delivering high-quality health care; drafting a longer-term workplan; improving monitoring; and developing an action plan and related mechanisms to ensure progress on longer-term goals.

GAO states that “[s]enior IHS officials have called for more adequate and stable funding for the agency, including by noting estimates that it is funded at approximately 49 percent of its level of need. IHS officials recently told [GAO] that funding constraints and a lack of staff hampered the agency’s ability to understand and address its facility and medical equipment needs.” The National Council of Urban Indian Health (NCUIH) supports IHS’ National Tribal Budget Formulation Workgroup (NTBFWG) in calling for full funding for IHS to address these issues.

Read the full report here.

About GAO’s High-Risk List

At the start of each new Congress, GAO issues an update to GAO’s High Risk List. The list highlights areas across the federal government with serious vulnerabilities to fraud, waste, abuse, and mismanagement, or in need of transformation. GAO uses five criteria to assess progress in addressing high-risk areas: (1) leadership commitment; (2) agency capacity; (3) an action plan; (4) monitoring efforts; and (5) demonstrated progress. The ratings are based on analysis of actions taken up to the end of the 118th Congress.

NCUIH will continue to monitor for any developments.

February Policy Updates: Federal Funding Threats, IHS Budget Advocacy & Key Tribal Actions

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📜 Federal Funding Freeze & UIOs at Risk: NCUIH’s latest report highlights how funding disruptions threaten Urban Indian Organizations (UIOs), with many unable to sustain operations beyond six months. Read the report and take action.

🚨 OMB Rescission & Future Threats: NCUIH urges Congress to exempt the Indian health system from future freezes and has submitted letters to OMB, HHS, and Congressional leaders advocating for protections.

📊 Executive Orders & Tribal Impacts: NCUIH tracks federal workforce reductions, DEI rollbacks, and ongoing threats to Indian health funding.

🏛 IHS Budget Advocacy: The IHS National Tribal Budget Formulation Workgroup recommends $73B for IHS and nearly $1B for UIOs in FY27. NCUIH continues to push for full funding.

⚖ Legislative & Legal Updates: NCUIH supports bills strengthening IHS leadership and Medicaid access while monitoring lawsuits challenging recent executive actions.

🎤 NCUIH in Action: Testifying AI/AN Public Witness Days hearings, co-hosting Medicaid webinars, meeting with Congress, and advocating at key events.

📬 ICYMI: Federal updates on IHS leadership changes, Tribal consultations, and new AI/AN health resources.

📆 Upcoming Events: HHS Tribal Budget Consultation, and NCUIH’s 2025 Annual Conference.

💰 Funding Opportunities: Grants available for behavioral health workforce development, Medicaid outreach, and AI/AN mental health programs.

OMB Federal Funding Freeze: New NCUIH Report Shows Federal Funding Pauses Threaten Critical Services at Urban Indian Organizations

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On February 12, NCUIH released a final report on the potential impact of federal funding disruptions on urban Indian Organizations (UIOs).​

  • Read the final report here.

Key Findings:

  • Operational Sustainability: Over half of UIOs would not be able to sustain operations beyond six months without federal funding.
  • Service Discontinuation: Over half of UIOs anticipate discontinuing critical services if federal funding disruptions were to persist.
  • Immediate Impact: Some UIOs can only sustain operations for 30 days or less without federal funds.

The potential disruption of UIO services could have far-reaching consequences for urban American Indian and Alaska Native (AI/AN) populations. The 41 UIOs collectively serve patients from over 500 federally recognized Tribes, providing crucial primary care, behavioral health, traditional medicine, and social services. Any interruption in these services could exacerbate existing health disparities and undermine decades of progress in urban American Indian and Alaska Native healthcare.

As we release this report, we call on policymakers, healthcare leaders, and advocates to recognize the critical role of UIOs in the Indian health system and take immediate action to ensure their continued operation and funding stability. The health and well-being of urban AI/AN communities depend on the uninterrupted services provided by these organizations.

Background on OMB Federal Funding Freeze 

On January 27, the Office of Management and Budget (OMB) issued a memorandum to Agencies that requires Agency leadership “to the extent permissible under applicable law…temporarily pause all activities related to obligation or disbursement of all Federal financial assistance.”

The OMB memo freezing financial assistance was rescinded on January 29, 2025, and there are current federal court orders blocking the enforcement of various Executive Orders (EOs) that disrupt federal funding. However, concerns remain about the potential for future freezes and their detrimental effects on the Indian health system.

In response, NCUIH…

Take Action! 

  • Tell Congress to protect Indian health system funding: While the recent OMB memorandum freezing financial assistance has been rescinded, NCUIH remains concerned about potential future impacts on the Indian health system. Let Congress know that it is critical that Indian health system funding is protected from any future disruptions, using this language for your representative.

Federal Hiring Freeze

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On January 20, President Trump issued a memorandum ordering a hiring freeze for federal civilian positions.

In response, NCUIH…

  • joined NIHB, National Congress of American Indians (NCAI), and Self-Governance Communication and Education Tribal Consortium in sending a letter to HHS regarding the memorandum issued by President Donald Trump instituting a federal civilian employee hiring freeze (January 31).
  • The letter requests an exemption for the IHS from any plans, policies, or incentives that seek to decrease its workforce because IHS is the principal health care provider for American Indian and Alaska Native people and is essential in fulfilling the United States legal and trust obligation to provide health care to American Indian and Alaska Native people.
  • The letter also states that exempting IHS from the federal civilian position hiring freeze is critically necessary to protect public safety.
  • Read our blog

HHS and DOI Confirm DEI EO Do Not Apply to American Indian and Alaska Native People

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A January 30 Department of Interior (DOI) Secretary’s Order “Ending DEI Programs and Gender Ideology Extremism” states that nothing in the order shall affect activities that implement legal requirements independent of the rescinded equity-related EOs, including activities the statutory authorities, treaty, and/or trust obligations of DOI and its Bureaus/Offices to Tribal Nations.

In a February 6th memo, HHS Acting General Counsel Sean Keveney responded to Senator Murkowski’s (R-AK) inquiry regarding the applicability of the EO on DEI to IHS programs serving AI/AN people. Acting General Counsel Keveney clarified that the Executive Order “does not apply to programs or activities of the Department of Health and Human Services that affect or serve AI/ANs.”

NOTE: We urge UIOs to discuss any questions you may have about the potential impact HHS’s note and DOI’s Secretary’s Order may have on your communications, funding, or programming with your General Counsel.

HHS Advisory Opinion on Application of DEI Executive Orders to the Department’s Legal Obligation to Indian Tribes and Their Citizens

On February 25the HHS Office of General Counsel issued an Advisory Opinion which reaffirms that recent Executive Orders do not alter the federal government’s trust responsibility to provide healthcare for AI/AN people. This opinion clarifies that recent Executive Orders do not alter the federal government’s distinct legal obligations to Indian Tribes and their citizens, as established by treaties, statutes, and the U.S. Constitution. It also notes that IHS facilities must comply with these Executive Orders in the operation of policy-based programming.

This action reflects responsiveness to calls from Tribal leaders and AI/AN organizations urging the administration to uphold its trust obligations. NCUIH has consistently advocated for the protection of the Indian health system, including UIOs, which provide health services for AI/AN people.

Read NCUIH’s statement.

Executive Order on Reducing the Federal Civil Workforce

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On February 11, 2025, the Administration issued an EO entitled “Implementing the President’s “Department of Government Efficiency” Workforce Optimization Initiative.”

 The EO aims to reform the workforce in several ways: 

  • Instituting a hiring ratio where “each agency hire no more than one employee for every four employees that depart.”
  • Instructing agencies to develop a plan the ensure career appointment hires are in highest-need areas.
  • Initiating reductions in the workforce, exempting functions related to public safety, immigration enforcement, or law enforcement.

According to news reports, officials in the Office of Personnel Management (OPM) met with agency leaders and advised them to dismiss probationary employees.

In response, NCUIH…

  • released an action alert urging advocates to contact Congress to demand they stop these layoffs and protect tribal programs (February 14).
  • joined other national Native organizations and the Navajo Nation in a letter to OPM advocating on behalf of federal employees who serve Indian Country (February 14).

Recission of IHS Employee Termination 

  • A February 17 news report noted HHS Secretary Kennedy rescinded the layoffs of 950 IHS employees.
  • With IHS facing a 30% vacancy rate, further reductions in staffing would severely impact healthcare access for AI/AN people.
  • NCUIH will continue to monitor these developments, and we remain committed to ensuring the federal government upholds its trust responsibility.

Protecting Indian Country Amid Executive Actions

Letter to Admin

  • On February 2, NCUIH and Tribal organizations sent a letter to the President, Members of Congress, and the Department of Interior Secretary calling on the Administration to ensure that recent executive actions do not undermine the unique sovereign political status of Tribal Nations as sovereign nations with which the federal government has trust and treaty obligations or disrupt federal funding that flows from those relationships for essential Tribal programs.

Letter to OMB

  • On February 14, NCUIH and Tribal organizations sent a letter to OMB Director Russell Vought to congratulate him on being confirmed to lead OMB and request a meeting with him as soon as possible to discuss implementing President Trump’s priorities in a manner that recognizes the sovereign governmental status of Tribal Nations and the United States’ longstanding trust and treaty obligations.

Monitoring the Bench

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State of New York v. Trump 

  • Lawsuit brought in the District Court of Rhode Island by 22 states to stop the federal funding freeze.
  • Temporary Restraining Order Granted on 1/31 – still in effect as of February 28, 2025. 
  • Defendants argued the OMB memo was rescinded and the case was moot, but Plaintiffs provided evidence from the Administration that there was still intent to implement the freeze.
  • Motion for Preliminary Injunction filed by Plaintiffs on 2/7 with a Hearing held on 2/21. The Motion was taken under advisement, and a decision has not been issued yet. In the meantime, the Temporary Restraining Order is still in effect.
  • Defendants appealed the Temporary Restraining Order to the 1st Circuit.
  • This was ordered to be voluntarily dismissed on 2/13.
  • Defendants filed an Emergency Motion for Permission to withhold FEMA and other funding – this was Denied on 2/12.
  • “Neither the TRO nor the Court’s subsequent Order require the Defendants to seek “preclearance” from the Court before acting to terminate funding when that decision is based on actual authority in the applicable statutory, regulatory, or grant terms.”

National Council of Nonprofits v. Office of Management and Budget (OMB) 

  • Lawsuit brought in the District Court of the District of Columbia by nonprofits to stop the federal funding freeze.
  • Temporary Restraining Order Granted on 2/3.
  • Plaintiffs filed their Motion for Preliminary Injunction on 2/11 with a Hearing held on 2/20.
  • A Preliminary Injunction was issued on 2/25, preventing the Trump administration from implementing the funding freeze before a final decision is made.
  • Judge AliKhan barred the federal government from “implementing, giving effect to or reinstating under a different name” the OMB directive to pause federal financial assistance.

NCUIH is monitoring litigation surrounding Executive Orders that directly or indirectly affect UIOs and/or urban AI/AN health.

IHS National Tribal Budget Formulation Workgroup Areas Recommend an Average Increase of $73 Billion for IHS and $998 Million for Urban Indian Health for FY 2027

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NCUIH Board Member Todd Wilson (Crow), NCUIH President Walter Murillo (Choctaw), NCUIH CEO Francys Crevier (Algonquin), and Executive Director of the Montana Consortium for Urban Indian Health Jason Smith.

On February 11-12, NCUIH joined the FY 2027 IHS National Tribal Budget Work Session where all 12 of the IHS Areas’ budget recommendations are consolidated into a comprehensive set of national health priorities and budget recommendations. NCUIH President Walter Murillo presented urban Indian health priorities, such as full funding for IHS and the Urban Indian line item, establishing permanent 100% FMAP for services provided to Medicaid beneficiaries at UIOs, exempting urban AI/AN Medicaid beneficiaries from Medicaid reform work requirements, and SDPI reauthorization.

  • Tribes drive the budget formulation process to ensure the IHS budget reflects the evolving health needs of AI/AN people and communities.
  • NCUIH always supports the Tribal Budget Formulation Workgroup budget request and advocates for full mandatory funding for IHS.
  • NCUIH is grateful for the Tribal Budget Formulation Workgroup’s advocacy for a fully funded Indian health care system, including UIOs.
  • The bottom line: Average Tribal recommendation increase for IHS for FY2027: $73 billion.
  • The bottom line: Average Tribal recommendation for Urban Indian Health for FY 2027: $998.1 million.

One more thing: During the FY 2027 IHS National Tribal Budget Formulation Work Session, IHS clarified that they are not anticipating delays in UIO contracts and are moving forward with contracts as normal at this time, in the midst of recent Executive Orders.

NCUIH Requests Full Funding for the Indian Health System for FY 2026

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NCUIH Testimony at House Interior Appropriations Subcommittee American Indian and Alaska Native Public Witness Hearing

On February 27, Robyn Sunday-Allen (Cherokee), CEO of the Oklahoma City Indian Clinic and NCUIH Board President-Elect, was NCUIH’s witness for the FY 2026 House Appropriations Committee’s AI/AN Witness Day.

  • Go deeper: Testimony advocated for:
  • Protecting Funding from cuts and freezes for IHS and fund Urban Indian Health at $100 million for FY 2026.
  • Maintaining Advance Appropriations for IHS, until mandatory funding is achieved, and protect IHS from sequestration.
  • Ensuring Federal Policies Uphold Trust Obligations to AI/AN Communities.

FY 2025 Appropriations and Budget Resolution

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Continuing Resolution and FY25 Funding: 

The current Continuing Resolution (CR), which temporarily funds the government, is set to expire on March 14.

  • What’s Next?: If Congress fails to reach an agreement on either a full-year funding bill or a year-long CR by this deadline, the government will face a shutdown. With the tight timeline and ongoing negotiations, Congressional leaders are now leaning toward passing a year-long CR to avoid a shutdown and maintain government operations.

Budget Resolution:

  • On February 21, the Senate passed a budget resolution following an 11-hour Vote-a-rama. No Tribal Amendments were included.
  • This sets up the Senate Committees with jurisdiction to develop budgets based on the guidelines outlined in the resolution. The Senate will then go through another round of Vote-a-rama to pass the final bill.
  • On February 25, the House of Representatives passed their version of a budget resolution.
  • This plan will set up Congress to pass President Trump’s legislative agenda in one bill, instead of two. President Trump has stated support for the House’s budget resolution over the Senate’s bill.
  • Next Steps: The Senate will now take up the House budget resolution and provide their suggested changes to match their priorities. Both Chambers need to adopt the same Budget Resolution in order to move forward.

NCUIH Supports the Partnership for Medicaid’s Call to Protect Medicaid amid Budget Resolution 

On February 6, NCUIH joined the Partnership for Medicaid in releasing a statement that calls on Congress to reject cuts to Medicaid during the budget reconciliation process.

The National Council of Urban Indian Health (NCUIH) joined the Partnership for Medicaid (P4M) in calling on Congress to protect Medicaid, while expressing a commitment to work with policymakers to identify more sustainable strategies to strengthen Medicaid and improve on its promise of providing high quality coverage and access to care for populations in need. On February 6, P4M issued a statement urging Congress to reject cuts to Medicaid during the budget reconciliation process, and on February 24, P4M released a statement urging Congress to vote “no” on the budget resolution which includes $880 billion in cuts for the Energy and Commerce Committee, which would likely significantly impact Medicaid.

  • Did you know?: NCUIH is a member of the Partnership for Medicaid, which is a nonpartisan, nationwide coalition of organizations representing clinicians, health care providers, safety-net health plans, and counties. The goal of the coalition is to preserve and improve the Medicaid program.

Legislative Updates

Illustration of two hands passing off a judge's gavel as if it were a baton.

House Hearing on the Stronger Engagement for Indian Health Needs Act of 2025 (H.R. 741)

On February 5, the House Subcommittee on Indian and Insular Affairs hearing on the bill, which NCUIH has worked on with Rep. Stanton (D-AZ-4) and has endorsed it since its first introduction.

  • What is it?: This bill would elevate the IHS Director to Assistant Secretary for Indian health within HHS, increasing their authority within the federal government on the health care needs of the AI/AN population.
  • What’s Next?: The bill will have to be voted on in the Subcommittee in order to be considered by the full House for a vote.

SCIA Hearing on 119th Congress Priorities for Indian Country 

On Feb. 12, 2025, the Senate Committee on Indian Affairs (SCIA) held a hearing to cover AI/AN priorities in the 119th Congress.

  • NIHB, the Council for Native Hawaiian Advancement, the National Indian Education Association Board, and Native American Financial Officers Association testified at the hearing on AI/AN priorities such as IHS workforce cuts, Native Behavioral Health Access Improvement Act, and nutritious food for AI/AN children.

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

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Jan. 15 – IHS Headquarters Office of the Director Reorganization Completion

  • The IHS Director wrote to Tribal leaders and UIO leaders in a follow-up to Tribal Consultation and Urban Confer on the IHS Headquarters reorganization of the offices that comprise the Deputy Director for Intergovernmental Affairs.
  • Following the publication of their Federal Register Notice on January 8, 2025, IHS announced the completion of this reorganization.

Jan. 16 – IHS Appointment of Deputy Director for Field Operations

  • The IHS Director wrote to Tribal leaders and UIO leaders to announce the appointment of Dr. Beverly Cotton (Mississippi Band of Choctaw Indians) as the Deputy Director for Field Operations at IHS.
  • As IHS DDFO, Dr. Cotton provides management oversight and resource allocation for four IHS Area Offices: Albuquerque, Navajo, Oklahoma City, and Tucson.

 Jan. 16 – IHS Interactive Web Map for Cancer Screening, Diagnosis, and Treatment

  • The IHS Director wrote to Tribal leaders and UIO leaders to share a vital resource developed by the IHS to help patients overcome barriers when accessing cancer care services in our communities.
  • IHS is building an interactive web map that provides IHS patients with a search tool to locate cancer services near home, and health care providers can use the map to plan appointments and referrals.
  • IHS Tribal and Urban health care cancer subject matter experts will populate the web map with the locations of cancer services, based on their discretion.

 Jan. 17 – HHS 27th Annual Tribal Budget Consultation

  • HHS wrote to Tribal leaders to invite them to the 27th HHS Annual Tribal Budget Consultation (ATBC). The ATBC will provide a forum for tribes to collectively share their views and priorities with HHS officials on national health and human services funding priorities and make recommendations for the Department’s FY 2027 budget request.
  • The ATBC will take place in-person on April 22 – 23, 2025, at the Hubert H. Humphrey Building at 200 Independence Avenue, SW, Washington, DC. Register to attend here.
  • The ATBC written comment period ends Monday, April 21, 2025, at 5:00pm ET and can be emailed to consultation@hhs.gov with subject line “HHS Annual Tribal Budget Consultation.”
  • Tribes are once again invited to register for one-on-one consultations in conjunction with the ATBC.

NCUIH in Action

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Earlier this month, NCUIH attended the 2025 State of Indian Nations Address hosted by the NCAI.

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On February 13th, NCUIH worked with NCAI & NIHB to facilitate and staff dozens of Congressional meetings for Tribal Leaders and provided talking points on provided talking points on Medicaid, IHS Appropriations, and the Special Diabetes Program for Indians (SDPI). NCUIH Visited 10 offices.

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On February 12, NCUIH VP of Policy and Communications Meredith Raimondi moderated a panel with NCUIH CEO Francys Crevier and NIHB Interim CEO A.C. Locklear on health care priorities during NCAI’s 2025 ECWS. The panel discussed federal funding and hiring freezes, protecting IHS funding, Medicaid in AI/AN communities, SDPI, and data collection as a tool for advocacy.

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On February 5, NCUIH and Georgetown CCF co-hosted a webinar on Medicaid in AI/AN Communities. Speakers included Winn Davis, NIHB and Lisa James, Montana Consortium of Urban Indian Health. Watch the webinar here.

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On February 3, NCUIH represented UIOs and presented policy updates at the American Academy of Pediatrics (AAP) Committee on Native American Child Health (CONACH) Spring Business Meeting.

NCUIH 2025 Annual Conference (April 22 – April 25) Award Nominations

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Call for Nominations! NCUIH’s 2025 Annual Conference Awards

Submit a nomination here by Friday, March 21, 2025

The National Council of Urban Indian Health (NCUIH) invites you to submit award nominations for our Annual Conference, on April 23 – April 24, 2025, in Washington, D.C.

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

  1. Urban Indian Organization Staff Member of the Year Award: This award recognizes a staff member of an Indian Health Service funded Urban Indian Organization (UIO) who exemplifies dedication and leadership in serving urban AI/AN populations through innovative initiatives and unwavering commitment.
  2. Urban Indian Organization Visionary Award: The Urban Indian Organization Visionary Award celebrates an individual within an Urban Indian Organization who has demonstrated visionary leadership and innovation in addressing challenges and opportunities within urban AI/AN communities. Nominees should have a track record of developing and implementing innovative programs, initiatives, or strategies that have significantly contributed to the advancement of urban Indian health and well-being.
  3. Urban Indian Legacy Award: The Urban Indian Legacy Award honors an individual who has made enduring and significant contributions to the urban Indian health movement over the years. This award recognizes individuals who have dedicated their careers to advocating for urban AI/AN health, preserving cultural heritage, and fostering community empowerment. Nominees should have a demonstrated legacy of leadership, service, and impact within the urban AI/AN health community.
  4. Tribal Leader Impact Award: The Tribal Leader Impact Award acknowledges a tribal leader who has demonstrated exceptional leadership, dedication, and impact in addressing health disparities and improving the well-being of AI/AN populations inclusive of urban communities. Nominees should have a proven track record of advocating for policies, programs, or initiatives that have positively influenced health outcomes, cultural preservation, and community resilience within their tribal communities and beyond.

Please submit your nominations via the form below which includes detailed instructions on the nomination process and criteria for each award. The deadline for submissions is Friday, March 21, 2025.

Upcoming Events and Important Dates

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  • March 4- NIHB 2025 Tribal Health Equity Data Symposium. Register for the livestream here.
  • March 5- HHS Annual Tribal Budget Consultation Planning Session. Register here.
  • March 19-20 IHS Tribal Self-Governance Advisory Committee meeting in Arlington, Virginia. More information here.

One last thing, check out these upcoming funding opportunities:

 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).

The Substance Abuse and Mental Health Administration is accepting applications for its Circles of Care for American Indian/Alaska Natives Program.

  • The purpose of this program is to provide AI/AN organizations with the resources to plan and design a family-driven, community-based, and culturally and linguistically competent system of care. Grant recipients are expected to organize a spectrum of community-based services and supports for AI/AN children who are experiencing or are at risk of mental health challenges.
  • Application Deadline Date: March 17, 2025 (Apply).

HRSA is accepting applications for its Behavioral Health Workforce Education and Training (BHWET) Program for Paraprofessionals

  • The purpose of the BHWET Program for Paraprofessionals is to develop and expand community-based experiential training such as field placements and internships to increase the skills, knowledge and capacity of students preparing to become mental health workers, peer support specialists, and other behavioral health paraprofessionals.
  • Application Deadline Date: March 18, 2025 (Apply).

For more funding opportunities, visit the NCUIH website. 

STATEMENT: NCUIH Responds to HHS Advisory Opinion: Safeguarding Native Healthcare Amid Policy Shifts

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FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (February 26, 2025) – The National Council of Urban Indian Health (NCUIH) welcomes the Advisory Opinion issued by the Department of Health and Human Services (HHS) Office of General Counsel on February 25, 2025. This opinion reaffirms that recent Executive Orders do not alter the federal government’s trust responsibility to provide healthcare for American Indian and Alaska Native (AI/AN) people. This opinion clarifies that recent Executive Orders do not alter the federal government’s distinct legal obligations to Indian Tribes and their citizens, as established by treaties, statutes, and the U.S. Constitution. It also notes that certain policies at Indian Health Service (IHS) facilities must comply with these Executive Orders.

This action reflects responsiveness to calls from Tribal leaders and Native organizations urging the administration to uphold its trust obligations. NCUIH has consistently advocated for the protection of the Indian health system, including Urban Indian Organizations (UIOs), which provide health services for AI/AN people.

Read Advisory Opinion

Francys Crevier (Algonquin), CEO of NCUIH, stated:

“We appreciate the Administration’s affirmation of the federal trust responsibility to provide healthcare for American Indian and Alaska Native people. Native-led Urban Indian Organizations play a critical role in delivering essential services to Native populations, and any policy changes must prioritize the health and well-being of our people.”

NCUIH calls on policymakers to continue listening to Tribal voices and Native organizations and uphold the federal trust responsibility without compromise. NCUIH remains steadfast in advocating for health care access for all Native communities.

Recent news:

PRESS RELEASE: Tribal Organizations Urge Administration to Respect Tribal Sovereignty and Uphold Trust and Treaty Obligations Amid Executive Actions (Feb. 3, 2025)

NCUIH Joins NIHB, NCAI and Self-Governance Communication and Education Tribal Consortium in Requesting the Indian Health System be Exempt from Federal Hiring Freezes (Feb 4, 2025)

IHS Employee Layoffs Halted After Urgent Advocacy Efforts (Feb. 19, 2025)

NCUIH Joins NIHB in Letter to Congressional Leadership Advocating for Protecting the Indian Health System from Funding Freezes (Feb. 25, 2025)

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

NCUIH Supports the Partnership for Medicaid’s Call to Protect Medicaid and Access to Care

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The National Council of Urban Indian Health (NCUIH) joined the Partnership for Medicaid (P4M) in calling on Congress to protect Medicaid, while expressing a commitment to work with policymakers to identify more sustainable strategies to strengthen Medicaid and improve on its promise of providing high quality coverage and access to care for populations in need. On February 6, P4M issued a statement urging Congress to reject cuts to Medicaid during the budget reconciliation process, and on February 24, P4M released a statement urging Congress to vote “no” on the budget resolution which includes $880 billion in cuts for the Energy and Commerce Committee, which would likely significantly impact Medicaid.  

Medicaid provides health coverage to more than 80 million Americans, including working families, children, seniors, and people with disabilities. It plays a key role in ensuring that people have access to doctors, hospitals, and treatment when they need it. In 2023, approximately 2.7 million Native people were enrolled in Medicaid across the United States, according to American Community Service data. Medicaid is a major source of health care funding, particularly for Urban Indian Organizations (UIOs), which provide essential healthcare services to Native people living in urban areas. The proposed Medicaid cuts would threaten the ability of UIOs to sustain necessary service offerings, potentially reducing access to essential health care services for urban Native people. 

NCUIH remains committed to working with policymakers and UIOs to support a strong Medicaid program. 

About the Partnership for Medicaid 

NCUIH is a member of the Partnership for Medicaid, which is a nonpartisan, nationwide coalition of organizations representing clinicians, health care providers, safety-net health plans, and counties. The goal of the coalition is to preserve and improve the Medicaid program. 

 

NCUIH Joins NIHB in Letter to Congressional Leadership Advocating for Protecting the Indian Health System from Funding Freezes

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On January 31, 2025, the National Council of Urban Indian Health (NCUIH) joined the National Indian Health Board (NIHB) in sending a letter to House and Senate leadership to communicate concerns about the impacts of the Office of Management and Budget’s (OMB) now-rescinded memorandum that implemented a temporary pause in federal funding. In the Letter, NCUIH and NIHB urged Congress to communicate and work with Administration officials on guidance about the unique relationship Tribes have with the United States and include a broad Tribal exemption from any future funding restrictions or pauses.

While the recent OMB memorandum has been rescinded, we will continue to monitor this situation and any potential impacts on Indian Health Service funding.

Read the full letter here.

Background on the OMB Memorandum

In a memorandum dated January 27, 2025, the OMB Acting Director, Matthew Vaeth, instructed the heads of executive departments and agencies to temporary pause agency grant, loan, and other financial assistance programs. The now-rescinded memorandum would have temporarily paused “all activities related to obligation or disbursement of all Federal financial assistance, and other relevant agency activities that may be implicated” by recent executive order (EOs). These EOs concern topics such as financial assistance for foreign aid, nongovernmental organizations, diversity, equity and inclusion (DEI) programs, “woke gender ideology,” and the green new deal. OMB later rescinded the memorandum in a memorandum dated January 29, 2025.

NCUIH will continue to monitor any developments.

NCUIH Joins Indian Country Coalition in Urging Senate Leadership to Honor Trust and Treaty Obligations for Native People in Upcoming Budget Reconciliation

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On February 20, 2025, the National Council of Urban Indian Health (NCUIH) joined a coalition of Tribes, Tribal Organizations and other national Native organizations in sending a letter to Majority Leader Thune (R-SD) and Minority Leader Schumer (D-NY) expressing concerns and highlighting opportunities for Indian Country as Congress considers budget reconciliation legislation.

The letter addresses the proposed cuts to federal spending related to taxation, border security, education, infrastructure laws, Tribal Temporary Assistance Program for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP) and Medicaid. Specifically, any cuts or caps to programs such as TANF, SNAP, and Medicaid would reduce access to critical resources that can have a disproportionate impact on American Indian and Alaska Native people. Work requirements for SNAP and Medicaid would directly impact access to healthy food and healthcare, which does not honor the trust and treaty responsibilities to American Indian and Alaska Native people. The letter reinforces to Senate leadership that the inclusion of long-standing tax priorities and other legislative actions affirms Tribal sovereignty and the unique relationship with the federal government is in fulfillment of trust and treaty obligations to all American Indian and Alaska Native people.

About the Indian Country Coalition

NCUIH has joined a coalition with over 20 Tribal organizations to ensure administrative actions account for the government-to-government relationship between Tribes and the United States and the trust and treaty responsibility to Tribal nations and citizens.

The coalition has been active in creating joint messages to share with policy makers, sending letters to key administration officials, and developing advocacy strategies. Access the Tribal Coalition’s online resource hub, where you can find our letters and other advocacy tools.

Full Letter Text

Dear Majority Leader Thune and Minority Leader Schumer,

On behalf of the undersigned organizations that collectively serve sovereign Tribal Nations and their citizens and communities, we write to express concern and highlight opportunities for Indian Country as Congress considers budget reconciliation legislation. While we recognize that Congress is seeking to address broader issues related to taxation and border security, we remind you that proposed changes to federal spending and programs are likely to have a disproportionate impact on Tribal Nations and our people. In addition, Tribal Nations have long sought changes to the tax code aimed at extending the governmental parity they are due. To that end, we urge that any reconciliation bill protect and advance the interests of Tribal Nations and our people, in fulfillment of trust and treaty obligations.

Unique Legal Status of Tribal Nations. Tribal Nations are and always have been inherently sovereign governments that have strong political relationships with our Tribal citizens and community members. We govern and police our lands, and we provide services aimed at keeping our communities safe and healthy. Tribal Nations also have political, government-to-government relationships with the United States, and we prepaid with our lands and resources for the trust and treaty obligations that the United States owes us in perpetuity. The U.S. Constitution singles out Tribal Nations and Native people as unique, and the U.S. Supreme Court has time and again affirmed the principle that United States actions that deliver on trust and treaty obligations to Tribal Nations, Tribal citizens, and Tribal communities do not run afoul of the U.S. Constitution’s equal protection requirements.

Scope of Trust and Treaty Obligations. The United States fulfills its trust and treaty obligations both through the direct delivery of Tribal programs and services and the provision of federal funding to Tribal Nations to deliver services to our own communities. Any Tribal program or funding delivered to Tribal Nations—including through Urban Indian Organizations and Tribal organizations serving Tribal Nations—is provided in furtherance of the United States’ trust and treaty obligations. The federal employees necessary for the functioning of Tribal programs and the disbursement of Tribal funds are also part of the trust and treaty obligations. These actions are not discretionary; they are legal obligations rooted in treaties, trust obligations, the U.S. Constitution, and long-standing federal statutes.

Concerns with Potential Changes to Federal Programs and Spending. As you consider reconciliation legislation in the Senate, we ask that you work to exempt Indian Country from the harmful impacts of changes to federal spending and policy. Reductions in the scope or funding of the programs that we access are not only violations of trust and treaty obligations, but will have devastating impacts for our people. As the budget reconciliation process continues to unfold, we would like to highlight our deep concern and opposition to the inclusion of any language that reduces services or funding to Indian Country. We call upon you to ensure that exemptions are provided for Tribal Nations, Tribal serving organizations, and Native people within any reconciliation legislation, including, but not limited to, the following changes:

Medicaid is critical method by which the United States seeks to deliver upon trust and treaty obligations to provide health care to Tribal Nations. Medicaid resources are vitally important to supplementing the chronically underfunded Indian Health System (comprised of the IHS, Tribal providers, and Urban Indian Organizations). Reforms, such as cost caps, would shift costs to states for American Indian and Alaska Native (AI/AN) Medicaid beneficiaries who currently have their costs covered by 100% Federal medical assistance percentage (FMAP) when seen at an Indian Health Service (IHS) or Tribal facility. Further, conditioning access to Medicaid with work requirements fails to honor trust and treaty obligations, and are not reflective of on-the ground realities in Indian Country. Specifically, many AI/ANs are employed but face unique barriers that make it difficult to prove this. These include limited mail access, poor broadband, insufficient transportation infrastructure, and language barriers. Additionally, Medicaid resources are a critical consideration for Tribal Nations deciding whether to take over Indian Health Programs under the Indian Self-Determination and Education Assistance Act (ISDEAA). Reducing access to Medicaid resources will disincentivize Tribal Nations from electing to take over programs from the IHS and reduce access to much needed supplemental resources for existing Tribal, IHS, and Urban Indian Organizations. This includes any changes to the FMAP or Medicaid expansion. Both AI/AN people and the Indian Health System must be made exempt from any Medicaid reforms. The last time Congress considered Medicaid reform in 2017, it provided such exemptions, and we ask you to do the same again. In addition, the first Trump Administration approved several section 1115 waivers related to work requirements that exempted AI/ANs, including in Arizona, Indiana, South Carolina, and Utah. We support the letter the National Indian Health Board sent on January 31, 2025, and encourage you to refer to that statement for further information.

Changes to Education Funding Structures. As Congress looks to restructure the core of the American education system and redirect federal funding to the states, it is essential that any block grant funding must explicitly protect Tribal Nations and Tribal education systems as eligible entities with dedicated set-asides in each program, ensuring that Tribal Nations and Tribal education systems do not have to seek federal funding through state governments. We highlight the importance of Title III programs under Higher Education Act (HEA) (20 U.S.C. § 1057), Title VI programs under the Elementary and Secondary Education Act (ESEA) (20 U.S.C. § 7401), Title I programs under ESEA (20 U.S.C. § 6301), and Impact Aid under Title VII of ESEA (20 U.S.C. § 7701), as well as all programs administered through the Office of Indian Education (OIE). As these programs may be relocated to other agencies, we want to ensure the funding and staffing levels necessary to operate these programs move with them. We encourage Congress to look to the Child Care and Development Block Grant (CCDBG) as a model for successful Tribal set-asides and direct Tribal funding. 42 U.S.C. § 618(a)(3)(B) ensures that Tribal Nations and Tribal serving Organizations receive funds directly from the federal government, enabling them to operate their own childcare programs tailored to the needs of their communities without requiring them to seek federal funding through state governments.

Changes to TANF. Nearly half of all federally recognized Tribal Nations are now served by a Tribal Temporary Assistance for Needy Families (TANF) program, which enables them to better meet community needs, deliver services in ways that honor Tribal culture, and take advantage of additional flexibilities. An indiscriminate reduction in TANF funding will jeopardize this vital funding. We urge the exemption of the Tribal TANF Block Grant from any funding reductions.

Changes to SNAP. Similarly, the Supplemental Nutrition Assistance Program (SNAP) is a critical program ensuring millions of low-income families, including AI/ANs, have access to food. As a federal program, it is also a critical mechanism by which the United States meets its trust and treaty obligations to Tribal Nations and communities. Federal programs to combat hunger like SNAP are important to Tribal communities— approximately 25 percent of Native Americans receive some type of federal food assistance, and in some Tribal communities, participation is as high as 80 percent. Our populations must be exempt from any reductions in SNAP benefits, including any reductions related to work requirements.

Repeal of Infrastructure Laws. Under recently enacted federal infrastructure packages, including the Inflation Reduction Act (IRA) and the Infrastructure Investment and Jobs Act, Tribal Nations have access to over $14 billion in direct funding and are eligible for billions more in funding through competitive grants, loans, loan guarantees, tax credits, and contracts. This funding is essential to addressing centuries of unmet infrastructure obligations across Indian Country, and we urge you to ensure it continues to flow to Tribal communities and enterprises.

Inclusion of Tribal Tax Priorities. With bipartisan, bicameral support, the Tribal Tax and Investment Reform Act amends the Internal Revenue Code to bring parity for Tribal governments to access the same financing opportunities and engage in the same economic development and job creation activities available to state governments. Enactment of this legislation will remove persistent barriers to accessing the necessary capital required to support economic development and growth in Tribal communities, including through parity in the issuance of tax-exempt bonds. To that end, we urge the inclusion of all the bill’s provisions in any reconciliation legislation. We further request the addition of language recognizing and protecting the sovereignty of Tribal governments, including our ability to retain the revenue generated within our borders through taxation that does not have to compete with taxes states attempt to collect for activities on our lands.

In recognition of the government-to-government relationship between Tribal Nations and the United States, and the federal trust and treaty obligations owed to us, we ask that you work to protect Indian Country from becoming collateral damage in the budget reconciliation process. We have prepaid for the services and funding delivered to us, much of which could be jeopardized without an exemption from larger policy change or reductions. We stand ready to work with you on the inclusion of our long-standing tax priorities and other legislative action that upholds and recognizes our sovereignty and unique relationship.

Sincerely,
Affiliated Tribes of Northwest Indians
American Indian Higher Education Consortium
Great Plains Tribal Chairman’s Association, Inc.
Indian Gaming Association Midwest Alliance of Sovereign Tribes
National Congress of American Indians
National Council of Urban Indian Health
National Indian Child Welfare Association
National Indian Education Association
National Indian Health Board
Native American Finance Officers Association
Self-Governance Communication & Education Tribal Consortium
United South and Eastern Tribes Sovereignty Protection Fund

IHS Employee Layoffs Halted After Urgent Advocacy Efforts

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On February 14,2025, the National Council of Urban Indian Health  (NCUIH) issued an urgent action alert calling on advocates to contact Congress and demand and immediate stop to the layoffs of probationary Indian Health Service (IHS) employees. That same day, NCUIH joined several national Native organizations in a letter to the Office of Personnel Management (OPM), urging federal leadership to protect IHS employees serving Indian Country. With IHS facing a 30% vacancy rate, further reductions in staffing would severely impact healthcare access for American Indians and Alaska Native people.

Following these advocacy efforts, a February 17 report confirmed that HHS Secretary Kennedy rescinded the layoffs of 950 IHS employees. NCUIH will continue to monitor these developments and we remain committed to ensuring the federal government upholds its trust responsibility.

ACTION ALERT: URGENT—Federal Layoffs Devastating Tribal Programs Are Happening TODAY, According to ICT News

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FOR IMMEDIATE RELEASE

Dear Advocates,

We need your immediate action—federal layoffs targeting essential tribal programs have begun TODAY, and the impacts will be catastrophic for Indian Country. According to ICT News, thousands of workers could be affected in health, education and other programs across Indian Country. The news reports that Trump administration has started laying off thousands of federal employees, threatening vital healthcare, education, law enforcement, and social services across tribal communities.

What’s Happening Right Now?

Mass Layoffs Underway: According to ICT News, the Trump administration has started laying off thousands of federal workers, including over 850 Indian Health Service (IHS) employees—doctors, nurses, pharmacists, and more.

Critical Services at Risk: Tribal healthcare facilities, schools, and public safety programs are losing essential staff. Communities that rely on these services will face immediate disruptions.

Trust Obligations:These layoffs will severely impact the federal government’s ability to fulfill the trust responsibility to Tribes and Native people.

According to ICT, the layoffs, targeted at probationary workers hired within the last year or two, are expected to impact programs at the Indian Health Service, Bureau of Indian Affairs, Bureau of Indian Education, and more. If no action is taken immediately, tribal communities will lose life-saving healthcare, childcare services, emergency response capabilities, educational support, and justice services.

Why This Is an Emergency

According to ICT, the layoffs are happening NOW. Without swift intervention from Congress, these cuts will send shockwaves through Indian Country.

How You Can Help—Act Now!

  1. Contact Congress Immediately: Call or email your representatives TODAY to demand they stop these layoffs and protect tribal programs.
  2. Spread the Word: Share this alert widely on social media to raise awareness about this urgent issue.

Sample Email to Your Representative:

Dear Representative [NAME],

I am writing with urgency as federal layoffs devastating tribal programs have already begun today. These cuts threaten the health and safety of Indian Country by targeting critical services such as healthcare, education, law enforcement, and social services.

According to ICT, over 850 Indian Health Service employees—including doctors and nurses—are being terminated right now, leaving tribal communities without access to essential care. These layoffs violate the U.S. government’s trust and treaty responsibilities to Tribal Nations and put lives at risk.

I urge you to take immediate action to stop these harmful layoffs and ensure that tribal programs are protected from further cuts. Please act now to uphold the federal government’s legal obligations to Indian Country.

Thank you for your swift attention to this urgent matter.

Additional information: https://ictnews.org/news/abrupt-federal-layoffs-expected-to-hit-tribal-programs

Sincerely,

[Your Name]

Time Is Running Out—Contact Congress Now!

These layoffs are happening as we speak—your voice can make a difference in protecting tribal communities from devastating harm. Let’s stand together to demand action before it’s too late!

Find Your Members of Congress

Use this link to find your members: https://www.congress.gov/members/find-your-member

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

FINAL REPORT: Urban Indian Health at Risk – Federal Funding Disruptions Threaten Critical Services

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REPORT: Impact of Federal Funding Pauses on Urban Indian Organizations

Today, February 12, 2025, we are providing an update on the National Council of Urban Indian Health (NCUIH) report regarding the potential impact of federal funding disruptions on Urban Indian Organizations (UIOs) funded by the Indian Health Service (IHS). The final report, released on February 11, 2025, builds upon the preliminary findings from February 3, 2025, offering a more comprehensive view of the challenges facing UIOs.

Background

Urban Indian Organizations were established in response to severe health, education, employment, and housing problems caused by federal forced relocation policies. Congress formally incorporated UIOs into the Indian Health System in 1976 with the passage of the Indian Health Care Improvement Act (IHCIA). Today, 41 UIOs operate over 85 facilities in 38 urban areas, serving patients from more than 500 federally recognized Tribes. These organizations provide crucial primary care, behavioral health, traditional medicine, and social services to American Indians and Alaska Natives living in urban areas.

Key Changes from February 3 to February 11 Report

Survey Participation

The final report reflects increased participation from UIOs. While the preliminary report on February 3 included responses from thirteen (13) of the forty-one (41) UIOs, the February 11 report incorporates data from twenty (20) UIOs.

Workforce Instability

The data on potential staff reductions has been refined:

  • February 3 report: 23.1% of UIOs definitely will need to furlough or lay off staff.
  • February 11 report: 25% of UIOs definitely will need to furlough or lay off staff.

Additionally, the percentage of UIOs indicating potential for staff reductions increased:

  • February 3 report: 38.5% indicate potential for staff reductions.
  • February 11 report: 45% indicate potential for staff reductions.

These changes suggest a slightly more severe outlook for workforce stability among UIOs.

Consistent Findings

Several key findings remain consistent between the two reports:

  1. Operational Sustainability: Over half of UIOs would not be able to sustain operations beyond six months without federal funding.
  2. Service Discontinuation: Over half of UIOs anticipate discontinuing critical services if federal funding disruptions persist. The potentially affected services remain the same, including primary care, behavioral health services, substance abuse treatment, community wellness initiatives, health programs, and cultural and youth programming.
  3. Immediate Impact: Some UIOs can only sustain operations for 30 days or less without federal funds.

Implications and Call to Action

The final report reinforces the critical nature of federal funding for UIOs and the potential far-reaching consequences of funding disruptions on urban American Indian and Alaska Native populations. The increased survey participation provides a more comprehensive picture of the challenges facing UIOs, while the slight increase in potential workforce instability underscores the urgency of addressing these funding concerns.

As we release this updated information based on the final NCUIH report, we continue to urge policymakers, healthcare leaders, and advocates to recognize the vital role of UIOs in the Indian health system and take immediate action to ensure their continued operation and funding stability. The health and well-being of urban Native communities depend on the uninterrupted services provided by these organizations.

Additional Information

February 3, 2025 – REPORT: Urban Indian Health at Risk – Federal Funding Disruptions Threaten Critical Services

February 4, 2025 – Action Alert: Contact Congress to Protect Indian Health System Funding