The Virtual Peer Support Act of 2021 (H.R. 2929/S. 157) seeks to expand virtual peer support services for “Tribal communities” alongside community-based providers through federal grant allocations. UIOs are included within the definition of “Tribal communities,” making this an inclusive effort to legislate for Indian health with UIO needs in mind.
Sen. Tina Smith introduces bill to amend the IHCIA to authorize special behavioral health programs for Indians, including urban AI/AN persons and the UIOs that serve them. This revision of the IHCIA helps Congress to fulfill its trust obligations to AI/AN populations while Urban Indians continue to disproportionately suffer from behavioral health issues at a rate much higher than the general population.
On June 22, 2021, the House of Representatives met to debate legislation including H.R. 3841, the Tribal Health Data Improvement Act of 2021, under suspension of the regular House procedural rules. Rep. Markwayne Mullin (R-OK), citizen of the Cherokee Nation, introduced the bill on June 11 on behalf of himself and cosponsor Rep. Tom O’Halleran (D-AZ). The House requested a recorded vote on June 23, 2021 where H.R. 3841 passed with broad bipartisan support.
The National Council of Urban Indian Health (NCUIH) attended the Department of Homeland Security Community Engagement Roundtable on Racial Equity, Community Policing, and Supporting Underserved Communities on June 24th, 2021. Director of Federal Relations, Sunny Stevenson, spoke to the Officer for Civil Rights and Civil Liberties, Katherine Culliton-González, on the inadequate healthcare and federal data standards of AI/AN people. Racial inclusivity in data standards is important for accurately representing the decades of adversity Native people have faced in fatal encounters with law enforcement, trafficking of indigenous women and girls, racism, and healthcare disparities like seen during the COVID-19 pandemic.
On June 15th, the Indian Health Service (IHS) held a virtual quarterly Tribal Leaders Diabetes Committee (TLDC) meeting. It was brought to the attention of the call participants that although Congress has funded the Special Diabetes Program for Indians (SDPI) at the current $150 million per year through Fiscal Year (FY) 2023, the FY2022 President’s budget includes funding for SDPI at $147 million— a $3 million decrease due to a mandatory sequester. While most mandatory spending is exempt, including Social Security, veterans’ programs, Medicaid and other low-income programs, it remains unclear why SDPI would be subject to a sequester.
To cover the sequester, funding must come from other pockets of the IHS budget. IHS Deputy Director for Division of Diabetes, Carmen Hardin, announced that offsets from FY2021 funding will cover the FY2022 SDPI $3 million sequestration to ensure no grantee will receive a decrease in their annual funding amount for FY2022. IHS has not indicated exactly where this offset is coming from, and with only $67.7 million for urban Indian health, there is concern that such redirections of funding could be drawing from already tight margins.
There were echoed sentiments among Tribal members on the call concerning the lack of consultation with Tribes around this sequestration and how the funding will be offset. IHS has not initiated urban confer on the matter.
On June 17, 2021, the Subcommittee on Indigenous Peoples of the United States held an oversight hearing on “Examining Federal Facilities in Indian Country”. Led by Chair Teresa Leger Fernandez and Ranking Member Don Young, the hearing included testimony from Mr. Randy Grinnell, Deputy Director for Management Operations, Indian Health Service and several other witnesses. The hearing is in response to facilities deterioration and the bureaucracy surrounding timely construction and funding and its impact in Native communities on and off the reservation.
Mr. Rick Mueller is the new Deputy Director for the IHS Office of Urban Indian Health Programs’ (OUIHP) in Rockville, MD. Rick Mueller is an enrolled member of the Central Council of the Tlingit and Haida Indian Tribes of Alaska. As Deputy Director of the OUIHP, Mr. Mueller is responsible for providing leadership and oversight of the Title V, Indian Health Care Improvement Act initiative and Urban health care delivery system as well as supervising staff and duties. Mr. Mueller has been with the OUIHP since February 2014 and previously served as the Heath System Specialist with OUIHP, where he provided policy analysis and development support for a wide-range of health care delivery and support activities for 41 urban Indian organizations. Before joining the IHS, Mr. Mueller worked a number of years in Alaska with regional Native health corporations, serving in various administrative capacities. Mr. Mueller holds a Bachelor of Science degree from Northern Arizona University in Flagstaff, AZ, and later earned a master’s degree in business administration, with a concentration in health service administration, from Alaska Pacific University in Anchorage, AK. We congratulate and welcome him as he embarks in this critical leadership role for the agency.
On January 28, 2021, Senators Amy Klobuchar (D-MN), Todd Young (R-IN), and Chris Van Hollen (D-MD) reintroduced the NCUIH endorsed Coronavirus Mental Health and Addiction Assistance Act. The bill intends to address the growing mental health and addiction crisis in the U.S. exacerbated by the COVID-19 pandemic by expanding mental health and substance use disorder services. If passed, the bill would require:
Even before the pandemic, American Indians and Alaska Natives (AI/ANs) residing in urban areas faced significant behavioral health disparities – for instance, 15.1% of urban AI/ANs report frequent mental distress as compared to 9.9% of the general public and the AI/AN youth suicide rate is 2.5 times that of the overall national average. The COVID-19 pandemic has inflamed the need for funding for UIOs to address the behavioral health and substance abuse crisis among urban Indians.
NCUIH welcomes Sen. Klobuchar, Sen. Young, and Sen. Van Hollen’s legislation to support mental health and addiction services during coronavirus pandemic.
WASHINGTON, DC (June 16, 2021) – Recently, on May 28, 2021, President Biden released the detailed annual budget proposal for Fiscal Year (FY) 2022. The proposal includes a total of $131.7 billion for the Department of Health and Human Services (HHS), which represents a nearly 23.5% increase to current enacted budget for FY21. The request includes $8.5 billion for the Indian Health Service (IHS), a $2.2 billion increase from FY21 and $100 million for urban Indian health, a nearly 60% increase. The request also endorses NCUIH’s priority fix for allowing urban Indian organizations to use existing IHS funding for facilities improvement and renovations.
On June 17, 2021, the Subcommittee on Indigenous Peoples of the United States Hearing: “Oversight Hearing on Examining Federal Facilities in Indian Country”. At the hearing Chair Teresa Leger Fernandez and Ranking Member Don Young Mr. Jason Freihage, Deputy Assistant Secretary for Management, Office of the Assistant Secretary for Indian Affairs; Mr. Randy Grinnell, Deputy Director for Management Operations, Indian Health Service; The Honorable Chief Allan, Chairman, Coeur d’Alene; The Honorable David Hill, Principal Chief, Muscogee Creek Nation; The Honorable Victoria Kitcheyan, Chairwoman, Winnebago Tribe of Nebraska; The Honorable Ned Norris Jr., Chairman, Tohono O’odham Nation; The Honorable Timothy Nuvangyaoma, Chairman, Hopi Tribe. The hearing comes as an oversight to facilities deterioration and the bureaucracy surrounding timely construction and funding and its impact in Native communities on and off the reservation.
Many committee members expressed over the inadequacies in the IHS priority construction planning process and overall compounding backlog of construction projects looming in Indian Country. In addition, Tribal leaders gave personal accounts of the overall devasting facilities conditions including unsafe school structures, to sanitation, and inability to provide basic clinical needs.
Rep. Rueben Gallego gave recognition to the IHS budget that includes a proposal to Urban Indian organizations to use their funds on renovation extra projects like other contractors, but stop short of full praise of the inclusion when directing questions to Mr. Randy Grinnell, Deputy Director for Management Operations, IHS to “expand the IHS proposal and explain why removing this restriction is necessary to allow UIOs to better serve their patients and passing legislation to just to enact the proposal” and “why language still exists as a restriction on UIOs today, when most no longer use the accreditation standard mentioned”? In response, Mr. Grinnell explained “in the past, up until now UIOs were not able to utilize funds from IHS related to any facility issues unless it had to do with accreditation through one of the accrediting bodies. Now there is proposed language in the 22 CJ that will help to address that issue, going forward. In addition, an urban confer is in place, where IHS receives input from those facilities on their needs”. Encouraged by Mr. Grinnell’s response Rep. Gallego went further to ask if “IHS feel positive about passing legislation to just to enact the proposal”? In response Mr. Grinnell stuttered in his explanation stating “he’s not exactly sure why the language for UIOs was included that way in the law, but he can only speculate that the drafters of that law did not have an understanding about the UIOs and their need. And referred the subcommittee to the IHS CJ on that issue for theFY22 President’s budget.” NCUIH along with 29 other Native organizations recently included this request in a joint letter on infrastructure priorities, which also advocated for $21 billion for Indian health infrastructure inclusive of UIOs.
National Council of Urban Indian Health
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Phone: 202.544.0344