July is almost over! Here’s what’s happening next week:

• Tuesday, August 2, 2022 from 2:00 – 3:30 pm Eastern – Tribal Consultation and Urban Confer on Indian Health Service (IHS) Health Information Technology (HIT) Modernization (DULL): Health IT Modernization Data Management Strategy (Registration Link)

1 Big Thing: Congressional hearing held on securing stable funding for the Indian Health Service

“A quarter of a century has passed without the Indian Health Service receiving full-year funding” said Chair Leger Fernandez.

Yesterday, NCUIH Board Member Maureen Rosette testified before Congress in support of stable funding for the Indian Health Service (IHS) through Advance Appropriations until mandatory funding is implemented. While legislation is not required for Advance Appropriations that can be accomplished through Appropriations bills, this hearing showed continued support from Congressional leaders in making Advance Appropriations a reality.

“The federal government has a responsibility, a sacred responsibility, to fulfill the central trust and treaty responsibility for health care services to Native Americans,” said Representative Betty McCollum (D-MN-04).

“Rather than fulfilling our trust responsibility to [Native people], instead, we tell them to wait until the government reopens. It really puts them in an unacceptable situation,” said Jay Obernolte (R-CA-8), SCIP Acting Ranking Member.

Native Organization leaders also emphasized the importance for urgently achieving advance appropriations.

“Every [Native] community has been impacted by government shutdowns that could be avoided through advance appropriations.”

– Jonathan Nez, President of the Navajo Nation and member of NIHB

“Indian Country has long supported advance appropriations as a pragmatic solution to the impact of funding disruptions that we’ve experienced all across the IHS system.”

– Fawn Sharp, Vice President of the Quinault Indian Nation and President of NCAI

“One of the most limited and scarcely resourced Urban Indian Organizations received seven overdose patients during the last shutdown after they were forced to close their doors, five of which were fatal.”

– Maureen Rosette, Chippewa Cree Nation, NCUIH board member and Chief Operating Officer at NATIVE Project

Go deeper: Acting Director of IHS Liz Fowler explained how Urban Indian Organizations are impacted by funding instability.

“Urban Indian organizations are funded through a different mechanism than our tribal health programs. They’re funded through contracts and grants. The contracts are Federal acquisition regulation contracts. One reason that they’re disproportionately impacted is that during a continuing resolution, we’re able to pay tribal programs, whose contracts and compacts have start dates within the continuing resolution period, their full year funding through an exception apportionment process. We are unable to do this for the urban Indian organizations and so they receive funding for a partial amount that’s consistent with the continuing resolution period. So it’s a piecemeal funding method for those programs.”

2. Senate releases draft funding bills with Advance Appropriations, Increase for Urban Indian Health

The Senate Appropriations Subcommittee has released its fiscal year (FY) 2023 Interior, Environment, and Related Agencies bill with $80.4 million for urban Indian health— $7 million above the current enacted level, and $32 million below the President’s request.

• The bill also authorizes $7.38 billion for the Indian Health Service (IHS), an increase of $762 million from FY 2022, but $1.72 billion below the President’s request.
• Thanks to the robust advocacy efforts from NCUIH, Urban Indian Organizations (UIOs) and Tribes alike, the bill text provides $5.577 billion of advance appropriations for IHS for FY 2024.
• Other key provisions include $9 million to improve maternal health, increased funding for mental health programs, and expanded funding for community health representatives.

What’s next: The Committee is not going to conduct markups and it is expected that there will be a continuing resolution when FY22 funding expires on September 30, 2022. NCUIH will continue to advocate for full funding for IHS and urban Indian health with Advance Appropriations for FY23 as negotiations proceed later in the year.

House Appropriations Status: The House passed H.R. 8294 as part of six-bill package on July 21, 2022. The bill included $200 million for urban Indian health, but fails to include advance appropriations for IHS.

3. On our radar: Challenge to Indian Child Welfare Act Advances at Supreme Court

The Supreme Court is preparing to hear a constitutional challenge to the Indian Child Welfare Act (ICWA) that consolidates four petitions to review the Fifth Circuit’s April 2021 en banc decision in Brackeen v. Haaland.

• In this decision, the United States Court of Appeals for the Fifth Circuit upheld the overall constitutionality of ICWA. However, it overturned certain ICWA processes and provisions that concern placement preferences of Native children in Indian homes.
• On May 26, 2022, the Court received amicus briefs from supporters of the ICWA challengers. The challengers and their amici argue that ICWA violates several constitutional provisions including equal protection, anticommandeering, and nondelegation.

Why it matters: ICWA represents the gold standard in child welfare proceedings, strengthening and preserving American Indian and Alaska Native (AI/AN) family structure and culture.

By the numbers: When ICWA was established in 1978, studies showed that between 25% and 35% of all Native children were removed from their homes by state child welfare and private adoption agencies. Of those, 85% were placed with non-Native families, even when fit and willing relatives were available.

The bottom line: ICWA re-established tribal authority to safeguard against such practices by requiring that Native children be placed with extended family members, other tribal members, or other Native families prior to placement in non-Indian homes.

What’s next: The next round of amicus briefs in support of ICWA and Tribal intervenors are due by August 12, 2022, and oral arguments are expected to begin after the Supreme Court term starts in October.

Go deeper: NCUIH previously provided an in-depth analysis on the impact of ICWA. We will continue to monitor ongoing developments as Brackeen v. Haaland proceeds to oral argument, and to provide updates on how the case impacts urban Indian communities.

4. From the blog: Bipartisan Support for Urban Confer at Senate Hearing, Labor-HHS funding update

• Bipartisan Support for Urban Confer at Senate Hearing
• Urban Indian Leaders Encouraged to Apply for New Environment Protection Agency Advisory Committee on Children’s Health
• Challenge to Indian Child Welfare Act Advances at Supreme Court
• House Appropriations Committee Approves Labor-HHS Bill with Funding Increases for Indian Country
• Resource: America’s Disproportionate Investment in Healthcare for American Indians and Alaska Natives

5. One last thing: Resource: America’s Disproportionate Investment in Healthcare for American Indians and Alaska Natives

NCUIH recently published a one-pager showcasing the disproportionate gaps in national healthcare investment for American Indians and Alaska Natives (AI/ANs).

Why it matters: The Indian Health Service (IHS) and Urban Indian Health budgets have long been underfunded.

What they’re saying: In the agency’s Fiscal Year (FY) 2023 Performance Budget Submission to Congress, IHS highlighted these disparities, noting that the “Indian health system is chronically underfunded compared to other healthcare systems in the U.S.”

By the numbers: NCUIH’s analysis of FY 2018 appropriations shows that the US spends $11,172 in healthcare costs per person. In contrast, Tribal and IHS facilities receive $4,078 per IHS eligible patient, while Urban Indian Organizations (UIOs), which support the over 70% of AI/ANs living off-reservation, receive just $672 per AI/AN patient from the IHS budget.

Go deeper: NCUIH data further shows that the gap between tribal budgetary needs submitted via requests to Congress and eventual appropriations has continued to skyrocket over recent years, thereby increasing discrepancies in per-person healthcare spending at UIOs.
(Download one pager)

We need you! We are calling on Native health advocates to contact the Speaker today to support Advance Appropriations! (Action Alert)

On June 17, 2022, the National Council of Urban Indian Health (NCUIH) submitted comments and recommendations to the Indian Health Service (IHS) about the Indian Health Program Policy  (the Policy) in the Indian Health Manual (IHM), Chapter 19, “Urban Indian Health Program.” These comments responded to the agency’s Dear Urban Indian Organization Leader letter dated April 14, 2022, initiating an Urban Confer and seeking recommendations for improving the Urban Indian Health Program policy, procedures, and effectiveness. NCUIH outlined recommendations for IHS, including improvements to the Policy’s oversight and management, improvements to the communication procedures, the addition of an appeals process for UIO annual reviews, clarification of reporting requirements, and general assistance to other federal agencies. NCUIH also requested that IHS develop additional sections about Health Information Technology (HIT) systems, data collection, and the use of federal government facilities and sources of supply.

Background

The main purpose of the Policy is to “establish policy, procedures and responsibilities for the Urban Indian Health Program,” as authorized by the Snyder Act. The government and UIOs use guidance from the Policy “to ensure access to high-quality and safe health care services for Urban Indians; to support health promotion and disease prevention programs targeted to urban populations; and to assess program performance to evaluate whether Urban Indian community needs are met.” In its comment, NCUIH noted that IHS has not updated the Policy since 1994. In the intervening 28 years, UIOs have undergone tremendous growth and change, including rapid adjustments in the last two years in response to the COVID-19 pandemic. The recommendations below, which come directly from UIOs’ experience with the Policy, will inform IHS on necessary areas of improvement.

NCUIH supports a collaborative process in which UIOs and IHS engage in open dialogue concerning the Policy to create a comprehensive document. A thorough process will serve UIOs and IHS, and guide all parties in their pursuit to provide high-quality and culturally focused healthcare to AI/ANs living in urban areas.

NCUIH’s Recommendations to IHS

NCUIH recommended the following improvements and additions to the Policy:

• Improve the Policy’s consistency concerning oversight and management
  • NCUIH shares UIOs’ concerns that the current language in the Policy needs to be strengthened, and the roles and responsibilities of the IHS and UIOs need to be more clearly defined.
  • There is also a general need to improve consistency across all levels of IHS concerning oversight and management, including disbursement of funds, communication, IT support, and more.
  • Over one year after enacting the American Rescue Plan Act, several UIOs still do not have the entirety of the funding, and the discrepancies between areas can vary greatly. Delayed funding due to the bureaucracy of a specific geographic region flies in the face of the federal trust responsibility to provide the highest level of health care to all AI/ANs regardless of residence.
  • NCUIH notes that many UIOs report strong working relationships with their Areas. As such, IHS should work with UIOs to identify best practices and distribute lessons learned across the Areas and Headquarters levels to improve the current inconsistencies UIOs are experiencing.
• Incorporate improved communication and annual training for Area Offices
  • NCUIH requests that IHS provide language on improved communication between Area Offices and UIOs as well as annual training for Area Offices.
• Provide more transparent communication regarding supplemental funding
  • NCUIH requests that IHS modify Section 3-19.3 G – H and Section 3-19.4 “Grants Programs” to clarify the processes and procedures for supplemental funding.
  • NCUIH also suggests that OUIHP develop one-pagers associated with each round of funding and its allowability for UIOs to utilize as they create Scopes of Work and update their contracts.
  • For future health emergencies, NCUIH recommends that IHS establish a plan to communicate funding changes to UIOs through webinars and resources to avoid dissemination of conflicting information.
• Include an appeals process for UIO Annual Reviews
  • NCUIH recommends that IHS include an Appeals Process for UIOs in Section 3-19.3 (F) “Program Evaluation and Review” to give UIOs recourse for program evaluations, opportunities to report UIO noncompliance or satisfactory performance, and a platform to voice their concerns.
• Clarify and update reporting requirements
  • NCUIH requests that Section 3-19.5 “Reports” be modified to further clarify what requirements are needed for UIOs to report.
• Provide general assistance to other federal agencies
  • As NCUIH works with other federal agencies to encourage them to implement Urban Confer mechanisms, we request that IHS similarly support these efforts to the maximum extent practicable.

In addition to the preceding recommendations regarding the current Policy, NCUIH also requested that IHS develop additional sections, including:

• Health Information Technology (HIT) Systems
  • NCUIH requests the updated Policy also include a section on Health Information Technology (HIT) systems and the IHS modernization process.
• Data Collection
  • UIOs have noted that the current Policy does not address data collection and request that this be included as a stand-alone section. Additionally, NCUIH asks that any section on data clearly outline how IHS will use the data and if there would be additional reporting requirements from UIOs.
• Use of Federal Government Facilities and Sources of Supply
  • The Policy should clarify how provisions related to utilization and acquisition of government facilities are carried out, the proper process for UIOs to request these resources, and IHS’ role in transferring any requested property.

NCUIH will continue to closely follow updates to the Policy and assess program performance to evaluate whether urban Indian community needs are met.

On June 30, 2022, the House Appropriations Committee approved its fiscal year (FY) 2023 Labor, Health and Human Services, Education, and Related Agencies funding bill by a 32-24 vote. The bill authorizes $124.2 billion for the Department of Health and Human Services (HHS)— an increase of $15.6 billion above the FY 2022 enacted level and $298 million below the President’s budget request. Other key provisions include a set-aside at the same FY 2022 funding levels of $15.6 million for IHS facilities/Tribally-Operated Health Programs/Urban Indian Health Programs under the National Health Service Corps (NHSC) Loan Repayment Program, increased funding for the Good Health and Wellness in Indian Country (GHWIC) program, increased funding for the Native Connections grant for behavioral health, and increased American Indian/Alaska Native (AI/AN) set-aside funding for Zero Suicide grants. A more detailed analysis follows below.

• Bill Report
• Bill Summary

Despite advocacy by the National Council of Urban Indian Health and Congressional support, urban Indian organizations (UIOs) were not included in the Substance Abuse and Mental Health Services Administration (SAMHSA) State Opioid Response (SOR) grant, which is increased by $250 million above the FY 2022 enacted level in the Committee’s funding bill for FY 2023. The tribal set-aside for this grant was increased by $15 million above the FY 2022 enacted level. The opioid epidemic impacts all AI/ANs regardless of residence and NCUIH will continue to advocate for UIO inclusion in these critical opioid grants.

Bill Highlights

Centers for Disease Control and Prevention (CDC)

• Bill Report: “The Committee recommendation for the Centers for Disease Control and Prevention (CDC) program level includes $9,540,696,000 in discretionary budget authority, $55,358,000 in mandatory funds under the terms of the Energy Employees Occupational Illness Compensation Program Act, and $903,300,000 in transfers from the Prevention and Public Health (PPH) Fund.” The bill funds the CDC at $10.5 billion, an increase of $2 billion above the FY 2022 enacted level and $231 million below the President’s budget request.

GHWIC

• Bill Report: “The Committee’s recommended level includes an increase of $4,000,000 for Good Health and Wellness in Indian Country.”

National Institute of Health (NIH)

• Bill Report: “The Committee recommendation for the National Institutes of Health (NIH) program level includes $46,038,300,000 in discretionary appropriations and $1,420,700,000 in Public Health Service Act (PHS Act) section 241 evaluation set-aside transfers.” The bill provides a total of $47.5 billion for NIH, an increase of $2.5 billion above the FY 2022 enacted level.

Improve Native American Cancer Outcomes

• Bill Report: “The Committee continues to be concerned that Native Americans experience overall cancer incidence and mortality rates that are strikingly higher than non-Native populations and encourages NCI to expand research efforts to reduce American Indian cancer disparities and improve outcomes. The Committee notes NCI’s successful efforts through the Cancer Moonshot’s Accelerating Colorectal Cancer Screening and Follow-Up through Implementation Science (ACCSIS) program, and parallel efforts by NCI Designated Cancer Centers collaborating with American Indian communities, that are improving colorectal cancer screening, follow-up, and referral for care among populations that have low colorectal cancer screening rates. The Committee encourages NCI to continue efforts such as the ACCSIS initiative to develop durable capacity for tribally-engaged cancer disparities research through an integrated program of research, education, outreach, and clinical access.”

SAMHSA

• Bill Report: “The Committee recommendation for the Substance Use And Mental Health Services Administration (SAMHSA) program level includes $9,024,713,000 in discretionary budget authority, $133,667,000 in Public Health Service (PHS) Act section 241 evaluation set-aside transfers, and $12,000,000 in transfers from the Prevention and Public Health Fund (PPHF).” The bill funds SAMHSA at $9.2 billion – an increase of $2.6 billion above the FY 2022 enacted level.

State Opioid Response Grants:

• Bill Report: “The Committee includes $1,775,000,000 for State Opioid Response (SOR) grants, an increase of $250,000,000. The Committee further directs SAMHSA to ensure that these resources continue to be managed by State alcohol and drug agencies defined as the agency that manages the Substance Use Prevention and Treatment Block Grant under part B of title X of the PHS Act. This approach will ensure continuity of funding, effective coordination of efforts, and decrease fragmentation within each State system. The Committee supports efforts from SAMHSA through SOR grants to expand access to SUD treatments in rural and underserved communities, including through funding and technical assistance. The Committee encourages SAMHSA to continue to focus on expanding access to evidence-based MOUD in counties that lack providers who are actively dispensing or prescribing MOUD.” The bill provides $1.8 billion for State Opioid Response Grants, an increase of $250 million above the FY 2022 enacted level, and $65 million for Tribes, an increase of $15 million above the FY 2022 enacted level.
  • Does not apply to UIOs

Zero Suicide Grants

• Bill Report: “The Committee includes an increase of $5,000,000 for the implementation of the National Strategy for Suicide Prevention, including raising suicide awareness, establishing emergency room referral processes, and improving clinical care practice standards. In addition, funding will further support the Zero Suicide model, a comprehensive, multi-setting approach to suicide prevention in health care systems. The Committee also includes an increase of $1,000,000 for the American Indian/Alaska Native (AI/AN) Suicide Prevention Initiative.” The bill funds the Zero Suicide AI/AN set-aside at $3.4 million.

Medication Assisted Treatment

• Bill Report: “The Committee includes an increase of $35,500,000 for Medication Assisted Treatment (MAT) for Prescription Drug and Opioid Addiction; an increase of $4,500,000, for grants to Indian Tribes, tribal organizations, or consortia; and an increase of $224,000 for general Targeted Capacity Expansion activities.”

Tribal Behavioral Grants (Native Connections)

• Bill Report: “The Committee includes an increase of $4,250,000 to expand efforts to address the high incidence of substance misuse and suicide among AI/AN populations.” The bill provides a total of $25 million for Native Connection grants.

Health Resources and Services Administration (HRSA)

• Bill report: “The Committee recommendation for HRSA includes $9,295,951,000 in discretionary budget authority, $256,370,000 in mandatory funding and $15,200,000 in trust fund appropriations for the Vaccine Injury Compensation Program Trust Fund, and $7,000,000 for the Countermeasures Injury Compensation Program.” The bill includes $9.6 billion for HRSA, an increase of $683 million above the FY 2022 enacted level and $792 million above the President’s budget request.

Health Centers Program

• Bill Report: “The Committee recommends $1,945,772,000 for the Health Centers program, $198,000,000 above the fiscal year 2022 enacted level and $107,750,000 above the fiscal year 2023 budget request. Health Centers deliver affordable, accessible, quality, and cost-effective primary health care to millions of people across the country regardless of their ability to pay. Programs supported by this funding include community health centers, migrant health centers, health care for the homeless, and public housing health service grants.”

NHSC

• Bill Report: “The Committee includes $155,600,000, an increase of $34,000,000 above the fiscal year 2022 enacted level, for NHSC to support competitive awards to health care providers dedicated to working in underserved communities in urban, rural, and tribal areas. Within this total, the Committee includes an increase of $10,000,000 for loan repayment for mental and behavioral health providers, including peer support specialists, that serve in crisis centers, as described in the fiscal year 2023 budget request. The Committee also includes $15,600,000, the same as the fiscal year 2022 enacted level, within the total to support NHSC awards to participating individuals that provide health services in IHS facilities, Tribally-Operated Health Programs, and Urban Indian Health Programs.”

On June 15, 2022, the House Committee on Natural Resources held a markup to consider a series of bills, including H.R. 5444. Several Members of Congress, such as Senator Cortez Masto (D-NV) and Representative McCollum (D-MN-04), expressed concerns and grievances about the horrific occurrences within boarding schools. Both the Majority and Minority agree that there needs to be a commission, however, four amendments were introduced on subpoena power, the compensation of commission members, the wording around funds, and the possibility for reparations. The only amendment to be accepted was the amendment editing, “such sums as may be necessary”. The bill has passed the committee and will be heading to The House floor.

NCUIH Submitted Testimony in Support of the Act

On May 26, 2022, the National Council of Urban Indian Health (NCUIH) submitted written testimony to the House Natural Resources Subcommittee for Indigenous Peoples of the United States in support of the Truth and Healing Commission on Indian Boarding School Policies in the United States Act (S. 2907/H.R. 5444), which would create a Truth and Healing Commission on Indian Boarding School Policies (the Commission).

Background

NCUIH worked with Senator Elizabeth Warren (D-MA) on this landmark legislation to begin the healing process from Indian Boarding School policies and ensure the inclusion of UIOs in the Commission. This ensures that the stories of the 70% of American Indians/Alaska Natives (AI/ANs) that live in urban areas will be included. NCUIH exists in part because of the historic oppression of the AI/AN population including federal boarding schools that resulted in the growing AI/AN populations in cities.

On September 30, 2021, in recognition of the National Day of Remembrance, Senator Elizabeth Warren (D-MA), Congresswoman Sharice Davids (D-KS-3), and Congressman Tom Cole (R-OK-4) introduced the Truth and Healing Commission on Indian Boarding School Policies in the United States Act.

Tasked with investigating and documenting the Indian boarding school policies and the historical and ongoing trauma that resulted, the Commission provides an environment for Native people to speak about their personal experiences and will provide recommendations to the government. Working in collaboration with other agencies, the Commission would also develop recommendations for the federal government on how to acknowledge the trauma and help Native communities heal.

The federal government funded these boarding schools as recently as the 1960s, specifically to wipe out Indigenous cultures. Children were forcibly removed from their families and experienced horrific emotional, physical, and sexual abuse while in custody of these schools. The Commission not only highlights the government’s role in the abuse but will also build on the work of Secretary Debra Haaland and the Department of the Interior in examining what happened at these schools.

On December 23, 2021, NCUIH submitted comments to the Department of the Interior regarding the agency’s Federal Boarding School Initiative reiterating its ongoing support for the Administration’s efforts to address the legacy of boarding school programs, while urging the Administration to use the Initiative to address the public health impact of boarding schools on urban AI/ANs.

• NCUIH Endorsed Bill Introduced by Sen. Warren, Rep. Davids and Rep. Cole on National Day of Remembrance
• NCUIH Submits Comments to DOI on Boarding School Initiative and the Lasting Impact on Urban Indian Health

Full Text of Testimony:

National Council of Urban Indian Health –Testimony for House Natural Resources Subcommittee for Indigenous Peoples of the United States in Support of Truth and Healing Commission on Indian Boarding Schools

My name is Francys Crevier, I am Algonquin and the Chief Executive Officer of the National Council of Urban Indian Health (NCUIH). On behalf of NCUIH, the national advocate for health care for the over 70% of American Indians and Alaska Natives (AI/ANs) living off-reservation and the 41 Urban Indian Organizations (UIOs) that serve these populations, we hereby submit this public witness testimony in support of legislation that would create a Truth and Healing Commission on Indian Boarding Schools in the United States. NCUIH exists in part because of the historic oppression of the AI/AN population including federal boarding schools that resulted in the growing AI/AN populations in cities.

Background and Impact of Indian Boarding School Policies on AI/ANs

The federal government funded boarding schools as recently as the 1960s, specifically to wipe out Indigenous cultures. The horrific aim was to “kill the Indian and save the man.” The United States Government’s Indian boarding school policy authorized the forced removal of hundreds of thousands of Native children, as young as five years old, relocating them from their homes in Tribal communities to one of the 408 Indian Boarding Schools across 30 states[1]. Between 1819 and 1969, the United States federal government stole Native children from their families to destroy their Indigenous identities, beliefs, and traditional languages to assimilate them into white American culture through federally funded Christian-run schools[2]. Children were forcibly removed from their families and experienced horrific emotional, physical, and sexual abuse while in the custody of these schools. The Relocation and Termination Era and Federal Indian Boarding Schools are inextricably linked to the urbanization of Native people today and the effects are profound.

Creating a Truth and Healing Commission Remains a Critical Priority for AI/ANs

NCUIH was pleased to work with Senator Elizabeth Warren on her landmark legislation to begin a healing process from Indian Boarding School policies. On September 30, 2021, in recognition of the National Day of Remembrance, Senator Elizabeth Warren (D-MA), Congresswoman Sharice Davids (D-KS-3), and Congressman Tom Cole (R-OK-4) Introduced the Truth and Healing Commission on Indian Boarding School Policies in the United States Act (H.R. 5444/S.2907).

Tasked with investigating and documenting the Indian boarding school policies and the historical and ongoing trauma that resulted, the Commission provides an environment for Native people to speak about their personal experiences and will provide recommendations to the government. Working in collaboration with other agencies, the Commission would also develop recommendations for the federal government on how to acknowledge the trauma and help Native communities heal. Senator Warren (D-MA) worked alongside NCUIH to promote UIO inclusion in this legislation. NCUIH is grateful for their support and the support of all co-sponsors for this Commission and for promoting the inclusion of UIOs. Their support has ensured that a longtime priority for UIOs may now become a reality.

Inclusion of UIOs in Truth and Healing Commission

NCUIH thanks the committee and the bill’s sponsors for including UIOs as one of the options for representation on the Commission. This ensures that the stories of the 70% of AI/ANs that live in cities will be included. Urban Indians are often left behind in legislation regarding AI/ANs and it is a sign of your hard work that urban AI/ANs now receive the inclusion they deserve. We thank you for your support of this inclusion provision.

Urban Indians have faced brutal treatment from the government through their forced removal to federally funded boarding schools. In order to truly heal from this experience, urban Indians must be included in efforts to come to terms with the historical trauma experienced by so many urban AI/ANs. In the future, we request that UIO inclusion be made mandatory in legislation impacting the legacy of these boarding schools. UIOs face the legacy of this historical trauma and the voices of urban AI/ANs must be heard.

Conclusion

In order to address these abuses, the Truth and Healing Commission must be formed. The truth of what happened to these AI/AN children must be acknowledged, witnessed, and validated. The government must take accountability for the horrors it oversaw. This Commission would allow AI/ANs to speak about their experiences at federally-funded boarding schools. This Commission will empower AI/AN voices by allowing them to provide recommendations to the federal government. No longer will AI/AN voices be silenced, rather, through this Commission, they would be uplifted. It is NCUIH’s hope that this will usher in a new era where the trust responsibility is better upheld to all Indigenous people, including the over 70% of AI/ANs who reside in urban areas as a result of policies like federal boarding schools.

NCUIH once again thanks this Committee, Senator Warren (D-MA), Congresswoman Sharice Davids (D-KS-3), and Congressman Tom Cole (R-OK-4) for their support of the Truth and Healing Commission on Indian Boarding School Policies. This bill would begin the healing necessary to make amends for past historical injustices. You have the unique opportunity to empower AI/ANs who were subject to the cruelty of these schools. I urge you to take this opportunity to make the changes so desperately needed.

[1] https://www.bia.gov/sites/default/files/dup/inline-files/bsi_investigative_report_may_2022_508.pdf

[2] Ibid.