On July 15, 2021, the House Appropriations Committee approved its fiscal year (FY) 2022 Labor, Health and Human Services, Education, and Related Agencies funding bill by a 33-25 vote. The bill authorizes $119.8 billion for the Department of Health and Human Services (HHS)— an increase of $22.9 billion above the FY 2021 enacted level and $129 million below the president’s FY 2022 budget request. Other key provisions include a $15 million set-aside 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 Centers for Disease Control and Prevention (CDC)— including an increase for the Good Health and Wellness in Indian Country (GHWIC) program, increased funding for the Substance Abuse and Mental Health Services Administration (SAMHSA), 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

Bill Highlights

CDC

• Bill Report: “The Committee recommendation for the Centers for Disease Control and Prevention (CDC) program level includes $9,612,761,000 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 $10.6 billion, an increase of $2.7 billion above the FY2021 enacted level.

GHWIC

• Bill Report: “The Committee’s recommended level includes an increase of $5,000,000 for Good Health and Wellness in Indian Country.”

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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.

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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 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.

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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:

• The Secretary of Health and Human Services to award grants to establish a Coronavirus Mental Health and Addiction Assistance Network. These grants would go to eligible entities offering appropriate mental health and addiction services, including Urban Indian Organizations (UIOs).
• Emergency authorization of $100 million to initiate or expand programs offering mental health and substance use disorder services in response to the pandemic, including support groups, telephone helplines and websites, training programs, telehealth services, and outreach services.
• The Department of Health and Human Services to gather data to better understand the effects of the pandemic on mental health and addiction and make recommendations on how to improve future mental health and addiction response efforts

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.

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