On Tuesday, September 3, NCUIH submitted comments to the Indian Health Service (IHS) on its Urban Confer regarding FY 2019 opioid funding for a Special Behavioral Health Pilot Program (SBHPP).  In the comments, NCUIH provided the following recommendations:

In the comments, NCUIH provided the following recommendations:

• The SBHPP objectives should be clearly stated and well-designed to address the opioid epidemic, and include sufficient flexibility
• The SBHPP must be flexible and allow creativity in program design in order to be most effective
• Adequate funding for UIOs to combat the opioid epidemic is key to advancing the goal of quality data collection and evaluation
• It is important that any effectiveness measures are not prescriptive and allow for flexibility because using a sole metric may work well in some areas but for a variety of reasons not be an adequate representation of success in others
• Sufficient data and appropriate evaluation metrics are important for the longevity of the program

The comments reiterated support for a SBHPP and the importance that UIOs be included in any such program design.

Call to Action: Ask Congress to Authorize the VA to Reimburse UIOs for Health Care

Representative Ro Khanna and Senator Tom Udall, vice chairman of the Senate Committee on Indian Affairs, introduced the Health Care Access for Urban Native Veterans Act, a bill to improve health care access for Native American Veterans by providing Department of Veterans Affairs (VA) coverage for care that Native American Veterans receive at urban Indian health centers.  This legislation would include “urban Indian organizations” in the statute requiring the VA to reimburse Indian Health Service (IHS) and Tribal health facilities for services they provide to native veterans. To ensure that the Health Care Access for Urban Native Veterans Act receives as much support as possible, we encourage you to contact your Member of Congress and request that they sign on as a cosponsor of this bill (if they have not already).

• View NCUIH one-pager on VA-IHS Memorandum of Understanding.
• NCUIH Press Release
• Udall, Khanna Press Release
• AP Story: Bill would expand health care options for Native veterans
• House bill (H.R. 4153)
• Senate bill (S. 2365)

Write to Your House Member

Please use the following text below as a template to call or email to your Representatives. You should call and email your representative; you can find your representative here.

Dear Representative [ ],

As your constituent, I respectfully request you sign on as a cosponsor to the Health Care Access for Urban Native Veterans Act recently introduced by Representative Ro Khanna and Senator Udall.  This bill is a critical language fix that would include “urban Indian organizations” in the statute requiring the Department of Veterans Affairs (VA) to reimburse Indian Health Service (IHS) and Tribal health facilities for services they provide to native veterans.

Urban Indian Organizations (UIOs) are an integral part of the American Indian and Alaska Native (AI/AN) health care delivery system. However, due to an oversight in legislation UIOs are the only part of the IHS Indian/Tribal/Urban (I/T/U) system that do not receive reimbursement under the VA-IHS MOU reimbursement agreement. However, UIOs were created by Congress as a response to Tribes that wanted to ensure their members would receive quality health care off of reservations as part of the trust obligation.

The Department of Veterans Administration has stated that it cannot address the issue on its own, and that only Congress has the authority to correct this oversight. The Health Care Access for Urban Native Veterans Act of 2019 would ensure that all three branches of the I/T/U system receive reimbursement for health care services delivered to AI/AN veterans.  We hope you will become a cosponsor of the Health Care Access for Urban Native Veterans Act and show your support for the health of urban AI/AN Veterans.

For the sake of the health of American Indian and Alaska Native Veterans and the fulfillment of the U.S. trust obligation,  we request your support of this simple language fix. To sign on, please contact Mr. Will McKelvey (Will.Mckelvey@mail.house.gov ) 202-225-2631 from Congressman Ro Khanna’s office.

Sincerely, [Your Name and Address]

Write to Your Senator

Please use the following text below as a template to call or email to your Senators.  You can find your Senators here.

Dear Senator [ ],

As your constituent, I respectfully request you sign on as a cosponsor to the Health Care Access for Urban Native Veterans Act (S.2365) recently introduced by Senator Udall and Representative Ro Khanna.  This bill is a critical language fix that would include “urban Indian organizations” in the statute requiring the Department of Veterans Affairs (VA) to reimburse Indian Health Service (IHS) and Tribal health facilities for services they provide to native veterans.

Urban Indian Organizations (UIOs) are an integral part of the American Indian and Alaska Native (AI/AN) health care delivery system. However, due to an oversight in legislation UIOs are the only part of the IHS Indian/Tribal/Urban (I/T/U) system that do not receive reimbursement under the VA-IHS MOU reimbursement agreement. However, UIOs were created by Congress as a response to Tribes that wanted to ensure their members would receive quality health care off of reservations as part of the trust obligation.

The Department of Veterans Administration has stated that it cannot address the issue on its own, and that only Congress has the authority to correct this oversight. The Health Care Access for Urban Native Veterans Act of 2019 would ensure that all three branches of the I/T/U system receive reimbursement for health care services delivered to AI/AN veterans.

We hope you will become a cosponsor of the Health Care Access for Urban Native Veterans Act and show your support for the health of urban AI/AN Veterans.

For the sake of the health of American Indian and Alaska Native Veterans and the fulfillment of the U.S. trust obligation, we request your support of this simple language fix. To sign on, please contact Ms. Kim Moxley (Kim_Moxley@indian.senate.gov ) 202-224-2251 from Senator Udall’s office.

Sincerely, [Your Name and Address]

Social Media

Twitter

• • From your Twitter account, tweet to your Senators and Members of Congress.
    • Find your Senators’ handles here.
      • Example tweet: “Dear [@ Senator’s handle], please sign on to Health Care Access for Urban Native Veterans Act to support Native Veterans! #urbanIndianhealth @ncuih_official”
    • Find your Members of Congress here.
      • Example tweet: “Dear [@ Member’s handle], please sign on to Health Care Access for Urban Native Veterans Act to support Native Veterans! #urbanIndianhealth @ncuih_official”
  • Retweet

Facebook

• Post your support on your Facebook.
• Example post: “Call your Member of Congress to sign on to the Urban Native Veterans Act supporting Native veterans! Find out more here: https://www.ncuih.org/policy_blog?article_id=283.”

Press Release: Bipartisan, Bicameral Legislation Introduced to Improve Health Care Access for American Indian and Alaska Native Veterans in Urban Areas

Washington, DC (August 2, 2019) — Today, Senator Tom Udall (D-NM) and Representative Ro Khanna (D-Calif.) introduced the Health Care Access for Urban Native Veterans Act (S. 2365) which would improve health care access for American Indian and Alaska Native (AI/AN) veterans by providing Department of Veterans Affairs coverage for care that AI/AN vets receive from Title V Urban Indian Organizations (UIOs). The legislation allows AI/AN veterans better access to culturally-competent care and alleviates burdens on the VA system. In addition to Udall and Khanna, the bill is co-sponsored by U.S. Senators Jerry Moran (R-Kan.), Jon Tester (D-Mont.), ranking member of the Senate Committee on Veterans Affairs, Mike Rounds (R-S.D.), and Tina Smith (D-Minn.) and U.S. Representatives Paul Gosar (R-Ariz.), Ben Ray Luján (D-N.M.), Don Young (R-Alaska), Gwen Moore (D-Wis.), Paul Tonko (D-N.Y.), Greg Gianforte (R-Mont.), Don Bacon (R-Neb.), and Deb Haaland (D-N.M.).   

The National Congress of American Indians (NCAI) passed a resolution in July supporting this legislative fix to help UIOs have the resources to better serve AI/AN veterans. The bill is also supported by the Iraq and Afghanistan Veterans of America and VoteVets.

“The Health Care Access for Urban Native Veterans Act is important legislation to ensuring that our veterans in urban areas are no longer left behind. Now, the Department of Veterans Affairs will have the explicit authority to reimburse the 41 Title V Urban Indian Organizations who are already providing critical resources for American Indian and Alaska Native veterans who have served the United States,” said NCUIH Executive Director Francys Crevier.

“The National Council of Urban Indian Health has made it a priority to ensure that Urban Indian Organizations are included in the IHS-VA MOU to help provide health care to American Indian and Alaska Native veterans. As a Native veteran myself, I understand the importance of coming home and knowing I have a safe space to receive care. Thank you to my own Representative Ro Khanna,  and we are grateful for the leadership of the 116th Congress in introducing this landmark legislation,” said NCUIH Vice President Sonya Tetnowski.

“At First Nations Community HealthSource, we never turn anyone – veteran or not – away. Native veterans in Albuquerque consider our facility a safe, accessible space to receive health care. With critical underfunding, this legislation would allow all Urban Indian Organizations to finally be reimbursed for the necessary care we already provide to our Native veterans,” said Linda Son-Stone, Chief Executive Officer of First Nations Community HealthSource, an Urban Indian Organization and member of NCUIH.

The NCAI resolution states: “The National Congress of American Indians (NCAI) urges Congress to pass legislation that amends the Indian Health Care Improvement Act at 25 U.S.C. §1645(c) to insert UIOs after IHS and Tribal Organizations and require VA to reimburse for services provided to AI/AN veterans at all of the IHS, Tribal, and urban (I/T/U) system, in order to protect the health and welfare of AI/AN veterans living in urban centers, thereby honoring their sacrifices.”

This is a big deal! The inclusion of $81 million for the urban Indian health line item in the House budget is a huge step for our programs.

Next week, the House of Representatives will vote on the bill that includes the $81 million line item for urban Indian health. NCUIH supports the bill in its current form with the inclusion of this large increase and recommends Members of Congress vote YES.

We need your help to urge the Senate to do the same. If this nearly $30 million increase is in both bills and signed into law, all 41 Urban Indian Organizations (UIOs) would see a major increase in funding.

If the budget includes this $30 million increase for the urban Indian health line item, all 41 programs will see impacts. The inclusion of $81 million for the urban Indian health line item by the House is a huge step for our programs. We need your help to urge the Senate to do the same. If it is included in both bills and signed into law, the 41 Urban Indian Organizations (UIOs) would see a major increase in funding.

Currently, the House bill that is moving to the floor for a vote has the $81 million line item for urban Indian health. The Senate has not published any of their funding bills for FY2020.

NCUIH Outreach

• Read our press release.
• Read our letter to the Senate Appropriations Committee requesting to match the funding for the urban Indian health line item in the House Appropriations bill that recently passed out of the full Appropriations Committee.

Advocacy Toolkit

Here are several ways you can advocate for this important funding in an easy-to-use toolkit. Please share with your networks the opportunity to advocate for this funding increase, whether through a newsletter, blog post, social media, letters from your community, and/or a press release.

Please contact Meredith Raimondi (mraimondi@ncuih.org) with any questions.

Graphic

• Download our graphic for inclusion in your newsletter/blog, Facebook post, tweet, etc.

Newsletter/Blog Entry

• Below is a sample newsletter entry to include in your next newsletter or blog post.
• Example Text:[Program Name] joins the National Council of Urban Indian Health in calling for the Senate to match the House budget of $81 million for the urban Indian health line item. We need members of our community also communicate this important message. Please send emails, letters or call Senators to advocate for this important increase. Presently, the Indian Health Service (IHS) budget for urban Indian programs, like ours, is less than 1%. This creates serious budget constraints to still provide culturally-competent and quality healthcare. An increase would provide [Program Name] with critical funding that is long overdue. Currently, the House bill is moving to the floor for a vote this week. The Senate has not published any of their funding bills for FY2020. Our Senators are [Senators for your state] and they can be reached here. Email your Senators using this sample letter.

Ask Your Community to Send E-mails and Letters to Your Senators and Members of Congress

Here is information that you can share with your community members for sending emails.

Letters to Senators

• Find your Senators here.
• Write to your Senators using this sample letter.

• Dear Senators [Senators from your state]:

  As a constituent of [State] and a community member of [Your Program], I humbly request that you honor the United States’ trust responsibility to urban Indians and support funding in the amount of $81 million for the urban Indian health line item.

  Last month the House Appropriations Committee approved the FY 2020 Interior, Environment, and Related Agencies appropriations bill that included an approximately $30 million increase – bringing funding to $81 million for Urban Indian programs. This needed increase would allow the 41 Urban Indian Organizations (UIOs), including ours, to hire more staff, expand vital services from behavioral health to substance misuse programs, and improve health outcomes for the growing demand of health care for urban Indians.

  I hope you will urge the Senate Appropriations Committee to include the line item of $81 million for Urban Indian programs and show your support for the health of urban American Indian/Alaska Native (AI/AN) people.

  Sincerely,
  [First and Last Name, Address, City, State, Zip]

Letters to the House of Representatives

• Find your Member of Congress here.
• Write to your Members of Congress using this sample letter.

• Dear [Member of Congress],

  As your constituent and a community member of [Your Program], I humbly request that you honor the United States’ trust responsibility to urban Indians and support funding in the amount of $81 million for the urban Indian health line item by voting YES on H.R. 3055.
  This needed increase would allow the 41 Urban Indian Organizations (UIOs), including ours, to hire more staff, expand vital services from behavioral health to substance misuse programs, and improve health outcomes for the growing demand of health care for urban Indians.

  I hope you will vote yes on H.R. 3055 to support the health of urban American Indian/Alaska Native (AI/AN) people with an increased budget of $81 million for urban Indian programs.  Thank you for your time and for your leadership.

  Sincerely,
  [First and Last Name, Address, City, State, Zip]

Twitter

• From your program’s Twitter account, tweet to your Senators and Members of Congress.
  • Find your Senators’ handles here.
    • Example tweet: “We urge [@ Senator’s handle] to please support the $81 million line item for urban Indian health to help our program in [YOUR STATE] in the Senate Appropriations Bill. #urbanIndianhealth @ncuih_official”
  • Find your Members of Congress here.
    • Example tweet: “Please support #urbanIndianhealth by voting YES on H.R. 3055 [@ Member’s handle], which includes $81 million for urban Indian health to help our program. @ncuih_official”

Facebook

• Post your support on your Facebook.
• Example post: “We need you to help advocate Congress for an increase of nearly $30 million for urban Indian health. Show your support for this important increase that would help our funding! Find out how here: https://www.ncuih.org/policy_blog?article_id=259”

Press Release

• Send a press release to your local media to let them know about your advocacy.
• This is a big deal! If the budget includes this $30 million increase for the urban Indian health line item, all 41 programs will see impacts. Your local media should care about how this would improve your program’s ability to serve your community.
• Example press release.