In this Edition:

• 📡 Senate Hearing on Shutdown Impacts in Native Communities
• 🏛️ Federal Funding Continued Through a New Continuing Resolution
• 🎤 Congressional Briefing on Preventing Substance Use Disorder and Overdose
• 📘 New Resources: AARP Family Caregiving Guide and Overview of the One Big Beautiful Bill Act (OBBBA)
• 🏥 Updates on Affordable Care Act Premium Tax Credits for American Indian and Alaska Native People
• 📝 Indian Health Service Fiscal Year 2028 Budget Formulation and Updated Information
• 🤝 Tribal Government-to-Government Roundtable on Strengthening Tribal Sovereignty
• 👥 Staffing Updates at the Department of Health and Human Services and the Indian Health Service
• ⚖️ Office of Management and Budget Deregulatory Memo and New Supplemental Nutrition Assistance Program Provisions
• 💊 Health Resources and Services Administration Updates on the 340B Rebate Pilot and the Ryan White Program
• 📊 Data Standards Committee Updates on Medicaid Enrollment, Health Information Technology Modernization, and NCUIH’s New Substance Use Disorder Fact Sheet

Appropriations and Shutdown Updates

Senate Committee on Indian Affairs Oversight Hearing

On October 29, 2025 the Senate Committee on Indian Affairs (SCIA) held an Oversight hearing addressed shutdown impacts on Native communities.

Vice Chairman Senator Schatz stated:

• “Native programs are not Diversity, Equity, and Inclusion spending or charity—they are the law.”
• “Attempting to cancel funds for Native programs, RIFing more that 42,000 federal employees, and eliminating tribal consultation policies – that’s not the Unites States government meeting its trust and legal obligations.”

Continuing Resolution / Federal Funding

On November 12, 2025, Congress reached an agreement on a Continuing Resolution (CR) to maintain FY 2025 funding through January 30, 2026.

• Prevents further shutdown disruptions that heavily impact Indian Country and Urban Indian Organizations.

The CR included language that reversed the RIF actions taken since October 1, as well as protections against future RIFs for the duration of the CR.

The CR also extended several key policy riders important to Indian country through January 30, 2026: 

• Funding for the Special Diabetes Program for Indians (SDPI) at $159 million annualized.
• Extension of the Medicare telehealth flexibilities, which allows IHS, Tribal, and Urban Indian programs to resume billing Medicare for tele-visits.
• Extension of Community Health Center and National Health Service Corps funding.

Legislative Updates

Federal Medical Assistance Percentage (FMAP) Update

Bipartisan Urban Indian Health Parity Act (H.R. 4722): Ongoing advocacy for extending the Federal Medical Assistance Percentage increase for Urban Indian Organizations.

• Reintroduced by Reps. Ruiz (CA-25) and Bacon (NE-02)
• NCUIH is working to secure republican co-sponsors.
• Request for Urban Indian Organizations: Email Republican offices to sign on to the House bill.

Special Diabetes Program for Indians (SDPI) 

Legislation supporting funding and reauthorization of SDPI has been introduced in the House and the Senate.

H.R.5488 – Bipartisan Special Diabetes Program for Indians Reauthorization Act of 2025

• $160 million for FY 2026-2030

S.2211 – Bipartisan Special Diabetes Program Reauthorization Act of 2025

• $160 million for FY 2026-2027

NCUIH Hosted Congressional Briefing

NCUIH hosted a congressional briefing on policy solutions to prevent Substance Use Disorder (SUD) and overdose in Native communities.

• Kerry Hawk-Lessard of Native American LifeLines presented on local initiatives and community-based efforts.
• NCUIH called on Congress to fund behavioral health programs that serve Native communities, especially in urban areas.

Highlights emphasized:

• The urgent need for culturally grounded prevention and treatment.
• The role of Urban Indian Organizations (UIOs) as essential access points.

New Resources Highlight

Overview of the One Big Beautiful Bill Act (OBBBA)

NCUIH has developed a one pager on key provisions and exemptions impacting American Indian and Alaska Native people in the OBBBA.

• This resource is available on the NCUIH Policy Resource Center webpage.

AARP Family Caregiving Guide

• The AARP Family Caregiving Guides support people navigating all stages of caregiving.

The guides include resources to:

• Find help assessing needs.
• Start important conversations.
• Evaluate your loved one’s needs.
• Develop or update a caregiving plan.
• Coordinate help while maintaining caretaker well-being.
• Manage grief and plan for life after caregiving.

Access here: https://www.aarp.org/caregiving/prepare-to-care-planning-guide/

Substance Use Disorder Fact Sheet​​

NCUIH Policy and Data Teams developed a new two-page fact sheet addressing:

• Disparities in overdose deaths among American Indian and Alaska Native people.
• The essential role of Urban Indian Organizations.
• Policy recommendations and needed federal actions.
• Fact sheet available for download on the NCUIH website.

NCUIH Advocacy for Premium Tax Credits

The letter highlights new analysis illustrating the impact on American Indian and Alaska Native families if enhanced premium tax credits expire. The Urban Institute estimates show:

• A significant portion of American Indian and Alaska Native people (318,000) rely on Marketplace plans with premium tax credits.
• Without enhanced tax credits, many (126,000) would lose coverage—representing an estimated 40 percent reduction for American Indian and Alaska Native enrollees.

NCUIH continues advocating for restored and enhanced Affordable Care Act premium tax credits for American Indian and Alaska Native families.

Indian Health Service Fiscal Year 2028 Budget Formulation

Indian Health Service has begun Fiscal Year 2028 budget formulation consultations.

Urban Indian Organization participation remains important for:

• Identifying priority service needs.
• Ensuring representation in federal budget recommendations.

NCUIH Technical Assistance: 

• NCUIH held a prep session for UIOs on October 15.
• NCUIH sent out slide templates and talking points to UIOs by Area.
• If your UIO would like to schedule a one-on-one session with NCUIH to prepare for your respective Area budget consultation, please don’t hesitate to reach out to policy@ncuih.org.

Upcoming scheduled consultations:  

• Phoenix: December 2-3, 9am-5pm AZ time (Hybrid)
• Alaska: December 9-11
• California: December 10
• Great Plains: December 10, 9am-3pm CST (virtual)

Updated Information Overall Funding Target  

• The total funding amount to meet for fiscal year 2028 is $29.8 billion.
• This recommendation is $43.2 billion less than the previous year’s recommendation.
• Due to the drastic decrease in recommended funding, the total recommendation for the Urban Health line item will likely be considerably less than previous years.
• NCUIH sent out updated resources with updated numbers.

Tribal Government-to-Government Roundtable Series

Third convening focused on preserving, protecting, and strengthening Tribal sovereignty.

NCUIH connected with:

• Rep. Begich (R-AK), Vice Chair of the Native American Caucus
• HHS Secretary Robert Kennedy Jr.
• HHS Senior Advisor Mark Cruz
• HHS Senior Advisor for Medicaid, Charles Chapman
• White House Office of Intergovernmental Affairs
• Tribal leaders

Federal Staffing Updates: IHS Announces New Chief of Staff

Indian Health Service

The Indian Health Service announced a new Chief of Staff, Clayton Fulton (Citizen of the Cherokee Nation)

• Responsible for overseeing the coordination of key agency activities and supporting the Office of the Director in a broad range of duties related to the development and implementation of IHS initiatives and priorities.
• NCUIH met with Clayton on Nov. 4 to discuss urban Indian health priorities.

NCUIH Leadership Meeting with Mark Cruz

• The NCUIH Board met with Senior Advisor to the HHS Secretary, Mark Cruz, on October 21 to discuss federal priorities.

Reduction in Force (RIFs)  

• IHS was not included in RIFs; HHS also extended that to tribal programs in other operating divisions.
• There is ongoing litigation regarding the RIFs.

HHS Grants  

• Cruz warned that funding may be cut across HHS authorizing divisions.
• Please let NCUIH know if you have any issues with your grant funding.

HHS Key Staffing Updates  

• IHS Director still has not been appointed. Acting Director Smith can serve until mid-November.
• Dr. Kim Hartwood started at IHS as Chief of Strategic Initiatives.
• The Senior Advisor who worked with Secretary Kennedy on SAMHSA matters, Chris Jones, resigned last Friday. Mark Cruz has been asked to caretake SAMHSA.
• Administration for Children and Families has a new Assistant Secretary – Alex Adams. Has experience working with Idaho Tribes.

Regulatory Updates: Office of Management and Budget and U.S. Department of Agriculture

Office of Management and Budget Deregulatory Memo

The memo is on streamlining the administration’s deregulatory efforts.

• Lays out guidance to agencies on how it should conduct Tribal consultation during a deregulation review process.
• Discussed that most deregulatory efforts should not trigger Tribal consultation, and that if there is a need for Tribal consultation, that general notice and comment period for stakeholders is considered sufficient consultation.
• Issues guidance on how political appointees can repeal regulations without a formal notice or comment period if the official deems the regulation unlawful.

U.S. Department of Agriculture Memo: Supplemental Nutrition Assistance Program (SNAP) Provisions in OBBBA 

OBBBA modifies exemptions to the Able-Bodied Adults Without Dependents (ABAWD) time limit rule of receiving SNAP for only 3 months in a 3-year period if they do not meet certain work requirements by:

• Expanding the age range to 18-64 (previously 18-54)
• Limits the exception for a parent with responsibility for a dependent child to children under 14 years of age (previously 18 years of age)
• Eliminating certain exemptions (homeless individuals, veterans, and foster youth).

New Exceptions for AI/AN people are not subject to the time limit:

• “An Indian” as defined in paragraph (13) of section 4 of the IHCIA;
• “An Urban Indian” as defined in paragraph (28) of Section 4 of the IHCIA; and
• “A California Indian” as described in section 809(a) of the IHCIA.

Health Resources and Services Administration (HRSA) Updates

340B Rebate Pilot Program

Background:

• Under the Program, covered entities continue to make purchases through their 340B wholesaler account and request rebates on specific drugs dispensed to 340B eligible patients after the purchase is made.
• All covered outpatient drugs, without a rebate model approved by HRSA, are subject to upfront discounted 340B prices.
• The Office of Pharmacy Affairs (OPA) has approved eight manufacturers’ plans for participation in the 340B Rebate Model Pilot Program for the January 1, 2026, start date.
• Ryan White HIV/AIDS Program

Background:

• HRSA is proposing to implement a funding methodology that calculates Ryan White HIV/AIDS Program (RWHAP) Part A and B formula awards based on living HIV and AIDS case data. This methodology would use the most recent address, rather than residence at diagnosis.
• The methodology for determining RWHAP Part A and B eligibility would remain unchanged.

Data Standards Committee Updates

Centers for Medicare & Medicaid Services Tribal Technical Advisory Group (TTAG) Data Subcommittee

Updates from July and August meetings:

• National Indian Health Board presentation on Indian Health Service registrants enrolled in Medicaid from 2019–2023.
• Some states with Medicaid expansion saw significant increases in enrollment.
• In 2023, approximately 57.1 percent of Indian Health Service registrants were enrolled in Medicaid.
• Wide variation in accuracy between Indian Health Service registrant data and the American Community Survey population across states.

No September or October updates due to the government shutdown.

Upcoming Tribal Consultations and Events

Consultation/Confer Dates:

• Urban Confer (virtual only): Thursday, January 8, 2026, 1:00 – 4:00 PM ET
• NCUIH will be holding a virtual prep session on January 7, 2025, at 1pm ET

Tribal Consultations (in person only):  

• Monday, December 15, 2025, 1:00 – 4:00 PM CT (Durant, OK)
• Tuesday, December 16, 2025, 1:00 – 4:00 PM MT (Denver, CO)
• Wednesday, December 17, 2025, 1:00 – 4:00 PM PT (San Diego, CA)
• Tuesday, January 6, 2026, 1:00 – 4:00 PM PT (Seattle, WA)

Comments:

• Comment submissions close on February 9th, 2025.

Other Upcoming Events:

• December 17: NCUIH Monthly Policy Workgroup (virtual)

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.

The Oklahoma City Indian Clinic Wellness Center has made history as the first American Indian and first Oklahoma facility to be certified by the Medical Fitness Association. This national certification represents the highest standard for medical fitness centers, recognizing organizations that meet rigorous criteria in safety, professional oversight, and evidence-based wellness programming. Certified facilities must demonstrate active medical supervision, individualized health screenings, and programs that prevent disease and promote therapeutic lifestyles. For the Oklahoma City Indian Clinic, this certification affirms a long-standing commitment to helping Native patients build healthier, stronger lives through integrative care that blends clinical medicine, behavioral health, and culturally grounded fitness initiatives like Med Fit. 

This recognition comes as the Clinic continues to draw national attention for its leadership in urban Native health. In June 2025, Secretary of Health and Human Services Robert F. Kennedy Jr. visited the Oklahoma City Indian Clinic to learn more about its innovative programs addressing food insecurity, chronic disease prevention, and the social drivers of health. During the visit, Chief Executive Officer Robyn Sunday Allen (Cherokee) highlighted how the Clinic’s integrated model—combining medical, behavioral, pharmacy, and wellness services under one roof—serves as a roadmap for improving Native health outcomes in urban settings. 

The Oklahoma City Indian Clinic’s recent achievements reflect the transformative potential of Native-led health programs when given the flexibility and resources to innovate. By achieving Medical Fitness Facility Certification, the Clinic has demonstrated not only operational excellence but also a deep commitment to culturally informed care that empowers Native communities to thrive. The National Council of Urban Indian Health proudly recognizes this milestone as a defining moment in the ongoing story of urban Native health leadership, wellness, and resilience in Indian Country.  

On October 16, 2025, NCUIH joined Families USA and 153 partner organizations in signing a letter to Majority Leader Thune, Minority Leader Schumer, Speaker Johnson, and Minority Leader Jeffries calling on Congress to permanently extend enhanced premium tax credits (ePTCs) that help make health coverage more affordable for millions of Americans.

The letter emphasizes that allowing the enhanced credits to expire would cause more than 20 million people, including small business owners, older adults, and families with children, to face rising health costs or lose coverage altogether. If not extended, an estimated 4 million people could lose insurance, and 11 million people with incomes between 100 and 150 percent of the Federal Poverty Level would lose access to zero-dollar premium plans.

The loss of the ePTCs will also have a significant impact on American Indian and Alaska Native (AI/AN) people. The Urban Institute estimates that 318,000 American Indian and Alaska Native (AI/AN) people are enrolled in the Marketplace in 2025 under tax credits and 126,000 AI/AN people will lose their Marketplace coverage without ePTCs, representing a 40 percent reduction for AI/ANs currently covered. Increasing premiums, even modestly, creates barriers for people with limited incomes, forcing many to choose between paying for health care and basic necessities.

Read the Full Letter Text

Dear Majority Leader Thune, Minority Leader Schumer, Speaker Johnson, and Minority Leader Jeffries:  

As millions of families across the country struggle to pay for the high and rising cost of health care, the more than 150 undersigned organizations representing patients, workers, small businesses, health care providers, public health professionals and other health care stakeholders strongly urge Congress to permanently extend the enhancements to the premium tax credit without delay and without any changes that could place health coverage out of reach for millions of vulnerable Americans. 

Without a timely extension of the enhanced premium tax credits, more than 20 million people – including about 5 million small business owners and self-employed people, along with 6 million older adults – will see their health care costs skyrocket. Roughly 4 million people are projected to lose their coverage altogether due to the higher cost. Further, if the enhancements expire, the 11 million people with Marketplace coverage who have incomes between 100 and 150 percent of the federal poverty level ($15,650 to $23,475 for an individual in 2025) would lose access to a silver plan with zero-dollar premiums. Data shows that the availability of such plans ensured that more people, and on average healthier people, are enrolled in coverage — a significant driver of recent record low numbers of Americans who are uninsured. 

Increasing the monthly cost of health care coverage, even by relatively modest amounts, for people with limited income would create significant barriers for them to maintain coverage, putting them at risk of dropping out of coverage altogether due to added confusion and red tape. Lowering income eligibility would particularly harm older adults, people in rural areas, and families with children by exposing them to skyrocketing costs. Those who could somehow manage to maintain their coverage might be forced to forgo other basic needs in order to pay for it. This reality further threatens people’s ability to treat ongoing health conditions like diabetes, heart disease, and cancer, as well as respond to new threats to their health.  

Changes made earlier this year in H.R.1 only compound the negative impact that losing enhanced premium tax credits will have by making vulnerable families unable to re-enroll in coverage if they fail to pay even a minimal premium. In that event, they would be ineligible for coverage for an entire year until the next Open Enrollment period – leaving millions vulnerable to even higher medical bills and greater uncompensated care costs for hospitals and health care providers already on the brink.  

The harms from eliminating these specific tax credits would be felt most acutely by people in states that have failed to expand Medicaid eligibility, including Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. Collectively, over six million people in those states who do not have access to Medicaid coverage with annual incomes below $21,597 are eligible for health care tax credits and a plan with zero-dollar premiums because of the enhancements. Texas, Florida, Georgia, and South Carolina in particular are among the top states in the country in terms of having the largest number of residents utilizing enhanced premium tax credits to get coverage. 

Raising health costs for people living paycheck to paycheck will endanger people’s health while making their financial predicament even more dire. To avoid this outcome, Congress must quickly extend the health care tax credits across all currently eligible income levels, including access to a zero-dollar premium plan for the most vulnerable families. We urge you and your colleagues to act without delay.  

Read the full letter here. 

In this Edition:

🧰 New Toolkit: NCUIH releases a step-by-step guide to help UIOs invite Members of Congress to visit their clinics.

⚠️ Government Shutdown: Congress fails to pass a Continuing Resolution; IHS operations continue through advance appropriations—IHS funding for UIOs is protected.

📢 Rapid Response: The Coalition for Tribal Sovereignty coordinated a joint letter to the Office of Management and Budget and an Action Alert for UIOs to advocate for Tribal-serving federal employees.

⚖️ Parity & Partnerships: Urban Indian Health Parity Act reintroduced; NCUIH urges bipartisan support.

🏥 Graduate Medical Pilot: VA launches PPGMER program—UIOs eligible; applications due Nov. 28.

🏛️ Federal Engagement: NCUIH meets with HHS Secretary Kennedy; STAC raises hiring freeze, staffing, and 340B concerns.

🧠 Behavioral Health: SAMHSA Native Connections grants released; NCUIH pushes for $30M funding increase in FY 2026.

🌾 Rural Health Transformation: CMS opens $50B RHTP funding for states; applications due Nov. 5.

📅 Event Updates: IHS UIO and Partner Summit postponed; NCUIH Congressional Briefing on SUD/Overdose prevention tentatively Oct. 27.

📊 FY 2028 Budget Formulation: Area consultations begin this month; NCUIH provides PowerPoint templates and TA for UIO participation.

FY 2028 Area Budget Formulation: Preparation and Tools

Why Participation Matters

• Area consultations directly shape recommendations for national funding priorities. Each Area’s input helps determine the Urban Indian Health line item, which is averaged from regional proposals.

UIO engagement ensures that urban needs are accurately reflected in IHS budget planning.

How NCUIH is Supporting UIOs

• Each UIO will receive an Area-specific PowerPoint template with highlighted sections to customize for your clinic and region.
• NCUIH offers technical assistance and can help review slides or testimony before submission.

📅 Upcoming Area Consultations

• Nashville: October 29 (Virtual)
• Oklahoma City: November 5–6 (Hybrid)
• Bemidji: November 18–19 (Wisconsin Dells, WI)
• Phoenix: December 2–3 (Hybrid)
• California: December 10
• If your area is not listed, we have not received any information yet. Please let us know if you have heard an announcement for your area.

To schedule a prep session, contact policy@ncuih.org.

Appropriations and the Government Shutdown

When Congress failed to pass a continuing resolution by September 30, the federal government entered a shutdown.

• IHS operations mainly continued thanks to advance appropriations.
• On October 1, NCUIH convened a rapid response call with UIOs and issued a press release to Capitol Hill.
• Together with CTS, NCUIH sent a letter to OMB requesting an exemption for federal employees serving Tribal Nations during any shutdowns.
• A CTS Action Alert was shared with UIOs, including a template letter, talking points, and list of federally funded Tribal accounts.

New Resource: Toolkit on Inviting Members of Congress to Visit Your Urban Indian Organization

NCUIH released a new toolkit designed to help Urban Indian Organization (UIO) leaders invite members of Congress to visit their clinics.
The guide includes:

• Step-by-step instructions and best practices for scheduling a congressional visit.
• Template email language to help connect with congressional schedulers.
• Tips for highlighting the impact of UIOs and issues facing Native communities in urban areas.

These visits serve as powerful opportunities to build relationships and raise awareness of Urban Indian health needs.

Legislative Updates

Urban Indian Health Parity Act (H.R. 4722) 

• Reintroduced by Reps. Ruiz (CA-25) and Bacon (NE-02), this bipartisan bill would ensure UIOs receive parity in health program funding.

👉 Action for UIOs: Email Republican offices to sign on as co-sponsors.

New VA Pilot Program on Graduate Medical Education and Residency (PPGMER) – UIOs Eligible 

This new program supports physician rotations at IHS, Tribal, and UIO facilities.

• Applications are due by November 28, 2025.

NCUIH encourages UIOs to apply for eligibility under this program to strengthen urban Native clinical training capacity.

Federal Engagement: STAC and HHS Updates

At the HHS Secretary’s Tribal Advisory Committee (STAC) meeting (Sept. 23–25): 

• NCUIH met with HHS Secretary Kennedy, advocating for continued support for Urban Indian health, the end of the federal hiring freeze and increased IHS staffing.
• IHS reported over 1,000 vacancies since January, despite adding 70 Commissioned Corps officers.
• STAC members requested:
• A Native representative on the new HHS Healthcare Advisory Committee.
• A Tribal exemption from HRSA’s 340B rebate pilot program.
• Litigation continues to prevent HHS from implementing its proposed reorganization.

Grant and Funding Update

SAMHSA Native Connections Grant 

Several UIOs faced grant delays this year, prompting NCUIH to elevate the issue to HHS and provide STAC talking points.

• All FY 2025 grants have now been released.

For FY 2026:

• Senate proposal: Maintain current $23.67M level.
  House proposal: Increase funding to $30M.
• NCUIH continues to advocate for the higher House amount.

SAMHSA leadership reaffirmed the program’s importance:

“This program is so impactful for Tribal communities.” — Arthur Kleinschmidt, SAMHSA Principal Deputy Assistant Secretary, Sept. 24

CMS Rural Health Transformation Program (RHTP)

• On October 8, CMS held an All-Tribes webinar on the $50 Billion Rural Health Transformation Program under the One Big Beautiful Bill Act.
• State applications due: November 5, 2025
• The program aims to strengthen rural and Tribal health systems through innovative funding models.

Highlighted Action from the Coalition for Tribal Sovereignty

► Coalition for Tribal Sovereignty (CTS) 

CTS Action Alert to reach out to OMB and Members of Congress– shared with all UIOs​

• Includes template letter, talking points, and a list of funded accounts with Tribal implications.

About CTS: The Coalition for Tribal Sovereignty (CTS) is a collaborative alliance that serves as a powerful unifying voice of regional and national inter-tribal policy-oriented, non-profit organizations to engage with federal policymakers on critical issues affecting the sovereign interests, rights, and authorities of Tribal Nations, tribal citizens, and community members across the United States.

Upcoming Events and Meetings

Postponed: IHS UIO and Partner Federal Agencies Summit

• Originally planned for October 21–22, now postponed due to the shutdown.
• The UIO Caucus (October 20) has also been canceled.
• New dates will be announced once federal operations resume.

Upcoming Events 

• November 3: NIHB MMPC meeting ahead of CMS Tribal Technical Advisory Group (TTAG)
• November 12–13: CMS TTAG Quarterly Meeting (DC)
• November 16–21: NCAI Annual Convention & Marketplace (Seattle, WA)
• November 19: NCUIH Monthly Policy Workgroup (Virtual)

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.