PRESS RELEASE: Tribal Organizations Urge Administration to Respect Tribal Sovereignty and Uphold Trust and Treaty Obligations Amid Executive Actions

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FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (February 3, 2025) – A coalition of Tribal organizations, representing Tribal Nations and their citizens and communities, is calling on the Administration to ensure that recent executive actions do not undermine the unique sovereign political status of Tribal Nations as sovereign nations with which the federal government has trust and treaty obligations, or disrupt federal funding that flows from those relationships for essential Tribal programs.

Following the issuance of multiple executive orders and Office of Management and Budget (OMB) directives, concerns arose over freezes on federal funding that Tribal Nations and Tribal organizations, including urban Indian organizations, rely on to provide critical healthcare, economic development, education, and social services to Tribal communities. While OMB has since rescinded the initial memorandum, questions remain about how federal agencies will interpret and implement the Administration’s executive orders and policies moving forward.

Tribal Nations are not special interest groups—they are sovereign governments with a unique legal and political relationship with the United States and with their own Tribal communities. The trust and treaty obligations of the federal government are political and debt-based in nature.  Tribal Nations’ sovereignty and the federal government’s delivery on its trust and treaty obligations must not become collateral damage in broader policy shifts.

The coalition emphasizes that federal funding for Tribal programs is not discretionary, but rather a legal mandate owed under the United States’ trust and treaty obligations and the many statutes that carry them out. The organizations urge the Administration to explicitly recognize Tribal sovereignty and trust and treaty obligations in the implementation of all executive orders and priorities and to ensure that federal agencies provide clear guidance that protects Tribal programs from unnecessary disruption.

As the Administration advances its priorities, it must do so in a way that respects Tribal sovereignty, strengthens self-determination, and delivers on trust and treaty obligations. We stand ready to work with federal partners to ensure that all policies and decisions uphold the government-to-government relationship beteen the U.S. and Tribal Nations.

The coalition will continue to advocate for Tribal sovereignty and fulfillment of the trust and treaty obligations and ensure that the voices of Indian Country are heard in Washington. A full copy of the sign-on letter can be found here: https://qrco.de/letter2225.

List of National Tribal Organizations

American Indian Higher Education Consortium
Association on American Indian Affairs
Affiliated Tribes of Northwest Indians
California Tribal Chairpersons Association
Great Lakes Inter-Tribal Council
Great Plains Tribal Chairmans Association
Indian Gaming Association
Inter-Tribal Association of Arizona
Midwest Alliance of Sovereign Tribes
Native American Finance Officers Association
National American Indian Court Judges Association
Native American Rights Fund
National Association of Tribal Historic Preservation Officers
Native Forward Scholars Fund
National Congress of American Indians
National Council of Urban Indian Health
National Indian Child Welfare Association
National Indian Education Association
National Indian Health Board
Northern California Tribal Chairperson’s Association
Rocky Mountain Tribal Leaders Council
Self-Governance Communication & Education Tribal Consortium
Southern California Tribal Chairmen’s Association
United South and Eastern Tribes

January 31, 2025 – National Council of Urban Indian Health Calls for Protection of Indian Health System Funding

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.

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NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org

PRESS RELEASE: National Council of Urban Indian Health Calls for Protection of Indian Health System Funding

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FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (January 31, 2025) – The National Council of Urban Indian Health (NCUIH) today urged Congress, the Office of Management and Budget (OMB), and the Department of Health and Human Services (HHS) to exempt the Indian Health System from any future funding restrictions or pauses. This call to action comes in response to recent events that temporarily froze resources critical to the operation of Tribal health care and Urban Indian Organization (UIO) facilities. While the recent OMB memorandum (M-25-13) has been rescinded, NCUIH remains concerned about potential future impacts on the Indian health system. The organization emphasizes that any disruption to funding could have severe consequences for American Indian and Alaska Native communities.

Key points from NCUIH’s communications include:

  1. Federal Trust Responsibility: NCUIH stresses the U.S. Government’s legal obligation to provide health services to Native people, as established by the Indian Health Care Improvement Act.
  2. Preventing Service Disruptions: Recent funding uncertainties forced UIOs to consider staffing cuts, service suspensions, and even facility closures.
  3. Historical Context: Past experience shows any disruption in funding can have grave consequences on the Indian health system. During the 2019 government shutdown, funding disruptions led to reduced services and facility closures, resulting in tragic consequences including fatal opioid overdoses in some communities.
  4. Specific Exemption Request: NCUIH is calling for a specific exemption for the entire Indian Health System, including the Tribal organizations, and UIOs, from any future funding restrictions.

Walter Murillo (Choctaw), Board President of NCUIH stated, “Even a temporary halt in funding could immediately deprive Native communities of necessary health services. As leaders of Urban Indian Organizations, we’re on the front lines of providing essential healthcare to Tribal citizens. We’re calling for a specific exemption for the entire Indian Health System from any future funding restrictions or pauses. This isn’t just about honoring agreements; it’s about fulfilling the federal government’s trust responsibility to provide healthcare for Tribal citizens, regardless of where they live.”

NCUIH is actively engaging with Congress, the OMB, and HHS to secure this specific exemption and prevent any future disruptions to critical health care services for Tribal citizens. The organization has sent letters to both Congress and HHS detailing the critical need for uninterrupted funding to the Indian Health System.

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.

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NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org

OMB Announces Temporary Pause on Federal Financial Assistance Programs: Implications for Urban Indian Organizations

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FOR IMMEDIATE RELEASE

Washington, D.C. (January 28, 2025)– On January 27, 2025, Matthew J. Vaeth, Acting Director of the Office of Management and Budget (OMB) at the Executive Office of the President released a memorandum addressed to all heads of Executive Departments and Agencies with the subject line “Temporary Pause of Agency Grant, Loan, and Other Financial Assistance Programs.” The memorandum requires that Agency leadership “to the extent permissible under applicable law…temporarily pause all activities related to obligation or disbursement of all Federal financial assistance.”

Each Agency must “identify and review all Federal financial assistance programs and supporting activities consistent with the President’s policies and requirements.” To determine whether such programs and supporting activities are “consistent with the President’s policies and requirements” Department and Agency heads should refer to the series of thirty-four (34) executive orders released by the President since he took office on January 20, 2025. Relevant topics “includ[e], but are not limited to, foreign aid, nongovernmental organizations, DEI, woke gender ideology, and the green new deal.” The temporary pause becomes effective today, January 28, 2025, at 5:00 p.m. There is presently no scheduled end date for the pause. All activities related to open Notice of Funding Opportunities are subject to the pause. OMB may “grant exceptions allowing Federal agencies to issue new awards or take other actions case-by-case basis.”

Application to Urban Indian Organizations and Next Steps

Urban Indian Organizations (UIOs) receive federal funding from various sources, some, if not all, of which will be affected by the pause. Urban Indian Organizations (UIOs) are advised to discuss the potential implications of this memorandum with their finance and legal departments. Please note that federal agencies may be unable to respond to inquiries or questions. The Department of Health and Human Services has issued a pause on issuing documents and public communications until February 1, 2025.

Additional Information

The memorandum requires Federal Agencies to:

  1. Immediately identify and notify OMB of any legally mandated actions or deadlines for assistance programs that will arise during the pause.
  2. Submit detailed information of any programs, projects, or activities subject to this pause no later than February 10,
  3. Carry out the following activities for each Federal financial assistance program:
    1. Assign responsibility and oversight to a senior political appointee to ensure Federal financial assistance conforms to Administration priorities;
    2. Review currently pending Federal financial assistance announcements to ensure Administration priorities are addressed, and, subject to program statutory authority, modify unpublished Federal financial assistance announcements, withdraw any announcement already published, and, to the extent permissible by law, cancel awards already awarded conflict with Administration priorities; and
    3. Ensure adequate oversight of Federal financial assistance programs and initiate investigations when warranted to identify underperforming recipients, and address identified issues up to and including cancellation of awards.

The memorandum defines “financial assistance program” as the term is defined in 2 CFR 200.1 meaning “assistance that recipients or subrecipients receive or administer in the form of:(i) Grants;(ii) Cooperative agreements;(iii) Non-cash contributions or donations of property (including donated surplus property);(iv) Direct appropriations; (v) Food commodities; and (vi) Other financial assistance,” but clarifies that the memorandum does not apply to Social Security benefits or Medicare.

Follow-up instructions provided by OMB on Federal Financial Assistance program analysis require all Federal agencies that provide Federal financial assistance complete a spreadsheet with information on any program that has funding or activities planned through March 15th. Agency heads must submit the completed spreadsheet to OMB no later than February 7th, 2025.

About NCUIH

The National Council of Urban Indian Health (NCUIH) is a national representative advocating 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 quality, accessible health and public health services for American Indians and Alaska Natives 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.

 

PRESS RELEASE: NCUIH Presents Good Medicine Awards to Outgoing Legislators Tester and Peltola

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FOR IMMEDIATE RELEASE

The “Good Medicine Award” recognizes exceptional leadership on behalf of Native communities in support of health care services.

WASHINGTON, D.C. (December 11, 2024)– On December 11, 2024, the National Council of Urban Indian Health presented two Good Medicine Awards to Members of Congress for their efforts to support the Indian Health Service and efforts to improve health outcomes for Native communities during their tenure in Congress.Senator Jon Tester (D-MT) and Representative Mary Sattler Peltola (D-AK) were recognized for their outstanding contributions and demonstrated leadership in advancing Native health care. Throughout their tenure in Congress, these individuals have gone above and beyond in their efforts to champion legislation, policies, and initiatives that promote the health, welfare, and rights of Native peoples, and have a proven track record of collaboration, bipartisan cooperation, and effectiveness in advancing legislative agendas that address critical issues relating to Native health.

NCUIH thanks Senator Tester and Representative Peltola for their proven dedication to upholding the federal trust and treaty obligation to provide healthcare services to all American Indian and Alaska Native people.

Photo of Senator Tester and Francys Crevier

Senator Jon Tester

During his 18 years in the United States Senate, Senator Tester has become widely known as one of the strongest supporters of Indian Country on Capitol Hill. Over the past nearly two decades, Senator Tester has fought fiercely to protect the Indian Health Service through legislation and appropriations. In 2023, Senator Tester supported advance appropriations for the Indian Health Service, protecting funding for the IHS regardless of the current year appropriations status. In 2024, he joined 20 colleagues in sending a letter to Senate leadership requesting full funding for the Indian Health System, including Urban Indian Health. Senator Tester’s consistent advocacy has protected access to culturally competent care for all American Indian and Alaksa Native people. Senator Tester has also been a fierce advocate for Native veterans and ensuring their easy access to Veterans Affairs services. He supported the Health Care Access for Urban Native Veterans Act, which greatly improved healthcare access for American Indian and Alaska Native veterans by providing Department of Veterans Affairs (VA) coverage for care that Native veterans receive from Title V Urban Indian Organizations (UIOs). In 2021, Senator Tester also supported the improved Memorandum of Understanding between the Indian Health Service and the VA. This has provided better access to culturally competent care and alleviated burdens on the VA system.  In addition, Senator Tester was monumental in the establishment of a U.S. Department of Veterans Affairs (VA) Copay Exemption for Native Veterans, leading to the exemption and/or reimbursement of over 234,000 copayments. This has saved Native veterans more than $4.1 million as of September 2024. Senator Tester has taken many actions throughout his career on behalf of American Indian and Alaska Native people and we are grateful for his service.

Representative Mary Sattler Peltola

Representative Mary Sattler Peltola

Although Representative Peltola only had one full term in Congress, her positive impact on Indian Country will last for decades. As co-chair of the Native American Caucus, she championed issues that upheld the Federal Trust Responsibility, including cosponsoring H.R. 7227, the Truth and Healing Commission on Indian Boarding Schools Policies Act. In May 2024, Representative Peltola also joined 51 of her colleagues in sending a letter to House Leadership requesting full funding for the Indian Health Service, including Urban Indian Health. The letter emphasized that the federal government has a trust responsibility to provide federal health services to maintain and improve the health of American Indian and Alaska Natives. Representative Peltola’s support has ensured that the Indian Health Service will be able to continue providing care to all American Indian and Alaska Native people.  Representative Peltola’s fierce leadership, voice, and dedication to upholding the trust responsibility to all American Indian and Alaska Native people will truly be missed and remembered.

About NCUIH

Organizations contracting with the Indian Health Service under the Indian Health Care Improvement Act. NCUIH is devoted to the support and development of quality, accessible, and culturally competent health and public health services for American Indians and Alaska Natives 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.

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NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org

PRESS RELEASE: National Council of Urban Indian Health Announces New Partnership with Alzheimer’s Association

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National Council of Urban Indian Health Announces New Partnership with Alzheimer’s Association

FOR IMMEDIATE RELEASE

Washington, D.C. (December 5, 2024) – The National Council of Urban Indian Health (NCUIH) and the Alzheimer’s Association recently announced a new partnership aimed at promoting brain health and increasing support for American Indian and Alaska Native (AI/AN) people living in urban settings affected by Alzheimer’s and other dementia. NCUIH and the Alzheimer’s Association will work together to engage urban AI/AN communities to raise concern and awareness of Alzheimer’s disease and all other dementia and to provide care, support, and information about advance care planning for the people impacted by dementia.

“Our partnership with the Alzheimer’s Association aims to provide vital support to American Indian and Alaska Native communities facing the challenges of dementia,” said NCUIH CEO Francys Crevier, JD (Algonquin). “This collaboration underscores our shared commitment to culturally tailored resources and services that honor Indigenous peoples’ unique traditions, experiences, and resilience. Together, we are working to ensure that no elder or family feels alone in navigating this journey.”

AI/AN individuals are more likely to develop Alzheimer’s or other forms of dementia than white Americans, yet they often have less access to health services and timely diagnosis. Twenty-seven percent of AI/AN individuals live in poverty, proportionately more than any other group and double the rate of 14 percent of Americans generally.

“We are delighted to collaborate with the National Council of Urban Indian Health to extend our outreach to American Indians and Alaska Natives living in urban settings,” said Dr. Carl V. Hill, chief diversity, equity and inclusion officer at the Alzheimer’s Association. “This partnership will enable us to provide essential disease-related information, care, and support resources while encouraging increased participation in Alzheimer’s and dementia research.”

Along with the partnership, the Alzheimer’s Association will offer educational programs and webinars to urban AI/AN communities. It will work to connect affected individuals and families in these communities to care and support resources, including the Association’s free 24/7 Helpline, referrals to local resources, and care consultation. In addition, the Alzheimer’s Association will sponsor and participate in NCUIH’s 2025 annual conference in Washington, D.C., on April 22-24, 2025.

About NCUIH

The National Council of Urban Indian Health is a national representative advocating 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 quality, accessible, and culturally competent 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.

About the Alzheimer’s Association

The Alzheimer’s Association is a worldwide voluntary health organization dedicated to Alzheimer’s care, support, and research. Our mission is to lead the way to end Alzheimer’s and all other dementia — by accelerating global research, driving risk reduction and early detection, and maximizing quality care and support. Our vision is a world without Alzheimer’s and all other dementia®. Visit alz.org or call 800.272.3900.

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NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org

PRESS RELEASE: President Biden Formally Apologizes for Federal Government Involvement in Indian Boarding Schools

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FOR IMMEDIATE RELEASE

Gila River Indian Reservation, Arizona (October 28, 2024) – President Joe Biden delivered a historic formal apology on behalf of the federal government for its 150-year policy of forcibly placing Native children in Indian Boarding Schools.

“The Federal Indian Boarding School policy and the pain it has caused will always be a significant mark of shame, a blot on American history,” said President Biden in historic remarks. “It’s a sin on our [Nation’s] soul.”

President Joe Biden at Gila River Indian Reservation, Arizona

Picture source: https://x.com/WhiteHouse/status/1849949471888519514/photo/1

“For 150 years, the government attempted to wipe out our Native cultures by removing and relocating thousands of Native children to boarding schools. The President’s historic apology is a painful reminder of this country’s history and our community’s immense resilience,” said Francys Crevier, J.D. (Algonquin), CEO of NCUIH. “Congress needs to act now and pass the Truth and Healing Commission on Indian Boarding Schools Act, and invest in Indian Country, so we can learn from our past and make sure these wrongs are never repeated.”

President Biden’s apology follows the Department of Interior’s (DOI) investigative report, which confirms that at least 973 American Indian, Alaska Native, and Native Hawaiian children died while attending federally operated or supported schools and identifies at least 74 marked and unmarked burial sites at 65 different school grounds. It estimates that the U.S. government appropriated more than $23.3 billion between 1971 and 1969 for the federal Indian boarding school system and other similar institutions and associated assimilation policies (dollars adjusted for inflation based on Fiscal Year 2023).

This act of recognition can foster healing and reconciliation, which are crucial for improving mental and physical health. By validating the experiences of Indigenous peoples and addressing the traumas associated with these institutions, the apology may encourage increased access to health care resources, culturally competent care, and a greater focus on mental health support. Ultimately, such measures can help bridge the gap in health disparities and promote overall well-being within these communities.

NCUIH is particularly grateful to the Native American Boarding School Healing Coalition (NABS) for its unrelenting leadership in securing the DOI’s report and introducing critical legislation in Congress.

Next Steps

Congress must swiftly pass the Truth and Healing Commission on Indian Boarding School Policies in the United States Act (S. 2907/H.R. 5444).

About NCUIH

The National Council of Urban Indian Health (NCUIH) is a national representative advocating 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 quality, accessible, and culturally competent health and public health services for American Indians and Alaska Natives 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.

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NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org

PRESS RELEASE: NCUIH Celebrates CMS Approval of Medicaid Coverage for Traditional Healing Services, Emphasizes Importance for Urban Indian Organizations

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FOR IMMEDIATE RELEASE

“This approval is a testament to the tireless advocacy of Tribal leaders, Urban Indian Organizations, and our partners,” said Francys Crevier, J.D. (Algonquin), CEO of NCUIH. “It marks a historic milestone in our ongoing efforts to ensure that American Indian and Alaska Native people in urban areas have access to culturally appropriate, holistic care that honors our Traditional Healing practices”.

“As we’ve long advocated, the ability to provide and be reimbursed for culturally relevant services offers a greater opportunity to deliver whole-person care,” Crevier added. “This CMS approval is a crucial step towards health equity and honoring the rich traditions of our diverse Native communities, including those in urban areas”.

– NCUIH CEO, Francys Crevier (Algonquin)

Washington, D.C. (October 18, 2024) – The National Council of Urban Indian Health (NCUIH) enthusiastically welcomes Wednesday’s announcement by the Centers for Medicare & Medicaid Services (CMS) approving Medicaid coverage for Traditional Healing services in four states: California, Arizona, New Mexico, and Oregon.

This landmark decision represents a significant step forward in recognizing the value of culturally-based traditional health care practices for American Indian and Alaska Native people, including those living in urban areas.

Urban Indian Organizations and State-Specific Waivers

While the CMS approval is a significant step forward, it’s important to note that the implementation and coverage for Urban Indian Organizations (UIOs) varies by state:

  1. Arizona (AHCCCS):  Traditional Healing is covered for IHS and Tribal facilities. UIOs are not explicitly included as covered facilities. However, Traditional health care practitioners or providers at UIOs contracting with an IHS or Tribal facility could be included.
  2. California (CalAIM): California will have expenditure authority to provide coverage for traditional health care practices received through IHS, Tribal, or UIO facilities by Medicaid and CHIP beneficiaries who are able to receive services delivered by or through these facilities. The state will initially provide this coverage only to beneficiaries eligible to participate in the Drug Medi-Cal Organized Delivery system. However, California will have authority to expand coverage to all Medicaid beneficiaries who receive services delivered by or through an IHS, Tribal, or UIO facility.
  3. New Mexico (Turquoise Care): The state will have expenditure authority to provide coverage for Traditional Healing practices received through IHS, Tribes, or UIO facilities.
  4. Oregon (OHP): Traditional health care practices received through IHS, Tribal, or UIO facilities will be covered when provided to a Medicaid or CHIP beneficiary who is able to receive services delivered by or through these qualifying providers. State expenditures for Traditional Healing delivered at UIOs will receive the applicable state service match.

Next Steps

NCUIH will continue to work closely with CMS, state Medicaid programs, and UIOs to ensure smooth implementation of this new coverage and to advocate for equitable inclusion of UIOs in all states.

 

About NCUIH

The National Council of Urban Indian Health (NCUIH) is a national representative advocating 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 quality, accessible, and culturally competent health and public health services for American Indians and Alaska Natives 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.

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NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org

PRESS RELEASE: NCUIH Releases Financing Toolkit for Providers to Address Behavioral Health Disparities in American Indian and Alaska Native Communities

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FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (October 9, 2024) – The National Council of Urban Indian Health (NCUIH) has released a new resource to combat the significant mental health challenges facing American Indian and Alaska Native (AI/AN) communities. The toolkit, Investing in Wellness: Financing Strategies for Behavioral Health in Indian Country, developed in response to the alarming statistic that 19 percent of AI/AN individuals reported experiencing a mental illness in the past year, seeks to provide sustainable funding solutions and resources to enhance behavioral health care access in Indian Country.

The toolkit comes at a time when behavioral health issues among AI/AN communities have not received equal policy attention or funding. Existing funding models often rely on short-term grants that inadequately address the persistent and complex needs of these communities. “The Investing in Wellness toolkit is essential for bridging the funding gap in behavioral health services,” said NCIUH CEO Francys Crevier, J.D. (Algonquin). “We aim to equip leaders with practical financing strategies tailored specifically for American Indian and Alaska Native health care systems, ultimately improving access to prevention, treatment, and recovery services. By focusing on the patient journey and incorporating traditional healing practices into behavioral health programming, the toolkit aligns with the growing advocacy for holistic approaches in treatment.”

Key strategies outlined in the toolkit include:

  • Enhancing Behavioral Health Care Access Through Optimizing Medicaid Reimbursement
  • Traditional Healing as a Financially Sustainable Strategy for Improving Behavioral Health
  • Cultivating Funding Opportunities for Behavioral Health Programming
  • Investing in Prevention, Crisis Care, and Integrated Services
  • Strategies to Build, Expand, and Sustain Behavioral Health

The development of this toolkit was guided by a community-based participatory approach, ensuring that the needs and voices of AI/AN communities were central to its creation. “Culturally sensitive care is an important part of any treatment regimen. The Investing in Wellness toolkit notably supports traditional healing practices, such as therapeutic talking circles and natural remedies, as proven ways to support person-centered health and wellness,” said Alaina McBournie, senior manager for the substance use prevention and treatment initiative at The Pew Charitable Trusts. “Pew is proud to partner with NCUIH to help expand access to lifesaving services for American Indian and Alaska Native people.”

View Toolkit

About NCUIH

The National Council of Urban Indian Health is a national non-profit organization devoted to the support and development of quality, accessible, and culturally competent health and public health services for American Indian and Alaska Native people living in urban areas. NCUIH advocates for the 41 Title V Urban Indian Organizations under the Indian Health Service in the Indian Health Care Improvement Act.

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.

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NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org, 202-417-7781

PRESS RELEASE: NCUIH Report Finds High Demand for Traditional Food Programming Despite Funding Barrier

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FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (October 7, 2024) – The National Council of Urban Indian Health (NCUIH) is proud to announce the publication of its report entitled “Recent Trends in Third Party Billing: Thematic Analysis of Traditional Food Programs at Urban Indian Organizations and Research on Traditional Healing.”

This year’s report highlights the importance of Traditional Food programming at Urban Indian Organizations (UIOs) and how UIOs use Traditional Foods to address health disparities and incorporate culture and community in urban American Indian and Alaska Native communities. NCUIH interviewed seven UIOs regarding their Traditional Food programs and the challenges they face in billing Medicaid for related activities. The interviewed UIOs emphasized the importance of incorporating cultural knowledge into their offerings to revive traditional healthy eating and physical activity practices. The Traditional Food programs UIOs highlighted included the Special Diabetes Program for Indians (SDPI), community gardens, nutritional counseling, and produce/food prescription programs. Despite these efforts, UIOs expressed a pressing need for increased funding to maintain or expand these services to promote equitable access to food security programs to address the disproportionately high rates of food insecurity and associated diseases in urban American Indian and Alaska Native populations. As found in last year’s report on Traditional Healing, funding continues to be a barrier to building and sustaining programs that include Traditional Food.

View Report

Background

This report serves as an update to NCUIH’s previous reporting on recent trends in third-party billing. It specifically serves as a follow-up to last year’s report, Recent Trends in Third-Party Billing at Urban Indian Organizations: Thematic Analysis of Traditional Healing Programs at Urban Indian Organizations and Meta-Analysis of Health Outcomes. In interviews conducted with UIOs for last year’s report, many UIOs specifically highlighted their Traditional Foods programs as crucial to improving the emotional, mental, spiritual, and physical health of their urban American Indian and Alaska Native patients, utilizing food as medicine. Based on this information, this year, NCUIH’s research focused on how UIOs integrate Traditional Food programming into their service offerings and the various funding mechanisms UIOs use to support these services.

Next Steps

NCUIH continues to closely monitor how states use Section 1115 demonstration waivers to address health-related social needs (HRSNs) and explore how Medicaid reimbursement can be used as a mechanism to provide funding for culturally appropriate care, like Traditional Food programming. NCUIH continues to educate policymakers regarding the importance of Traditional Healing for American Indian and Alaska Native people in urban areas and the importance of developing reimbursement models that are culturally sensitive and appropriate.

Traditional Food Infographic

About NCUIH

The National Council of Urban Indian Health is a national representative advocating 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 quality, accessible, and culturally competent 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.

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NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org, 202-417-7781

PRESS RELEASE: Supreme Court Rules 5-4 in Favor of Tribes on Reimbursement of Contract Support Costs for Third-Party Expenses

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FOR IMMEDIATE RELEASE

“Today, the Supreme Court required the United States to uphold its responsibility to fully support Tribal self-determination under the Indian Self Determination Education and Assistance Act (ISDEAA). Contract support costs are necessary to ensure that Tribes that exercise their rights under ISDEAA receive the same amount of funding support as other federally run programs. Tribal governments know the needs of their people, and protecting and supporting Tribal self-determination is essential to ensuring the health and well-being of American Indians and Alaska Natives. NCUIH is a strong supporter of Tribal self-determination and proudly signed on to the National Indian Health Board’s amicus brief to the Supreme Court in support of the respondent Tribes.”

– NCUIH CEO, Francys Crevier (Algonquin)

Washington, D.C. (June 6, 2024) – The Supreme Court delivered their opinion in Becerra v. San Carlos Apache (consolidated with Becerra v. Northern Arapaho Tribe), authored by Chief Justice John Roberts. The decision in this case will benefit and assist Tribes operating under self-determination contracts with IHS. Moving forward, additional funding will be allocated within IHS’ budget to pay contract support costs related to Tribes using third-party revenue for administering their healthcare programs. In support of Tribal sovereignty and efforts of Tribes to ensure IHS carries out the federal trust responsibility, NCUIH signed on to the amicus brief filed by the National Indian Health Board (NIHB).

The court relied on language found in the Indian Self-Determination Act (ISDA), to show that, under Section 5325(a), the contract support costs incurred are eligible for repayment since they were done so to “ensure compliance with the terms of the contract.” The collection and spending of third-party revenue was done by Tribes as required by their contracts with IHS – to carry out operations transferred from IHS to the Tribes. Therefore, the court interprets ISDA to assume the administrative and overhead costs incurred as a result would be defined as contract support costs. Section 5326 of ISDA was also discussed by the court, which found that the limitations included “do not preclude payment of costs incurred by the required spending of program income under a self-determination contract.”

A highlight of the opinion is the court recognizing that reading ISDA differently would penalize Tribes who pursue self-determination. The purpose of contract support costs is to prevent funding gaps between IHS and Tribes, and finding differently would impact Tribes ability to finance and operate their healthcare programs.

About NCUIH

The National Council of Urban Indian Health (NCUIH) is a national non-profit organization devoted to the support and development of quality, accessible, and culturally-competent health and public health services for American Indians and Alaska Natives (AI/ANs) living in urban areas. NCUIH advocates for the 41 Urban Indian Organizations contracting with the Indian Health Service under the Indian Healthcare Improvement Act.

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.

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NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org, 202-417-7781