NCUIH President-Elect Appointed To VA Advisory Committee

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FOR IMMEDIATE RELEASE 10.15.2021

Media Contact:
National Council of Urban Indian Health
Meredith Raimondi, Director of Congressional Relations
MRaimondi@ncuih.org
651-470-1857

NCUIH nominated Ms. Tetnowski to represent urban Native Veterans.

 

WASHINGTON, D.C. (October 15, 2021) – National Council of Urban Indian Health (NCUIH) President Elect and CEO of Indian Health Center of Santa Clara Valley, Sonya Tetnowski, a member of the Makah Tribe, was appointed to the Department of Veterans Affairs (VA) first-ever Advisory Committee on Tribal and Indian Affairs. The Committee will advise the Veterans Affairs Secretary based on personal experience on all matters relating to Indian Tribes, Tribal organizations, Urban Indian Organizations (UIOs), Native Hawaiian organizations, and Native American Veterans. NCUIH advocated for the bill that established the advisory committee and nominated Ms. Tetnowski for the role. In the past many advisory committees that relate to Indian health, including urban Indian health, have excluded urban Indian leaders from positions and conversations, which makes this appointment especially historic.

“NCUIH is proud of Sonya Tetnowski’s representation of urban Indian organizations on the Department of Veterans Affairs new Advisory Committee on Tribal and Indian Affairs. As a Veteran and urban Indian leader Sonya is uniquely qualified to serve on this committee. Sonya will be a strong voice for American Indian and Alaska Native Veterans who reside in urban areas,” said NCUIH President Walter Murillo (Choctaw Nation of Oklahoma).

Ms. Tetnowski was deployed multiple times during her service in the Army and has tirelessly advocated on behalf of health equity for American Indians, including Native Veterans, through Congressional testimony and leadership at NCUIH. In 2019, Ms. Tetnowski testified on bill H.R. 4153, the Health Care Access for Urban Native Veterans Act, which allows Urban Indian Organizations (UIOs) to be reimbursed for providing culturally competent care to American Indian and Alaska Native (AI/AN) Veterans residing in urban areas. Most recently, Ms. Tetnowski appeared before the House Committee on Natural Resources in July 2021. She submitted testimony on Native Veterans Suicide Prevention on behalf of NCUIH in September. Also in October, the Indian Health Center of Santa Clara Valley was recognized with the National Indian Health Board’s 2021 Outstanding Service Award.

“It is an honor to be a part of the first-ever VA Committee on Tribal and Indian Affairs. With approximately 160,000 Native Veterans around the country, it is vital to have a representative on the committee that can ensure that the healthcare needs for our Native Veterans is always a part of the broader discussion to ensure we are removing barriers to care while providing culturally competent care. I appreciate the VA’s foresight and vision to address these challenges” said Sonya Tetnowski (Makah), NCUIH President Elect and CEO of the Indian Health Center of Santa Clara Valley.

“Native Americans serve in the military at a higher rate than any other population, and over 70 percent of Native Americans live in urban areas. Urban Indian organizations, like the Indian Health Center of Santa Clara Valley (IHC) fill a crucial gap in the health care system for Native Americans that do not have access to more remote facilities run by the Indian Health Service. I congratulate Sonya Tetnowski (Makah), CEO of the IHC on her appointment to the inaugural Tribal Veterans Affairs Advisory Committee to represent our Native Veterans,” said Rep. Ro Khanna (D-CA-15).

“A wide range of VA activities impact urban Indian organizations and the communities they serve. Sonya‘s appointment as the Committee representative for urban Indians provides an added layer of accountability for VA to uphold its trust responsibility to Native Veterans living outside of reservation boundaries,” said Sunny Stevenson (Walker River Paiute Tribe), NCUIH Director of Federal Relations.

Resources 

Testimonies by Ms. Tetnowski 

 

Congressional Hearing Highlights How Lack of Urban Confer Delayed Vaccine Rollout for Urban Indians

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FOR IMMEDIATE RELEASE 10.15.2021

Media Contact:
National Council of Urban Indian Health
Meredith Raimondi, Director of Congressional Relations
MRaimondi@ncuih.org
651-470-1857

The Administration and bipartisan Members of Congress emphasized the need for urban confer legislation in yesterday’s House Natural Resources hearing.

WASHINGTON, D.C. (October 6, 2021) – On Tuesday, the National Council of Urban Indian Health (NCUIH) testified before the House Natural Resources Subcommittee for Indigenous Peoples of the United States (SCIP) in support of the Urban Indian Health Confer Act (H.R. 5221), sponsored by Chairman Raúl Grijalva (D-AZ-3). NCUIH President and Chief Executive Officer of NATIVE HEALTH, Walter Murillo (Choctaw Nation of Oklahoma), spoke in support of the NCUIH-endorsed legislation which would require agencies within the Department of Health and Human Services (HHS) to confer with urban Indian organizations (UIOs) on policies related to healthcare for urban American Indian/Alaska Natives (AI/ANs).

In Chair Grijalva’s opening remarks, he noted that the Administration’s currently limited scope served as a barrier to UIOs and to other healthcare agencies and departments. “This was highlighted during the COVID-19 pandemic when it came to vaccine allocations. The current policy indicates that HHS was only obligated to initiate communications with Tribal governments and other agencies, not UIOs. As a result, UIOs were prevented from providing input and delayed vaccine distribution to many American Indians and Alaska Natives. H.R. 5221 will remedy this and codify a proper confer policy between HHS and urban Indian organizations.” 

The current public health crisis has only amplified the long-due need for urban confer among HHS agencies to adequately communicate the constantly changing healthcare policies with UIOs that directly impact their patients. However, only the Indian Health Service (IHS) has a legal obligation to confer with UIOs. President Murillo’s testimony spoke to the ongoing challenges that UIOs and urban AI/ANs continue to face absent an urban confer policy across all HHS agencies.

In his opening statement, Mr. Murillo explained, “Few are aware that urban confer policies are a response to decades of deliberate federal efforts, such as forced assimilation, termination, relocation, and boarding schools, that have resulted in 70% of American Indian and Alaska Native people living outside of Tribal jurisdictions…We must move past the notion that only IHS has a trust obligation to Native people, because the truth is the FEDERAL government has a responsibility to provide health care for all Native people.”  Finally, he noted how none of the $125 million appropriated in the CARES Act to the Centers for Disease Control and Prevention (CDC) by Congress for the Indian health system, including urban Indian health, was distributed to UIOs. Repeated attempts to contact CDC and further determine why UIOs have yet to receive funds remain unanswered and would be rectified by an urban confer policy with the Department.

 

Watch Full Hearing

NCUIH Testimony

IHS Testimony

 

Administration Emphasizes the Importance of Urban Indian Inclusion in Federal Communication

In response to a question regarding vaccine distribution, IHS Deputy Director for Intergovernmental Affairs, Benjamin Smith, said “Initially urban Indian organizations were not included in the discussion and request from the Department of Health and Human Services about whether urban Indian organizations would receive their vaccine allocation from the state or from the Indian Health Service. As a result, it was unclear to urban Indian organizations on whether they were expected to make a similar decision as tribes did. It was ultimately determined that the urban Indian organizations could select a state or Indian Health Service for their vaccine allocation. In some urban Indian organizations, however, there were delays in the initial vaccine rollout.” For example, the Baltimore UIO, Native American LifeLines, did not receive vaccines until just 5 days before the general public was eligible in a pandemic that took the lives of AI/ANs at the highest rates of any population. [Note: The majority of UIOs that received vaccines through IHS were expedient and efficient in their rollouts, which were touted as a success by the Administration in the high vaccination rates of AI/ANs.]

Deputy Director Smith, reflected on his personal connection as an urban Indian, “We acknowledge that there are many members of federally recognized Tribes that reside in urban areas. I’m an example of one. I’m a member and citizen of the Navajo Nation that resides here in the Washington D.C. area.” He went on to explain the importance of agency-wide urban confer with UIOs by saying, “It is extremely important to understand how members of American Indians/Alaska Natives that are residing in urban setting have access to healthcare services as outlined in this important piece of legislation.”

When asked about why it’s critical to boost urban Indian health coordination and resources, Darryl LaCounte, the Director of the Bureau of Indian Affairs, affirmed that “Approximately 70% of enrolled Native Americans live off reservation and in urban areas and think its vitally important that those people are served.” He continued to say, “I had a previous Assistant Secretary express his frustration to me one day that we were only serving 30% of the Indian population, I’d say we serve more than that but that’s the lay of the land.”

Bipartisan Support from the House Natural Resources Committee Members

Members of Congress from both sides of the aisle demonstrated strong support for urban Indian health and confer policies with UIOs. Subcommittee Chair Leger Fernandez expressed support for the bill and UIOs, emphasizing that “UIOs are a pillar of the Indian Health System.”  Representative Matt Rosendale (R-MT-AL) emphasized Murillo’s statement regarding urban Indian parity: no policies about us, without us. “If none of us take anything from this hearing today, that should be the one statement that everybody should take home and make sure that they remember,” said Rep. Rosendale. ​Rep. Darren Soto (D-FL-9) said, “It’s time to modernize and improve health access for our Native Americans. This requires us to have greater urban access through the Indian Health Service and the U.S. Department of Health and Human Services, which is why we applaud Chair Grijalva for this great bill.”

“Even before the pandemic, we’ve known that resources within the Indian Health System were stretched thin. Urban Indian health centers in particular play a critical role in providing healthcare to Indigenous communities and remain on the frontlines during the pandemic, all of which they do while dealing with longstanding parity issues within the Indian Health System— supply shortages, closures, and financial hardships,” said Rep. Jesus “Chuy” Garcia (D-IL-4). “We cannot afford to leave urban Natives without access to adequate care during this public health crisis especially.”

Representative Melanie Stansbury (D-NM-1) expressed direct support of the Urban Indian Health Confer Act and provided comments on the impact of UIOs on healthcare in New Mexico. “Urban Indian Organizations are vital to serving the healthcare needs of our Tribal communities across the country, and especially here in my home state of New Mexico. The First Nations Community HealthSource in my district is a member of the National Council of Urban Indian Health and is the sole urban Indian health center in the state of New Mexico. […] I want to take a moment to shout out and lift up their incredible work,” said the Congresswoman.

NCUIH thanks SCIP for scheduling a hearing for testimony on this crucial urban confer bill and furthering parity for UIOs and the urban AI/AN patients whom they serve with the rest of the Indian Health System.

NEXT STEPS

NCUIH will request a full Committee markup and expeditious floor consideration. NCUIH urges advocates of Indian health to request their Members of Congress cosponsor H.R. 5221.

BACKGROUND

An urban confer is an established mechanism for dialogue between federal agencies and UIOs. NCUIH has long advocated for the importance of facilitating confer between numerous federal branches within HHS and UIO-stakeholders without any resolve. It is important to note that Urban Confer policies do not supplant or otherwise impact tribal consultation and the government-to-government relationship between Tribes and federal agencies. 

The Urban Indian Health Confer Act will ensure the many branches and divisions within HHS and all agencies under its purview establish a formal confer process to dialogue with UIOs on policies that impact them and their AI/AN patients living in urban areas. The bill was introduced on September 10, 2021, by Chair Grijalva, Rep. Betty McCollum (D-MN), Rep. Tom Cole (R-OK), Rep. Don Young (R-AK), Rep. Karen Bass (D-CA), and Del. Eleanor Holmes Norton (D-DC). It currently has 10 cosponsors.

RESOURCES

PRESS RELEASE: Bipartisan Padilla-Moran-Lankford NCUIH Amendment for Urban Indian Health Passes Senate

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The technical fix will be critical to improving health infrastructure for off-reservation American Indians and Alaska Natives.

FOR IMMEDIATE RELEASE – 8.2.21

Media Contact: National Council of Urban Indian HealthMeredith Raimondi, Director of Congressional Relations MRaimondi@ncuih.org 202-417-7781

Washington, D.C. (August 2, 2021) – On Monday, the Senate voted on amendments to the bipartisan infrastructure package including the Padilla-Moran-Lankford Urban Indian Health Amendment, which passed 90-7. The National Council of Urban Indian Health (NCUIH) has worked closely on a bipartisan basis for the past year on this technical legislative fix to support health care for tribal members who reside off of reservations. This amendment would allow existing resources to be used to fund infrastructure projects within the Indian health system.

“We applaud Senators Padilla, Moran, Lankford, Rounds, Smith, Feinstein, Schatz, and Schumer for their steadfast and tireless leadership on behalf of Indian Country. This technical fix will be critical to expanding health care infrastructure for Native communities who have been devastated by the COVID-19 pandemic. We also thank the National Congress of American Indians for their partnership in advocating for improved outcomes for all of Indian Country,” said Francys Crevier (Algonquin), CEO of NCUIH.

Next Steps

The Senate will continue to debate amendments to the bipartisan infrastructure plan. In the meantime, NCUIH will continue to advocate for $21 billion for Indian health infrastructure in the budget reconciliation package from the a joint letter led by the National Congress of American Indians (NCAI) on April 13, 2021.

Background

“Urban Indian Organizations (UIOs) are a lifeline to Native Americans living in urban areas across California,” said Senator Alex Padilla (D-CA). “Yet, UIOs are prohibited from using Indian Health Service funding for facilities, maintenance, equipment, and other necessary construction upgrades. During the pandemic, many UIOs couldn’t get approval for ventilation upgrades, heaters, generators, and weatherization equipment. Removing this unjust burden on UIOs is a commonsense fix and would allow them to improve the quality of the culturally competent care that they provide.”

“Oklahoma has the second-largest Urban Indian patient population and is proudly served in both Tulsa and Oklahoma City clinics. We should continue to improve health care access for our Urban Indian population and broaden the flexibility for Urban Indian Organizations’ use of facilities renovation dollars, in addition to those for accreditation, to meet patient needs,” said Senator James Lankford (R-OK).

“The impacts of COVID-19 will be with our Native communities for a long time to come. It is critical that the Indian Health Care Center of Santa Clara Valley and other UIOs be able to provide a safe environment for the families and patients we serve. We are extremely grateful for Senator Padilla’s leadership in rectifying a longstanding barrier preventing us from using existing funding to make urgent upgrades,” said Sonya Tetnowski (Makah), CEO of Indian Health Care Center of Santa Clara Valley, President of California Consortium for Urban Indian Health (CCUIH), and President-elect of NCUIH.

“It is time to live out this Country’s commitment to each other to live with respect for one another and in community. With this legislation, Friendship House in San Francisco will build a home village site for our urban Native Americans, so that our people may contribute to saving and enriching our homeland, which we must now all share and care for or lose. We greatly appreciate Senator Padilla’s leadership on this issue,” said Abby Abinanti (Yurok), President of the Friendship House Association of American Indians Board of Directors.

UIOs lack access to facilities funding under the general IHS budgetary scheme, meaning there is no specifically allocated funding for UIO facilities, maintenance, sanitation, or medical equipment, among other imperative facility needs. While the whole IHS system has made the transition to telehealth, negative pressurizing rooms, and other facility renovations to safely serve patients during the pandemic, restrictions in the relevant statutory text did not allow UIOs to make those transitions. Section 509 currently permits the IHS to provide UIOs with funding for minor renovations and only in order to assist UIOs in meeting or maintaining compliance with the accreditation standards set forth by The Joint Commission (TJC).

These restrictions on facilities funding under Section 509 have ultimately prevented UIO facilities from obtaining the funds necessary to improve the safety and quality of care provided to American Indian/Alaska Native (AI/AN) persons in urban settings. Without such facilities funding, UIOs are forced to draw from limited funding pools, from which they must also derive their limited funding for AI/AN patient services. This lack of facility funding for UIOs is a breach of the federal trust obligation to AI/AN health care beneficiaries, necessitating congressional action to include UIOs in future legislative measures for IHS facility funding.

In May, Congressman Ruben Gallego (D-AZ) and Congressman Don Bacon (R-NE) introduced the Urban Indian Health Facilities Provider Act (H.R. 3496) in the House of Representatives which expands the use of existing IHS resources under Section 509 of the Indian Health Care Improvement Act (IHCIA) (25 U.S.C. § 1659) to increase the funding authority for renovating, constructing, and expanding Urban Indian Organizations (UIO). Senators Alex Padilla (D-CA), James Lankford (R-OK) along with co-sponsors Moran (R-KS), Feinstein (D-CA), and Smith (D-MN) on the Senate Indian Affairs Committee introduced the identical Senate bill (S. 1797).

Last month, NCUIH testified before the House Natural Resources Subcommittee for Indigenous Peoples of the United States (SCIP) and the Senate Committee on Indian Affairs (SCIA) in support of the Urban Indian Health Facilities Provider Act (H.R. 3496 / S. 1797). Sonya Tetnowski (Makah Tribe), NCUIH President-Elect and Chief Executive Officer of the Indian Health Center of Santa Clara Valley, testified before SCIP and Robyn Sunday-Allen (Cherokee), NCUIH Vice President and CEO of the Oklahoma City Indian Clinic, testified before SCIA.

This fix is broadly supported in Indian Country and the National Congress of American Indians passed a resolution in June to “Call for Congress to Amend Section 509 of the Indian Health Care Improvement Act (IHCIA) to Remove Facility Funding Barriers for Urban Indian Organizations”.

PRESS RELEASE – NCUIH Testifies at House and Senate Hearings Highlighting Need for Urban Indian Health Infrastructure Fix

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Washington, D.C. (July 22, 2021) – This week, the National Council of Urban Indian Health (NCUIH) testified before the House Natural Resources Subcommittee for Indigenous Peoples of the United States (SCIP) and the Senate Committee on Indian Affairs (SCIA) in support of the Urban Indian Health Facilities Provider Act (H.R. 3496 / S. 1797). On Tuesday, Sonya Tetnowski (Makah Tribe), NCUIH President-Elect and Chief Executive Officer of the Indian Health Center of Santa Clara Valley, testified before SCIP. On Wednesday, Robyn Sunday-Allen (Cherokee), NCUIH Vice President and CEO of the Oklahoma City Indian Clinic, testified before SCIA. Tetnowski and Sunday-Allen spoke in support of the NCUIH-endorsed Urban Indian Health Providers Facilities Improvement Act, which will pave the way for increased investment in the renovation and construction of Urban Indian Organization (UIO) facilities. It will amend Section 509 of The Indian Health Care Improvement Act (IHCIA) (25 U.S.C. § 1659) to permit UIOs to access existing avenues for Indian Health Services (IHS) facilities renovation funding. This bipartisan amendment of prior legislation will not otherwise affect federal facilities funding for IHS or Tribally operated programs through existing Indian Health Service appropriations for improvements and renovations.

Read Full NCUIH SCIP Testimony              Watch Full SCIP Hearing

Read NCUIH’s Full SCIA Testimony               Watch Full SCIA Hearing

 

Leaders from the House Natural Resources Committee Expressed Support for the Bill

Subcommittee Chair Leger Fernandez supported the bill and Chair Grijalva said “Mr. Gallego’s bill is particularly important as a follow-up to the COVID pandemic and to the follow-up on the disparity with regard to the healthcare that Indigenous people receive. It’s a really good piece of legislation, very timely given all of the other discussions that are going on right now in terms of reconciliation, etc.” Ranking Member Young also expressed support for H.R. 3496 and suggested it be moved forward. ​

“Making sure UIOs can use their limited resources on the projects they know will most benefit patients is how we ensure that these vulnerable populations receive the best care possible. That’s why my bipartisan bill simply removes this obsolete provision of law and allows UIOs to spend their money where it will be most effective for patients,” said Rep. Ruben Gallego (D-AZ-07).

Several Members of Congress from both sides of the aisle demonstrated a strong interest in expanding resources in urban Indian health and followed up with Ms. Tetnowski about the implications of the legislation. For example, Chair Leger Fernandez asked about the impacts of any changes on accreditation processes for the 41 UIOs, and Ms. Tetnowski explained the legislation will have no effect on accreditation statuses for UIOs.
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In a hearing last month, IHS also reiterated the law is archaic and there is no reason to retain this provision that ultimately impedes health care for urban AI/ANs.

Senate Hearing Highlights Urgency for Parity for Urban Indian Health

Senator James Lankford (R-OK) introduced Robyn Sunday-Allen and the bill of which he is the primary sponsor, “I strongly believe that more must be done to achieve parity for the UIOs within the Indian Health System umbrella.” In addition to support from Chair Schatz and Vice Chair Murkowski, IHS Deputy Director for Management Operations, Randy Grinnell testified that providing UIOs with broader authority “to improve their health care facilities will assist in providing the high quality, safe, and culturally relevant health care for the urban Indian population.”

Several other parity issues for urban Indian health were raised by the Senators, including Native Behavioral Health and the need for 100% FMAP for UIOs. Senator Cantwell asked IHS, “How long will it take for us to get full FMAP for Urban Indian Health?” IHS said they would have to follow up with a response and was unable to provide any timeline for when resources would reach urban Indian organizations. To date, UIOs have not received any benefits from the 100% FMAP for UIOs included in the American Rescue Plan Act passed in March of this year.

The Senate hearing also covered the Native American Child Protection Act. The bill includes the following updates for UIOs that were advocated for by NCUIH and noted by Heidi Todacheene:

  • Includes the establishment of a 12-member Advisory Board appointed by the Secretary of the Interior that will consist of representatives from Indian tribes, Tribal organizations, and urban Indian organizations with expertise in child abuse and child neglect.
  • Includes development of training and technical assistance materials on the prevention, identification, investigation, and treatment of incidents of family violence, child abuse, and child neglect for distribution to Indian tribes, Tribal organizations, and urban Indian organizations.

We at NCUIH would like to thank SCIP and SCIA for scheduling hearings for testimony from stakeholders in Indian health regarding infrastructure expansion in Indian Country. These hearings are an important first step for bringing UIOs and the urban AI/AN patients whom they serve into parity with beneficiaries served at IHS or Tribal health facilities.

SCIP and SCIA will take the requests from Tetnowski’s and Sunday-Allen’s testimonies this week into consideration as its members prepare their legislative priorities in deciding which bills may be included in the upcoming bipartisan infrastructure framework proposal. NCUIH will request markups by both Committees.

Background

UIOs lack access to facilities funding under the general IHS budgetary scheme, meaning there is no specifically allocated funding for UIO facilities, maintenance, sanitation, or medical equipment, among other imperative facility needs. While the whole IHS system has made the transition to telehealth, negative pressurizing rooms, and other facility renovations to safely serve patients during the pandemic, restrictions in the relevant statutory text did not allow UIOs to make those transitions. Section 509 currently permits the IHS to provide UIOs with funding for minor renovations and only in order to assist UIOs in meeting or maintaining compliance with the accreditation standards set forth by The Joint Commission (TJC).

These restrictions on facilities funding under Section 509 have ultimately prevented UIO facilities from obtaining the funds necessary to improve the safety and quality of care provided to American Indian/Alaska Native (AI/AN) persons in urban settings. Without such facilities funding, UIOs are forced to draw from limited funding pools, from which they must also derive their limited funding for AI/AN patient services. This lack of facility funding for UIOs is a breach of the federal trust obligation to AI/AN health care beneficiaries, necessitating congressional action to include UIOs in future legislative measures for IHS facility funding.

RESOURCES

PRESS RELEASE: NCAI PASSES RESOLUTION URGING CONGRESS TO REMOVE FEDERAL FACILITIES FUNDING BARRIERS FOR URBAN INDIAN ORGANIZATIONS

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The fix called for in the resolution will better ensure that UIOs can meet the changing health care delivery needs for tribal citizens residing in urban areas.

Washington, D.C. (June 28, 2021) – After extensive advocacy from NCUIH and our partners for Urban Indian health, the National Congress of American Indians (NCAI) passed resolution AK-21-020: Call for Congress to Amend Section 509 of the Indian Health Care Improvement Act to Remove Facility Funding Barriers for Urban Indian Organizations (UIOs) on June 24, 2021, during NCAI’s Mid-Year Conference. The resolution urges Congress to enact legislation to amend the Indian Health Care Improvement Act (IHCIA) to remove the language restricting UIO facilities’ funding availability only to minor renovations to meet or maintain accreditation standards.

“Facility-related use of federal funds remains the most requested priority for our UIOs,” said NCUIH CEO Francys Crevier (Algonquin). “The current limitations found in the Indian Health Care Improvement Act force UIOs to use their limited third-party reimbursement funds for necessary minor facility improvements to meet or maintain accreditation by Joint Commission for Accreditation of Health Care Organizations. NCUIH leadership advocated for the adoption of this important resolution, and we applaud NCAI for passing it.”

NCAI resolutions are one of the policy mechanisms used to express the organizational positions on tribal, federal, state, and/or local legislation, litigation, and policy matters that affect tribal governments or communities. NCAI members establish the organization’s positions on issues that affect tribal nations and Native people through a resolution process. Resolutions to be considered at the Mid-Year Convention are only accepted if they are determined to be emergency in nature and national in scope. The resolution, submitted by NCUIH Director of Federal Relations, Sunny Stevenson (Walker River Paiute), calls on Congress to continue to honor the obligations made to tribal members by the federal government.

NCAI has been a longtime partner of NCUIH, having collaborated on previous resolutions adopted in favor of Urban Indian health, including the extension of the Federal Tort Claims Act (FTCA) to be inclusive of UIOs, temporary 100% FMAP for UIOs under the American Rescue Plan Act, and federal reimbursement for AI/AN Veterans served at UIO facilities. Each of these NCAI resolutions has been instrumental in compelling Congressional action to pass these critical means of addressing contemporary issues that urban AI/AN persons encounter in seeking care under the federal trust responsibility. NCAI’s resolution follows the introduction of the Urban Indian Health Providers Facilities Improvement Act under identical House and Senate bills (H.R. 3496 / S. 1797). The bipartisan, bicameral bills will pave the way for increased investment in the renovation and construction of UIO facilities. The passage of the Urban Indian Health Providers Facilities Act would amend Section 509 of the Indian Health Care Improvement Act (25 U.S.C. § 1659), the provision of IHCIA that pertains to UIO facility funding. The amendment will not otherwise affect federal facilities funding for IHS or tribally-operated programs through existing Indian Health Service appropriations for improvements and renovations.

 

RESOURCES

 

Full Resolution Text

List of NCAI Mid-Year Resolutions 

NCUIH Statement on Indigenous Residential and Boarding Schools

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Washington, D.C. (June 25, 2021) – In Canada this past May, the discovery of 215 unmarked graves at Kamloops Indian Residential School brought past Indigenous traumas into the international spotlight. Yesterday, over 700 more unmarked graves were found on the grounds of the former Marieval Indian Residential School in Canada.

Boarding schools and residential schools are a tragic thread in history that the United States and Canada share: The United States Government Indian Boarding School Policy authorized the forced removal of hundreds of thousands of Native children, as young as 5 years old, relocating them from their homes in Tribal communities to one of the 367 Indian Boarding Schools across 30 States. Between 1869 and the 1960s, the United States federal government stole Native children from their families to destroy their indigenous identities, beliefs, and traditional languages to assimilate them into White American culture through federally funded Christian-run schools.

Today, National Council of Urban Indian Health Chief Executive Officer Francys Crevier (Algonquin) released the following statement in response to these recent discoveries:

“I am devastated to hear the discovery of mass graves of our children, but tragically, I am not surprised. The National Council of Urban Indian Health (NCUIH) exists because of the historic oppression like this that forced relocation of our people by the United States (and Canadian) governments, which included ripping our children from their families and placing them in federally funded boarding schools in their attempt to “kill the Indian, save the man.” Indian Country’s social determinants of health demonstrate the connection to the historical trauma inflicted by these governments that caused tremendous health consequences for our people – most recently with the COVID-19 pandemic taking the lives of many of our relatives. At NCUIH, we are charged with holding the US government to its trust and treaty responsibility of providing health care for all Native people.

The atrocities Native children experienced during the boarding school era are marked by years of pain as Indigenous communities were forced to suffer in silence. These long-standing intergenerational trauma cycles are, unfortunately, nothing new to Native people.  Federal policies in the United States and Canada attempted to destroy Native identity, culture, and language and continue to be a cause of suffering in our communities. For centuries of historic trauma, this process has been a long and challenging journey for our relatives.

With that, we applaud Secretary Deb Haaland, the first Native American cabinet holder, for beginning the conversation to hold the United States government that created these boarding schools accountable through the Federal Indian Boarding School Initiative. The Department of the Interior will identify boarding school sites, locations of known and possible student burial sites located at or near school facilities and identify the children and their tribal affiliations to bring them home to their families.

As the effort continues to bring these children home, we are reminded of the resilience of Native people and ask our relatives to lean on each other as more information from the boarding school era is revealed to the public. While Natives have been well aware of the government’s violation of basic human rights and genocide of our people, it is important for the United States and Canada to finally take responsibility for these horrific actions.

At NCUIH, we are charged with holding the US government to its trust and treaty responsibility of providing health care for all Native people. Our work will continue as we fight to make up for centuries of oppression and needless deaths of our people – including our own children. The United States government can begin to rectify their actions by finally honoring its trust and treaty responsibilities to our people.”

For more information on the history of Native American Boarding Schools, please visit The National Native American Boarding School Healing Coalition website.

Recommended Readings: 

Pipestone My Life in an Indian Boarding School

Boarding School Seasons American Indian Families, 1900-1940

The Middle Five: Indian Schoolboys of the Omaha Tribe

Stringing Rosaries: The History, the Unforgivable, and the Healing of Northern Plains American Indian Boarding School Survivors

They Called Me Uncivilized: The Memoir of an Everyday Lakota Man from Wounded Knee

A Voice in Her Tribe: A Navajo Woman’s Own Story

Boarding School Blues: Revisiting American Indian Educational Experiences

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The National Council of Urban Indian Health (NCUIH) is the 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 is the only national representative of the 41 Title V Urban Indian Organizations (UIOs) under the Indian Health Service (IHS) in the Indian Health Care Improvement Act (IHCIA). NCUIH strives to improve the health of the over 70% of the AI/AN population that lives in urban areas, supported by quality, accessible health care centers.

PRESS RELEASE: NCUIH BILL INTRODUCED TO EXPAND USE OF EXISTING RESOURCES FOR URBAN INDIAN HEALTH CARE

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FOR IMMEDIATE RELEASE

Press Contacts: 

NCUIH: Sara Williams, swilliams@ncuih.org 

THE BILL WOULD ALLOW EXISTING INDIAN HEALTH SERVICE RESOURCES TO ALLOW FOR RENOVATIONS, CONSTRUCTION, AND EXPANSION OF URBAN INDIAN ORGANIZATIONS. 

Washington, D.C. (May 25, 2021) – Today, Congressman Ruben Gallego (D-AZ) and Congressman Don Bacon (R-NE) introduced a bill in the House of Representatives that would expand the use of existing Indian Health Service (IHS) resources under Section 509 of the Indian Health Care Improvement Act (IHCIA) (25 U.S.C. § 1659) to increase the funding authority for renovating, constructing, and expanding Urban Indian Organizations (UIO). Senators Alex Padilla (D-CA), James Lankford (R-OK) along with co-sponsors Moran (R-KS), Feinstein (D-CA), and Smith (D-MN) on the Senate Indian Affairs Committee introduced the identical Senate bill.  

UIOs do not have access to facilities funding under the general IHS budgetary scheme, meaning that there is no specifically allocated funding for UIO facilities, maintenance, sanitation, or medical equipment, among other imperative facilities needs that have arisen in the wake of the COVID-19 pandemic. While the whole IHS system had to make the transition to telehealth, negative pressurizing rooms, and other facility renovations to safely serve patients during the pandemic, UIOs were not allowed to make those transitions due to this restriction. Section 509 currently permits the IHS to provide UIOs with funding for minor renovations, and only in order to assist UIOs in meeting or maintaining compliance with the accreditation standards set forth by The Joint Commission (TJC). These restrictions on facilities funding under Section 509 have ultimately prevented UIO facilities from obtaining funds necessary to improve the safety and quality of care provided to American Indian/Alaska Native (AI/AN) persons in urban settings. Without such facilities funding, UIOs are forced to draw from limited funding pools, from which they must also derive their limited healthcare funding for AI/AN patients. 

“The impacts of COVID-19 will be with our Native communities for a long time to come. It is critical that the Indian Health Care Center of Santa Clara Valley and other UIOs be able to provide a safe environment for the families and patients we serve,” said Sonya Tetnowski (Makah), NCUIH President-elect, President of California Consortium for Urban Indian Health (CCUIH), and CEO of the Indian Health Care Center of Santa Clara Valley. “We are extremely grateful for this Congressional leadership in rectifying a longstanding barrier preventing us from using existing funding to make urgent upgrades.” 

With only 1 out of the 41 UIOs predicted to maintain TJC accreditation, it is imperative for Congress to expand the use of existing IHS facilities funding under Section 509. UIOs serve a fundamental role in aiding Congress in fulfilling its trust obligation to approximately 70% of federally enrolled Indians who do not live on tribal lands. A failure for Congress to expand IHS facilities funding under the current model would amount to a violation of its fiduciary duties in providing AI/AN citizens with accessible healthcare. 

“Urban Indian Organizations are a lifeline to Native Americans living in urban areas across California,” said Senator Padilla. “Yet, UIOs are prohibited from using Indian Health Service funding for facilities, maintenance, equipment, and other necessary construction upgrades. During the pandemic, many UIOs couldn’t get approval for ventilation upgrades, heaters, generators, and weatherization equipment. Removing this unjust burden on UIOs is a commonsense fix and would allow them to improve the quality of the culturally competent care that they provide.”  

86 percent of UIOs report needing to make facilities and infrastructure upgrades, while 74 percent of UIOs report unmet need for new construction to better serve patients. These needs include but are not limited to the construction of urgent care facilities and infectious disease areas, capacity expansion projects, ventilation system improvements, and upgrades to telehealth and electronic health records systems. However, under an existing obsolete provision of law, UIOs are prevented from using the money allocated to them by Congress on these critical projects. The Urban Indian Health Providers Facilities Improvement Act amends the law to allow UIOs to spend appropriated funding on construction and renovation projects to improve the safety and quality of care provided to urban Indian patients. 

“Oklahoma has the second-largest Urban Indian patient population and is proudly served in both Tulsa and Oklahoma City clinics. We should continue to improve health care access for our Urban Indian population and broaden the flexibility for Urban Indian Organizations’ use of facilities renovation dollars, in addition to those for accreditation, to meet patient needs,” said Senator Lankford. “We should finalize these changes to ensure we provide more, quality options for Tribal health care. I look forward to the support from the leadership of the Senate Committee on Indian Affairs on this important legislation.” 

“Despite having extremely limited resources, Urban Indian organizations have been on the front lines of the COVID-19 pandemic, and for long before that have provided comprehensive, culturally competent care to urban Indians and other medically underserved patients across the country,” said Rep. Gallego. “Congress must immediately end this erroneous restriction on UIOs’ ability to spend the money Congress gave them on the projects that will best serve their patients. We must pass this bill without delay.” 

“Like many community healthcare centers, Urban Indian Organizations (UIOs) have been hit financially because of COVID and have struggled to renovate their facilities and expand capacity requirements,” said Rep. Bacon. “Under current law, UIOs cannot use federal funds to pay for these improvements and keep their doors open. Our bill lifts that restriction and grants access to these funds. These health centers care for so many members in our Nebraska community. It’s only right we close this loop hole so they can provide quality care to their patients.” 

BACKGROUND 

Recently, NCUIH was successful in working with Congress to allow some of the COVID-19 funds to be used for COVID-19 related facilities updates. However, the limitations of the IHCIA provision have continued to pose a barrier for UIOs for facility maintenance. Senator Tina Smith (D-MN) and Senator Lankford (R-OK) also inquired about the impacts of the restrictions at a recent Senate Indian Affairs Committee hearing. 

NCUIH along with 29 other Native organizations recently included this request in a joint letter on infrastructure priorities, which also advocated for $21 billion for Indian health infrastructure inclusive of UIOs.  

READ THE FULL LEGISLATIVE TEXT ONE PAGER: REMOVE FACILITIES RESTRICTIONS ON UIOS

PRESS RELEASE: NCUIH’S ANNUAL CONFERENCE WEEK STARTS TODAY

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PRESS RELEASE: NCUIH’S ANNUAL CONFERENCE WEEK STARTS TODAY

CIRCLE OF RESILIENCE: EMPOWERING INDIAN COUNTRY IN A VIRTUAL WORLD

FOR IMMEDIATE RELEASE

Press Contact: Sara Williams, swilliams@ncuih.org

Washington, D.C. (May 24, 2021) – The National Council of Urban Indian Health’s 2021 Annual Conference, themed Circle of Resilience: Empowering Indian Country in a Virtual World, starts this week running Tuesday, May 25 through Thursday, May 27, 12 – 5 p.m. EST daily. The National Council of Urban Indian Health (NCUIH) will highlight high priority issues such as COVID-19, mental health disparities, community outreach, Missing and Murdered Native Americans (MMNA), and policy that is directly affecting American Indian and Alaska Native (AI/AN) populations in urban areas and offer many networking opportunities.

“Against all odds, Indian Country has proven to be resilient. We know you have worked nonstop this year, working harder shifts and longer hours to provide more services for your communities than ever before,” said NCUIH CEO Francys Crevier (Algonquin). “This year’s conference is not just a reflection of the work we have done, but the chance for our community members to highlight all the work done at home.” 

NCUIH is excited to host an array of subject matter experts, Members of Congress, and representatives from federal agencies with dedicated spaces to collaborate throughout the conference. Today’s ever-changing virtual world brings a unique set of challenges while offering leaders the opportunity to innovate within their organizations to better reach the communities they serve.

We want to express our gratitude to our sponsors who graciously contributed to the 2021 NCUIH Annual Conference and to our exhibitors who will offer information and products during the conference for attendees to view or purchase between sessions. We invited a wide range of organizations including arts and crafts vendors to provide an engaging experience for attendees to build relationships and show their support for Indian Country in this new and exciting virtual event space.

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EXHIBITORS:

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This year’s Annual Conference will offer three days of agency reports, best practices to empower and equip urban Indian organizations at the local level, and collaboration focused on culture, healing, culture, medicine, and wellness

REGISTER NOW  CONFERENCE ATTENDEE HUB

PRESS RELEASE: National Council of Urban Indian Health Partnered with Uber to Provide Transportation to Vaccine Clinic for urban Indians in the D.C. Metropolitan Area

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Press Contacts: 

NCUIH: Sara Williams, swilliams@ncuih.org 

Uber: UberPress@GlobalStrategyGroup.com 

Uber is donating 2,000 FREE/discounted rides to connect the American Indian and Alaska Native Communities to the COVID-19 Vaccine in DC metropolitan region and Baltimore. 

WASHINGTON, D.C. (May 13, 2021) – Today, the National Council for Urban Indian Health (NCUIH) announced a new partnership with Uber to provide rides to Native American LifeLines Baltimore for urban American Indians and Alaska Natives (AI/AN) living in the Washington, D.C., Maryland, and Virginia (DMV) metropolitan area to receive their COVID-19 vaccination. Through this partnership, Uber provides 2,000 free or deeply discounted rides to members of the AI/AN community in the DMV to ensure vaccine equity.   

“Since last fall, NCUIH and Native American LifeLines have pushed for the inclusion of the 65,000 Natives in the DMV as Natives are dying from COVID-19 at the highest rates worldwide,” said NCUIH CEO Francys Crevier (Algonquin). “Lack of transportation should not hinder our relatives from having access to vaccinations. This partnership with Uber will ensure safe and convenient transportation to and from appointments as we continue this fight against the COVID-19 pandemic.”   

“We understand the necessity of high-quality health care and are proud to partner with the National Council of Urban Indian Health to help them make access to the COVID-19 vaccine seamless for the community they serve,” said Michele Blackwell, Public Affairs Manager for Uber. “Transportation is often a critical barrier that prevents vulnerable communities from accessing the health care they need. Uber is working hard in Baltimore and in the Washington, DC region to be part of the solution and ensure all people have access to the transportation they need to protect themselves and their families from this virus.”  

Promo codes will be distributed to individuals in the DMV from NCUIH and Native American LifeLines and will be redeemable until September 30, 2021. Offers will ensure each participant can get to and from each vaccination appointment at little to no cost to them. This announcement is part of Uber’s commitment to donate 10 million free rides to vaccine appointments nationally.   

For a comprehensive list of ways Uber has helped Move What Matters in the DMV since the outset of the pandemic, check out our blog www.uber.com/blog/moving-what-matters-in-the-dmv/. Visit www.ncuih.org/vaccine for more information on the vaccination clinic and our Be a Good Relative Campaign encouraging urban AI/AN to get vaccinated. 

PRESS RELEASE: Senate Hearing Highlights Importance of Urban Indian Health as COVID-19 Rages On

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Policy Contact: Meredith Raimondi, mraimondi@NCUIH.org

Press Contact: Sara Williams, swilliams@NCUIH.org

NCUIH President Walter Murillo testified on the critical work of urban Indian health. 

Washington, D.C. (April 14, 2021) – Today, the President of the National Council of Urban Indian Health (NCUIH) testified before the Senate Committee on Indian Affairs for an oversight hearing on “Examining the COVID-19 Response in Native Communities: Native Health Systems One Year Later.” Walter Murillo (Choctaw), CEO of Native Health in Phoenix, joined representatives from the Indian Health Service (IHS), National Indian Health Board, Papa Ola Lokahi, and Alaska Native Medical Center for the virtual hearing.

“Because the Indian health care system and UIOs have never been properly funded, we started from an extreme deficit when the pandemic hit,” Murillo said. He continued, “UIOs only receive $672 per patient for the year – this is unacceptable. The past 12 months have reminded us how resilient our people are and highlighted how critical our Indian health care system is to the lives of American Indians and Alaska Natives. Tragically, we have planned many funerals and lost far too many members of our communities.” 

Native health systems “started the rollout of some of the most successful vaccine campaigns in the country, and they continue to work every day to keep native communities safe. It really is remarkable how native health systems have overcome long odds, considering how under-resourced they were to begin,” said Chair Brian Schatz (D-HI) in his opening statement.

Senators from both sides of the aisle emphasized the importance of the federal government’s trust responsibility to provide health care for all Native people and key fixes needed to improve urban Indian health. Senator Tina Smith (D-MN) said, “We need to make sure that Congress is providing sufficient resources directly for the urban Indigenous.”  Senator Lankford (R-OK) who championed legislation to extend the Federal Tort Claims Act (FTCA) to UIOs applauded the IHS for swift implementation of that provision which passed as a standalone bill last year.

Hot Topic: 100% FMAP for UIOs

Senator Maria Cantwell (D-WA) pushed for the enactment of a permanent 100% Federal Medical Assistance Percentage (FMAP) for services provided by Urban Indian Organizations (UIOs). “There’s no reason to distinguish between an IHS, Tribal, or UIO facility. They all should get full 100% FMAP reimbursement. Urban Indian health is suffering, and there is no reason not to give them parity,” said Senator Cantwell. Mr. Murillo, who has been fighting for full FMAP for 20 years, explained how parity would help equalize serious funding shortages experienced by urban Indian organizations.

Hot Topic: Facilities

Infrastructure was another key topic of the hearing discussion with both Senator Smith and Senator Lankford inquiring about restrictions faced by UIOs with regards to facilities upgrades. In his written testimony, Mr. Murillo requested the Committee support $21 billion for Indian health infrastructure inclusive of UIOs and the support of removing restrictions on UIOs. Senators learned about how UIOs cannot access any infrastructure funds under the IHS facilities line item and the need for the American Jobs Plan to include avenues for improvements for urban Indian health facilities.

Next Steps

The Senate Committee on Indian Affairs will take the recommendations from today into consideration as they prepare their legislative priorities for this Congress related to responding to COVID-19.

More Information 

Read Written Testimony Watch Testimony