PRESS RELEASE: Gallego, Mullin Introduce FTCA Bill to Reduce Burdens for Urban Indian Organizations

/0 Comments/in /by

FOR IMMEDIATE RELEASE

Contact: Meredith Raimondi, 202-417-7781, mraimondi@ncuih.org

The long-needed fix would allow urban Indian organizations to direct funds back to the patients who need it most.

Washington, DC (April 21, 2020) – Rep. Ruben Gallego (D-AZ) and Rep. Markwayne Mullin (R-OK) introduced H.R. 6535 last week to expand Federal Tort Claims Act (FTCA) coverage to urban Indian organizations, giving them a desperately needed boost in resources as many suffer critical supply shortages, closures, and financial hardship as a result of the COVID-19 pandemic.

Urban Indian organizations (UIOs) are doing everything they can to keep their doors open during this pandemic while still dealing with paying for costly medical malpractice insurance. Unfortunately, urban Indian organizations may be forced to make extremely difficult choices – facing competing priorities and expenses like increased PPE prices, testing supplies, in addition to very costly malpractice insurance. H.R. 6535 would create parity within the Indian Health Service health system by extending FTCA coverage to urban Indian organizations, who currently are forced to divert resources away from health care in order to foot exorbitant liability costs themselves.

“We are extremely grateful for Congressman Gallego and Congressman Mullin’s leadership in introducing this legislation for a long-needed fix to the medical malpractice liability protection, which ensures parity for Urban Indian Organizations (UIOs). A single UIO can pay as much as $250,000 annually, funds that could be spent providing health care for the American Indians and Alaska Natives they serve. As all other Indian Health Care Providers are covered by FTCA and Community Health Centers employees as well as volunteers are also covered, this legislative fix is critical to ensure continuity of health care in a time when it’s needed most,” said Francys Crevier, Executive Director of NCUIH.

“Urban Indian organizations, including Native Heath in my District, are on the front lines of this pandemic. Individual facilities are reporting skyrocketing costs in the hundreds of thousands and dangerous supply shortages. Three UIOs have already closed their doors as a result of the strain,” said Rep. Gallego, Chair of the Subcommittee for Indigenous Peoples. “We cannot afford to leave urban Indians without access to care during this public health crisis. My bill will both bring long overdue parity to urban Indian health providers and provide an infusion of desperately resources to an urban Indian health system on the brink.”

“Urban Indian Health Centers play a critical role in providing health care to Native Americans. Our bill ensures they are covered by the FTCA so that they won’t have to use their limited resources to cover costly liability bills. I want to thank Congressman Gallego for working with me on this legislation that will improve health care for Native Americans,” said Rep. Mullin.

Next Steps

NCUIH has long-advocated for the introduction of this legislation and will be requesting that lawmakers include it in the next COVID-19 package.

Background

###

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: National Council of Urban Indian Health Announces New Board of Directors

/0 Comments/in /by

FOR IMMEDIATE RELEASE 

Contact: Meredith Raimondi, 202-417-7781, mraimondi@ncuih.org

Washington, DC (March 25, 2020) – The National Council of Urban Indian Health (NCUIH) announces the election of the new members to its Board of Directors. The election took place during the 2020 Annual Virtual Meeting on March 25, 2020.

“I am pleased to welcome our newest members to our Board of Directors. All individuals are poised to support the development of quality, accessible, and culturally-competent health services for American Indians and Alaska Natives living in urban areas,” said Francys Crevier, Executive Director of NCUIH.

Officers

President Walter Murillo*
Vice-President Robyn Sunday-Allen
President-Elect Sonya Tetnowski
Secretary Linda Son-Stone
Treasurer Scott Black

Note: Walter Murillo was confirmed in a previous election.

Board Members

Region Board Members
1 Kerry Lessard
2 RoxAnne Lavallie-Unabia
3 Reid Wendel
4 Todd Wilson
5 Maureen Rosette
6 Sonya Tetnowski, Scott Black
7 Walter Murillo, Linda Son-Stone, Robyn Sunday-Allen
8 Adrianne Maddux

NCUIH 2020 – 2021 Board of Directors

Region 1
Kerry Lessard, Board Member
Descendant of Absentee Shawnee
Executive Director
Native American Lifelines of Baltimore
106 West Clay St. Baltimore, MD 21201
Region 3
Reid Wendel, Board Member
Rosebud Sioux Tribe
Executive Director
South Dakota Urban Indian Health, Inc.
1200 N West Ave, Sioux Falls, SD 57103
Region 4
Todd Wilson, Board Member
Crow
Executive Director
Helena Indian Alliance-Leo Pocha Clinic
501 Euclid Ave, Helena, MT 59601
Region 6 (b)
Scott Black, Board Treasurer
Descendant of Miami of Ohio and Mohican of Ohio 
Executive Director
American Indian Health Services
4141 State Street #B-11, Santa Barbara, CA 93110
Region 7 (a)
Linda Son-Stone, Board Secretary
Executive Director
First Nations Community HealthSource
5608 Zuni NE, Albuquerque, NM 87108
Region 7 (c)
Robyn Sunday-Allen, Board Vice-President
Cherokee
Chief Executive Officer
Oklahoma City Indian Clinic
4913 West Reno Avenue, Oklahoma City, OK 73127
Region 2
RoxAnne M Lavallie-Unabia, Board Member
Turtle Mountain Band of Chippewa
Interim Executive Director
American Indian Health Service of Chicago
4326 W Montrose Ave, Chicago, IL 60641
Region 5
Maureen Rosette, Board Member
Chippewa Cree
Chief Operations Officer
N.A.T.I.V.E. Project
1803 Maxwell Ave. Spokane, WA 99201
Region 6 (a)
Sonya Tetnowski,Board President-Elect
Makah Tribe
Executive Director
Indian Health Center of Santa Clara Valley
1211 Meridian Avenue. San Jose, CA 95125
Region 7 (b)
Walter Murillo, Board President
Choctaw
Chief Executive Officer
Native Health Center
4041 North Central Avenue, Building C. Phoenix, AZ 85012
Region 8
Adrianne Maddux, Board Member
Hopi
Executive Director
Denver Indian Health and Family Services
2880 W. Holden Place. Denver, CO 80204

 

 

 

###

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: HHS Announces Action by CDC to disburse $80 Million for Indian Country including Urban Indian Health

/0 Comments/in /by

FOR IMMEDIATE RELEASE

Contact: Meredith Raimondi, 202-417-7781, mraimondi@ncuih.org

14 days after the supplemental bill was enacted, HHS announced action to disburse funds.

Washington, DC (March 20, 2020) – On March 20, 2020, the Department of Health and Human Services (HHS) announced action by the Centers for Disease Control and Prevention (CDC) to provide $80 million in funding to tribes, tribal organizations, and Urban Indian Organizations for resources in support of our nation’s response to the 2019 novel coronavirus (COVID-19).

“While the cities across the country are shutting down, our Urban Indian Organizations (UIOs) are doing all they can to stay open for the patients and communities. As UIOs have risen to the challenge without any additional federal funding to date, helping not only their patients but their counties, the timing of this is critical and will be essential to protecting the personnel who are risking their lives without proper protective equipment. This is an important step in the right direction to helping Indian Country mitigate this deadly virus. We must thank our leaders in Congress – Rep. Betty McCollum, Rep. Tom Cole, Rep. Markwayne Mullin, Rep. Paul Cook, Rep. Raul Grijalva, Rep. Ruben Gallego, Sen. Chuck Schumer, Sen. Elizabeth Warren and Sen. Tom Udall – who have been instrumental in ensuring this funding reaches the most vulnerable populations impacted by this pandemic,” said Francys Crevier, Executive Director of NCUIH.

Current Status

The Indian Health Center of Santa Clara Valley, the UIO in San Jose, California, is at the front lines of the COVID-19 pandemic, where it confirmed its first COVID-19 case on March 13 and cases have increased more than threefold in that area over the past few days. In Utah, the Urban Indian Center of Salt Lake has several patients who were exposed to COVID-19 through a March 9 event where a number of girls interacted directly with Utah Jazz player Rudy Gobert (the namesake of Rudy’s Kids Foundation) – who tested positive for COVID-19 two days later.  The UIO located in Seattle, WA, an area currently experiencing a significant level of outbreak, is projecting a monthly loss of $734,922 during this pandemic.  Another UIO has had to reduce operations to two days a week. A UIO is also considering layoffs due to lack of PPE. And, one UIO has determined it must close for 30 days – with a handful of rotating staff (to minimize the potential for spread) providing telemedicine services only.

On March 6, 2020, H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (Act) became law (P.L. 116-123). The Act provides $8.3 billion in emergency funding for federal agencies to respond to the COVID-19 outbreak, including $2.2 billion for the Centers for Disease Control and Prevention (CDC), of which not less than $950,000,000 will be distributed via grants or cooperative agreements to states, localities, territories, tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes, and a proviso that “not less than $40,000,000 of such funds shall be allocated to tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes.” Grants or cooperative agreements with urban Indian health organizations will provide these funds to carry out surveillance, epidemiology, laboratory capacity, infection control, mitigation, communications, and other preparedness and response activities to prevent, prepare for, and respond to COVID-19, as well as to reimburse costs expended for these purposes incurred between January 20 and March 6, 2020.

Background

###

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: Congressional Native American Caucus Supports Policy Priorities Identified by NCUIH and Other National Native Organizations for Third Funding Bill

/0 Comments/in /by

FOR IMMEDIATE RELEASE

Contact: Meredith Raimondi, 202-544-0344, mraimondi@ncuih.org

As Indian Country awaits funding, Congress continues to prioritize Native Americans and UIOs are keeping their doors open.

Washington, DC (March 18, 2020) – On March 17, 2020, the Congressional Native American Caucus sent a letter to the House Committee on Appropriations Chair Nita Lowey and Ranking Member Kay Granger urging the inclusion of tribal priorities in the third supplemental coronavirus package.

The request from the Native American Caucus incorporates a joint letter submitted by the National Council of Urban Indian Health (NCUIH), National Indian Health Board (NIHB), and National Congress of American Indians (NCAI) (collectively, Native Organizations).  The Native Organizations outlined the need to address critical funding and policy priorities to protect and prepare the American Indian/Alaska Native (AI/AN) communities for COVID-19.

“We are encouraged by the attention of Congress to Indian Country as it continues to advance legislation to address this global pandemic. From Santa Clara Valley to Baltimore, our communities are ground zero for this health crisis, providing life-saving critical care without any additional federal resources to date. Despite a complete lack of additional federal resources, Urban Indian Organizations are doing everything they can to keep their doors open and ensure their patients and staff are safe. As this crisis continues to unfold, however, some programs are being forced to reduce hours due to funding shortages and potentially lay off staff to cope due to a lack of personal protective equipment. All Indian Health Care Providers are experiencing devastating impacts from this pandemic yet they continue to step up every day as operators on the front lines. The trust responsibility to Indian Country must not end in this time of crisis when it is needed most of all,” said Francys Crevier, Executive Director of NCUIH.

The Congressional Native American Caucus letter provides that “[i]t is imperative that the requests of American Indians and Alaska Natives (AI/ANs) are thoroughly considered in the preparation of this package to reflect the needs of all 574 federally-recognized Native Nations and 41 urban Indian organizations (UIOs) in furtherance of the federal trust responsibility.”

The Caucus further notes that “[t]he inclusion of these urgent recommendations is imperative for the health of tribal communities and their citizens as this unforeseen pandemic continues to escalate in the United States.”

The priorities include requesting that Congress provide $1.1 billion in funding for the Indian Health Service (IHS) Services Account – funding that is essential to meet the increased demand for health services and education, recruit providers, increase testing capacity, and address other needs of Indian Health Care Providers including UIOs, as well as enable them to secure medical supplies. In addition, Native Organizations requested Congress to ensure parity across the IHS system by extending the full Federal Medicaid Assistance Percentage to services provided at UIOs.

NCUIH Letter to Native American Caucus

Additionally, NCUIH sent a letter to the House Native American Caucus, advocating for the inclusion of Indian Health Care Providers, including UIOs, in emergency coronavirus legislation.

To date, UIOs have received zero federal dollars to combat COVID-19; yet, currently, at least 10% of UIOs have patients that have tested positive or are under investigation/quarantine for COVID-19 and the remainder have expended resources to prepare for the likely spread of the novel coronavirus to patients in their cities. NCUIH therefore requested a minimum of $58-$94 million in funding to be provided for emergency supplies and services for urban Indian organizations and parity among the IHS/Tribal/UIO system through Medicaid reimbursement and medical malpractice coverage.

Letters

Press Releases

###

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: Federal Government Has Yet to Disburse Funds to UIOs

/0 Comments/in /by

FOR IMMEDIATE RELEASE

Contact: Meredith Raimondi, 202-417-7781, mraimondi@ncuih.org

UIOs have received no funding from COVID-19 emergency bill.

Washington, DC (March 17, 2020) – To date, urban Indian organizations (UIOs) across the country have yet to receive any federal funding from the $8.3 billion emergency supplemental appropriations to combat the COVID-19 coronavirus pandemic, despite having been specifically listed in the legislation. UIOs already have an immediate funding need for services and supplies to combat the pandemic, and as the urgency, infection rate, and death toll intensifies, UIOs will need more funding resources to protect and preserve human life.

“As Congress and the Administration is working hard to address COVID-19, we are gravely concerned about the timeline for funds and resources to Indian Country. We have seen urban areas be adversely impacted by this virus and our Urban Indian Organizations have yet to receive any funding from the Administration despite Congress including UIOs in the bill. Lives are at stake and time is of the essence for action as our programs are already tackling this crisis without the resources they need,” said Francys Crevier, Executive Director of NCUIH.

The National Council of Urban Indian Health (NCUIH) partnered with the National Indian Health Board, National Congress of American Indians, Native American Finance Officers Association, and the United South and Eastern Tribes Sovereignty Protection Fund in a letter to Congressional appropriators detailing the need for UIO COVID-19 emergency supplies and services funding to be set at a minimum of $58-$94 million. UIOs receive primary IHS funding from only one line item in the IHS budget, which provides a mere $57,684,000 for urban Indian health. 41 UIOs that operate 74 health facilities in 22 states are thus faced with significantly constrained budgets.

With over two-thirds of the American Indian and Alaska Native (AI/AN) population living in urban areas, UIOs fill a crucial gap in the health care system for AI/ANs that do not have access to more remote facilities run by the Indian Health Service (IHS). UIOs must receive this critical funding without delay so that they may continue to provide high quality care to their patients while also managing local outbreaks and minimizing risks to their communities.

UIOs already have an immediate need for access to the emergency funding appropriated by Congress, as many are located in some of the hardest-hit areas of the United States.

  • The Indian Health Center of Santa Clara Valley, the UIO in San Jose, California, is at the front lines of the COVID-19 pandemic, where it confirmed its first COVID-19 case on March 13 and cases have increased more than threefold in that area over the past few days. In Utah, the Urban Indian Center of Salt Lake has several patients who were exposed to COVID-19 through a March 9 event where a number of girls interacted directly with Utah Jazz player Rudy Gobert (the namesake of Rudy’s Kids Foundation) – who tested positive for COVID-19 two days later.
  • The UIO located in Seattle, WA, an area currently experiencing a significant level of outbreak, is projecting a monthly loss of $734,922 during this pandemic.
  • These are only a few examples of the impacts UIOs are already experiencing – yet they have not received any COVID-19 funding to date.

On March 6, H.R.6074, the “Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020” (Act) became law. The Act provides $8.3 billion in emergency funding for federal agencies to respond to the COVID-19 outbreak, and includes at least $950,000,000 for states, localities, tribes, tribal organizations, and UIOs. A further proviso provides that “not less than $40,000,000 of such funds shall be allocated to tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes” through the Centers for Disease Control and Prevention (CDC). Grants or cooperative agreements with urban Indian health organizations will be to carry out surveillance, epidemiology, laboratory capacity, infection control, mitigation, communications, and other preparedness and response activities to prevent, prepare for, and respond to COVID-19, as well as to reimburse costs for these purposes incurred between January 20 and March 6, 2020.

NCUIH will continue to monitor this rapidly evolving situation, the ongoing health risks to AI/AN patients, and the urban Indian communities where they reside.

Letters and Press Releases

Related Bills

News

Background

###

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: Health Care Access for Urban Native Veterans Act Passes out of the House Subcommittee on Indigenous Peoples

/0 Comments/in /by

FOR IMMEDIATE RELEASE

Contact: Meredith Raimondi, 202-417-7781, mraimondi@ncuih.org

Washington, DC (March 11, 2020) – Today, H.R. 4153 – Health Care Access for Urban Native Veterans Act was considered and ordered to be reported by the House Natural Resources Committee during a legislative markup. H.R. 4153, introduced by Representative Ro Khanna, has bipartisan support with 27 cosponsors including 16 Democrats and 11 Republicans.

“Right now, urban Indian Veterans are being left behind by the United States.  This bill will allow Urban Indian Organizations to continue to provide life-saving health care to American Indian and Alaska Native Veterans, no matter where they live. We are grateful for the House Natural Resources Committee, including Chairman Grijalva and Representative Khanna for their continued efforts to push this legislation across the finish line,” said Francys Crevier, Executive Director.

“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, 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. To honor their service to the United States, we must ensure that Native Veterans have access to the care that best fits their cultural and health needs,” said Rep. Ro Khanna.

In July of 2019, the National Congress of American Indians passed a resolution calling on Congress to “enact legislation ensuring the provision of health care to American Indian and Alaska Native Veterans living in urban centers.” The NCAI resolution states: “The National Congress of American Indians (NCAI) urges Congress to pass legislation that amends the Indian Health Care Improvement Act at 25 U.S.C. §1645(c) to insert UIOs after IHS and Tribal Organizations and require VA to reimburse for services provided to AI/AN Veterans at all of the IHS, Tribal, and urban (I/T/U) system, in order to protect the health and welfare of AI/AN Veterans living in urban centers, thereby honoring their sacrifices.”

This important urban Indian health bill has widespread endorsements by NCUIH’s valued partners across Indian Country along with valuable Veteran organizations, such as NCAI, Iraq and Afghanistan Veterans of American, and VoteVets.

Senate

The Senate companion, S. 2365, is led by Senators Udall, Moran, Tester, Rounds, and Smith.

Next Steps

NCUIH will continue to monitor the bill as it moves forward and continue to advocate for health care access for urban Indian Veterans.

Background

 

###

PRESS RELEASE: Congress Announces $8.3 Billion for Coronavirus with Funding for Urban Indian Organizations

/0 Comments/in /by

FOR IMMEDIATE RELEASE

Contact: Meredith Raimondi, 202-417-7781, mraimondi@ncuih.org

NCUIH helped ensure Urban Indian Organizations were included in funding.

Washington, DC (March 4, 2020) – Today, Congress announced they have reached an $8.3 billion agreement for emergency supplemental appropriations to combat Coronavirus. The bill includes CDC funds totaling $2.2 billion which includes funding for cooperative agreements for “tribes, tribal organizations, urban Indian health organizations, or health service providers to tribes, to carry out surveillance, epidemiology, laboratory capacity, infection control mitigation, communications, and other preparedness and response activities.” The bill also included $40 million for tribal organizations, urban Indian health organizations, or health service providers to tribes through the CDC.

This is a major victory for Urban Indian Organizations (UIOs) as UIOs were missed in past emergency funding such as the Zika response efforts. This funding will assist in UIOs properly preparing to combat this outbreak for urban AI/ANs.

“NCUIH is glad to see Congress come together so quickly to provide the critical funding necessary to protect the health of American Indian and Alaska Native (AI/AN) patients across Indian Country,” said Francys Crevier, Executive Director “particularly to protect those AI/ANs who live within cities and urban areas, where the COVID-19 is spreading at a rapid pace.”

On Friday, February 28, the National Council of Urban Indian Health sent a letter to Appropriations Chair Betty McCollum urging Congress to include UIOs in Coronavirus response efforts. NCUIH also issued a press release calling for Congress to support urban Indians in emergency supplemental funding. NCUIH has been working closely with the House and Senate on bill language to ensure the whole IHS I/T/U system is included in resources for coronavirus.

The House plans to vote today on the bill, with the Senate expected to pass the package on Thursday.

NCUIH will continue to monitor this legislation and the ongoing health risks to American Indian and Alaska Native patients and the urban Indian communities where they reside.

###

PRESS RELEASE: NCUIH Urges Congress to Include Urban Indians in any Efforts to Address Coronavirus

/0 Comments/in /by

FOR IMMEDIATE RELEASE
Contact: Meredith Raimondi, 202-417-7781, mraimondi@ncuih.org

Urban Indian Organizations must be explicitly included in emergency funding.

Washington, DC (March 2, 2020) – The National Council of Urban Indian Health has requested that Congress honor the United States trust responsibility to urban Indians by passing emergency funding that includes Urban Indian Organizations for the prevention and treatment of the Coronavirus -Covid 19 risk. In its letter, NCUIH requested:

  • At the very least $94 million for emergency funding and health education/promotion for UIOs.
  • Include the term “Urban Indian Organization” in legislation to ensure the funding goes to those programs because often times if Urban Indian Organizations are not explicitly mentioned, they are forgotten. Urban Indian Organizations (UIOs) are one of the three components of the Indian Health Service health care delivery system, Indian Health/Tribal/Urban Organizations (I/T/U) – yet UIOs have received no support for other potential epidemics, like Zika virus.

“As Congress moves forward on its consideration of funding for the Coronavirus-Covid 19, NCUIH would like to ensure that funds are available to our 41 urban Indian organizations. The U.S. government cannot allow UIO patients to die during a Covid 19 outbreak due to unavailability of critical services. UIOs operate on such low funding margins that interruptions in daily operations (including those leading to funding shortfalls) have dire effects and have been forced to close entirely,” said Francys Crevier, Executive Director of NCUIH.

According to the World Health Organization, the coronavirus has reached more than 30 countries and is expected to cause major strain upon the United States medical health care delivery system.  More than 70% of American Indian and Alaska Natives (AI/ANs) reside in urban or suburban areas (i.e. urban Indians). Data has shown that AI/AN people already have a disproportionate burden of infectious disease morbidity compared with the general U.S. population – including influenza.

UIOs provide culturally-competent healthcare to AI/AN patients, however they are forced to operate on such low funding margins that interruptions in daily operations  have dire effects, even leading to death of AI/AN patients. In order to effectively prevent the spread of the Coronavirus – Covid 19, test and treat AI/AN patients, UIOs must be included in the emergency or supplemental budget.

###

PRESS RELEASE: NCUIH Releases 2018-2019 Urban Indian Organization Shutdown Report

/0 Comments/in , /by

FOR IMMEDIATE RELEASE
Contact: Meredith Raimondi
202-417-7781
mraimondi@ncuih.org

Report Shows Devastating Impacts of Shutdown and Highlights Urgency for Advance Appropriations and 100% FMAP

WASHINGTON, DC (February 14, 2020) – The National Council of Urban Indian Health (NCUIH) has released the 2018 – 2019 Urban Indian Organization Shutdown Report. The report summarizes and presents the results of a survey NCUIH circulated during the 2018-2019 shutdown to capture important metrics and narratives regarding its impacts. The United States federal government shutdown of 2018-2019 occurred from midnight Eastern Standard Time on December 22, 2018 until January 25, 2019. Nineteen out of forty-one Urban Indian Organizations (UIOs) reported. The responses from this survey were used in NCUIH’s policy and legislative advocacy initiatives during and after the shutdown. Although the Indian health care delivery system consists of three prongs — Indian Health Service (IHS), Tribal Health Programs, and UIOs — the report focuses on UIOs.

“The 2018-2019 Urban Indian Organization Shutdown Report demonstrates that the longest U.S. government shutdown in history had instant, longstanding, and severe negative impacts on UIOs and the American Indians and Alaska Natives (AI/ANs) they serve across the country. The federal trust responsibility to provide for the healthcare of all AI/ANs mandates that federal funding problems be fixed so that the impacts of any future shutdowns are minimized, and the lives of AI/ANs are not put at risk. Because UIOs operate on very low margins, every aspect of their abilities to deliver essential healthcare was affected by the 2018-2019 shutdown, including their abilities to hire and retain staff, to provide direct services, and, in some cases, even to remain open and available for their patients. IHS funding at the level of need, an increase in the Urban Indian Health budget line item, advance appropriations, and 100% FMAP for UIOs are all necessary fixes to protect the delivery of healthcare to AI/ANs,” said Francys Crevier, Executive Director of NCUIH.

The interruption in funding precipitated by the shutdown had dire consequences for UIOs and, consequently, on American Indians and Alaska Natives (AI/ANs) across the country. The impact on AI/ANs, many of whom depend on UIOs for their healthcare needs, ranged from patients unable to get vital medication for chronic conditions to fatal overdoses. UIOs had to make difficult decisions regarding cancellation of certain services, reduction in practitioner hours, staff retention, facility operation, and whether to use savings earmarked for other purposes to shield staff and patients from the impact of the shutdown.

NCUIH shifted its policy and advocacy focus during the shutdown to limit the disruptions to the daily operations of the UIOs it represents and urged Congress and the administration to immediately end the shutdown and restore funding to IHS. Following the shutdown and restoration of funding, NCUIH remains dedicated to establishing safeguards for UIOs against potential shutdowns in the future. NCUIH is working with Congressional officials to raise awareness for bills that would provide the Indian Health Service (IHS) with advance appropriations (H.R. 1128, S. 229) and provide 100% Federal Medical Assistance Percentage (FMAP) for UIOs (H.R. 2316, S. 1180).

Key Findings

UIOs operate on very low margins.

  • UIOs operate on very low margins such that even very minor changes to their funding structures lead to devastating impacts on the services they provide to AI/ANs and even affect their abilities to keep their facilities operational.

All aspects of the urban Indian healthcare delivery system were impacted by the shutdown, but the UIO workforce was the first to experience its disastrous effects.

  • The survey results point to a pattern which suggests that among the difficult decisions UIOs were forced to make during the 2013 and the 2018-2019 shutdowns, delaying hiring, reducing hours, and laying off staff were typically the first decisions made.

UIO services were greatly impacted.

  • Another pattern the survey highlighted is that UIOs were forced to cut back on services that were not as consequential as others, such as dental services, transportation, case management, and community outreach services. However, some UIOs were forced to cut even the essential services such as substance abuse services and purchase requests for diabetes and blood pressure medications.

UIOs were forced to use savings designated for other purposes to shield staff and patients from the impact of the last two government shutdowns.

  • Yet another pattern illustrated in the survey results suggests that UIO leaders made an effort to protect their staff and current services by using savings earmarked for program growth.

PRESS RELEASE: President Proposes $49.6 Million in FY 2021 Budget for Urban Indian Health

/0 Comments/in /by

FOR IMMEDIATE RELEASE
Contact: Meredith Raimondi
202-417-7781
mraimondi@NCUIH.org

Request for FY 2021 is $8 Million below FY 2020 Enacted

WASHINGTON, DC (February 11, 2020) – On February 10, 2020, the President released the annual budget proposal for Fiscal Year (FY) 2021. The proposal includes a total of $96.2 billion for the Department of Health and Human Services (HHS), which represents a nearly 10 percent cut to current enacted budget. Under the request, the Indian Health Service (IHS) would receive approximately $6.4 billion in FY 2021.  NCUIH, in conjunction with the Tribal Budget Formulation Workgroup (TBFWG), had encouraged the Administration to fund IHS at $9.1 billion with an urban Indian health line item of $105.9 million for FY 2021. This is an increase of $48.2 million for urban Indian health over the enacted FY 2020 budget. The proposed IHS budget falls nearly $3 billion short of TBFWG’s overall IHS recommendation, and the proposed urban Indian health funding amount constitutes $56.3 million less than the TBFWG recommendation.

“NCUIH looks forward to working with the Administration and Congress to fully fund IHS and the urban Indian health care line item. NCUIH was encouraged by the enacted FY 2020 IHS budget of approximately $6.0 billion, an increase of 4% above the enacted FY 2019 level. The FY 2020 Enacted appropriation funded urban Indian health at approximately $57 million and provided over $115,000 in increases for 39 of the 41 Urban Indian Organizations. For FY 2021, NCUIH encourages Congress to meet the TBFWG recommendation of approximately $106 million for the urban Indian Health line item, which is $56.3 million above the President’s FY 2021 request,” said Francys Crevier, Executive Director of NCUIH.

Congress will consider the President’s request as it begins to draft appropriations bills for FY 2021. Please find below a summary of some of the proposed funding amounts that would impact urban Indian health.  A more in-depth analysis of the White House’s FY 2021 Budget is forthcoming.

Urban Indian Line Item

  • The spending proposal recommends a funding level for the urban Indian line item at $49,636,000. This is an approximately $8 million decrease from the FY 2020 Enacted amount, but it is $865,000 increase from the President’s FY 2020 budget request.

Special Diabetes Program for Indians (SDPI)

  • The President’s budget also includes continued funding for the SDPI at the current funding levels of $150 million through FY 2021. It includes expected spending for the program over a 10-year period if Congress extends funding only through FY 2021 and does not include a long-term re-authorization.

Federal Tort Claims Act

  • The budget proposes to expand medical malpractice coverage under the Federal Tort Claims Act to Urban Indian Organizations (UIOs), which would protect UIO employees from malpractice lawsuits, saving some UIOs upwards of $250,000 annually in malpractice insurance costs. It also proposes an expansion of malpractice coverage for IHS volunteers.

105(l) Leases

  • The FY 2021 budget adds $101 million for 105(l) leases. In FY 2019, IHS was forced to reallocate $72 million in FY 2019 to pay for $101 million in leases under section 105(l) of the Indian Self-Determination and Education Assistance Act. In FYs 2018 and 2019, IHS reprogrammed approximately $782,000 each year from urban Indian health inflation funds to pay for 105(l) leases. The $101 million in 105(l) lease costs in FY 2019 represented a nearly fourfold increase to the amount requested in FY 2018 – if this trend continues, there is concern $101 million will be insufficient and IHS will again reprogram other funds.

Centers for Disease Control and Prevention and National Institutes of Health

  • The budget request would trim funding for the Centers for Disease Control and Prevention by almost 16 percent. This is a funding loss that would affect the HHS core mission of preventing and controlling emerging public health issues, such as opioid and substance use disorders.
  • The proposal includes an approximately $38 billion budget for the National Institutes of Health in FY 2021, which is – about $3 billion less than the current funding level. This cut would affect priorities to include research on the opioid epidemic and stimulants such as methamphetamine, issues that are at critical to address in Indian Country.

National Health Service Corps

  • The proposal seeks to reauthorize the National Health Service Corps loan repayment program with $15 million. UIOs’ employees are eligible for participation in the loan repayment program.

HIV/AIDS at HRSA

  • New programs proposed include a focus on HIV/AIDS with $302 million allocated to the Health Resources and Services Administration (HRSA) for HIV prevention providing the funding for diagnosis services expansion at Health Centers and expanded treatment through the Ryan White HIV/AIDS program.

Quick Glance

  • $6,232,568,000 – IHS budget authority total
  • $4,507,113,000 – IHS services budget
  • $49,636,000 – Urban Indian Health
  • $150,000,000 – Special Diabetes Program for Indians
  • $101,000,000 – Section 105(l) ISDEAA
  • $15,000,000 – The National Health Service Corps loan repayment program
  • $302,000,000 – HRSA for HIV prevention

###