PRESS RELEASE: NCUIH Testifies Before House Interior Appropriations American Indian and Alaska Native Public Witness Day

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FOR IMMEDIATE RELEASE

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

President Rosette Requested Congress Meet the Urban Indian Health Line Item of $106 Million as Recommended by the Tribal Budget Formulation Work Group

WASHINGTON, DC (February 11, 2020) — National Council of Urban Indian Health President Maureen Rosette (Chippewa Cree Nation) testified before the House Interior Appropriations Subcommittee as part of American Indian and Alaska Native Public Witness Days (February 11 and 12, 2020). President Rosette was invited as an Honorable expert witness participating on the health care panel of the 1st day of tribal and urban leader hearings.

Each year, NCUIH provides in depth testimony addressing the needs of urban Indian health care. This is the second year in a row that President Rosette has spoken to the House Appropriations Subcommittee, thanking them for their continued work.

“NCUIH is appreciative for the Subcommittee’s strong leadership and continued bipartisan support for urban Indian health. For FY 2021, NCUIH requests that the Subcommittee meet the Tribal Budget Formulation Workgroup recommendation of $106 million for the Indian Health Services (IHS) urban Indian health line item,” testified President Rosette.

While delivering testimony, President Rosette advocated for an increase in funding for FY 2021 to a minimum of $81 to $106 million for the Indian Health Services (IHS) urban Indian healthcare line item. The FY 2021 request from the President included $49.6 million, $8 million below current enacted levels. In FY 2020, the House included $81 million in FY 2020 for urban Indian health and the final bill included $57 million, a $6 million increase.

In her opening remarks today, Chair McCollum stated, “The United States government entered into treaties guaranteeing health care to Native Americans…centuries later the government, our government, the United States government, is still not meeting its responsibilities.”

NCUIH is grateful to be included in the Public Witness Days. NCUIH has been encouraged by the strong leadership of Chair McCollum and Ranking Member Joyce for urban Indian health in FY 2020 and looks forward to continuing these efforts for FY 2021.

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PRESS RELEASE: NCUIH President-Elect Walter Murillo Recognized as Health Equity Health Advocate of the Year by Families USA

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The Native Health CEO was one of four awardees honored this year.

WASHINGTON, DC (February 7 , 2020) – Walter Murillo (Choctaw Nation of Oklahoma), Chief Executive Officer at Native Health in Phoenix, Arizona, has been recognized as Health Equity Health Advocate of the Year by Families USA. Murillo was selected for his exemplary work championing for better health care in Arizona in his over 21 years at Native Health. Under his leadership, Native Health has long provided quality, culturally-competent health care for urban Indians.

“Walter truly understands what it means to be a health equity health advocate,” said Frederick Isasi, Families USA’s executive director. “He is working tirelessly in Arizona to ensure that his neighbors do not face barriers accessing quality health care because of who they are, where they live or how they identify.”

Murillo was honored on January 24, 2020 at an awards luncheon during the Families USA 2020 Health Action Conference in Washington, D.C. Each year during its Health Action Conference, Families USA honors the efforts of state and community leaders in advancing social justice through health care advocacy. Awards are presented in recognition of the organization’s four focus areas: Health Equity, Health Care Value, Coverage and Consumer Experience.

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PRESS RELEASE: CMS Releases Guidance to States on Medicaid Block Grants

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Washington, DC (January 31, 2020) –  On January 30, 2020, the Centers for Medicare and Medicaid Services (CMS) announced the Healthy Adult Opportunity Initiative (HAO), a guideline for states to convert Medicaid funding into block grants – effectively establishing a cap on federal funding on Medicaid.  The letter, sent to state Medicaid directors, provides guidance for states seeking to carry out demonstration projects under section 1115 of the Social Security Act to include either an aggregate or per-capita cap financing model in their state Medicaid programs – in contrast to the current open-ended financing system that provides for unlimited (i.e. does not cap) federal matching funds for all state spending under Medicaid’s federal rules.

“NCUIH is extremely concerned with the CMS guidance that is completely against the intent of Congress. This harmful guidance paves the way to restrict Medicaid in ways that would violate the United States trust obligation to provide health care services to American Indian and Alaska Natives.  Urban Indians face many barriers with chronic underfunding of the Indian health care system and we are disappointed to see yet another obstacle for Native people who need health care.  By establishing a cap on spending for essential services, this proposal will have negative impacts on our urban Indian organizations (UIOs) and could result in significantly reduced services.  We urge CMS to reconsider this guidance and follow the intent of Congress to ensure that Medicaid funds continue to flow into all Indian Health Care Providers, including UIOs,” said NCUIH Executive Director Francys Crevier.

By tying Medicaid spending to a set cap, states would be incentivized to limit Medicaid spending or assume risk for Medicaid costs that exceed the annual cap.  In addition, if a state imposes an aggregate cap, if the state’s spending on Medicaid falls below the limit, it could receive a portion of the “savings” – or the amount below the spending cap the state’s actual expenditures were.  Because services provided at UIOs are not reimbursed to the state by the federal government at 100% (the Federal Medical Assistance Percentage or FMAP), UIOs already receive lower Medicaid reimbursements than the other components of the I/T/U system.  Under CMS’s guidance proposed yesterday, Medicaid spending for services provided to AI/ANs at UIOs will be included in calculating spending caps.  It is essential that the Medicaid program continue to be a vital lifeline for AI/ANs.

Medicaid is a critically important resource for American Indians and Alaska Natives and Indian Health Care Providers.  Imposing barriers to access to health care, like reducing Medicaid covered individuals and services would impose a significant financial burden on an already severely underfunded Indian health system.  Any state plans that reduce the Medicaid funds that flow into the I/T/U system would further strain the Indian health care system.

UIOs depend on every dollar of limited federal funding, including third-party reimbursements from Medicaid, to provide high quality, culturally competent services to their AI/AN patients.  Restricting these funds would violate the U.S. obligation to provide health care to AI/ANs.  NCUIH calls on CMS to ensure states do not impose limitations on their Medicaid programs that would result in decreased funding available to UIOs and the I/T/U system.

NCUIH will continue to monitor updates and provide further information as it becomes available.

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PRESS RELEASE: Congress Announces $6M Increase for Urban Indian Health and Renews SDPI, CHC Through May

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This is the highest increase for the urban Indian line item ever.

WASHINGTON, DC  (December 16, 2019)  – On Monday, December 16, 2019, the House announced a $1.4 trillion bipartisan, bicameral agreement to fund the federal government through fiscal year 2020. The House will begin the process imminently and a vote is expected later in the week.

The bill provides $6.047 billion for the Indian Health Service (IHS), $243 million more than fiscal year 2019 and $138 million more than the President’s budget request. The IHS will see a 4% increase over FY19. The agreement includes $6 million in additional funds for the Urban Indian Health Programs, a long-overdue increase.

“The National Council of Urban Indian Health endorses the FY20 Minibus Appropriations Bill that includes the highest-ever increase for urban Indian health. Over 41 urban Indian health programs will be able to provide more essential resources to American Indians and Alaska Natives at a time when it is most critical. We are extremely encouraged by Congress coming together with help from countless advocates on both sides of the aisle and both chambers to reach this deal. We are especially grateful to House Interior Chairwoman Betty McCollum and Ranking Member David Joyce and Senators Tom Udall and Chuck Schumer and Senate Majority Leader Mitch McConnell,” said Francys Crevier, Executive Director of NCUIH.

The bill includes increases of $125 million to meet court-ordered requirements for tribal lease operating costs owed to tribes. The bill includes Senate report language directing IHS to implement better budget procedures to address this in the future.

The health extenders including SDPI and CHC has been extended until May 22, 2020. This date provides additional time for negotiations on a longer-term reauthorization. NCUIH will continue to try to ensure the programs are extended for a longer-term, likely 5 years, and to fight for any increases we can for the programs that have not seen any.

NCUIH will continue to monitor the process and provide further updates.

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

PRESS RELEASE: NCUIH AND IHS HOST LISTENING SESSION ON ELIMINATING HEPATITIS C AND HIV IN INDIAN COUNTRY

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THE LISTENING SESSION FOCUSED ON URBAN INDIAN HEALTH SUCCESSES AND BARRIERS AND INCLUDED INFORMATION FROM A RECENT UIO SURVEY ON CAPACITY TO ADDRESS THE ISSUE.

Panelists: Walter Murillo, Kerry Hawk Lessard, Rick Haverkate, LCDR Danica Brown, Robyn Sunday-Allen, Francys Crevier

FOR IMMEDIATE RELEASE

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

WASHINGTON, DC – (December 13, 2019) On Tuesday, December 10, 2019, the National Council of Urban Indian Health (NCUIH) hosted a Listening Session in partnership with the Indian Health Service (IHS) on “Eliminating Hepatitis C and HIV in Indian Country: A Focus on Urban Indian Health”. Over 15 federal agencies were represented with nearly 100 participants in person and online. This listening session was created in response to the announcement in March 2019 from IHS to create an “Eliminating Hepatitis C and HIV/AIDS in Indian Country Initiative”.

“We are looking forward to a strong partnership between federal agencies and Urban Indian Organizations (UIOs) in reducing the rates of Hepatitis C and HIV/AIDS in Indian Country.  Although UIOs are successfully implementing innovative measures to combat HIV and viral hepatitis for their American Indian and Alaska Native (AI/AN) patients, AI/ANs are ranked 4th in the nation for new HIV diagnoses and insufficient funding of programs directed at this crisis continues to be an issue.  NCUIH is excited to know that IHS has implemented this critical initiative, however it is important for IHS to hear directly from UIOs to truly understand the needs of the programs and AI/AN patients in urban areas.  As IHS and CDC apply for additional funding to reduce infections and provide resources, we urge them to consult and engage with UIOs – to ensure that urban Indian health care is able to provide the same quality of care as the other partners within the IHS I/T/U system,” said Executive Director Francys Crevier.

“Combating Hepatitis C and HIV/AIDS in communities most impacted by these epidemics—including AI/ANs in urban centers—must be a top priority for lawmakers.  Methamphetamine and opioid use have been key drivers of rising Hepatitis C and HIV/AIDS rates in Indian Country and across the United States.  That is why I introduced the Comprehensive Addiction Resources Emergency (CARE) Act, ambitious legislation to tackle the opioid and substance use epidemic head-on.  The CARE Act—which is modeled after the Ryan White HIV/AIDS Program—would invest $100 billion over ten years to fight the epidemic, including over $800 million annually provided directly to tribal governments, tribal epidemiology centers, urban Indian health organizations, and other entities serving Native communities.  I appreciate NCUIH’s support for the CARE Act,” said Senator Elizabeth Warren in a statement.

“In a recent survey of UIOs, many report that the services they provide are making an impact upon the urban communities they serve – and although insufficient funding is an issue, UIOs are able to conduct ongoing activities to fight HIV/HCV while finding opportunities to increase access for AI/AN patients,” said Dr. Kimberly Fowler, Director of Technical Assistance and Research Center at NCUIH.

Rick Haverkate, National HIV/AIDS & Hep C Program Director for IHS provided an update from IHS on HIV/HCV Prevention and Treatment. Dr. Kimberly Fowler and Julia Dreyer, Director of Federal Relations of NCUIH moderated a session with UIOs who provided an overview of the current status of HIV/HCV prevention and treatment at Urban Indian Organizations (UIOs).

Representatives from Oklahoma City Indian Clinic, Robyn Sunday-Allen, CEO and LCDR Danica Brown, Clinical Pharmacist, gave a presentation on the clinical aspects of the current state of prevention and treatment. Kerry Hawk Lessard, Executive Director of Native American Lifelines, presented on the role of the community and support mechanisms in place currently. Finally, Walter Murillo, CEO, Native Health, initiated a discussion on the policy considerations of eliminating Hepatitis C and HIV in urban Indian communities.


Community Support by Kerry Hawk Lessard

In February 2019, the current Administration announced the Ending the HIV Epidemic: A Plan for America initiative with a primary goal to reduce new HIV infections in the United States by 75 percent in five years and by 90 percent by 2030. Additionally, in March 2019, IHS introduced and highlighted the Eliminating Hepatitis C and HIV/AIDS in Indian Country Initiative under the administration’s A Plan for America initiative. The president’s fiscal year 2020 budget proposed $25 million in new investments to expand partnerships between IHS and Native communities to end the HIV epidemic in Indian Country.

Additionally, it has been proven that reoccurring health problems are more acute for AI/ANs living in urban areas. Urban Indians have greater rates of mortality from chronic disease compared to all other races. Urban Indians are also less likely to receive preventive care compared with the non-Indian urban population and less likely to have health insurance. Survival rates for AI/AN peoples living with HIV/AIDS are lower than any other population. Additionally, Native peoples who have been diagnosed with HIV/AIDS most often suffer from related diseases, such as diabetes, tuberculosis and hepatitis. Mental health, substance abuse and addiction complicate primary care-seeking behaviors of Native people with HIV. Data have shown that HIV diagnoses have steadily increased in Indian Country over the last few years.

Across the country, UIOs provide culturally competent health care services and resources that are critical to addressing these health care challenges while struggling with constant underfunding.  This listening session served as a platform for UIOs to express their community’s circumstances, needs, identify gaps, and to share their perspectives and interests with others who are diligently working to support the “Eliminating Hepatitis C and HIV in Indian Country Initiative”.

PRESS RELEASE: Senate Committee on Indian Affairs Advances “Health Care Access for Urban Native Veterans Act” and Nomination of RADM Weahkee

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FOR IMMEDIATE RELEASE

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

The National Council of Urban Indian Health was one of 88 organizations providing letters of support for RADM Weahkee.

NCUIH Representatives at the Hearings Today: Carla Lott, Francys Crevier, Kerry Hawk Lessard, Maureen Rosette, Walter Murillo, Jamie Ishcomer-Aazami

Washington, DC (December 11, 2019)— Today, December 11, 2019, the Senate Committee on Indian Affairs held a markup on S. 2365, the Health Care Access for Urban Native Veterans Act and a Nomination Hearing to consider RADM Michael D. Weahkee, of New Mexico, to be Director of the Indian Health Service, U.S. Department of Health and Human Services. S. 2365 was ordered to be reported favorably by voice vote by the Senate Committee on Indian Affairs.

“Passing the Health Care Access for Urban Native Veterans Act through the Senate Committee on Indian Affairs is a monumental step in ensuring the health and wellness of urban Native Veterans,” said Francys Crevier, Executive Director of the National Council of Urban Indian Health, “Native people serve in the military at a higher rate than any other population and when they come home from serving our country, Native Veterans deserve the right to access culturally competent health care at an Urban Indian Health program. We thank Chairman Hoeven and the Committee for their outstanding leadership on moving this legislation forward to help our Native Veterans.”

“We write to express our support of the nomination of Rear Admiral (RADM) Michael D. Weahkee. Despite comprising over two-thirds of AI/ANs, urban Indians are too often excluded from federal policies and programs designed to carry out the trust responsibility. While serving in his post, RADM Weahkee has repeatedly established his understanding that UIOs are an integral part of the Indian health system, which is comprised of the Indian Health Service (IHS), Tribes, and tribal organizations, and urban Indian organizations (collectively, I/T/Us),” wrote NCUIH Board President Maureen Rosette in the nominating letter.

“In partnership with Tribes and Urban Indian Organizations, we have developed a comprehensive and aggressive five-year strategic plan for the IHS, focused on expanding access to care, improving the quality of care that we provide, and improving the management and operations of the Agency,” said Rear Admiral Michael D. Weahkee, Nominee for Director of the Indian Health Service, Department of Health and Human Services in his opening statement.

The IHS is an agency within the U.S. Department of Health and Human Services responsible for providing federal health care to approximately 2.6 million American Indians and Alaska Natives. In 37 states, there are over 605 hospitals, clinics, and health stations located on or near tribal communities under the purview of the IHS and 41 urban Indian health programs. The Director of the IHS oversees the administration of health care programs and services within the agency, including management of the budget of approximately $6.9 billion and employment of more than 15,000 professionals.

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PRESS RELEASE: USET Honors NCUIH with Partnership Award

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NCUIH and USET are Long Partners Promoting and Protecting Tribal Sovereignty

(November 21, 2019, Washington, DC) – On November 5, 2019, NCUIH was honored and recognized at the 2019 United South and Eastern Tribes, Inc./USET Sovereignty Protection Fund Annual Meeting. NCUIH received this award for the longstanding partnership with USET and the USET SPF. At the event, USET and USET SPF celebrated 50 years of growth and success as an organization. Meredith Raimondi, Senior Manager of Communications and Events, accepted the award on behalf of NCUIH.

“On behalf of NCUIH, we were humbled to be included in USET’s recent awards ceremony honoring our joint work on the protection of Tribal sovereignty. We are truly grateful for our partnership with USET and congratulate them on 50 incredible years. Our collaboration has led to better defenses against attacks on Tribal nations which ensures the trust and treaty obligations thrive which take care of our people. Our relatives who have been fighting decades before us would be proud. We thank President Kirk Francis and Executive Director Kitcki Carroll for this honor,” said NCUIH Executive Director Francys Crevier.

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

PRESS RELEASE: Senate Passes Short Term Funding Bill Funding Urban Indian Health and SDPI

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FOR IMMEDIATE RELEASE

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

Shutdown Averted Through Dec. 20, 2019

The Senate has voted to keep funding the government and the President is expected to sign the bill before the deadline tonight. Following the lead of House who passed legislation on Tuesday, (H.R. 3055), the Senate passed the bill that will keep the government open until December 20, 2019. The stopgap measure is similar to the last Continuing Resolution in that it includes many health programs and the urban Indian health line item.  Notably, the Continuing Resolution extends the Special Diabetes Program (SDPI) for Indians – which will push back SDPI’s expiration to December 20th and give Congress another month to consider a longer-term re-authorization.  The bill also extends funding for Community Health Centers and the National Health Service Corps.

As federal legislators have been in negotiations regarding the FY2020 budget, the National Council of Urban Indian Health (NCUIH) has pressed Congress to fund urban Indian health at $81 million and to pass responsible legislation regarding the future success of urban Indian organizations.

Contact Congress Today

Contact your Member of Congress to encourage them to pass a budget for IHS to include the Urban Indian line item with increased appropriations that reflects and honors the trust responsibility.

For further assistance, please contact:
Director of Congressional Relations, Carla Lott (cmlott@ncuih.org).

NCUIH Urges Congress to Take Prompt Action on the U.S. Civil Rights Commission Broken Promises Report

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Watch NCUIH Testify at Hearing View NCUIH Testimony

FOR IMMEDIATE RELEASE 

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

NCUIH Executive Director Francys Crevier Requested the House Subcommittee on Indigenous Peoples Address Chronic Underfunding

Washington, DC (November 20, 2019)— On November 19, 2019, the Subcommittee for Indigenous Peoples of the United States held an Oversight Hearing Reviewing the Broken Promises Report: Examining the Chronic Federal Funding Shortfalls in Indian Country. NCUIH Executive Director Francys Crevier, JD (Algonquin) testified before the Subcommittee and made several recommendations in response to the U.S. Civil Rights Commission “Broken Promises” Report.

“The Broken promises report, like many other well-intentioned reports and research, such as the IHS Urban Indian Needs Assessment and the Urban Indian Organization demonstration projects, raises awareness of these issues, but without a prompt true long-term commitment and subsequent actions to address these disparities, a report is only a report, and has little impact on the health status of our people. We ask Congress to treat this health system like the only one that you, your children and family have. We thank Chairman Gallego and Ranking Member Cook for holding this important hearing,” said NCUIH Executive Director Francys Crevier, JD (Algonquin).

In her testimony, Ms. Crevier emphasized that Congress has long recognized that the federal government’s obligation to provide health care for Native people off of reservations, declaring:

“The responsibility for the provision of health care, arising from treaties and laws that recognize this responsibility as an exchange for the cession of millions of acres of Indian land does not end at the borders of an Indian reservation. Rather, government relocation policies which designated certain urban areas as relocation centers for Indians, have in many instances forced Indian people who did not [want] to leave their reservations to relocate in urban areas, and the responsibility for the provision of health care services follows them there.”

“Data shows that reoccurring health problems are more acute for Natives living in urban areas than other populations. Urban Indians have greater mortality rates from chronic disease compared to all other populations, including diabetes, liver disease, tuberculosis and suicide,” added Ms. Crevier.

NCUIH made the following recommendations:

  • IHS UIO parity for FTCA, 100% FMAP and the IHS-VA MOU
  • Increase urban Indian line item budget to $81 million (currently it is less than 1% of the IHS Budget)
  • Advanced Appropriations to prevent future devastation during shutdowns as shown through the NCUIH Shutdown Preliminary Report

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Witness List

Panel I  

  • The Honorable Patricia Timmons Goodson (testimony),  Vice-Chair, U.S. Commission on Civil Rights
  • Dr. Anna Maria Ortiz (testimony), Director, Natural Resources and Environment, U.S. Government Accountability Office
  • Rear Adm. Chris Buchanan (testimony), Deputy Director, Indian Health Service, U.S. Department of Health and Human Services
  • Mr. Jason Freihage (testimony), Deputy Assistant Secretary for Management, Bureau of Indian Affairs, U.S. Department of the Interior

Panel II

  • The Honorable Fawn Sharp (testimony), President, National Congress of American Indians
  • The Honorable Lynn Malerba (testimony), Secretary, USET Sovereignty Protection Fund
  • The Honorable Jonodev Chaudhuri (testimony), Ambassador, Muscogee Creek Nation
  • Ms. Stacey Bohlen (testimony), Chief Executive Officer, National Indian Health Board
  • Ms. Francys Crevier (testimony), Executive Director, National Council of Urban Indian Health

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About the National Council of Urban Indian Health

The National Council of Urban Indian Health (NCUIH) is the national organization devoted to the support and development of quality, accessible, and culturally-competent health services for American Indians and Alaska Natives (AI/ANs) living in urban settings. NCUIH envisions a nation where comprehensive, culturally competent personal and public health services are available and accessible to AI/ANs living in urban communities throughout the United States.  NCUIH is the only organization that represents all 41 Urban Indian Organizations (UIOs) federally funded by the Indian Health Service.