Tag Archive for: Letters

NCUIH Joins NIHB and over 130 Tribal Nations and Other Organizations in Urgent Push for Stable Funding for the Indian Health Service

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As Native American Heritage Month ended, advocates for Native communities joined together during the Tribal Nations Summit in Washington, DC to call for Congress and the White House to enact Advance Appropriations for Indian health now.

On December 12, 2022, the National Council of Urban Indian Health (NCUIH) joined the National Indian Health Board (NIHB) and over 130 groups, including Urban Indian Organizations (UIOs), Tribal Nations, and friends of Indian health in sending letters to the President and Congressional leadership while negotiations on Fiscal Year (FY) 2023 spending are currently underway. The letters request support for the House-passed funding of $8.121 billion for the Indian Health Service (IHS) for FY 2023 and advance appropriations for IHS for FY 2024. The urgency is being felt among advocates as the government is currently funded under a Continuing Resolution through December 16. During the last government shutdown, UIOs reported at least 5 patient deaths and significant disruptions in patient services. Securing stable funding for IHS in the final FY 2023 omnibus has been a major priority for Indian Country to ensure the continuation and delivery of health services to all Native people regardless of where they live.  There is bipartisan support for ensuring advance appropriations and ending budget delays for the Indian Health Service.

This week, allies joined in support of a Day of Action on November 30, 2022 on the last day of Native American Heritage Month and the first day of the White House Tribal Nations Summit.

Photo of Chairman W. Ron Allen

Native Leaders Call on Congress to Act Now on Advance Appropriations

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A Bipartisan Tradition: Supporting Stability for the Indian Health Service Unites a Divided Congress

Currently, 107 current Members of Congress have expressed support for advance appropriations for the Indian Health Service since the first bill was introduced by the late Representative Don Young (R-AK-At Large; H.R. 3229) and Senator Lisa Murkowski (R-AK; S. 1570) in 2013. Closing today, House Native American Caucus Co-Chairs Sharice Davids (D-KS-03) and Tom Cole (R-OK-04) are leading the third bipartisan letter of the year to the House Appropriations Committee calling for advanced appropriations for IHS to be included in the final FY23 Appropriations bill. Members of Congress also joined the Day of Action conversation by expressing their direct support for protecting IHS funding. For example:

  • Longstanding sponsor of the Indian Health Service advance appropriations, Rep. Betty McCollum (D-MN-04) called on her colleagues to vote in support of advance appropriations and stated that “Vital health care services should NOT be interrupted if there’s a government shutdown.”
  • Former Chair of the Senate Committee on Indian Affairs and current Committee Member, Senator John Tester (D-MT) stated, “Our Native communities deserve a stable health care system—yet the Indian Health Service is the only major federal provider without stable funding. I stand with advocates across Indian Country today in pushing for advance appropriations for the IHS.”
  • Champion of the Honoring Promises to Native Nations proposal, Senator Elizabeth Warren (D-MA) said, “IHS is the only major federal provider of health care that faces budget uncertainty. It’s time for Congress to guarantee predictable funding and end this inequity.”
  • Melanie Stansbury (D-NM-01), member of the House Natural Resources Committee, stated that “When budget negotiations falter, Indigenous lives are at stake… I stand with Indigenous communities in support of advance appropriations for the Indian Health Service.”.
  • Staunch advocate for IHS on the Energy and Commerce Committee, Rep. Raul Ruiz (D-CA-36) stated that “Lack of funding shouldn’t be an impediment for our Tribes to receive the lifesaving services they need and deserve.”
Full List of Letter Supporters

The full list of supporting Tribal Nations and organizations is as follows:

Tribal Nations:
  • Absentee Shawnee Tribe of Oklahoma
  • Caddo Nation
  • Chickasaw Nation
  • Citizen Potawatomi Nation
  • Cloverdale Rancheria of Pomo Indians of California
  • Confederated Tribes of the Colville Reservation
  • Cowlitz Tribe
  • Fond du Lac Band of Lake Superior Chippewa
  • Jamestown S’Klallam Tribe
  • Jamul Indian Village of California
  • Keweenaw Bay Indian Community
  • La Posta Band of Mission Indians
  • Lummi Indian Business Council
  • Manchester Point Arena Band of Pomo Indians
  • Match-E-Be-Nash-She-Wish Band of Pottawatomi Indians (Gun Lake Tribe)
  • Mississippi Band of Choctaw Indians
  • Nez Perce Tribe
  • Oneida Nation
  • Pechanga Band of Indians
  • Peoria Tribe of Indians of Oklahoma
  • Poarch Creek Indians
  • Pueblo of Tesuque
  • Pyramid Lake Paiute Tribe
  • Rappahannock Tribe
  • Resighini Rancheria
  • Saint Regis Mohawk Tribe
  • San Carlos Apache Tribe
  • Sault Ste. Marie Tribe of Chippewa Indians
  • Skokomish Tribe
  • Sokaogon Chippewa Community
  • Standing Rock Sioux Tribe
  • Swinomish Indian Tribal Community
  • Tohono O’odham Nation
  • Tsalagiyi Nvdagi Tribe
  • Tunica-Biloxi Tribe of Louisiana
  • Upper Mattaponi Indian Tribe
  • Walker River Paiute Tribe
  • Wampanoag Tribe of Gay Head (Aquinnah)
  • Ysleta del Sur Pueblo
Organizations:
  • ACA Consumer Advocacy
  • AI/AN Health Partners
  • Alaska Native Health Board
  • Alaska Native Tribal Health Consortium
  • Albuquerque Area Indian Health Board, Inc.
  • American Academy of Dermatology Association
  • American Academy of Pediatrics
  • American Indian Health & Services
  • American Indian Health Commission for Washington State
  • American Indian Health Service of Chicago
  • Association on American Indian Affairs
  • Bakersfield American Indian Health Project, Inc.
  • Bristol Bay Area Health Corporation
  • California Consortium for Urban Indian Health
  • California Rural Indian Health Board
  • Canoncito Band of Navajos Health Center
  • Caring Ambassadors Program
  • Choctaw Health Center
  • Coalition of Large Tribes
  • Colorado Consumer Health Initiative
  • Consolidated Tribal Health Project, Inc.
  • Cook Inlet Tribal Council, Inc.
  • Copper River Native Association
  • Council of Athabascan Tribal Governments
  • Every Texan
  • Fallon Tribal Health Center
  • Families USA
  • Family Voices
  • First Focus on Children
  • Fresno American Indian Health Project
  • Great Lakes Area Tribal Health Board
  • Great Plains Tribal Leaders’ Health Board
  • Health Care Voices
  • Hepatitis C Mentor & Support Group, Inc.
  • Hunter Health
  • Indian Health Care Resource Center of Tulsa
  • Indian Health Center of Santa Clara Valley
  • Indigenous Pact
  • Inter Tribal Association of Arizona
  • International Association for Indigenous Aging
  • International Association of Forensic Nurses
  • Justice in Aging
  • Kansas City Indian Center
  • Kids Forward
  • Maniilaq Association
  • Metro New York Health Care for All
  • Michigan League for Public Policy
  • National Association of Pediatric Nurse Practitioners
  • National Council of Urban Indian Health
  • National Indian Health Board
  • National Indigenous Women’s Resource Center
  • National League for Nursing
  • National Native American Boarding School Healing Coalition
  • National Partnership for Women & Families
  • Native American Connections
  • Native American LifeLines, Inc.
  • Native American Rehabilitation Association of the Northwest, Inc.
  • Native Americans for Community Action, Inc.
  • NATIVE Project – Urban Indian Health Program – Spokane, WA
  • Nevada Coalition to End Domestic and Sexual Violence
  • Nisqually Tribal Health & Wellness Center
  • Northwest Harvest
  • Northwest Portland Area Indian Health Board
  • Oklahoma City Indian Clinic
  • Oklahoma Policy Institute
  • Partners In Health
  • R2H Action [Right to Health]
  • Riverside-San Bernardino County Indian Health, Inc.
  • Rocky Mountain Tribal Leaders Council
  • San Francisco AIDS Foundation
  • Sault Tribe Health Division
  • Seattle Indian Health Board
  • Self-Governance Communication & Education Tribal Consortium
  • SF Hep B Free – Bay Area
  • South Dakota Urban Indian Health
  • Southcentral Foundation
  • Southeast Alaska Regional Health Consortium
  • Southern Indian Health Council, Inc.
  • Southern Plains Tribal Health Board
  • Texas Native Health
  • Treatment Action Group
  • Tuba City Regional Health Care Corporation
  • United American Indian Involvement, Inc.
  • United South and Eastern Tribes Sovereignty Protection Fund
  • Universal Health Care Foundation of Connecticut
  • University of California San Francisco School of Medicine HEAL Initiative
  • Urban Inter-Tribal Center of Texas – Urban Indian Health Program – Dallas, TX
  • USAging
  • Wiconi Wakan Health and Healing Center
  • Work for Consolidated Tribal Health Project
Friends of Indian Health:
  • Angela Alvary
  • Ken Artis (Ho-Chunk Nation), Artis Law Office
  • Lana Fox
  • Miranda Carman, LCSW
  • Patricia Powers
  • Yana Blaise
Next Steps

NCUIH continues to advocate for the inclusion of advance appropriations for IHS in the final FY 2023 appropriations package. NCUIH will also provide updates on the status of advance appropriations in Congress during final negotiations.

NCUIH Signs Tribal Partner Organization Letter Requesting Legislative Fix to Carcieri v. Salazar

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On October 7, 2022, NCUIH signed on to a letter submitted by the United South and Eastern Tribes (USET) Sovereignty Protection Fund (SPF) to Senate Majority Leader Schumer. The letter calls on the Senate to pass a legislative fix addressing the Supreme Court’s decision in Carcieri v. Salazar, 222 US 379 (2009). The full text of this letter is available here.

Background

Carcieri v. Salazar Impact on Indian Country

In 2009, the Supreme Court issued its decision in Carcieri v. Salazar.  The case considered whether the Secretary of the Interior could use their authority pursuant to the Indian Reorganization Act (IRA) to take land into trust for the Narragansett Tribe.  The Court held that the IRA Act did not apply to Tribes that were not recognized by the federal government at the time the statute was enacted in 1934.  Since the Narragansett were not formally recognized by the federal government until 1983, the Court also held that the Secretary of the Interior did not have the authority to take land into trust for the Tribe.

 

According to testimony provided by Larry Echo Hawk, the Assistant Secretary for Indian Affairs in 2011, “The Carcieri decision was inconsistent with the longstanding policy and practice of the United States under the Indian Reorganization Act of 1934 to assist federally recognized tribes in establishing and protecting a land base sufficient to allow them to provide for the health, welfare, and safety of tribal members, and to treat tribes alike regardless of their date of federal acknowledgment.”  The Supreme Court’s decision has significantly impacted the federal government’s fee-to-trust process requiring the Department of the Interior (DOI) to engage in extensive legal and historical research prior to taking land into trust. In some cases, it has also stopped the DOI from taking land into trust for some tribes altogether.

Letter Highlights

In their October letter, USET notes that more than 13 years have passed since the Carcieri v. Salazar ruling, arguing that this decision jeopardizes the ability of federally recognized Tribal Nations to rebuild their communities and provide essential governmental programs. Tribal land bases are considered the foundation of Tribal sovereignty, and this ruling has sparked legal challenges, many of which threaten Tribal lands that have been in trust for decades, that aim to dismantle Tribal sovereignty altogether.  If this decision remains unaddressed, USET states that substantial litigation over existing trust lands will ensue.

In addition, USET explains that Tribal Nations have been expressing a desire for a legislative fix to Carcieri v. Salazar with two specific components. The first component is a restoration of the Secretary’s authority to take land into trust for all Tribal Nations. The second component is to reaffirm the existing Tribal government trust lands and the actions of the Secretary to take land into trust.

The letter also recognizes that H.R. 4352 (To amend the Act of June 18, 1934, to reaffirm the authority of the Secretary of the Interior to take land into trust for Indian Tribes, and for other purposes) is a critical piece of legislation necessary to stop the growing legal challenges threatening Tribal authority and overall sovereignty. In addition, USET goes on to express their support of enacting S. 4830 (A bill to reaffirm actions taken by the Secretary of the Interior for the benefit of Indian Tribes, and for other purposes). These bills would enable Tribal Nations and the Department to move forward in restoring their Tribal homelands. Congress has enacted similar legislation for specific Tribal Nations over the years, but this would make it so that Congress does not have to consider individual bills in a piecemeal fashion.

Next Steps

As a passionate supporter of Tribal sovereignty and strong Tribal economies, NCUIH was proud to sign the Tribal Partners Organization letter. NCUIH also signed on to a similar letter in April with other leading American Indian and Alaska Native advocacy organizations.

NCUIH urges Congress to pass legislation that restores the Secretary of the Interior’s authority to take land into trust for all federally recognized Tribes and which reaffirms the status of existing Tribal trust lands.

NCUIH Sends Letter in Support of the IHS Request to Detail Public Health Service Commissioned Officers to Urban Indian Organizations

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On May 24, 2022, the National Council of Urban Indian Health (NCUIH) sent a letter to the Chairs of the House and Senate Appropriations Committees, Representative Chellie Pingree (D-ME-1), and Senator Jeff Merkley (D-OR), and to the Ranking Members Representative David Joyce (R-OH-14) and Senator Lisa Murkowski (R-AK), expressing NCUIH’s support for detailing Public Health Service Commission Officers (PHSCOs) to Urban Indian Organizations (UIOs). Detailing officers to UIOs would assist UIO personnel in providing skilled, culturally competent healthcare, help address workforce shortages, and increase collaboration across the federal healthcare system.

Amending the law would provide the Indian Health Service (IHS) with the discretionary authority to detail PHSCOs directly to a UIO to perform work related to the functions of the Service. Such authority would be comparable to the existing authority to detail Officers to Indian Self Determination and Education Assistance Act (ISDEAA) contractors and compactors for the purpose of carrying out the provisions of their ISDEAA contracts (section 7 of the Act of August 5, 1954 (42 U.S.C. § 2004b). The bill would support the 41 UIOs that serve the 70% of American Indians and Alaska Natives that live outside of reservations. Currently, UIOs only get 1% of IHS funding, so to fully staff UIOs, Public Health Service Commissioned Officers need to be deployed.

The Biden Administration and IHS support this deployment of PHSCOs to UIOs by including the provision in their Fiscal Year 2023 budget. NCUIH urges Chair Pingree and Merkley and Ranking Members Joyce and Murkowski to support this provision in the 2023 budget, and if not feasible, to support this provision in the next budget or in a stand-alone bill.

Background

Section 215 of the Public Health Service Act (PHSA) authorizes the Secretary of Health and Human Services (HHS) to detail officers to federal agencies and state health or mental health authorities. While UIOs have requested that officers be detailed to them to fill many roles related to the functions of the Public Health Service, subsection (c) of Section 215 (42 U.S.C. 215(c)) prevents UIOs from receiving detailed officers because they do not fall within the requirement that non-profits eligible for detailing be educational or research non-profits, or non-profits engaged in health activities for special studies and dissemination of information.” UIOs do not qualify under the current statutory language. Changing this language would allow IHS to detail officers to UIOs to perform work related to the functions of the Indian Health Service.

DOJ Consultation Meeting on the Public Safety and Criminal Justice Needs of Native Americans

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On January 14, 2022, the U.S. Department of Justice (DOJ) Office of Tribal Justice (OTJ) issued a Dear Tribal Leader letter inviting Tribal leaders to a two-day government-to-government consultation on March 16 and 17, 2022. The purpose of this two-day consultation is to discuss “DOJ’s efforts to address the unacceptably high rate of violent crime in Native communities, including the rates of missing or murdered indigenous persons.” Deputy Attorney General Lisa Monaco directed this consultation in her November 15, 2021  memorandum establishing the DOJ’s Steering Committee to address the crisis of missing and murdered indigenous persons (MMIP). The OTJ is also welcoming written comments via email to OTJ@usdoj.gov until April 15, 2022. The meetings will be held from 3:00 p.m. – 4:30 p.m. EST on both days.

On November 15, 2021, during the White House Tribal Nations Summit, President Biden signed Executive Order 14053 (E.O.) “Improving Public Safety and Criminal Justice for Native Americans and Addressing the Crisis of Missing or Murdered Indigenous People,” which directed the Administration to work together with Tribes to “build safe and healthy Tribal communities and to support comprehensive law enforcement, prevention, intervention, and support services.”  The E.O. also recognizes that because “approximately 70 percent of American Indian and Alaska Natives live in urban areas and part of this epidemic of violence is against Native American people in urban areas, we must continue that work on Tribal lands but also build on existing strategies to identify solutions directed toward the particular needs of urban Native Americans.”  To that end, in her November 15, 2021 memorandum, Deputy Attorney General Monaco directed DOJ’s Steering Committee to seek and consider the views of stakeholders including Urban Indian Organizations.