The Biden-Harris Administration released the 2023 Progress Report for Tribal Nations (“Progress Report”) during the December 6-7, 2023, White House Tribal Nations Summit. The Progress Report touches on several areas of concern to urban Indian organizations (UIOs) as discussed in the National Council of Urban Indian Health’s (NCUIH) 2023 Policy Priorities. The Progress Report also highlights work done in partnership with UIOs, such as initiatives addressing Missing and Murdered Indigenous Peoples (MMIP), Native Veteran Health and Homelessness, Mental Health, Health Information Technology (HIT) Modernization, and Reproductive Health Care.
Successes with Urban Native Communities Highlighted MMIP
In January 2023, The Department of Health and Human Services (HHS) submitted the MMIP Prevention, Early Intervention, and Victim and Survivor Services Plan to the White House Domestic Policy Council and to the President. Developed in consultation with the Department of the Interior, Tribal Nations, research and community-based organizations and UIOs, it is a comprehensive plan to support prevention efforts that reduce risk factors for victimization of Native Americans and increase protective factors, including by enhancing the delivery of services for Native American victims and survivors as well as their families and advocates.
In support of the Native American Veterans Homelessness Initiative, VA and other federal agencies engaged with UIOs to support and offer resources to AI/AN Veterans experiencing homelessness. The Initiative took the following actions in 2023:
- VA and Indian Health Service (IHS) developed an informational brochure for Native American veterans experiencing homelessness and distributed these brochures to UIOs, IHS facilities, and external partners across the country.
- VA and IHS developed and launched an interagency interactive map of UIOs and VA healthcare systems with points of contact information in June 2023.
- VA developed and implemented training webinars for UIOs to raise awareness of VA homeless programs among Native American veterans and to build or increase effective, responsive, and collaborative relationships between UIOs and VA.
- VA and various UIOs collaborated on Stand Down events in Seattle, Phoenix, Los Angeles, Albuquerque, and soon Alaska. These one-to-three-day events bring VA staff and volunteers together to provide food, clothing, and health screenings to homeless and at-risk veterans and receive referrals for healthcare, housing solutions, employment, substance use treatment, mental health counseling, and other essential services.
The Veterans Health Administration amended its medical regulations to implement a statute exempting eligible Indian and urban Indian veterans from copayment requirements. This change is based on a requirement within the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020. As of October 2023, 2,674 Native veterans have been approved for the copayment exemption, with copayment cancellations totaling just over $1.5 million.
HHS announced a new $35 million grant opportunity, enabled by the Bipartisan Safer Communities Act, to better support the 988 Suicide and Crisis Lifeline services in Tribal communities. One of the aims of the program is to facilitate collaborations between Tribal, state, and territory health providers, UIOs, law enforcement, and other first responders in a manner that respects Tribal sovereignty.
Throughout the process for selecting the new Electronic Health Record (EHR) vendor, IHS coordinated with Tribal and urban Indian organization partners through extensive Tribal engagement via Tribal consultations, listening sessions, urban confers, advisory committee meetings, an Industry Day, and the participation of hundreds of Tribal, urban Indian, and IHS system users in vendor product demonstrations. IHS ultimately awarded a 10-year contract to General Dynamics Information Technology to build, configure, and maintain a new enterprise EHR system utilizing Oracle Cerner technology.
Reproductive Health Care
In response to President Biden’s Executive Order on Strengthening Access to Affordable, High-Quality Contraception and Family Planning Services, IHS added new over-the-counter contraception options to the IHS National Core Formulary, which will expand access to high-quality contraception for patients. IHS encouraged Tribally or UIO operated IHS facilities to make the same options available to patients.