Last week, the Senate began considering a $10 billion COVID-19 funding package related to the manufacture and distribution of vaccines, testing, and therapeutics. Senator Mitt Romney (R-UT) introduced an amendment in the nature of a substitute to H.R. 4373 Department of State, Foreign Operations, and Related Programs Appropriations Act 2022. As part of the negotiations, the new funding was to be off-set primarily by reductions to past unspent COVID-19 relief funding. 

One of those cuts was proposed to the Local Assistance and Tribal Consistency Fund (Tribal Fund) which would reduce funding to Tribal governments by $221.75 million. Romney’s amendment rescinds $250 million of $500 million of the Tribal Fund that Senator Ron Wyden added to the American Rescue Plan Act. It also eliminates a portion of the Tribal State Small Business Credit Initiative allocation. The National Indian Health Board (NIHB), Tribes, and other Tribal organizations including the National Congress of American Indians (NCAI), fought back against these cuts. During a procedural vote on Tuesday, April 5, 2022, which failed primarily due to issues over immigration matters, Senator Wyden voted against the amendment.

NIHB applauds Senator Wyden for standing with Indian Country; however, this fight is not over. Congressional leaders and the President intends to see this COVID-19 funding signed into law soon. Senators will still expect to have the funding off-set in some fashion. In addition, the funding should provide for some assistance to Indian Country. In its current form, it is not specific to Indian Health Service or Tribes.

On Tuesday April 5, 2022 the National Indian Health Board (NIHB) Chairman William Smith testified before the Subcommittee on Interior, Environment, and Related Agencies of the House Committee on Appropriations. The hearing "FY2023 National Tribal Organizations Public Witness Day" was to receive input and guidance from witnesses on Fiscal Year (FY) 2023 appropriations.

The subcommittee also received testimony from other national Tribal organizations including Fawn Sharp, President of the National Congress of American Indians; Jason Dropik, President of the National Indian Education Association; and Sonya Tetnowski, President-elect of the National Council of Urban Indian Health. 

Chairman Smith's testimony reflected the collaborative work of NIHB and the Indian Health Service (IHS) Tribal Budget Formulation Workgroup to request full funding of the IHS at $49.8 billion, support mandatory funding of the IHS, request direct funding through Indian Self Determination and Education Assistance (ISDEAA) contracts and compacts, and put forth other recommendations for IHS program expansions. 

Read Chairman Smith's testimony here. 

Senator Cotton is currently serving his second term in the U.S Senate. He supports immigration reform, national security, and foreign policy.

Senator Cotton's sponsored legislation focuses on national security and foreign policy. He co-sponsored S. 1512 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, sponsored by Senator Brian Schatz (D-HI), a comprehensive telehealth legislation. The bill would expand coverage of telehealth services under Medicare including removing “originating site” restrictions for expanding telehealth coverage in Native health facilities that would provide greater flexibility for patients visiting Native health facilities, which was introduced on April 29, 2021.

Representative Westerman represents Arkansas's fourth Congressional district and is serving his fourth term in the U.S House of Representatives. He is seeking re-election in the 2022 November elections. Westerman is a licensed forester and professional engineer where his policy reflects his credentials in protecting natural resources and promoting the economy simultaneously.  

Representative Westerman co-sponsored one Tribal-related legislation - H.R 4504 Tribal Biochar Promotion Act of 2021. This bill would establish a biochar demonstration project for AI/AN Tribes to support the development and commercialization of biochar. 

Representative Hill serves Arkansas's second Congressional district and is seeking re-election in the 2022 November elections. His priorities include oversight on federal spending, economic business development, and private and federal loan parity.

He co-sponsored H.R 2903 CONNECT for Health Act of 2021 sponsored by Rep. Mike Thompson (D-CA-5). It is the identical bill to the S. 1512.

He also co-sponsors H.R 1667 Dr. Lorna Health Care Provider Protection Act. The bill provides for the Secretary of Human and Health Services to, among other things, establish a program to award grants to Tribes or Tribal organizations to support the training of health care students, residents, or health care professionals in evidence-based or evidence-informed strategies to address mental and substance use disorders and improve mental health and resiliency among health care professionals. The bill was signed by the President and became law on March 18, 2022.

On March 31, 2022 the Government Accountability Office (GAO) released a report on Indian Health Service (IHS) COVID-19 relief funding and responses to the pandemic. The Coronavirus Aid, Relief, and Economic Security Act (CARES) Act required the GAO report on the IHS's federal response to the pandemic. 

The report surveyed all 24 federally run IHS hospitals including staff and officials to document responses on ways in which IHS took steps using federal COVID-19 funding to address administrative, medical, infrastructure challenges that arose during the pandemic. IHS received $9 billion in COVID-19 relief funding to address short and long term health care needs related to the pandemic. The COVID-19 relief funding also allowed certain funds to be used for longer standing needs of IHS facilities including updating electronic health record systems, implementing telehealth capabilities, funding sanitation and water projects. 

To read the full GAO report, click here. 

On Thursday March 31, United States Senator Elizabeth Warren (D-Mass.), Representative Ruben Gallego (D-Ariz.), Senator Martin Heinrich (D-N.M.), and Representative Tom Cole (R-Okla.) introduced the Centers for Disease Control and Prevention (CDC) Tribal Public Health Security and Preparedness Act in order to ensure tribal nations have equal access to funding through the CDC to prepare for public health emergencies. The bill would make Tribes nations are not eligible to apply for the CDC’s Public Health Emergency Preparedness (PHEP) cooperative agreement program, as currently they are not. 

The CDC PHEP program is a critical source of funding for eligible state, local, and territorial public health departments, helping them build and strengthen their ability to respond to public health threats and associated emergencies, such as the COVID-19 pandemic. Many heavily rely on these funds to meet needs related to staffing, supplies, planning, training, and exercises. Provisions under the proposed legislation include: 

The National Indian Health Board endorsed this bill, along with the National Congress of American Indians and the National Council of Urban Indian Health. 

To read the press release, please click here.

For any questions, please reach out to Erin Morris, Congressional Relations Manager, emorris@nihb.org or Verne Boerner, Interim Director of Public Health Policy & Programs, vboerner@nihb.org.

Before breaking for the Easter recess, Congress had a busy week with the Senate considering COVID-19 funding and the House of Representatives holding three hearings on Indian health-related issues. 

First, the Subcommittee on Interior, Environment, and Related Agencies of the House Committee on Appropriations held a hearing titled "FY2023 National Tribal Organizations Public Witness Day.” See article above.

Next, on Tuesday, April 5, 2022 the Subcommittee on Health of the House Committee on Energy and Commerce held a hybrid hearing titled "Communities in Need: Legislation to Support Mental Health and Well-Being". 

The Subcommittee held the hearing to consider 19 mental health related bills that would provide resources to address substance use disorder and mental health recovery efforts, including one Tribal health bill: H.R. 4251, the Native Behavioral Health Access Improvement Act. This hearing is a first step towards developing comprehensive legislative package on mental health and substance use disorder. 

Chairman Frank Pallone (D-NJ-6) of the Committee on Energy and Commerce sponsored H.R. 4251 which was introduced on June 30, 2021. This bill would require the Indian Health Service (IHS) to allocate $200 million for the authorization of a special program for behavioral health needs of American Indian and Alaska Native (AI/AN) communities. 

Chairman Pallone asked Dr. Miriam E. Delphin-Rittmon, Assistant Secretary for Mental Health and Substance Use of the Department of Health and Human Services, mental health trends among AI/AN communities her department has noted. Dr. Delphin-Rittmon testified the troubling trends of increased rates of overdoses and suicidal ideation and thoughts in AI/AN communities between ages of 18-25 during the pandemic. The Native Behavioral Health Access and Improvement Act is important for AI/AN communities to develop health programs through the IHS for the prevention and treatment of mental health and substance use disorder trends noted by Dr. Delphin-Rittmon. 

Read hearing testimonies and Member statements here.

Finally, the Subcommittee on Oversight and Investigations of the House Committee on Natural Resources also held a hearing on April 5, 2021 titled "Opioid Crisis in Tribal Communities". The hearing examined how the federal government can provide resources to support programs addressing the opioid crisis in Tribal communities and for urban Indian organizations.

The witnesses of the hearing include Principal Chief Hoskin Jr. of the Cherokee Nation; Maureen Rossette, Board Member of the National Council for Urban Indian Health; Vice President Art Del Cueto of the Western Region National Boarder Control Council; Wayne Cortez of the Riverside-San Bernarnido Indian Health, Inc.

Read member statements and witness testimonies here.

The National Indian Health Board (NIHB) invites you to register for the virtual National Tribal Public Health Summit (TPHS) 2022. TPHS is a premiere Indian public health event that attracts over 700 Tribal public health professionals, elected leaders, advocates, researchers, and community-based service providers. 

This year’s summit theme is Tribal Health is Public Health and will feature dynamic national speakers, interactive workshops and roundtable discussions, a welcome reception, a fitness event, as well as the presentation of the Native Public Health Innovation Awards. 

Register here.