The National Indian Health Board is a dedicated advocate to Congress on behalf of all Tribal Governments and American Indians/Alaska Natives. Each weekly issue contains a listing of current events on Capitol Hill, information on passed and upcoming legislation, Indian health policy analysis, and action items. To view all of our legislative resources, please visit www.nihb.org/legislative/washington_report.php.
| |
|
NIHB and NCAI Collaborate to Seek Tribal Testimony on Advance Appropriations
The National Indian Health Board (NHIB) and the National Congress of American Indians (NCAI) are partnering to reach out to Tribes in order to amplify your voice and help save Native lives. We are collecting primary data from Tribes on the impacts of government shutdowns on the delivery of Indian Health Service (IHS) programs. We will collect, analyze and report back to you so you have a single source of this information ready and at your finger tips.
Endorsing advance appropriations for the IHS, the Biden Administration is aware of the adverse impacts of discretionary funding and has included advance appropriation in the fiscal year (FY) 2023 budget proposal. While the House Appropriations Committee did not initially signal support, the House Natural Resources Subcommittee on Indigenous Peoples’ hearing on HR 5549 expressed strong, broad bi-partisan support. That same day the Senate Appropriations Chair Patrick Leahy (D- VT) released the Senate’s draft FY 2023 appropriations bills which included IHS advance appropriations. More information on that action can be found by clicking here.
While the House did not include advance appropriations in their spending bill and the Senate did include advance appropriations in their spending bill, the securement for advance appropriations for the Indian Health Service is not final.
Tribes need advance appropriations for IHS funding now. Our allies in Congress are asking for your stories to help get their colleagues on board. Members of Congress frequently ask, “Why do Tribes need Advance Appropriations?” and “How do funding disruptions harm Tribal nations and their people?”
Please complete our survey by clicking on the link below. Once you have completed the survey, you will be routed to a separate link to enter to win a Pendleton for taking this survey. It should only take 10 minutes of your time.
For questions, please contact NIHB Director of Government Relations Aaron Payment, EdD, at apayment@nihb.org.
| |
NIHB Testifies on the Indian Health Service Advance Appropriations Act
On July 28, Jonathan Nez, President of the Navajo Nation and a National Indian Health Board (NIHB) Board Member, testified before the United States House of Representatives Natural Resources Committee Hearing. Introduced by the late Congressman Don Young (AK), the hearing was to receive testimony on HR 5549 Indian Health Services (IHS) Advance Appropriations Act.
The HR 5549 IHS Advance Appropriations Act is a continuation of bipartisan Congressional efforts that increases Tribal and federal government efficiency, reduces federal taxpayer waste, and saves American Indian/Alaska Native (AI/AN) lives by providing stable funding for health care services in Indian Country. NIHB is pleased to see advance appropriations included in President Biden’s fiscal year (FY) 2023 funding request and urges Congress to include advance appropriations for IHS in this FY appropriations bill, which sets overall spending limits by agency.
During the most recent 35-day government shutdown in 2019, IHS was the only federal health care program directly harmed. President Nez explained, “The Navajo Nation’s 27,000 square miles of land and more than 400,000 Tribal citizens were especially hard hit during the worldwide COVID-19 pandemic. While there is no good time for government shutdowns to occur, it will take years following the COVID-19 pandemic before Tribal nations are resilient enough to withstand another government shutdown.”
IHS faces chronic challenges made worse by endless use of continuing resolutions (CRs) and the persistent threat of government shutdowns. IHS is the only one of four federal health delivery programs not protected from government shutdowns and CRs. Medicare/Medicaid receive mandatory appropriations. The Veterans Health Administration (VHA) receive advance appropriations starting a decade ago.
In September 2018, the Government Accountability Office (GOA) issued a report that noted “uncertainty resulting from recurring CRs and from government shutdowns has led to adverse financial effects on Tribes and their health care programs.” If the uncertainly of CR’s continue, so too does the threat to an interruption of the treaty and trust obligation for the only class of Americans with a federal treaty right to health care.
"Advance Appropriations for IHS is a step towards fully honoring the treaty and trust obligation for health. It would constitute a demonstrated commitment that Congress will enact solutions that address the health inequities and ensure the health and wellness of Tribal communities,” said President Nez.
NIHB is dedicated to ensuring funding for IHS and other agencies affecting health care in Indian Country is increased.
Read the full written testimony here.
| | |
|
Senator Jon Tester (D-MT)
A third generation farmer and former school teacher, Senator Tester is serving his third term in the U.S Senate representing the 12 Tribal Nations of Montana. Tester, who has the former chairman of the Senate Committee on Indian Affairs and currently is on the Committee, is advocate for Tribal nations and our Native veterans' healthcare. Championing for the protection of Montana's natural resources, Tester also focuses his legislation on clean and renewable energy, quality veterans' healthcare, and small business opportunities. Tester leads the Committee on Veterans' Affairs and the Subcommittee on Department of Defense on the Committee on Appropriations, sits on the Committee on Indian Affairs, and the Committee on Commerce, Science, and Transportation.
Tribal Healthcare Legislation
Supporting a longstanding Tribal recommendation and request, Tester cosponsors Indian Programs Advance Appropriations Act. This bill would provide advance appropriations for the Bureau of Indian Affairs, Bureau of Education, and the Indian Health Service (IHS). NIHB is pleased to see advance appropriations included in President Biden’s fiscal year (FY) 2023 funding request and in the Senate spending bills which sets overall spending limits by agency.
Tester cosponsors the Truth and Healing Commission on Indian Boarding School Policies Act. This bill would establish a commission to investigate and document the detrimental Indian boarding school policies and historical trauma resulting from those policies and to make recommendations, among others, for federal resources and assistance to aid in healing from that trauma. NIHB has led efforts in Congress and the Administration to secure more behavioral health care services as well as in-patient behavioral health treatment facilities, particularly through the Budget Reconciliation measure pending before Congress and in other legislation and administrative means. Read NIHB Resolution no. 22-01 Boarding School Healing Resolution that was adopted at the First Quarter and Annual Board Meeting on February 23 and 24, 2022.
Supporting another longstanding Tribal request, Tester cosponsor's Senator Tina Smith's improvement bills. Senator Smith introduced the Tribal Health Data Improvement and the Native Behavioral Health Access Improvement Act. Both bills are intended to elevate American Indian/Alaska Native (AI/AN) healthcare. The Tribal Health Data bill would improve Tribal access to important public health data and information. It also reauthorizes through FY 2026 the National Center for Health Statistics in the Centers for Disease Control and Prevention (CDC). The Department of Health and Human Services (HHS) must (1) establish a strategy for providing data access to Indian Tribes and Tribal epidemiology centers; and (2) make available all requested data related to health care and public health surveillance programs and activities to IHS, Tribes, Tribal organizations, and Tribal epidemiology centers.
The Native Behavioral Health bill would provide important base funding for Tribal communities to address behavioral health issues. More specifically, this bill would expand Tribal access to public health care data and public health surveillance programs. It would require HHS to establish a strategy for providing data access to Indian Tribes and Tribal epidemiology centers. In addition, the bill would make available all requested data related to health care and public health surveillance programs and activities to IHS, Tribes, Tribal organizations, and Tribal epidemiology centers.
| | |
Senate Committee on Appropriations Releases FY 2023 Appropriations Bills with Historic Commitment to Advance Appropriations for
Indian Health Service
The National Indian Health Board (NIHB) Chairman William Smith (Valdez Native Tribe) highlighted, “The historic nature of the possibility of enacting advance appropriations for the Indian Health Service to stabilize health care in Indian Country.”
The Interior and Related Agencies bill provides $11.52 billion for Tribal programs. For fiscal year (FY) 2023, the bill provides $7.38 billion for IHS, an increase of $762 million above the FY 2022 enacted level. This provides $2.7 billion for hospitals, clinics, doctors, nurses, and health services; $260 million for dental health; and $127 million for mental health programs such as suicide prevention initiatives for American Indian /Alaska Native (AI/AN) youth, and tele-behavioral health programs.
The bill also provides an advance appropriation of $5.577 billion for IHS for FY 2024. Therefore, the vast majority of IHS funding will be provided by an advance appropriation. The Committee noted in the appropriation bill summary that “Budget uncertainty due to temporary lapses of appropriations and continuing resolutions affect the orderly operations of critical healthcare programs for AI/AN communities.” Advance appropriations will enable IHS to continue to provide health services without interruption or uncertainty, improving the quality of care and providing peace of mind for patients and medical providers.
This funding also increases Indian health facilities investments by 15 percent for a total of $1.08 billion for new hospital construction, new and replacement equipment, and water and solid waste infrastructure improvements for AI/AN communities, which are critically important for public health.
For nearly a decade, NIHB has worked alongside Tribal nations and other Tribal and urban Indian health advocates to secure advance appropriations for IHS. Following the devastating impact in 2013 of the 16-day government shutdown, NIHB moved quickly to pass Resolution 14-03 which supports advance appropriations. Since that time, there have been numerous bi-partisan bills introduced in support of advance appropriations for IHS by champions such as Senator Lisa Murkowski (AK), Congresswoman Betty McCollum (MN), and the late Don Young (AK).
Jonathan Nez, President of the Navajo Nation and an NIHB Board Member, testified last week in support of advance appropriations as the first and vital step toward truly honoring the treaty and trust obligation as an entitlement. “This first step in elevating Indian Health Care to advance appropriations is significant and welcomed,” said NIHB Chairman Smith.
More information on the Senate Interior and Related Agencies Appropriation Bill:
What can Tribes do? Tribes can contact their member of Congress and ask them to support this legislation.
For questions, please contact Aaron Payment, EdD, NIHB Director of Government Relations at apayment@nihb.org.
| | |
THE POWER OF IDENTITY: A PATH TO TRIBAL HEALTH EQUITY
Join the National Indian Health Board (NIHB) as we take a look back at the history of NIHB and build our plans for the next 50 years. Together we will explore the topics of health equity, health policy, Tribal advances in health, and many more. The National Tribal Health Conference (NTHC) The event will be held in Washington, DC at the Hyatt Regency Capitol Hill from September 25-29, 2022. Learn more and register here.
NIHB is accepting nominations for the 2022 Outstanding Service Awards until August 23. All awards will be presented at the Annual Heroes in Health Awards Gala, taking place as part of NTHC. The Gala will be held at the National Museum of the American Indian in Washington, DC, on Tuesday, September 27, 2022. Learn more and submit Award Nomination here.
| | | | | |
