Indian Health Service Announces $251 Million for Urban Indian Health for COVID-19

On April 16, 2021, the Indian Health Service announced allocation decisions for $4.3 billion of the more than $6 billion in new resources appropriated to the IHS in the American Rescue Plan Act (ARPA), which was signed into law by President Biden on March 11, 2021. The funding allocations include $251 million for urban Indian health – the most robust investment ever to provide health services to the over 70% of American Indians and Alaska Natives who reside in cities. The 41 Urban Indian Organizations (UIOs) operating in 77 facilities have been on the front lines throughout the COVID-19 pandemic. Last week, the IHS Director celebrated the millionth COVID-19 vaccine administered through the IHS system at the Indian Family Health Clinic in Great Falls, MT.

“Urban Indian health has been underfunded for decades so this historic investment from Congress and the Biden Administration is a welcome change that will greatly improve health outcomes for the over 70% of American Indians and Alaska Natives residing in cities. The pandemic has highlighted the critical role of Urban Indian Organizations (UIOs) who have been applauded for their highly successful testing and vaccination efforts over the past year. As Natives are still dying at record rates from COVID-19, it is important that the federal government is honoring its trust responsibility by providing lifesaving resources to Indian Country,” said NCUIH CEO Francys Crevier (Algonquin).

The National Council of Urban Indian Health (NCUIH) and UIOs attended an urban confer on ARPA allocations on March 15. The ARPA included a minimum of $84 million for urban Indian health and a recommendation for Urban Indian Organizations (UIOs) to access the additional resources within the over $6 billion for the Indian Health Service. In its comments, NCUIH recommended that IHS allocate essential resources to UIOs, including the minimum floor of $84 million in UIO funds, and ensure UIO eligibility of the additional earmarks for the Indian health system, consistent with Congressional intent. NCUIH commends the IHS for following its recommendation to provide these critical resources to UIOs, which includes lost revenue reimbursements and other much needed resources, as outlined below. NCUIH also applauds the Biden Administration’s continued efforts in furtherance of its commitment to a pandemic response that reaches all people and all communities by ensuring that urban Indians are included.

Lost Revenue Reimbursements for UIOs are Critical

The $80 million for lost reimbursements for UIOs will be critical as NCUIH estimates that UIOs lost $160.1 million of expected reimbursement during the first year of the pandemic due to cancelled appointments and reduced services – nearly 3/4ths of what they were projected to earn in 2020 before the pandemic began. While UIOs were eventually able to make use of Provider Relief Distributions as part of the CARES Act, the process was very slow and UIOs only recovered 13% of their losses with federal funds (a collective $20.9 million). This has been a major challenge to long-term capacity of the urban Indian health system to provide holistic care.

NCUIH Advocacy

• On February 2, NCUIH joined 17 national Native organizations in requesting $8 billion for Indian health in ARPA.

• On April 13, NCUIH joined 29 national Native organizations in requesting $21 billion for Indian health infrastructure in the forthcoming American Jobs Plan.

Background

• Fact Sheet: Biden Administration Invests $4 Billion in American Rescue Plan Funding to Combat COVID-19 in Indian Country

• Dear Tribal Leader and Urban Indian Organization Leader Announcing Allocation Decisions for Approximately $4.3 Billion in New Resources Appropriated to the IHS in the American Rescue Plan Act

Funding Breakdown

$84 million for Maintaining Operations of the Urban Indian Health Program

$2 billion for Lost Reimbursements

• $80 million to support UIOs

• $1.920 billion to IHS federal health programs and Tribal Health Programs (THPs)

$500 million for Additional Health Care Services

• $20 million to support UIOs

• $480 million to IHS federal health programs and THPs

$140 million for Information Technology, Telehealth Infrastructure, and the IHS Electronic Health Record

• $3 million to support UIOs

• $67 million to IHS federal health programs and THPs

• $70 million for IHS electronic health record modernization

$600 million for COVID-19 Vaccine-related Activities

• $24 million to support UIOs

• $526 million to IHS federal health programs and THPs

• $50 million to maintain systems improvements necessitated by the Agency’s role in vaccine distribution, as both the principal health care provider to American Indians and Alaska Natives, and as a distinct jurisdiction under the vaccine distribution effort. A portion of these funds will also be used for critical vaccine-related public health support activities.

$1 billion to Detect, Diagnose, Trace, Monitor, and Mitigate COVID-19 Infections

• $40 million to support UIOs

• $960 million for IHS federal health care programs and THPs