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NIHB Coordinates Visits on Capitol Hill in Conjunction with National Congress of American Indians Executive Council Winter Session

Tribal leaders meet with Majority and Minority staff of the Senate Committee on Indian Affairs

The National Congress of American Indians (NCAI) held its Executive Council Winter Session (ECWS) in Washington, DC on the week of February 12, 2024. As part of the activities organized for the ECWS, NCAI, NIHB, and other Tribal partners organized hill visits to support Tribal Leaders to meet with Congressional Leaders on issues impacting Indian Country. The NIHB, NCAI, and the National Council on Urban Indian Health (NCUIH) lead two groups of Tribal Leaders to speak on critical health priorities to advance during the remaining 118th Congress.

As Tribal Leaders met with their Congressional Representatives, they spoke on the importance of the Special Diabetes Program for Indians (SDPI), which is set to expire with the end of the current Continuing Resolution (CR) on March 8th. Tribal Leaders urged that Congress fully reauthorize SDPI during the next budget vote and to stop with short-term extensions, which can be detrimental to SDPI programs’ ability to staff and plan. SDPI Reauthorization legislation has already passed the House (HR 5378, Lower Costs, More Transparency Act), and a standalone bill was passed out of committee in the Senate (S 1855).

Tribal leaders spoke to the success of the program in their own communities in delivering important dietary education to Tribal members on traditional foods; support of physical exercise to increase movement and reduce the risk of diabetes; and the impact of the program on comorbidities outside of diabetes which can complicate Tribal members’ diabetes diagnoses. The SDPI has been one of the most successful public health programs in the United States’ history, achieving a decrease in the diagnosis prevalence of diabetes and pre-diabetes for American Indians and Alaska Natives.

In addition to the need for reauthorization of SDPI, Tribal Leaders spoke to the importance of the Indian Health Service budget, particularly the need to move Contract Support Costs and Section 105(l) Lease Payments out of the IHS’s discretionary budget and from under the Interior, Environment, and Other Related Agencies Budget cap. Moving these programs to so-called “mandatory” funding would allow for more growth in funding for critical direct health services.

Other important legislative priorities were also raised. New legislation to support Tribal members burdened by medical debt related to the IHS Purchased and Referred Care Program was of keen interest to offices on the Hill. Senators Mike Rounds (R-SD) and Maria Cantwell (D-WA) introduced the PRC Improvement Act of 2024 (S 3797) to require IHS to pay its PRC-approved care debts to providers, clarifying that Tribal members are not responsible for those debts for PRC care, and requires the IHS to develop a repayment process for Tribal members who paid for that care out-of-pocket to avoid adverse impacts to their credit.

The groups visiting with Congressional offices also shared the need for additional authority for Tribally directed programs in behavioral health programs. A Special Behavioral Health Program for Indians, modeled on the success of the SDPI, could provide the needed funding and program authority for Tribes to deliver culturally competent and appropriate services and programs that target the needs of individual Tribal communities. Indian Country is not a monolith, and Tribes and Tribal Leaders require flexibility in programming to design effective programs that meet the needs of their people. As Congressional offices look to reintroduce authorizing legislation, the Hill visits built awareness of the issue to develop support for new legislation.

The NIHB Chairman, Chief William Smith, and Councilmember Andrew Joseph, NIHB Portland Area Alternate Representative, among other Tribal Leaders were able to meet with House and Senate offices, including the Senate Indian Affairs Committee staff, Sens. Catherine Cortez Masto (D-NV), Dan Sullivan (R-AK), Patty Murray (D-WA), Maria Cantwell (D-WA), Chuck Schumer (D-NY), Steve Daines (R-MT), Jon Tester (D-MT), and Reps. Ryan Zinke (R-MT-01), Matt Rosendale (R-MT-02), Mark Amodei (R-NV-02). NIHB’s Congressional Relations Team looks forward to continuing the dialogue with these offices to advance health priorities for Indian Country.

National Indian Health Board
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