National Urban Indian Health Council (NCUIH)

Senate Releases Fiscal 22 Funding Bills with Historic Increase for Urban Indian Health, IHS, Advance Credits, MMIW, and UIO Facility Fix

The Senate bill includes an increase of $ 30 million above the level passed for fiscal year 21 for urban Indian health.

October 19, 2021

Source: National Urban Indian Health Council (

On October 11, 2021, the Senate Appropriations Committee published its draft law on the interior, the environment and related agencies for the fiscal year 2022, with $ 92.7 million for urban Indian health. The bill would authorize $ 7.61 billion for the Indian Health Service (IHS) for FY22, an increase of $ 1.38 billion above the level passed for FY21 and 593 million dollars below the president’s request. Other key provisions include an additional $ 6.58 billion in advance funding to IHS for fiscal 23 and a fix for facilities allowing Urban Indian Organizations (UIOs) to use existing IHS funding for improvement and maintenance. renovation of facilities.

“After decades of ignorance and oblivion, we applaud the Senate Appropriation Committee for the strong legislation proposed to improve outcomes for the Indian country. We are particularly encouraged to see the commitment to ensure equitable consideration for all Indigenous communities. We are grateful to all members of Congress who have supported the demand for comprehensive Indian health funding, including urban Indian health, especially Senators Schatz, Feinstein, Murkowski, Tester, Moran, Merkley, Hoeven, Van Hollen, Heinrich and Murray, ”said Francys Crevier, CEO of NCUIH.

Source: Senate Releases Fiscal 22 Funding Bills with Historic Increase for Urban Indian Health, Indian Health Service, Advance Appropriations, MMIW, and Repair of Indian Facilities UIO, the National Urban Indian Health Council


The National Urban Indian Health Council (NCUIH) and the Tribal Budget Formulation Task Force (TBFWG) requested $ 12.759 billion for the Indian Health Service (IHS) with an urban Indian health post of $ 200.5 million for fiscal year 2022. In addition, 28 congressional leaders requested $ 200.5 million for urban Indian health in fiscal year 2022 from the House Appropriations Committee.

Home loan status

The House bill (HR 4372) included $ 200.5 million for urban Indian health and was put forward by the subcommittee on June 28, and $ 8.1 billion for service to Indian health. The measure was part of a package of seven bills the House passed on July 29.

Highlights of the Senate Bill

Appropriations Chairman Patrick Leahy said in the summary of the bill: “The bill makes an unprecedented investment in fulfilling the federal government’s treaty and trust responsibilities to Native Americans by providing 18 , $ 1 billion for tribal programs and – for the first time – guaranteeing advanced credit for Indian health. Service (IHS). The advance allocation for IHS for fiscal year 2023 will allow IHS to continue providing healthcare services without disruption and uncertainty, improving the quality of care and providing peace of mind for patients and providers. “

Indian health service

  • $ 7,616,250,000 for IHS for fiscal year 2022, an increase of $ 1,379,971,000 to adopted level and a decrease of $ 593,029,000 upon request

Urban Indian Health

  • $ 92,684,000 for the Urban Indian Health program, $ 30,000,000 above adopted level and $ 7,316,000 below budget request.

Correction of facilities for urban Indian health

  • SECOND. 435. The Secretary of Health and Human Services may authorize an urban Indian organization (as defined in section 4 of the Indian Healthcare Improvement Act (25 USC 1603) to be assigned a grant or contract under Title V of that Act (25 USC 1651 et seq.) to use the funds provided in this grant or contract for minor renovations of facilities or the construction or expansion of facilities , including leased facilities, to help the Urban Indian Organization meet or maintain standards issued by federal or state governments or accreditation bodies. “

Advance credits for IHS

  • $ 6,586,250,000 in anticipated appropriations for fiscal year 2023, equal to the Committee’s recommendation for fiscal year 2022 in accordance with the accompanying resolution on the budget for fiscal year 2022
    • “The Committee’s recommendation also provides, for the first time, for advanced funding for Indian health services and Indian health facilities. The bill includes advance appropriations of $ 6,586,250,000 for fiscal year 2023, which is the equivalent of the committee’s recommendation for fiscal year 2022 in accordance with the accompanying budget resolution for fiscal year 2022. The committee recognizes that budget uncertainty due to the temporary expiration of appropriations and continued resolutions has an effect on the proper functioning of essential health care programs for Native American communities. Existing challenges related to the recruitment and retention of health care providers, administrative burden and costs, and financial effects on tribes were identified as areas of concern in a government accountability office. [GAO] study (GAO-18-652).

Contractual support costs and leases 105 (l)

  • “The Committee strongly supports the revision of the budgetary classification of contractual support costs and payments for tribal leases with the aim of including the language necessary to codify such a change in the final appropriation act for fiscal year 2022” .

Office of Indian Affairs – Missing and Murdered Indigenous Women

  • Missing and Murdered Indigenous Women: $ 24.9 million
    • “The Committee is concerned about the crisis of missing, trafficked and murdered indigenous women which has plagued indigenous communities. Native American women face high rates of violence, and the lack of data on the number of women and girls reported missing or murdered further complicates the nation’s ability to cope with this crisis. The committee’s recommendation includes both funding and direction from the Bureau of Indian Affairs and the Indian Health Service to improve the federal response to this outbreak. “
    • To note: It is not clear at this time whether OUIs would be eligible for funding resources provided to IHS under this provision.

Indian Education Bureau – Native Residential Schools Initiative

  • Residential Schools Initiative: $ 7 million
    • “In June 2021, the ministry announced an investigation into the federal government’s past oversight of residential schools. Past policies of forcing children to attend these schools have torn families apart and resulted in a loss of culture and identity for generations of young Native Americans. The Committee applauds the Ministry’s efforts to re-examine this era and looks forward to the findings. The bill provides $ 7,000,000 for these efforts.

Next steps

Congress will likely pass another pending resolution before current spending expires on Dec. 3, 2021. If Democrats get into “basic” budget negotiations quickly, they may pass an omnibus funding plan in the Senate.

Senate Appropriations Committee101821

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