News Release

National Council of Urban Indian Health

Yesterday, House Appropriations Committee released the bill report for the Fiscal Year (FY) 2021 Interior, Environment, and Related Agencies funding bill. The bill includes $6.5 billion for the Indian Health Service (IHS), an increase of $445 million above the FY 2020 enacted level and $199 million above the President’s budget request for FY 2021. The full Appropriations Committee will mark up the bill on Friday at 9:00 a.m.

The bill includes $66.1 million for Urban Indian Health line item in the Indian Health Service budget, which is $8.4 million above FY20 and $16.5 million about the President's request for FY21. The National Council of Urban Indian Health (NCUIH) requested $106 million Urban Indian Health as recommended by the Tribal Budget Formulation Workgroup (TBFWG) for FY 2021. The bill also includes $83.9 million in Direct Operations for Indian Health Service and directs Indian Health Service to confer with Urban Indian Organizations to conduct a study on infrastructure needs. Additionally, Alzheimer’s Disease and the Hepatitis C & HIV/AIDS Initiative would receive $5 million respectively with provisions to work with Urban Indian Organizations.

“We are grateful for Chair McCollum, Ranking Member Joyce and the Committee for their tireless efforts in ensuring all of Indian Country has the resources needed to protect and care for our relatives. We are encouraged by the inclusion of $66.1 million for urban Indian health and the long-needed infrastructure study for urban Indian health facilities who require new resources to safely operate amid this pandemic,” said Francys Crevier, Executive Director of National Council of Urban Indian Health.

In June, National Council of Urban Indian Health testified before the House Committee on Appropriations Subcommittee on Interior, Environment and Related Agencies for a hearing on the Indian Health Service (IHS) COVID-19 Response. National Council of Urban Indian Health highlighted the dire need for facilities and infrastructure funding, which is currently unfunded, in the wake of the COVID-19 crisis. In February, National Council of Urban Indian Health testified as part of American Indian and Alaska Native Public Witness Day.

Indian Health Service

Note: Additional analysis is forthcoming.

  • Indian Health Service - $6.5 billion, an increase of $445 million above the FY 2020 enacted level and $199 million above the President’s budget request.
  • Urban Indian Health - $66.1 million, $8,443,000 above the FY20 enacted level and $16,491,000 above the President's budget request
  • Health Services - $4.5 billion, an increase of $225 million above the FY 2020 enacted level and $33 million above the President’s budget request. This reflects the move of Payment for Tribal Leases (Indian Self-Determination and Education Assistance Act section 105(l) lease cost agreements, commonly referred to as “section 105(l)” leases) to a separate, indefinite appropriation account.
    • Note: Urban Indian Organizations are ineligible for the 105(l) leases. Over the past few years, Indian Health Service has diverted over $1.5 million of Urban Indian Organizations funds to cover the cost of these leases, so a separate appropriation to cover 105(l) lease costs will ensure future Urban Indian Organizations funding is not diverted again for this reason.
  • Health Facilities - $935 million, an increase of $23 million above the FY 2020 enacted level and $166 million above the President’s budget request.
    • Note: Even though the bill language does not exclude Urban Indian Organizations, there is still the limitation found in 25 U.S.C. § 1659 that limits Urban Indian Organizations facility renovation or construction to “minor” activities for the sole purpose of meeting Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accreditation standards.
  • Alzheimer’s Disease - $5 million
    • The Committee directs Indian Health Service, in consultation with Indian Tribes and Urban Indian Organizations (UIOs), to develop a plan to assist those with Alzheimer’s, the additional services required, and the costs associated with increasing Alzheimer’s patients and submit this information to Congress within 270 days of enactment of this Act.
  • Hepatitis C & HIV/AIDS Initiative- $5 million
    • The Committee encourages Indian Health Service to confer with Urban Indian Organizations to determine how they may participate in this Initiative. 

Next Steps

On Tuesday, the House Interior Appropriations Subcommittee approved the bill with funding for the Indian Health Service. On Friday, the full House Appropriations Committee will markup the Interior bill. While the House is expected to move swiftly, the Senate is in recess until July 20 and has yet to begin their COVID-19 emergency response package. Majority Leader Mitch McConnell has signaled the Senate will still recess for August meaning that the Senate Appropriations process may not be underway until September. As it is an election year, the chances of a passage for an Interior Appropriations Bill in both chambers is dwindling and it's looking like a Continuing Resolution will be needed.


The National Council of Urban Indian Health (NCUIH) is the national non-profit organization devoted to the support and development of quality, accessible, and culturally-competent health and public health services for American Indians and Alaska Natives (AI/ANs) living in urban areas. National Council of Urban Indian Health is the only national representative of the 41 Title V Urban Indian Organizations (UIOs) under the Indian Health Service (IHS) in the Indian Health Care Improvement Act (IHCIA). National Council of Urban Indian Health strives to improve the health of the over 70% of the American Indian/Alaska Native population that lives in urban areas, supported by quality, accessible health care centers.

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