Padilla, Lankford, Gallego, Bacon Introduce Bipartisan Bill to Improve Urban Indian Health Care

Fix will allow UIOs to spend appropriated funding on construction and renovation projects

WASHINGTON, D.C. – Today, U.S. Senators Alex Padilla (D-Calif.) and James Lankford (R-Okla.) and U.S. Representatives Ruben Gallego (D-Ariz.) and Don Bacon (R-Neb.) introduced the Urban Indian Health Providers Facilities Improvement Act to pave the way for increased investment in the renovation and construction of urban Indian health facilities. U.S. Senators Dianne Feinstein (D-Calif.) and Tina Smith (D-Minn.) are cosponsors of the bill.

The Indian Health System is made up of the Indian Health Service (IHS), Tribal health programs, and urban Indian organizations (UIOs). UIOs provide culturally competent care for the over 70 percent of American Indians and Alaska Natives who live in urban centers, many in low-income, medically underserved areas.

The Urban Indian Health Providers Facilities Improvement Act will have a critical impact on California, which has one of the largest populations of American Indians in the United States and is home to 723,225 American Indians of sole and mixed race. Unlike American Indian populations in other states, American Indians in California are not linked by a dominant tribal affiliation, nor are they concentrated on reservations. In fact, nearly 90 percent  of the American Indian population in California resides in urban areas. Additionally, between 60,000 and 70,000 out-of-state Native Americans settled in Los Angeles and San Francisco – these cities have two of the largest urban Native American populations in the United States.

“Urban Indian Organizations are a lifeline to Native Americans living in urban areas across California,” said Senator Padilla. “Yet, UIOs are prohibited from using Indian Health Service funding for facilities, maintenance, equipment, and other necessary construction upgrades. During the pandemic, many UIOs couldn’t get approval for ventilation upgrades, heaters, generators, and weatherization equipment. Removing this unjust burden on UIOs is a commonsense fix, and would allow them to improve the quality of the culturally competent care that they provide.”

86 percent of UIOs report needing to make facilities and infrastructure upgrades, while 74 percent of UIOs report unmet need for new construction to better serve patients. These needs include but are not limited to the construction of urgent care facilities and infectious disease areas, capacity expansion projects, ventilation system improvements, and upgrades to telehealth and electronic health records systems. However, under an existing obsolete provision of law, UIOs are prevented from using the money allocated to them by Congress on these critical projects. The Urban Indian Health Providers Facilities Improvement Act amends the law to allow UIOs to spend appropriated funding on construction and renovation projects to improve the safety and quality of care provided to urban Indian patients.

“Oklahoma has the second-largest Urban Indian patient population and is proudly served in both Tulsa and Oklahoma City clinics. We should continue to improve health care access for our Urban Indian population and broaden the flexibility for Urban Indian Organizations’ use of facilities renovation dollars, in addition to those for accreditation, to meet patient needs,” said Senator Lankford. “We should finalize these changes to ensure we provide more, quality options for Tribal health care. I look forward to the support from the leadership of the Senate Committee on Indian Affairs on this important legislation.”

“Despite having extremely limited resources, Urban Indian organizations have been on the front lines of the COVID-19 pandemic, and for long before that have provided comprehensive, culturally competent care to urban Indians and other medically underserved patients across the country,” said Rep. Gallego. “Congress must immediately end this erroneous restriction on UIOs’ ability to spend the money Congress gave them on the projects that will best serve their patients. We must pass this bill without delay.”

“Like many community healthcare centers, Urban Indian Organizations (UIOs) have been hit financially because of COVID and have struggled to renovate their facilities and expand capacity requirements,” said Rep. Bacon. “Under current law, UIOs cannot use federal funds to pay for these improvements and keep their doors open. Our bill lifts that restriction and grants access to these funds. These health centers care for so many members in our Nebraska community. It’s only right we close this loop hole so they can provide quality care to their patients.”

“The impacts of COVID-19 will be with our Native communities for a long time to come. It is critical that the Indian Health Care Center of Santa Clara Valley and other UIOs be able to provide a safe environment for the families and patients we serve. We are extremely grateful for Senator Padilla’s leadership in rectifying a longstanding barrier preventing us from using existing funding to make urgent upgrades,” said Sonya Tetnowski (Makah), CEO of Indian Health Care Center of Center Clara Valley, President of California Consortium for Urban Indian Health (CCUIH), and President-elect of National Council for Urban Indian Health (NCUIH).

“It is time to live out this Country’s  commitment to each other to live with respect for one another and in community. With this legislation Friendship House in San Francisco will build a home village site for our urban Native Americans, so that our people may contribute to saving and enriching our homeland, which we must now all share and care for or lose. We greatly appreciate Senator Padilla’s leadership on this issue,” said Abby Abinanti (Yurok), President of the Friendship House Association of American Indians Board of Directors. 

“As with the implementation of racist legislations that resulted in generations of cultural displacement of American Indians, this new legislations will be an impetus for urban American Indians to establish a sacred space and place that will restore self-sufficiency, and a critical step towards transitional and social justice that honors and supports the basic principle of Indigenous Sovereignty. We commend Senator Padilla for his leadership on this issue,” said Nelson Jim (Navajo), Acting Chief Executive Officer, the Friendship House Association of American Indians.

Text of the legislation can be found here.