Advance Appropriations for Indian Health Service

Res #:	Committee:	Submitted by:	Title:         Pass →	Yes	No	Amended/Tabled	To NCAI
19-03	Health	Andy Joseph	Advance Appropriations for Indian Health Service	X

 2019 Winter Convention 

Portland, Oregon 

RESOLUTION #19 – 03 

“ADVANCE APPROPRIATIONS FOR INDIAN HEALTH SERVICE” 

PREAMBLE 

We, the members of the Affiliated Tribes of Northwest Indians of the United States, invoking the divine blessing of the Creator upon our efforts and purposes, in order to preserve for ourselves and our descendants rights secured under Indian Treaties, Executive Orders, and benefits to which we are entitled under the laws and constitution of the United States and several states, to enlighten the public toward a better understanding of the Indian people, to preserve Indian cultural values, and otherwise to promote the welfare of the Indian people, do hereby establish and submit the following resolution: 

WHEREAS, the Affiliated Tribes of Northwest Indians (ATNI) are representatives of and advocates for national, regional, and specific tribal concerns; and 

WHEREAS, ATNI is a regional organization comprised of American Indians/Alaska Natives (AI/AN) and tribes in the states of Washington, Idaho, Oregon, Montana, Nevada, Northern California, and Alaska; and 

WHEREAS, the health, safety, welfare, education, economic and employment opportunity, and preservation of cultural and natural resources are primary goals and objectives of the ATNI; and 

WHEREAS, the United States has a unique and special relationship with American Indians and Alaska Natives (AI/ANs) to provide health care as established through the U.S. Constitution, Treaties, U.S. Supreme Court decisions and federal legislation; and 

WHEREAS, although the trust relationship requires the federal government to provide for the health and welfare of tribal nations, the Indian Health Service (IHS) remains chronically underfunded and AI/ANs suffer from among the lowest health status nationally; and

WHEREAS, IHS, an agency within the Department of Health and Human Services, administers health care to 2.2 million AI/ANs residing in tribal communities in 35 states, directly, or through contracts or compacts with tribes and tribal organizations under the Indian Self-Determination and Education Assistance Act of 1975 (ISDEAA); and 

WHEREAS, in recent years, federal appropriation bills have not been enacted in a timely manner, thus hampering tribal and IHS health care providers’ budgeting, recruitment, retention, provision of services, facility maintenance, and construction efforts; and 

WHEREAS, since FY 1998, there has only been one year (FY2006) in which the Interior, Environment and Related Agencies Appropriations bill has been enacted before the beginning of the new fiscal year; and 

WHEREAS, ATNI believes that moving to the Advance Appropriations process protects tribes and tribal organizations and the IHS direct service units from cash flow problems that regularly occur at the start of the federal fiscal year due to delays in enactment of annual appropriations legislation; and 

WHEREAS, Congress has recognized the difficulties inherent in the provision of direct health care that relies on the appropriations process and traditional funding cycle through enactment of the Veterans Health Care Budget Reform and Transparency Act of 2009 (PL 111-81), which authorized Advance Appropriations for Veterans Administration (VA) medical care programs; and 

WHEREAS, IHS should be afforded the same budgetary certainty and protections extended to the VA which is also a federally-funded provider of direct health care; now 

THEREFORE BE IT RESOLVED, that ATNI requests that Congress amend the Indian Health Care Improvement Act to authorize Advance Appropriations for IHS; and 

BE IT FURTHER RESOLVED, that ATNI requests that Congress include our recommendation for Advance Appropriations for IHS in the Budget Resolution; and 

BE IT FINALLY RESOLVED, that ATNI requests that Congress include in the enacted appropriations bill Advance Appropriations for IHS. 

CERTIFICATION 

The foregoing resolution was adopted at the 2019 Winter Convention of the Affiliated Tribes of Northwest Indians, held at the Doubletree by Hilton – Portland Oregon, on January 28-31, 2019, with a quorum present. 

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