[Congressional Record Volume 167, Number 191 (Monday, November 1, 2021)]
[House]
[Pages H6044-H6046]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
URBAN INDIAN HEALTH CONFER ACT
Ms. LEGER FERNANDEZ. Madam Speaker, I move to suspend the rules and
pass the bill (H.R. 5221) to amend the Indian Health Care Improvement
Act to establish an urban Indian organization confer policy for the
Department of Health and Human Services.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 5221
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Urban Indian Health Confer
Act''.
SEC. 2. URBAN INDIAN ORGANIZATION CONFER POLICY.
Section 514(b) of the Indian Health Care Improvement Act
(25 U.S.C. 1660d) is amended to read as follows:
``(b) Requirement.--The Secretary shall ensure that the
Service and the other agencies and offices of the Department
confer, to the maximum extent practicable, with urban Indian
organizations in carrying out--
``(1) this Act; and
``(2) other provisions of law relating to Indian health
care.''.
The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from
New Mexico (Ms. Leger Fernandez) and the gentleman from Arkansas (Mr.
Westerman) each will control 20 minutes.
The Chair recognizes the gentlewoman from New Mexico.
General Leave
Ms. LEGER FERNANDEZ. Madam Speaker, I ask unanimous consent that all
Members may have 5 legislative days in which to revise and extend their
remarks and include any extraneous material on the measure under
consideration.
The SPEAKER pro tempore. Is there objection to the request of the
gentlewoman from New Mexico?
There was no objection.
Ms. LEGER FERNANDEZ. Madam Speaker, I yield myself such time as I may
consume.
Madam Speaker, H.R. 5221, the Urban Indian Health Confer Act,
introduced by Natural Resources Chair Raul Grijalva from Arizona will
require agencies and offices within the United States Department of
Health and Human Services, or HHS, to confer with Urban Indian
Organizations, or UIOs, on policies and initiatives related to
healthcare for American Indians and Alaska Natives.
[[Page H6045]]
The Indian Health Care Improvement Act established Urban Indian
Organizations in response to many American Indians and Alaska Natives
living in urban areas and seeking healthcare. Today, approximately 70
percent of all American Indians and Alaska Natives live in urban areas.
The Indian Health Service supports contracts and grants to 41 UIO
programs that offer medical services ranging from dental care,
optometry, pharmacy services, and community services, such as alcohol
and drug abuse prevention, nutrition education, and counseling.
An urban confer policy at HHS will serve as the preferred method of
dialogue between the agency and UIOs. Currently, the Indian Health
Service is the only agency that maintains a legal obligation to confer
with UIOs. This limited scope serves as a barrier for UIOs to
communicate with other agencies and offices within HHS.
During the COVID-19 pandemic, the issues with this limited confer
policy were, sadly, highlighted. Despite congressional and Tribal
support for the inclusion of UIOs and the agency's vaccine allocations,
HHS refrained from initiating communications with them. As a result,
UIOs were unable to provide input on the vaccine rollout allocations
until the deadline, which delayed the vaccine's distribution to many
urban American Indians and Alaska Natives.
The failure to communicate with UIOs about healthcare policies that
impact urban Indian communities is inconsistent with the Federal trust
responsibility and contrary to sound public health policy.
H.R. 5221 will establish direct lines of communication for UIOs
across the entire Department and ensure that urban American Indians and
Alaska Natives are aware of significant healthcare policy changes.
I want to thank Chair Grijalva for championing this critical
bipartisan legislation. I am pleased to be a cosponsor of the bill and
I urge quick adoption. I reserve the balance of my time.
House of Representatives,
Committee on Natural Resources,
Washington, DC, October 26, 2021.
Hon. Robert C. ``Bobby'' Scott,
Chair, Committee on Education and Labor, House of
Representatives, Washington, DC.
Dear Chair Scott, I write to you concerning H.R. 5221, the
``Urban Indian Health Confer Act.''
I appreciate your willingness to work cooperatively on this
legislation. I recognize that the bill contains provisions
that fall within the jurisdiction of the Committee on
Education and Labor. I acknowledge that your Committee will
not formally consider H.R. 5221 and agree that the inaction
of your Committee with respect to the bill does not waive any
future jurisdictional claim over the matters contained in the
bill that fall within your Committee's Rule X jurisdiction.
I am pleased to support your request to name members of the
Committee on Education and Labor to any conference committee
to consider such provisions. I will ensure that our exchange
of letters is included in the Committee Report and the
Congressional Record during floor consideration of the bill.
I appreciate your cooperation regarding this legislation and
look forward to continuing to work with you as this measure
moves through the legislative process.
Sincerely,
Raul M. Grijalva,
Chair, Committee on Natural Resources.
____
House of Representatives,
Committee on Education and Labor,
Washington, DC, October 21, 2021.
Hon. Raul M. Grijalva,
Chairman, Committee on Natural Resources,
Washington, DC.
Dear Chairman Grijalva: I write concerning H.R. 5221, the
Urban Indian Health Confer Act. This bill was primarily
referred to the Committee on Natural Resources, and
additionally to the Committee on Education and Labor. As a
result of Leadership and the Committee on Natural Resources
having consulted with me concerning this bill generally, I
agree to forgo formal consideration of the bill so the bill
may proceed expeditiously to the House floor.
The Committee on Education and Labor takes this action with
our mutual understanding that by forgoing formal
consideration of H.R. 5221, we do not waive any jurisdiction
over the subject matter contained in this or similar
legislation, and we will be appropriately consulted and
involved as the bill or similar legislation moves forward so
we may address any remaining issues within our Rule X
jurisdiction. I also request that you support my request to
name members of the Committee on Education and Labor to any
conference committee to consider such provisions.
Finally, I would appreciate a response confirming this
understanding and ask that a copy of our exchange of letters
on this matter be included in the Committee Report filed by
the Committee on Natural Resources and in the Congressional
Record during floor consideration of H.R. 5221.
Very truly yours,
Robert C. ``Bobby'' Scott,
Chairman.
____
House of Representatives,
Committee on Natural Resources,
Washington, DC, November 1, 2021.
Hon. Frank Pallone,
Chair, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Chair Pallone: I write to you concerning H.R. 5221,
the ``Urban Indian Health Confer Act.''
I appreciate your willingness to work cooperatively on this
legislation. I recognize that the bill contains provisions
that fall within the jurisdiction of the Committee on Energy
and Commerce. I acknowledge that your Committee will not
formally consider H.R. 5221 and agree that the inaction of
your Committee with respect to the bill does not waive any
future jurisdictional claim over the matters contained in the
bill that fall within your Committee's Rule X jurisdiction.
I am pleased to support your request to name members of the
Committee on Energy and Commerce to any conference committee
to consider such provisions. I will ensure that our exchange
of letters is included in the Committee Report and the
Congressional Record during floor consideration of the bill.
I appreciate your cooperation regarding this legislation and
look forward to continuing to work with you as this measure
moves through the legislative process.
Sincerely,
Raul M. Grijalva,
Chair, Committee on Natural Resources.
____
House of Representatives,
Committee on Energy and Commerce,
Washington, DC, November 1, 2021.
Hon. Raul M. Grijalva,
Chairman, Committee on National Resources,
Washington, DC.
Dear Chairman Grijalva: I write concerning H.R. 5221, the
``Urban Indian Health Confer Act,'' which was additionally
referred to the Committee on Energy and Commerce.
In recognition of the desire to expedite consideration of
H.R. 5221, the Committee agrees to waive formal consideration
of the bill as to provisions that fall within the Rule X
jurisdiction of the Committee. The Committee takes this
action with the mutual understanding that we do not waive any
jurisdiction over the subject matter contained in this or
similar legislation, and that the Committee will be
appropriately consulted and involved as this bill or similar
legislation moves forward so that we may address any
remaining issues within our jurisdiction. I also request that
you support my request to name members of the Committee to
any conference committee to consider such provisions.
Finally, I would appreciate the inclusion of this letter
into the Congressional Record during floor consideration of
the measure.
Sincerely,
Frank Pallone, Jr.,
Chairman.
{time} 1645
Mr. WESTERMAN. Madam Speaker, I yield myself such time as I may
consume.
Madam Speaker, today, the Indian Health Services Urban Indian Health
Program consists of 41 nonprofit programs nationwide.
These programs are funded through grants and contracts from the
Indian Health Service, pursuant to the authorities of the Indian Health
Care Improvement Act.
Urban Indian health organizations that participate in the program
provide services such as information, outreach and referral, dental
services, primary care services, community health, and other important
services.
In 2010, as part of the Patient Protection and Affordable Care Act,
Congress reauthorized and amended the Indian Health Care Improvement
Act by adding a requirement that the Indian Health Service confer with
urban Indian organizations.
In 2014, the Indian Health Service established a policy to guide when
the Indian Health Service seeks input from Urban Indian Organizations
on health policy matters.
Other agencies within the Department of Health and Human Services
that serve American Indians and Alaska Natives, such as the Centers for
Medicare and Medicaid Services, the Centers for Disease Control and
Prevention, and the Substance Abuse and Mental Health Services
Administration, and others, do not have policies regarding conferring
with Urban Indian Organizations.
Throughout the COVID-19 pandemic, Urban Indian health organizations
were provided no notice that they were required to make selections for
COVID-19 vaccine distribution until the day of the deadline imposed by
an agency.
[[Page H6046]]
This resulted in Urban Indian Organizations struggling to provide
accurate responses to changing public health decisions for Indians
living in urban areas.
This bill would amend the Indian Health Care Improvement Act to
require all agencies within the Department of Health and Human Services
to establish an urban Indian organization confer policy.
I thank the sponsor of this legislation, Chairman Grijalva, and I
reserve the balance of my time.
Ms. LEGER FERNANDEZ. Madam Speaker, I yield as much time as he may
consume to the gentleman from Arizona (Mr. Grijalva), the chairman of
the Natural Resources Committee.
Mr. GRIJALVA. Madam Speaker, as stated before, today marks the first
day of National Native American Heritage Month.
I want to thank the gentlewoman from New Mexico, the chair of the
Subcommittee on Indigenous Peoples of the United States, Ranking Member
Westerman, and Ranking Member Young for putting a package together for
Congress to vote specifically on significant bipartisan pieces of
legislation that deal specifically with Indian Country. I think it is
noteworthy and symbolic, and as you see these pieces of legislation,
very much necessary. I want to extend my thanks to all of them for
that.
While it is a time to celebrate the histories and achievements of
Native Americans in this country, it is also a time for Congress to
fully recognize the trust and treaty obligations the U.S. Government
owes to Tribal governments and to indigenous people in our country.
Ensuring equity for Tribal healthcare entities is an essential part
of the Federal trust responsibility, which is the reason that I am
proud to sponsor H.R. 5221, the Urban Indian Health Confer Act.
The accessible and culturally competent healthcare services that
Indian Health Services provides to Tribal communities are critical to
ensuring their well-being.
As stated by the chairwoman, over 70 percent of American Indians and
Alaska Natives began seeking healthcare outside of Tribal jurisdictions
in our cities and nonreservation communities across this country. Urban
Indian Organizations, UIOs, were created to fill that gap.
Today, IHS supports 41 of these programs that offer vital medical
services, including dental care, mental health support, optometry
services, and social services, such as nutrition, education, and home
healthcare.
Although UIOs have been recognized as critical components of the
Tribal healthcare system, they continue to experience parity and
recognition of purpose and the attention that they deserve for the
services they provide to indigenous people and the family services they
provide to nonreservation Native people across this country.
At the Department of Health and Human Services, only IHS maintains an
obligation to confer with UIOs regarding any healthcare policy changes
that may affect urban Indian communities. This issue became glaringly
obvious during the COVID-19 pandemic, when the Department excluded UIOs
in the vaccine rollout discussions, leaving urban Indian communities
among the last to receive vaccine allocations through their local urban
Indian centers.
As a Member of Congress who represents a UIO, the Tucson Indian
Center, I am grateful for their essential work to keep Tribal
communities safe and healthy, especially as we go into a post-COVID-19
pandemic era.
H.R. 5221 will establish direct lines of communication between UIOs
and the Department of Health and Human Services so that UIOs have a
seat at the table for all relevant Tribal healthcare policy changes.
Ensuring that UIOs achieve equity at the Department is sound public
health policy and upholds the U.S. Government's Federal trust
responsibility to Indian Country. H.R. 5221 represents a much-needed
change.
Madam Speaker, I urge the quick adoption of this bipartisan
legislation.
Mr. WESTERMAN. Madam Speaker, I am ready to close, and I yield back
the balance of my time.
Ms. LEGER FERNANDEZ. Madam Speaker, I want to, once again, thank
Ranking Member Westerman, as well as Ranking Member Don Young and
Chair Grijalva, for bringing forth this legislation. It addresses
immediately something that we saw that had lingered, but the pandemic
shown its ugly light on what happens when we let things linger and do
not deal with them. This legislation fixes that. It highlights the
importance of communication, of cooperation, and the confer policy that
must be adopted across all of our agencies, not only at HHS.
Madam Speaker, I urge my colleagues to support this legislation, and
I yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentlewoman from New Mexico (Ms. Leger Fernandez) that the House
suspend the rules and pass the bill, H.R. 5221.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds
being in the affirmative, the ayes have it.
Mr. ROY. Madam Speaker, on that I demand the yeas and nays.
The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution
8, the yeas and nays are ordered.
Pursuant to clause 8 of rule XX, further proceedings on this motion
are postponed.
____________________