Dear USET/USET SPF Family,

On June 16, 2021, the Indian Health Service (IHS) issued a Dear Tribal Leader Letter announcing an allocation distribution for the remaining $1.8 billion in funds appropriated to IHS through the American Rescue Plan Act (ARPA) (P.L. 117-2). ARPA authorized $6.1 billion in COVID-19 resources to IHS and IHS issued an initial allocation of $4.3 Billion of these funds on April 16, 2021. Click here to view USET SPF’s previous Alert on this first IHS ARPA allocation.

Tribal Health Programs (THPs) will receive these remaining ARPA funds through unilateral modifications and/or amendments to their existing Indian Self Determination and Education Assistance Act (ISDEAA) 638 contracts or compacts. The $1.8 billion ARPA funds will be distributed as follows—

$240 Million for Public Health Workforce Activities

• $225 million to IHS federal health programs and THPs.
  • Allocations will follow existing distribution methodologies for proportionate increases based on hospitals and health clinics, public health nursing, health education, and community health representatives funding amounts. A THP’s eligible Contract Support Costs may be added to this funding with IHS and THPs negotiating these amounts after payments are made.
• $10 million to support Urban Indian Organizations (UIOs).
• $5 million for IHS to support additional hiring actions required from these ARPA funds.

$420 Million for Mental Health and Substance Abuse Prevention and Treatment

• $378 million for IHS federal health programs and THPs.
  • Allocations will follow existing distribution methodologies for proportionate increases based on mental health, alcohol, and substance abuse funding amounts. A THP’s eligible Contract Support Costs may be added to this funding with IHS and THPs negotiating these amounts after payments are made.
• $17 million to support UIOs.
• $25 million for IHS to support mental health and substance abuse prevention.

$500 Million to Detect, Diagnose, Trace, Monitor, and Mitigate COVID-19

• $211 million to IHS federal health programs and THPs.
  • Allocations will follow existing distribution methodologies for proportionate increases based on hospitals and health clinics, purchased/referred care, mental health, alcohol, and substance abuse, public health nursing, and community health representatives funding amounts. A THP’s eligible Contract Support Costs may be added to this funding with IHS and THPs negotiating these amounts after payments are made.
• $9 million to support UIOs.
• $280 million for the National Supply Service Center to support purchase of additional testing supplies, personal protective equipment, and related COVID-19 supplies.

$600 Million for COVID-19-Related Facilities Activities

• $357 million to IHS federal health programs and THPs.
  • Allocations will follow existing distribution methodologies for maintenance and improvement activities, such as the lease, purchase, construction, alteration, renovation, and maintenance and improvement of facilities. A THP’s eligible Contract Support Costs may be added to this funding with IHS and THPs negotiating these amounts after payments are made.
  • These funds will not be restricted to Maintenance and Improvement (M&I) activities and will only use the M&I annual allocation formula for distribution purposes.
• $167 million to federal health programs and THPs for COVID-19 related sanitation facilities construction projects.
• $23 million for IHS federal health programs and THPs for COVID-19 equipment needs.
• $29 million for additional facilities support and environmental health activities.
• $24 million to support UIOs.

IHS is planning to distribute these ARPA funds as soon as possible and has stated that it will work with THPs and UIOs to facilitate this process and continue response efforts to the COVID-19 pandemic. USET SPF submitted comments to IHS on March 19, 2021 regarding the allocation of the $6.1 billion in COVID-19 resources authorized under ARPA. Click here to view USET SPF’s comments to IHS.

For more information, please contact Brian Howard, USET SPF Senior Policy Analyst, at bhoward@usetinc.org.