December 6, 2022

Dear USET/USET SPF Family,

On December 5, 2022, the Indian Health Service announced its decision on the distribution of funds for the $210 million in American Rescue Plan Act of 2021 (ARPA) funding for public health workforce activities. The IHS conducted Tribal Consultation on the distribution of funds in late 2021, and accepted comments through January 2022. During Tribal Consultation, Tribal Nations requested the funding be distributed through ISDEAA Self-Governance contracts and compacts. It was also requested that the funding by distributed on a pro-rata basis to the IHS Areas and then shared with each individual Tribal Nation following further Tribal Consultation. Commenters also requested maximum flexibility for the funding and minimized reporting requirements. USET SPF has advocated in the past for distribution of these funds via self-governance agreements, limited reported and maximum flexibility in these programs, and submitted comments to that effect during the comment period in December 2021. 

The $210 million for public health workforce activities has been approved for the following uses:

1. $92 million for Registered Nurses in Bureau of Indian Education (BIE) Funded Schools
   1. $90 million will support one RN for each of the 181 BIE schools, $1.5 million will support evaluation activities, and $800,000 will support administrative support activities at IHS headquarters
2. $47 million for Public Health Capacity Building in Indian Country
   1. These funds will support health programs operated by Tribes, Tribal Organizations and UIOs to establish goals and performance measures, assess their current management capacity, analyze programs and develop infrastructure for public health activities
   2. The IHS will distribute the funds via competitive award mechanisms in order to track outcomes and performance of the funds. The IHS will provide clear guidelines and maximum flexibility.
3. $20 million for Emergency Preparedness Capacity at the IHS
   1. The funds will support salaries and benefits for dedicated emergency management staff at IHS headquarters and each IHS Area office. It will also support annual training for staff.
4. $45 million for Additional IHS Loan Repayment Program Awards
   1. Funds will be used to expand the current IHS Loan Repayment Program to provide approximately 200 additional 2-year loan repayment contracts for health care professionals each year for 5 years.
5. $6 million for Core Surveillance and Epidemiology Functions
   1. The funds will support two crucial activities: increasing surveillance for vaccine-preventable diseases in Indian Country, and IHS mortality and natality data activities and reporting
   2. Of the $6 million, around $2.3 million will be used for the first function, and $3.6 million will be used to restore IHS capacity to compile and report on critical mortality and update important data files like the “Mortality and Natality Data Tables” and the National Death Index File, among others.

More information on the programs and activities above can be found in the Dear Tribal Leader Letter. A summary of the IHS’s current health surveillance and epidemiological activities can be found online at the IHS website.

For more information, please contact Ashton Martin, USET SPF Health Policy Analyst, at amartin@usetinc.org.

Established in 2014, the USET Sovereignty Protection Fund (USET SPF) is a non-profit, inter-Tribal organization advocating on behalf of thirty-three (33) federally recognized Tribal Nations from the Northeastern Woodlands to the Everglades and across the Gulf of Mexico. USET SPF is dedicated to promoting, protecting, and advancing the inherent sovereign rights and authorities of Tribal Nations and in assisting its membership in dealing effectively with public policy issues.