Bill seeks to improve access to health care for urban Native Americans

President Joe Biden participates remotely in a summit of tribal nations from the Eisenhower Executive Office Building in Washington, DC on November 15, addressing tribal leaders and announcing a number of measures to improve public safety and justice for Native Americans. Photo by Jim Lo Scalzo / EPA-EFE

WASHINGTON, November 22 (UPI) – A proposed amendment to India’s Improved Healthcare Act aims to improve access to healthcare for American Indians who live in urban areas, its advocates say.

The Urban Indian Health Confer Act would require the Department of Health and Human Services to consult with 41 Indian organizations – nonprofit organizations governed by Native Americans – on health policies for the 2.8 million Indians in the country. America and Alaska Natives who live in urban areas.

The bill was introduced by Representative Raul Grijalva, DN.M., and co-sponsored by 19 members of the House. It was passed by the House on November 2 and awaits action from the Senate.

About 70 percent of American Indians and Alaska Natives live in urban areas and face inequalities in access to health care because the Department of Health and Human Services is not required to consult with urban organizations when creating policies that impact urban Indians, Grijalva said.

American Indians began to move to urban areas after the enactment of the Indian Relocation Act of 1956. The law prompted American Indians and Alaskan Natives to live in urban areas in their country. promising housing, jobs and health care.

Other American Indians left reserve lands to pursue higher education and employment opportunities.

According to the Home Office, the United States has a fiduciary duty to provide American Indians with health care, education, and social protection in return for colonizing Indigenous lands. This fiduciary responsibility also follows individuals once they leave reserve lands.

Limited health care options

Yet for many American Indians leaving tribal lands, health care options are limited.

For Grijalva, the Urban Indian Health Confer Act would improve parity between urban natives and American Indians living on tribal lands.

“Passing the Urban Indian Health Confer Act will give urban Indian health organizations a critical role in planning and decision-making for Alaska Natives and American Indians. I look forward to working with my Senate counterparts to bring this bill across the finish line. and on the president’s desk, ”Grijalva said in a November 2 press release.

Sunny Stevenson (Walker River Paiute), director of federal relations for the National Urban Indian Health Council, said urban Indian organizations were under-resourced, underfunded, and not found in all metropolitan areas at all.

Stevenson said the bill supporting urban Indians would not reduce funding for the IHS or disadvantage Indians living on reserves.

“A policy of urban consultation with any part of the administration does not conflict with, supplant or undermine any tribal consultation or government-to-government relationship,” Stevenson said.

Monumental benefits

RoxAnne Unabia (Chippewa), executive director of the American Indian Health Service in Chicago, said the benefits of the act of conferring would be monumental.

“We hope that through the urban conference we can explain and discuss with Congress how much money is needed for urban natives,” Unabia said. “I have so many people who choose to pay for their heating rather than come for a visit.”

With additional funding, Unabia hopes to hire specialists, such as rheumatologists and cardiologists, to come to the clinic to better help Indians in towns.

American Indians are disproportionately affected by health problems, including lower life expectancy and higher rates of chronic diseases, such as diabetes, according to the Indian Health Service.

Unabia said the clinic has to outsource appointments, which means city dwellers pay more and wait longer. Additional funding could also lower the co-payment for drugs, which many of his patients cannot afford.

“Our patients have to choose between paying utilities, paying rent and buying prescriptions. And they want to continue living at home. They want a roof over their heads and that of their families,” he said. she declared.

Lack of health insurance

Unabia said 40% of its patients are uninsured because they are not eligible for Medicare and Medicaid, and many urban natives do not have health insurance.

“When the families were on the reserve, we were always told it was part of your treaty right to receive health care,” Unabia said. “But the US government never fully fulfilled the treaty obligations.”

For Stevenson, an urban conference would be the first step towards improving the health of urban Indians, but conferences must be monitored to be successful. She said it is important for urban Indian organizations to complete a satisfaction survey after consulting a federal agency. Then the comments of the Indian Urban Organization should be made public immediately.

“If the administration is to increase transparency, remain accountable and be held to a high standard, it is important that it publishes the results of the investigation as they arrive,” Stevenson said.

A conference would become almost pointless, Stevenson said, if federal agencies don’t respond quickly. She recommended 30 to 60 days.

Stevenson said federal agencies will also need to establish a point of contact to communicate with urban Indian organizations. The resource person must not only relay the information, but also be able to influence the change, she added.

“If you have people out there who are just there to listen and relay information, that’s really insufficient,” Stevenson said. “You have to have people out there who can agree to make commitments on behalf of Indians. ”

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