Trump administration seeks $150 million to help tribes with opioid crisis'A crisis in our Native communities'
By Kevin Abourezk
@Kevin_Abourezk Among the few bright spots for Indian Country within President Donald Trump’s proposed budget is a $413 million increase for the Indian Health Service. According to the fiscal year 2019 request, the funding will provide a significant boost for direct clinical services, referred care, drug and alcohol rehabilitation and mental health care. And as part of a larger, $10 billion national campaign to combat the opioid epidemic, the president has proposed $150 million in new funding to the IHS to provide multi-year competitive grants based on need for opioid abuse prevention, treatment, and recovery support in Indian Country. "We have a crisis in our Native communities,” Rep. Don Young (R-Alaska) said at the winter session of the National Congress of American Indians in Washington, D.C., on Tuesday, telling tribal leaders that drug traffickers are “abusing and killing your kids.” Young wasn't the only one who brought up the issue on the opening day of NCAI's meeting. Rep. Darrell Issa (R-California), who is not running for re-election this year, said tribes face the same problems with addiction as others and mustn’t be forgotten as they fight those problems. “Let’s be candid. In Indian Country you are not exempt from the problem of the opioid crisis,” Issa said.
The IHS provides health care to more than 2.2 million Native Americans and Alaska Natives. Many tribes, through compacts and contracts with the agency , administer their own health care programs. Those tribes manage more than 60 percent of IHS’s total budget. According to an NCAI analysis released on Tuesday, Trump’s budget would reduce or eliminate funds for many tribal program while increasing funding primarily only for Indian health and justice programs. Among the many Indian programs targeted for elimination are the Indian Community Development Block Grant, Low Income Home Energy Assistance Program and Tribal Energy Loan Guarantee Program. The largest proposed increase for IHS is a $353 million increase in funding for direct health care services, which would allow IHS to expand those services across the country. Direct health care services include outpatient and inpatient care in hospitals and clinics, behavioral health services, and dental health services. “The budget prioritizes funding for direct health services to support improved health outcomes for American Indians and Alaska Natives,” an HHS budget overview said. Special Diabetes Program for Indians. It proposes to classify the $150 million in annual grants as "discretionary" rather than "mandatory," a change that could affect future efforts to fund the program. Given that the program was about to expire until Congress recently extended the program for two years after strong lobbying efforts from Indian Country, the change has advocates worried. Keeping the program going "should not even be a question, that should be a fact,” Rep. Nancy Pelosi (D-California), the Democratic leader in the House, said at NCAI on Tuesday.
National Congress of American Indians President Jefferson Keel kicks off winter session in Washington DC. Busy day hearing from members of Congress and officials from Trump administration pic.twitter.com/BBN6QxHoYU— indianz.com (@indianz) February 13, 2018
Though the Trump administration has sent a slew of top officials to the meeting, no one from the Department of Health and Human Services or the Indian Health Service is represented on the agenda. That's a marked change from NCAI's prior meetings. More than a year into the new era, the IHS also lacks a permanent leader. President Trump nominated Robert Weaver, a citizen of the Quapaw Tribe, for the job but he never secured a confirmation hearing in the Senate amid questions about his qualifications. "We keep hearing positive signs on one hand and negative on the other," NCAI President Jefferson Keel said of the lack of a director for the IHS. "We just don't know. That is inexcusable." Department of Health and Human Services FY2019 Budget Documents:
Budget in Brief | Indian Health Service
Join the Conversation
Related StoriesIndian diabetes program included in bill to keep government running (February 7, 2018)
Ponca Tribe secures key permit for big development in Nebraska (February 6, 2018)
Winnebago Tribe moves forward with takeover of troubled hospital (February 6, 2018)
Annie Belcourt: The hidden health inequalities facing Native Americans (January 29, 2018)
Indian Health Service enters another year without permanent leader (January 25, 2018)
Shutdown ends but the battle for Indian health care funding continues (January 23, 2018)
Tribes continue battles against drug companies amid a setback in court (January 17, 2018)
Mary Annette Pember: Indian Health Service still lacks a permanent leader (January 17, 2018)
Bill John Baker: Cherokee Nation battles opioid epidemic among our people (August 2, 2017)