Trump administration moves slowly on coronavirus funding for Indian Country

Monday, March 23, 2020

By Acee Agoyo

After two weeks of complaints from tribal leaders and protests from key lawmakers, the Trump administration finally announced plans to distribute much-needed funding to Indian Country as the number of coronavirus cases continues to grow in communities that have long been underserved by the federal government.

The Department of Health and Human Services on Friday said it would provide a total of $80 million to tribes, urban Indians and Alaska Natives. That's double the amount that was set aside by Congress through the H.R.6074, the Coronavirus Preparedness and Response Supplemental Appropriations Act.

But the Trump administration rejected calls to have the Indian Health Service distribute the money. Instead, the Centers for Disease Control and Prevention, which does not have the same experience and expertise in dealing with tribes and their communities, is in charge of the first influx of coronavirus funding to tribes and their communities.

Native community #COVID19 needs to Congress:

Econ. Development: https://t.co/cY6M0f8hDB (1/2)

Econ. Development tech.: https://t.co/9ie5y14wlR (2/2)

Health, Ed., Nutrition: https://t.co/UwJmq0lGqs

Gov & Housing: https://t.co/qei6aAOpkD

CONTACT YOUR HILL MEMBERS NOW! pic.twitter.com/1hjFDFfKUf
— NCAI (@NCAI1944) March 21, 2020

CDC's plans, reviewed by Indianz.Com over the weekend, reflect the disconnect. Of $30 million being directed to three Indian nations, plus nine organizations, no funding has been set aside for the Great Plains, even though one of the first confirmed COVID-19 cases originated in the region and most of the tribes there rely on the IHS for direct services.

Similarly, none of the $30 million is going to the Phoenix Area or the Tucson Area of the IHS amid a growing number of cases in the state of Arizona. The area was overlooked despite restricting immigration, building a wall through tribal homelands and limiting the flow of people across the U.S. border with Mexico being pet causes of the president.

The vast majority of American Indians and Alaska Natives live in urban areas. CDC's plans, though, call for just an additional $8 million to be shared among the 41 health centers that serve such large segment of the population, where some of the first COVID-19 cases had an impact early on in the crisis.

Sara Anderson and Vernon Black Eyes -- an urban Indian couple -- prepare to walk up to an Omaha elder's apartment in Lincoln, Nebraska, on March 22, 2020. Photo by Kevin Abourezk

“While the cities across the country are shutting down, our Urban Indian Organizations (UIOs) are doing all they can to stay open for the patients and communities," said Francys Crevier, the executive director of the National Council of Urban Indian Health, which pointed out that it took "14 days" for the announcement to come from official Washington.

"As UIOs have risen to the challenge without any additional federal funding to date, helping not only their patients but their counties, the timing of this is critical and will be essential to protecting the personnel who are risking their lives without proper protective equipment," added Crevier.

Tribal and Indian leaders are welcoming the arrival of the initial funding, and they remain hopeful that the CDC can rise to respect the policies of sovereignty, self-determination and self-governance that are already enshrined at the IHS. But they are not banking on any promising changes, and there are already internal talks to find a way to share some money -- albeit it small amount -- with Great Plans and Tucson.

Otherwise, tribes in the two regions will have to wait for the CDC to announce how it is going to distribute additional coronavirus resources. According to the plans reviewed by Indianz.Com, the agency will be awarding $40 million in "non-competitive grants" once a notice goes up on grants.gov.

With at least 40 COVID-19 cases in the IHS system, plus untold numbers in urban communities and at facilities run directly by tribes, the slow roll-out has been a major concern. Key members of Congress from both parties, Democrat and Republican alike, have been pushing the Trump administration to act quicker in light of the unique legal obligations owed to Indian nations and their citizens.

“Every department of our federal government has a legal trust responsibility to American Indian and Alaska Native tribes established by hundreds of treaties between the U.S. and sovereign tribes,” 23 members of the U.S. House of Representatives -- including the four tribal citizens who serve in the chamber -- wrote in a letter on Friday to Secretary Alex Azar, the Trump administration's leader of the Department of Health and Human Services.

“In light of the current pandemic, it is more important than ever that we uphold this responsibility by making sure tribes can access adequate, sorely needed resources in a timely manner,” the lawmakers said.

ICYMI: The so-called "Phase 3" #Coronavirus relief package leaves Indian Country behind. Here's what Kevin Allis, Chief Executive Officer of the National Congress of American Indians, said about the CARES Act. @NCAI1944 #COVID19 #CoronavirusIndianCountry pic.twitter.com/pVy0RCIOUe
— indianz.com (@indianz) March 21, 2020

Fortunately, the $80 million from the CDC is not the final word. H.R.6201, the Families First Coronavirus Response Act, authorizes $64 million to be provided to the IHS to help address the impacts of COVID-19 in tribal communities.

Yet it's not just the executive branch where troubling signs have emerged. S.3548, the Coronavirus Aid, Relief, and Economic Security Act, was announced to much fanfare last Thursday but the 247-page bill leaves out the first Americans.

"It has completely ignored and does not include Indian Country," National Congress of American Indians Chief Executive Officer Kevin Allis, a citizen of the Forest County Potawatomi Community, told reporters of the so-called "phase 3" coronavirus package on Friday. He said the omission could lead to a "disaster" in tribal nations.

Three new positive COVID-19 cases reported among Navajo people WINDOW ROCK, Ariz. — Navajo Nation President Jonathan...
Posted by Navajo Nation President Jonathan Nez and Vice President Myron Lizer on Monday, March 23, 2020

Health care for American Indians and Alaska Natives is premised on numerous treaties and federal laws. But the IHS remains woefully underfunded -- it barely meets about half of the need in tribal and urban Indian communities, according to the U.S. government's own reports and data.

"Together these reports provide the very harsh reality that for decades, and even centuries, tribal nations have been severely and chronically underfunded in every public sector imaginable, whether it's health care, law enforcement, education or infrastructure," NCAI President Fawn Sharp said on Friday. Sharp leads the Quinault Nation in Washington state, one of the hardest hit regions in terms of COVID-19 cases and deaths.

According to the CDC plans that were seen by Indianz.Com, $30 million is being awarded to supplement a federal-tribal partnership known as the Tribal Public Health Capacity Building and Quality Improvement Cooperative Agreement. The agreement includes tribes and organizations in nearly every part of Indian Country -- except the Great Plains, a region that includes South Dakota, North Dakota, Iowa and Nebraska, and the tribes along the border near Tucson, Arizona.

Within this select group, three tribes are to be selected for awards drawn from the $30 million pot. They include the Navajo Nation, which as of Monday afternoon reported 29 COVID-19 cases. President Jonathan Nez on Friday imposed an unprecedented "stay at home order" in hopes of slowing the spread of a disease that has already taken a hold on the largest reservation in the United States.

“To prevent a massive public health crisis, every person must remain home," Nez said on Monday. "The fact is that the number of positive tests is growing. We know some may need food, medicine, or other essential items, but beyond that we shouldn’t have anyone traveling or going out into the public. This includes public gatherings and meetings.”

This just in: Navajo Nation President Jonathan Nez and Vice President Myron Lizer confirmed 3 new #COVID19 cases on the reservation, the largest in the United States. The announcement brings the number of #Coronavirus cases among Navajo citizens to 29. https://t.co/pH4Hv6c70f
— indianz.com (@indianz) March 23, 2020

In addition to the Navajo Nation, the Choctaw Nation and the Chickasaw Nation are set to receive funds out of the $30 million. Both tribes are based in Oklahoma, home to the second-largest population of American Indians and Alaska Natives in the country, and both have curtailed operations -- including their lucrative gaming establishments -- in order to slow the spread of the coronavirus.

"The health and safety of Chickasaws, our employees, patrons and communities continues to be our main priority," the tribe said in a statement on Friday.

The nine organizations set to receive coronavirus funds as a result of the cooperative agreement represent most area of Indian Country, except for the Great Plains and the parts of Arizona that do not fall within the Navajo Nation. The list follows:

• Alaska Native Tribal Health Consortium (Alaska)

• Albuquerque Area Indian Health Board, Inc. (New Mexico)

• Bristol Bay Area Health Corporation (Alaska)

• California Rural Indian Health Board

• Great Lakes Inter-Tribal Council, Inc. (Wisconsin)

• Northwest Portland Area Indian Health Board (Oregon, Washington)

• Rocky Mountain Tribal Leaders Council (Montana, Wyoming)

• Southern Plains Tribal Health Board (Oklahoma, Kansas, part of Texas)

• United South and Eastern Tribes, Inc. (New England, Northeast, Southeast, part of Texas)

Due to the threat of COVID-19 & the increased danger it poses on our patients, beginning Monday, March 23, all patients will check in for an appointment & then return to their vehicle. #OKCIC new hours are 8am -5pm. M-F. All groups and Wellness Center are canceled #NativeHealth pic.twitter.com/dYgKFjgH8G
— OKC Indian Clinic (@OKCIndianClinic) March 21, 2020

According to the CDC's plans, another $8 million is to be directed to urban Indian centers, plus another $2 million for the National Indian Health Board, which has been leading coronavirus education efforts across the country.

That leaves $40 million to be distributed to tribes through a "new non-competitive" grant program, according to the CDC's plans. Grants will be available to "eligible" tribes, the agency says.