COVID-19 exposes inadequate funding levels at Indian Health Service

Thursday, June 11, 2020

By Acee Agoyo

With coronavirus cases continuing to rise at disproportionate rates in Indian Country, advocates are calling on Congress to live up to its trust and treaty obligations by providing adequate funding for health care in tribal and urban communities.

The Indian Health Service needs at least $9.1 billion to meet the needs of the first Americans, key lawmakers are being told at a hearing on Thursday afternoon, among the first in the COVID-19 era. The agency's budget currently falls far short of that amount.

"The COVID-19 pandemic has further exposed the vast deficiencies in health care access, quality, and availability that exists across the Indian health system," Stacy Bohlen, Chief Executive Officer of the National Indian Health Board, says in written testimony.

Today I am visiting with our exceptional team at the Crownpoint Health Care Facility in New Mexico to see their efforts to respond to #COVID19, which include drive-up testing services. Thank you to our entire Navajo Area team for your dedication to our patients. #IndianCountry pic.twitter.com/x6eDhDUNLa
— Rear Adm. Michael D. Weahkee (@IHSDirector) May 28, 2020

As states across the nation emerge from coronavirus closures, tribal communities are bearing the brunt of the pandemic, Bohlen points out. Data in Montana, New Mexico, Oregon, South Dakota and Wyoming shows that American Indians and Alaska Natives are being infected at higher rates than the general population.

"Most poignantly, in a new data visualization of COVID-19 case rates per 100,000 by Tribal Nation created by the American Indian Studies Center at the University of California Los Angeles, it was found that if Tribes were states, the top five infection rates nationwide would all be Tribal Nations," Bohlen tells the lawmakers who control the IHS budget.

The vast majority of Native Americans live in urban areas and they too are suffering from the effects of inadequate funding during the worst public health crisis in decades. At least $1.7 billion is needed to ensure providers in their communities can address their needs, according to the National Council of Urban Indian Health.

"Decades of underfunding of the Indian Health Service system, coupled with added burdens of chronic disease, put AI/ANs at higher risk of poor outcomes due to COVID-19," Francys Crevier, the organization's executive director, observes in written testimony. "The disproportionate impact COVID-19 has on AI/ANs, like the federal obligation for the provision of health care to AI/AN people, does not stop at the borders of a reservation."

Native Americans are disproportionately suffering from #coronavirus. At today’s Interior-Environment Subcommittee hearing, Chair @BettyMcCollum04 & @AppropsDems will examine the current status of COVID-19 cases in Indian Country.

Watch live at 1 PM: https://t.co/4dxdshqwBJ pic.twitter.com/JWZqDSH1Wg
— House Appropriations (@AppropsDems) June 11, 2020

But if tribes and their citizens are looking to the recently confirmed leader of the IHS to call for additional funding, they won't find it in the testimony submitted by the Trump administration. The written statement makes no mention of the federal trust and treaty responsibility, instead painting a much more optimistic view of COVID-19 efforts in Indian Country, crediting the "White House" for bringing more testing to the first Americans.

We are detecting COVID-19 through screening and state-of-the-art lab testing," states IHS Director MIchael Weahkee, who was confirmed to his position in April, following a delay that lawmakers traced to the Trump administration.

"Through White House-led testing initiatives, we have distributed, or are in the process of distributing a total of 350 Abbot ID NOW rapid point-of-care analyzers, as well as hundreds of thousands of testing supplies for various testing platforms," Weahkee adds, overlooking problems seen with the Abbot machines returning incorrect results.

The hearing before the House Committee on Appropriations comes as Congress slowly returns to work following passage of several bills responding to COVID-19. The IHS so far has received nearly $2 billion to support health efforts at the tribal, urban and federal levels.

Democrats are hoping to add another $2.1 billion to the IHS budget through a bill known as the Heroes Act. But while the measure passed the U.S. House of Representatives last month, it's gone nowhere in the U.S. Senate, which is under Republican control.

"State, local, and tribal governments desperately need funding to ensure vital workers can stay on the job to continue keeping us safe, American families need additional direct cash payments to cushion the extreme financial strain many are facing, and more investments are needed to expand testing, treatment, and contact tracing and isolation measures to help contain the spread of COVID-19," Rep. Betty McCollum (D-Minnesota) said of H.R.6800, a massive package valued at $3 trillion overall.

Indian Health Service #Coronavirus data shows 13,806 #COVID19 cases as of June 9, 2020. Overall, 8.2% of @IHSgov tests are positive, though rates are much higher in Navajo Area (22%), Nashville Area (13.4%) and Phoenix Area (12.3%). https://t.co/zzCROBlDaZ
— indianz.com (@indianz) June 11, 2020

McCollum chairs the House Appropriations Subcommittee on Interior, Environment, and Related Agencies. The legislative panel is in charge of writing the bill that funds the IHS and most other Indian Country programs.

In normal times, the appropriations measure surfaces every June but COVID-19 has upended the schedule. The committee started resuming in-person hearings last week -- only one hearing took place between mid-March through the end of May.

House Committee on Appropriations Notice

Subcommittee on Interior, Environment, and Related Agencies - Indian Health Service Covid-19 Response June 11, 2020