Special News for Indian Country:
Congress Passes Bipartisan Infrastructure Bill, Securing $3.5 Billion for Indian Health Serivce Sanitation Facilities Construction
The Chairman of the National Indian Health Board (NIHB), Chief William Smith, Vice-President of the Valdez Native Tribe, applauded final passage of the Bi-partisan Infrastructure bill, H.R. 3684, the Infrastructure Investment and Jobs Act, late Friday night, November 5, 2021. It was passed by Congress by a vote of 228-206. The bill will now head to the President to be signed into law.

“The National Indian Health Board thanks Congress for finally passing this important piece of legislation. We want to thank Senator Lisa Murkowski, in particular, for fighting for and including this funding in the bill. It will infuse much needed funding for necessary sanitation and safe water systems in Tribal communities. These are tremendous long-standing obligations of the federal government which Tribal nations have fought for years to address. For example, in Alaska Native villages alone, the sanitation deficiencies exceeded $1.3 billion. Many other Tribal communities have extensive sanitation deficiencies as well which will no longer be ignored. The National Indian Health Board urges the President to quickly sign the bill into law and stands ready to work with the Administration to see it implemented expeditiously in accordance with Tribal voices.”

Stacy A. Bohlen, Chief Executive Officer of the NIHB, echoed Chairman Smith’s words in stating that “the NIHB advocated for Tribal health care infrastructure funding in the Bipartisan Infrastructure bill. This funding is an opportunity and beginning for the United States to uphold its trust responsibility and treaty obligations to Tribal nations. We look forward to working with the Administration and Tribes to see this important work carried out for the benefit of Tribal nations.”

This bill is intended to carry out portions of the President’s domestic agenda related to infrastructure, such as roads, bridges, and broadband. This bill contains $550 million in new spending and additional funding for existing programs. The Indian health care-related provisions include $3.5 billion for the Indian Health Service (IHS) sanitation facilities construction program and an additional $2 billion for the Tribal Broadband Connectivity Program in which telehealth is an allowable use. This sanitation funding should address the known projects of the program.

The key provisions of the $3.5 billion for the IHS sanitation facilities construction program are as follows:

  • $700 million each year for FY 2022 to FY 2026, to remain available until expended.
  • Up to $2.2 billion for projects that exceed economical unit cost and available until expended.
  • No more than 3% for salaries, expenses, and administration.
  • 0.5% for the Office of Inspector General to provide oversight of the program.
  • No funds available for IHS salaries, expenses or administration are available to Tribes under Indian Self-Determination and Education Assitance Act (ISDEAA).
  • This is one-time funding for Tribes, not recurring funding under ISDEAA.

There are a few considerations for Tribes regarding these sanitation provisions. Most notably, the amount of funding is intended to address the sanitation deficiencies list, including the “infeasible” projects”. But because the authorization is for five fiscal years, the $700 million per year is intended to be used expeditiously. However, the bill does not dictate or change the order of the projects. Tribal consultation may be in order to help IHS determine how to proceed. It is important to note that the bill does not prohibit the use of self-governance compacts or self-determination contracts.

The bill will head to the President’s desk to be signed into law. Additionally, the House agreed late Friday that would allow the Infrastructure Bill vote first and then a procedural vote on the Build Back Better Act, setting up a vote on that bill during the week of November 15.

For more information on the bill, please go to the NIHB website or contact Interim Director of Congressional Relations Rhonda Harjo at rharjo@nihb.org.
National Indian Health Board Mission Statement

Established by the Tribes to advocate as the united voice of federally recognized American Indian and Alaska Native Tribes, NIHB seeks to reinforce Tribal sovereignty, strengthen Tribal health systems, secure resources, and build capacity to achieve the highest level of health and well-being for our People.
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Janee Andrews at jandrews@nihb.org