The National Indian Health Board is a dedicated advocate in Congress on behalf of all Tribal Governments and American Indians/Alaska Natives. Each weekly issue contains a listing of current events on Capitol Hill, information on passed and upcoming legislation, Indian health policy analysis, and action items. To view all of our legislative resources, please visit www.nihb.org/legislative/washington_report.php.
May 26, 2022
News From Capitol Hill
Indian Health Service Director Nominee Appears Before Senate Committee on Indian Affairs, Addresses Commitment and Tenure to the Agency

Yesterday, the Senate Committee on Indian Affairs (SCIA) held a hearing to consider the nomination of Roselyn Tso to serve as the next Director of the Indian Health Service (IHS). As previously reported by the National Indian Health Board (NIHB), Tso was nominated on March 9, 2022 by President Biden to serve as IHS Director. 

Presiding over the nomination hearing, Chairman Brian Schatz (D-HI) initially remarked: The [IHS] Director is more than just a manager of a multimillion-dollar budget and over 15,000 full time federal employees. The Director is the most senior Senate-confirmed official in Native health, charged with developing IHS healthcare policies, respecting tribal sovereignty, promoting tribal self-determination. All are key to fulfilling the Agency’s mission to raise the health outcome of Native communities.”

NIHB passed Resolution 22-02 on February 24, 2022, calling on President Biden to nominate an IHS Director to ensure that IHS has a leader who can set forth a vision to address the health disparities that American Indian/Alaska Native (AI/AN) people face.

On March 7, 2022, NIHB sent a letter to the SCIA to highlight the ambitious, necessary priorities the Tribes expect the new Director to embrace. The agency must have a permanent, competent leader who is capable and willing to advocate and act with diplomacy and tenacity, to respect Tribal nations and their voice, and to transform and reform institutional operations through innovative, effective, and sustainable systems-wide changes.

A citizen of the Navajo Nation, Roselyn Tso is currently the Director of the Navajo Area of IHS, and previously held the position of Director of the Office of Direct Services and Contracting Tribes at IHS. Tso began working for IHS in 1984, and prior to working with the Navajo Area, she spent years working in the Portland Area, which included roles such as the Portland Area Planning and Statistical Officer, Equal Employment Officer, Special Assistant to the Area Director, and as Director of the Office of Tribal and Service Unit Operations. As Director for Tribal and Service Unit Operations, she was responsible for implementing the Indian Self-Determination and Education Act, working directly with Tribes and direct service Tribes.

Concerning Tribal consultation, Tso stated in her testimony before the committee: “Certainly, the Indian Health Service as well as [Department of Health and Human Services] has a robust Tribal consultation process that we utilize. However, it is more than that. It’s not just meeting and having a conversation with Tribal leaders. It is really understanding the needs of each Tribal community to help them best serve the people in their communities.”

Currently, IHS is led by Acting Principal Deputy Director Elizabeth Fowler, who has been serving on an interim basis since the resignation of Rear Admiral Michael Weahkee on January 20, 2021.  The absence of a confirmed Director impedes the ability of both the Tribes, the Administration as well as Congress to carry out a bold vision for the Indian, Tribal and Urban, or I/T/U, system for which the IHS is responsible.

Next Steps
The record for the nomination hearing will remain open for two weeks. During this time, Senators serving on the committee may meet with Tso to ask questions of the nominee. It is unclear when a vote will be held to pass the nomination out of committee. The nomination of IHS Director will then need to be confirmed by the full Senate through a simple majority. 

You can watch the recorded nominee hearing here.

For any questions regarding the nomination and confirmation process for the Director of the Indian Health Service, please contact Erin Morris, Congressional Relations Manager, at [email protected] or Ciara Johnson, Congressional Relations Associate at [email protected]

Vice President Kamala Harris Gives Historic Recognition of Native Maternal Health  

The National Indian Health Board (NIHB) was honored to have Vice President Kamala Harris who provided a video message on the ongoing desperate outcomes of Native women, their maternal health journey, and what she and the Administration are doing to address it during the National Tribal Public Health Summit (TPHS) 2022. 

Vice President Harris remarked, “Native maternal health must be elevated as a national priority” as she spoke to the need for culturally competent care throughout Indian Country delivering her remarks to over 800 Tribal leaders, practitioners, researchers, and policy experts. she encouraged research at minority institutes including Tribal serving institutes to study the social determinants of health. Importantly, Vice President Harris acknowledged the need to invest more in the Indian Health Service (IHS) and expand essential post partem coverage to women. She ended with, “There is more work to do together; we must fight for a better future, a future in which every woman has access to the health care she needs.” NIHB stands ready to work with the Administration and the nation to address these critical issues. 

Read NIHB’s letter to Vice President Harris praising her Call to Action to Reduce Maternal Mortality and Morbidity and informing her NIHB is prepared to work with her office in its efforts. 
Meet Your Member
Iowa
Representative Cynthia Axne (D-IA-3) 
 
Representative Axne is currently serving her second term in the U.S House of Representatives and is up for re-election in 2022. Axne's areas of focus include agriculture, healthcare covering prescription drugs and rural community healthcare, and job creation in rural communities. Anxe sits on the House Committee on Financial Services and the House Committee on Agriculture.  
 
Indian Healthcare Legislation  
Representative Anxe cosponsored Dr. Lorna Breen Health Care Provider Protection Act, H.R 1667, which became law on March 18, 2022. This bill establishes grants and requires other activities to improve mental and behavioral health among health care providers. Specifically, the Department of Health and Human Services is to develop programs to award grants to health profession schools, Indian Tribes, or Tribal organizations. Further, to support the training of health care students, residents, or healthcare professionals in evidence-based strategies to address mental health and substance use disorders and improve mental health and resiliency among healthcare professionals.   
  
Additionally, Anxe cosponsored H.R 2903 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021. This bill would expand coverage and remove restrictions on telehealth services under Medicare. Specifically, this bill would remove restrictions on health facilities, including Indian Health Service and Native Hawaiian Health Care systems, allowing greater flexibility in receiving telehealth services. 
Senator Joni Ernst (R-IA) 
 
Senator Ernst is serving her second term in the U.S Senate. She serves as Iowa's only federally-recognized Tribe's Senator - the Sax & Fox Tribe of the Mississippi in Iowa. As a former Iraq veteran, Hurst's legislative priorities focus on veterans' affairs and homeland security policies, small business protection, and opposition to regulatory efforts to mitigate climate change. Currently, she is the Ranking Member of the Subcommittee on Rural Development and Energy of the Committee on Agriculture, Nutrition, and Forestry. She also sits on the Committee on Environment and Public Works and the Committee on Armed Services.  
 
Indian Healthcare Legislation 
Senator Ernst cosponsored the house companion bill for CONNECT for Health Act, S. 1512. This bill removes restrictions on Native health facilities to provide greater flexibility in receiving telehealth medical care.  
Congressional Spotlight
DOI Releases Boarding School Report and House Natural Resources Holds Hearing on Boarding School Bill Within Days of Each Other 

On May 11, Secretary of the Interior Deb Haaland and Assistant Secretary for Indian Affairs Bryan Newland released the first Volume report of the Federal Indian Boarding School Initiative. Secretary Haaland announced the introduction of The Federal Indian Boarding School Initiative of June last year.  

Under the supervision of the Assistant Secretary for Indian Affairs, the report for the first time acknowledged the federal governments direct involvement of cultural assimilation policies in Indian boarding schools. The report found the federal government, between 1819 and 1969, operated or support 408 boarding schools across 37 states, including 21 in Alaska and 7 in Hawai’i.

With COVID-19 restrictions, closing of research facilities, and operating under continuing resolution and limited appropriations, the Assistant Secretary recommends additional research and a second volume of the report to further identify names and Tribal affiliations of children, number of federal dollars spent supporting the boarding schools, and identify schools that were operated on land-in-trust.

Last year, the National Indian Health Board (NIHB), joined the National Native American Boarding School Healing Coalition in recognizing September 30, 2021 as the National Day of Remembrance for U.S. Indian Boarding Schools. On the same day, Senator Elizabeth Warren and House Native American Caucus Co-Chairs Sharice Davids (D-KS) and Tom Cole (R-OK) introduced the Truth and Healing Commission on Indian Boarding School Policies Act H.R 5444 / S. 2907. This bill would establish a commission to investigate and document the detrimental Indian boarding school policies and historical trauma resulting from those policies and to make recommendations, among others, for federal resources and assistance to aid in healing from that trauma.  

On May 12, 2022, the House Subcommittee for Indigenous Peoples of the United States held a hearing on H.R 5444 where boarding school survivors and Tribal organizational leaders testified in support of H.R 5444 and shared their personal experiences during forced attendance of boarding schools. Witnesses include James LaBelle of the National Native American Boarding School Healing Coalition, Matthew War Bonnet, Boarding School Survivor of the Rosebud Sioux Tribe, Dr. Ramona Charette Klein, Boarding School Survivor of the Turtle Mountain Band of Chippewa Indians, Ben Barnes, Chief of the Shawnee Tribe, Deborah Parker, CEO of the National Native American Boarding School Healing Coalition, and Dr. Janine Pease, Founding President of the Little Big Horn College.  
 
The Subcommittee for Indigenous Peoples of the United States is accepting electronic statements for consideration of H.R.5444 until May 26, 2022. The National Native American Boarding School Healing Coalition encourages survivors to submit their stories to the House Committee on Natural Resources by email to[email protected].  
 
NIHB has led efforts in Congress and the Administration to secure more behavioral health care services as well as in-patient behavioral health treatment facilities, particularly through the Budget Reconciliation measure pending before Congress and in other legislation and administrative means. To further honor and remember these Native children, NIHB hosted the National Tribal Health Conference October last year titled “Our Trauma: A Discussion to Address the Legacy of Federal Indian Boarding Schools and Looking to the Future."

Read NIHB Resolution no. 22-01 Boarding School Healing Resolution that was adopted at the First Quarter and Annual Board Meeting on February 23 and 24, 2022.