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Three major Acts of Congress have passed into law this month to combat the COVID-19 pandemic. With each proposal, emergency spending packages grow exponentially larger. Below are summaries of how the legislation affects tribes and how tribes are responding.
Signed into law March 6, 2020
Total spending: $8.3 billion
Includes $40 million for tribes, but unclear on how funding will be delivered from the CDC to tribes
The act is aimed primarily as bolstering the medical capacity of the U.S., including $2.2 billion to support “federal, state, and local public health agencies to prevent, prepare for, and respond to the coronavirus.” The funding increases the ability of the healthcare system “to conduct public health activities such as … laboratory testing to detect positive cases, contact tracing to identify additional positive cases, infection control at the local level to prevent additional cases,” and more. The act directs “more than $3 billion for research and development of vaccines, therapeutics, and diagnostics to prevent or treat the effects of coronavirus.” These funds are allocated to the Biomedical Advanced Research and Development Authority (BARDA) and the National Institutes of Health (NIH) “to support advanced research and development of vaccines, therapeutics, and diagnostics.” The act also supplies $1 billion in small business disaster loans.
Tribes were largely concerned with how they would receive the $40 million in funding since it was allocated through the Centers for Disease Control and Prevention (CDC), rather than the Indian Health Service (IHS). Tribes stated that there are already formal relationships and operational agreements in place for funding to flow easily from IHS to tribal nations, but there are no such mechanisms in place for tribes to receive funds from the CDC. Tribes cited this as a grave injustice. Meanwhile, adding to the sense of unfairness, states were immediately able to receive the funding allocated to them in the legislation. Tribal organizations requested that the Department of Health and Human Services (HHS) authorize an inter-agency transfer of these funds from the CDC to IHS for quick and efficient distribution. That request was denied. Furthermore, tribes understood the $40 million to be inadequate to address their needs. Tribes asked for an increase in funding from $40 to $120 million, minimum.
Another major concern for tribes was the threat of losing medical staff at IHS hospitals and clinics when they are needed most. Tribal organizations emphasized the need to keep IHS medical staff in the Public Health Commission Corps stationed where they currently are. They recommended that these staff be deemed “mission critical” at the IHS facilities they are currently stationed at rather than being pulled away from Indian Country, which already suffers from a shortage of medical staff and resources.
Signed into law March 18, 2020
Total spending: $100 billion
Includes $64 million for IHS
The Families First Coronavirus Response Act expanded on the scope of the Phase I legislation by incorporating other forms of aid for families. It ensures free COVID-19 testing for the public, regardless of an individual’s health insurance status. It provides paid sick leave for certain employees directly impacted by COVID-19. And it allocates nearly $1 billion each for unemployment aid and nutritional assistance programs.
This Act provides $64 million in funding for IHS for health services related to the COVID-19 response. It also covers the cost of COVID-19 testing and related services for American Indians and Alaska Natives receiving health services through IHS.
The funding for IHS services related to COVID-19 were helpful, but viewed as only a first step in further actions needed. As Kevin Allis, Chief Executive Officer of NCAI stated the day before the spending bill was signed, “As the urgency, infection rate, and death toll of the COVID-19 pandemic intensifies, it has become increasingly clear that Indian Country needs significantly more funding resources to protect and preserve human life.” After the Phase II legislation was signed, attention immediately turned to the development of the Phase III spending package.
Signed into law March 27, 2020
Total spending: approximately $2 trillion
For tribal nations: $8 billion set aside for the use of tribes and tribal enterprises.
This is a massive relief spending bill that aims to keep the economy afloat while Americans are being asked to stay home. More than one quarter of the funding allocation is set aside for direct payments to individual Americans (with income limitations): $1,200 per adult; families are eligible for $500 per child. The law also includes $500 billion in financial support for large corporations, such as those in the airline industry. $377 billion is set aside for small businesses and approximately $340 billion will go to state and local governments.
Prior to passage of the bill, the largest and most influential organizations in Indian Country joined forces to develop specific and meaningful policy priorities for inclusion in the Phase III spending package. Led by the National Congress of American Indians, Native American Finance Officers Association, and the National Indian Health Board, these organizations worked with lawmakers on Capitol Hill to ensure that tribes would not be left out, but rather that their needs would be met in parity with the rest of the nation. They published several policy documents including this extensive list of priorities for the Phase III spending package. Priority areas included economic development, employment, governance, housing, community development, health, education, and nutrition.
Senators Martha McSally (R-AZ) and Steve Daines (R-MT) sent a letter to Majority Leader Mitch McConnell requesting that emergency funding for tribal communities be included in the latest coronavirus relief package. Congressional Representatives Raúl Grijalva and Tom O’Halleran issued their own requests on behalf of tribal nations.
It is still early, but for now, tribal inclusion in this package is being seen as a win for Indian Country, although in the future tribes and tribal organizations, like many public and private institution interest groups, will likely seek further assistance as the crisis continues to affect American lives. NCAI has published a summary of the CARES Act provisions.