Tribal Provisions in the FY’23 Omnibus Appropriations Act President Biden signed the FY’23 Omnibus Appropriations Act into law on December 29, 2022, to secure funding for government agencies and programs through the remainder of Fiscal Year 2023 – September 30, 2023. The law includes historic policy victories for Indian Country health care and increases funding to meet the public safety and justice, economic development, and other funding needs of Native communities. Below is a summary of those top line achievements. Indian Health Service Advanced Appropriations. Tribal governments and organizations nationwide have worked congressional leaders for more than a decade to provide for advanced appropriations for Indian Health Services. The IHS is the only major federal healthcare program exposed to government shutdowns and continuing resolutions. The budgetary uncertainty undermines the ability to recruit and retain quality doctors and nurses and increases administrative costs that should be used for patient care. In the wake of the 2018-19 shutdown, Tribal health programs were forced to reduce hours and services, faced staff resignations, and other negative impacts on patient care. Thanks to a united nationwide effort, the FY’23 Omnibus Act provides an advance appropriation of $5.129 billion for fiscal year 2024 to provide budget certainty for Indian health programs, guarding them from essential service disruptions due to government shutdowns. The law brings the IHS into parity with other federal health care providers, all of which either receive advance appropriations or mandatory funding. The provision helps recruitment and retention of Indian healthcare providers, and prevents impacts on IHS funding uncertainty, while reducing administrative burdens and costs. At its core, this provision will go far in helping fulfil the federal government’s treaty and trust responsibility to provide Native Americans with quality health care. Native Behavioral Health Resources. The bill appropriated “$80 million for each of fiscal years 2023 through 2027” to address behavioral health and substance abuse prevention in Native communities. The provision directs the DHHS Assistant Secretary of Mental Health and Substance Abuse (SAMHSA) to coordinate with the Director of the Indian Health Service – and in consultation with Indian tribes – to develop a formula and award funds to tribal governments. Funding may be awarded to tribes through ISDEAA contracts or compacts. This historic level of new funding will help Native communities nationwide address a crisis of substance abuse that has intensified during the pandemic. COVID Relief Funding Extension and Flexibility. The FY’23 Omnibus also included a provision that extends the deadline for tribes to utilize COVID relief funding that is budgeted for eligible infrastructure projects. The American Rescue Plan Act of 2021 made water, wastewater, and broadband infrastructure eligible for pandemic funding. Thanks to an effort by Senators Padilla (D- CA) and Cornyn (R-TX), the new law provides flexibility for governments to spend relief allocations. The FY’23 Omnibus also includes substantial increases to essential federal programs and services that both respect the status of Indian Tribes as governments and attempts to meet the governments solemn treaty and trust obligations to Native Nations. Below are some of the top line programmatic increases included in the new law: Indian Health Care. $6.928 billion for IHS (+$297 million over FY’22) for Indian health programs and services to reduce wait times, build hospitals in areas that currently have insufficient access to healthcare, better equip health facilities with medical equipment, and modernize health records. Bureau of Indian Affairs / Indian Education. $3.842 billion for BIA/BIE programs and services (+$297 million / 7% increase over FY’22 levels). The Omnibus Act provides funding increases for critical needs facing Tribal governments, including public safety and justice, special initiatives to address Missing and Murdered Indigenous Women cases, Tribal courts, and Indian land consolidation. This Act also boosts the BIE by $119 million, or 9 percent, over the fiscal year 2022 level to support BIE and tribal schools and Tribal Colleges.
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