The federal government’s trust responsibility to provide American Indians and Alaska Natives (AI/AN) healthcare does not end at the borders of an Indian reservation, Alaska Native Village, Pueblo or Tribal lands, and Congress acknowledged during the 1987 reauthorization of the Indian Health Care Improvement Act the responsibility for the provision of health care services follows AI/AN to urban areas.

The first year of the COVID-19 Public Health Emergency has exposed the failure of the federal government to uphold its trust and treaty obligations to AI/ANs, resulting in poor health outcomes. According to CDC, age-adjusted rates of COVID-19 hospitalization among AI/ANs from March 1, 2020, through January 23, 2021, were 3.6 times higher than for non-Hispanic Whites. January 2021 was the deadliest month so far in the US, with 958 recorded Native deaths – a 35% increase since December, a bigger rise than for any other group.

We call upon Health and Human Services (HHS) to prioritize the vaccination of all AI/AN people by immediately convening an Emergency COVID-19 Urban Indian Task Force to create a strategy to inoculate AI/ANs living outside of the reach of the Indian health system, including the 17 cities listed in the HHS/Indian Health Service (IHS) report to Congress on the new needs assessment of the Urban Indian health program and the communities it serves, last updated in 2016.

We also respectfully request that HHS, through IHS, the Centers for Disease Control and Prevention (CDC), and/or the Health Resources and Services Administration (HRSA), provide full resources, technical assistance, and support to ensure all Urban Indian Organizations (UIO) facilities can administer COVID-19 vaccines to their patients. This request includes targeted technical support for Native American Lifelines in Baltimore, Maryland, the UIO serving the Washington, District of Columbia (DC) area.