Bill Overview
Title: Urban Indian Health Confer Act
Description: This bill requires the Department of Health and Human Services (HHS) to confer with urban Indian organizations regarding health care for American Indians and Alaska Natives living in urban areas. Currently, only the Indian Health Service (IHS) is required to confer with urban Indian organizations on matters relating to the Indian Health Care Improvement Act. The bill requires HHS to ensure that the IHS and other agencies and offices within HHS confer with urban Indian organizations on (1) matters relating to the Indian Health Care Improvement Act, and (2) other provisions of law relating to health care for American Indians and Alaska Natives.
Sponsors: Sen. Smith, Tina [D-MN]
Target Audience
Population: Urban American Indians and Alaska Natives
Estimated Size: 3640000
- The bill primarily impacts American Indians and Alaska Natives living in urban areas across the United States.
- There are about 5.2 million people identified as American Indian and Alaska Native in the United States, according to the U.S. Census.
- A significant number of American Indians and Alaska Natives live in urban areas, though exact numbers vary, estimates suggest around 70% of Native Americans live in urban areas.
- Therefore, the legislation would affect a significant portion of the urban Native American population in the United States.
- While the bill focuses on the U.S., it may serve as a source of reference for enhancing indigenous healthcare systems in other countries.
Reasoning
- The Urban Indian Health Confer Act targets urban American Indians and Alaska Natives, aiming to improve healthcare communication and delivery for this group.
- A large proportion of Native Americans (approximately 70%) live in urban settings, translating to an estimated target population of around 3.64 million according to the U.S. Census.
- Given budget constraints ($10 million for the first year and $100 million over 10 years), the policy's direct impact per individual is expected to be moderate but significant over time, especially in terms of enhanced health consultations and services.
- The policy won't create immediate drastic changes due to time needed for implementation and scaling efforts, with gradual improvements projected over a multi-year span.
- We've deliberately included interviews of people who vary in how directly they are impacted by the policy, including some non-impacted general urban dwellers, as well as those significantly affected to contrast varying perspectives and wellbeing outcomes.
Simulated Interviews
Community Health Worker (Los Angeles, CA)
Age: 34 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 5/20
Statement of Opinion:
- I see this as a positive step towards better healthcare for our urban Native communities.
- Historically, we have been overlooked in urban settings; this policy could change that.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
Marketing Specialist (New York City, NY)
Age: 45 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 15/20
Statement of Opinion:
- I've heard of issues faced by urban Native communities but haven't been directly involved.
- Any policy that promises better healthcare access is worthwhile.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Software Developer (Seattle, WA)
Age: 29 | Gender: other
Wellbeing Before Policy: 8
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- This might help bridge the tech and healthcare gap that exists in urban Native communities.
- Conferences could lead to better digital health solutions.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 9 | 8 |
| Year 5 | 9 | 8 |
| Year 10 | 9 | 8 |
| Year 20 | 9 | 8 |
Retired (Phoenix, AZ)
Age: 55 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 2/20
Statement of Opinion:
- I rely heavily on urban health services, and improved policies would bring much relief.
- Our healthcare challenges are often invisible in cities.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 9 | 5 |
Entrepreneur (San Francisco, CA)
Age: 38 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- I've seen how health inequities affect urban Native communities; this act addresses some of those gaps.
- Affordable access is crucial, hope this policy ensures that.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 7 |
Student (Chicago, IL)
Age: 23 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- This policy could be a learning resource for other health initiatives concerning marginalized communities.
- Conferences are good, but practical implementations are key.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Retired Nurse (Denver, CO)
Age: 60 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 3/20
Statement of Opinion:
- From my experience, better engagement can improve the health outcomes.
- Hope these efforts can bridge the cultural gaps in urban settings.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
Healthcare Consultant (Houston, TX)
Age: 40 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 8.0 years
Commonness: 6/20
Statement of Opinion:
- The Urban Indian Health Confer Act seems like a pivotal policy for bridging healthcare gaps.
- Ensuring urban Indigenous populations receive attention is crucial.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 9 | 8 |
| Year 20 | 9 | 8 |
Urban Planner (Albuquerque, NM)
Age: 53 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- Infrastructure planning improvements are expected if this policy is implemented efficiently.
- I want to see concerted efforts in all urban areas equally.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 9 | 8 |
| Year 10 | 9 | 8 |
| Year 20 | 9 | 8 |
Banker (Miami, FL)
Age: 48 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 12/20
Statement of Opinion:
- I may not be directly impacted, but I think this policy is a step in the right direction.
- Improvement in healthcare access for any community potentially benefits all.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
Cost Estimates
Year 1: $10000000 (Low: $5000000, High: $15000000)
Year 2: $10000000 (Low: $5000000, High: $15000000)
Year 3: $10000000 (Low: $5000000, High: $15000000)
Year 5: $10000000 (Low: $5000000, High: $15000000)
Year 10: $10000000 (Low: $5000000, High: $15000000)
Year 100: $10000000 (Low: $5000000, High: $15000000)
Key Considerations
- The bill primarily focuses on increasing communication efficiency and health service coordination among urban Indian organizations and various HHS offices.
- While primarily an administrative and collaborative effort, the potential long-term impact could be significant if it improves access to healthcare resources and outcomes for the target population.
- Initial costs are predominantly related to administrative and potential staffing adjustments within HHS.