During the year, USET SPF leadership attends consultations, listening sessions, commission meetings, and various committees to advocate legislation on various issues, subjects, and initiatives.  USET SPF also will comment on notices of proposed rulemaking, legislation, or court cases.  Click on the links below for specific comments you would like to view from USET SPF.


USET SPF Comments to HHS on Tribal Consultation Policy 3.15.2019

SUMMARY:  The critical component Tribal consultation has in the government-to-government relationship between Tribal Nations and the United States. Tribal Nations access various programs within HHS, not just services through IHS. We further caution HHS from making any unilateral revisions to the TCP that would diminish HHS’ ability to fully deliver upon the trust responsibility and obligations. As an agency of the federal government, HHS, including all OPDEV’s, are charged with delivering upon the trust responsibility to provide comprehensive health care to Tribal Nations.


USET SPF Comments to HHS on the National Viral Hepatitis Action Plan 3.11.2019

SUMMARY:  According to the Centers for Disease Control and Prevention (CDC), AI/ANs are experiencing devastating effects of HCV infections, including:

  • the highest mortality rate at 10.8 deaths per 100,000 population compared to a national average of 4.5 deaths per 100,000 in 2016;
  • 2.3 times higher (age-adjusted) rates of chronic liver disease and cirrhosis deaths compared to Whites in 2016;
  • a 9% increase in mortality rates from 2010 to 2016; and
  • 2.9 times higher HCV incidence (number new of cases) rates compared to Whites in 2016.

The NVHAP must fully reflect the unique HCV treatment circumstances of Tribal communities and include critical strategies on how the agency will ensure Tribal governments and citizens have access to quality health care. The federal government has a trust responsibility to ensure Tribal Nations have access to resources, financial and otherwise, to address HCV in our communities. Among the vital resources needed to combat HCV in Tribal communities is access to direct federal funding for treatment and prevention programs. It is critical now, more than ever, that HHS address the disparities Tribal Nations face in access to critical funding resources when seeking to treat HCV infection within our communities.

Economic Development

USET SPF Comments to SBA and HUBZone Program Office on Proposed Revisions 2.14.2019

SUMMARY: Unlike other individually owned enterprises, Tribal governments relay on Tribally-owned enterprises for economic development to provide basic government services such as public safety, education, housing, and cultural programs. Therefore, modifications to the HUBZone Program can only be effective in Indian Country if they are inclusive of individual Native American as well as Tribal governments which have critical capital responsibilities that are essential to growing their economies, creating economic opportunities, and providing services. In our letter, we provide comments and recommendations to the SBA on how to implement the HUBZone Program in order have a meaningful and significant difference in the success of Tribal

LAND USET SPF Comments on DOI evaluation of the Secretary of the Interior’s authority to take land into trust in Alaska under the IRA via the extension of Section 5 of the IRA to Alaska in 1936 1.25.2019
SUMMARY: In our letter we provide input on DOI’s consideration of these issues given the significance of fee-to-trust acquisitions for all Tribal Nations, as well as the wide-ranging consequences that might follow different treatment for a group of Tribal Nations on the basis of geography  that is not supported by law.  We urge DOI, in accordance with its trust obligations and the clear mandates of Section 5 of the IRA as extended to Alaska as well as subsequent acts of Congress, including but not limited to 25 U.S.C. §5123 (f) and (g), to halt further examination of the Secretary’s trust acquisition authority in Alaska. Further, M-37043 should be restored as binding legal authority on DOI. To act otherwise contravenes clear statutory directives, and undermines DOI’s obligation to uphold its trust responsibility Tribal Nations in Alaska and across the United States.
HEALTH USET SPF Comments to Center for Medicare and Medicaid Services Virginia Work Requirements 1115 Demonstration Waiver 1.4.2019

SUMMARY:In our comments we oppose mandatory Medicaid work and community engagement requirements that do not provide an exemption for American Indians and Alaska Natives (AI/ANs), and express our concern that the Demonstration Application does not clearly exempt AI/ANs from new premiums and cost-sharing as required by the Social Security Act. We further stated changes or improvements to the Medicaid program must move forward in a manner that respects Tribal sovereignty and upholds federal treaty and trust responsibilities. Conditioning access to Medicaid on state imposed work requirements is a violation of the federal trust obligation. We continue to oppose, in the strongest possible terms, any action taken by the federal government that fails to recognize this sacred duty, including the approval of the Extension Application, or any 1115 waiver, that does not contain an exemption for AI/AN from work requirements. We urge CMS to retract its deeply flawed legal interpretation and work with Tribal Nations to preserve AI/AN access to Medicaid. We also urge CMS to ensure that existing statutory AI/AN protections from premiums and cost-sharing are reflected in the waiver.


Centers for Medicare & Medicaid Services (CMS) approved Maine’s request for a new Medicaid demonstration project, entitled “MaineCare” in accordance with section 1115(a) of the Social Security Act. The approval is effective December 21, 2018 through December 31, 2023.