May 08, 2019

Warren, Cummings, Udall, Haaland, and More Than 95 Colleagues Reintroduce the Bicameral, Comprehensive CARE Act to Combat the Opioid and Substance Use Epidemic in Native Communities

Endorsed by over 200 organizations, the CARE ACT is most ambitious legislation of its kind in Congress and would allocate $100 billion over 10 years to fight the crisis across the U.S.

Over $800 million per year would go directly to tribal nations and organizations
Washington, DC – U.S. Senator Elizabeth Warren (D-Mass.), Representative Elijah E. Cummings (D-Md.), Chairman of the House Committee on Oversight and Reform, along with Tom Udall (D-N.M.), Vice Chairman of the Senate Committee on Indian Affairs, U.S. Representative Deb Haaland (D-N.M.), and over 95 of their colleagues in the Senate and House today reintroduced the Comprehensive Addiction Resources Emergency (CARE) Act, the most ambitious legislation ever introduced in Congress to confront the opioid and substance use epidemic.
The CARE Act of 2019 would invest $100 billion in federal funding over ten years to fight the opioid and substance use epidemic, including a total of more than $800 million a year provided directly to tribal governments and organizations. 
“The United States federal government is bound by a sacred trust relationship with tribal nations, and in failing to address the opioid and addiction epidemic, we are failing to uphold our duty to protect and preserve the well-being of indigenous people,” said Senator Warren. “I want to thank Chairman Cummings, Senator Udall, and Representative Haaland for their partnership in the fight to end the opioid epidemic and make good on our promises to sovereign tribal nations.”
“For too long, the opioid epidemic has left its mark on too many communities – and New Mexico and Indian Country have been among the hardest hit,” said Senator Udall. “We urgently need strong, sustained funding for evidence-based treatment and recovery services that will help individuals get on the road to recovery, especially in rural and Native communities that have been devastated by the opioid crisis. This vital legislation will funnel critical resources on the scale we really need to the frontline communities battling this deadly public health crisis, and enable them to confront it head on. As a senior member of the Appropriations Committee, I’ll keep fighting for the resources our communities need to combat this epidemic and connect people with the help they need.”
“Our country needs to address the opioid crisis and offer services to folks suffering with addiction, but many places including my home state of New Mexico don’t have the resources to address this issue. As someone who has struggled with addiction, I know it is an illness that needs persistent treatment, and this bill will put a focus on ensuring our communities can effectively address the opioid crisis and heal,” said Representative Haaland.
Life expectancy in the United States has now dropped three years in a row—and drug overdoses are the single biggest reason why. In 2017, over 70,000 Americans died from drug overdoses—the highest rate of drug overdose deaths ever in the United States. Opioid-related overdoses accounted for 47,600—or 68%—of these deaths. Yet, only about 10% of those in need of specialty treatment for substance use disorders are able to access it. 
The opioid crisis is devastating communities across the nation—but it has a particularly severe impact on American Indians and Alaska Natives. CDC data shows that drug overdose death rates for American Indians and Alaska Natives living in nonmetropolitan areas increased by 500% between 1999 and 2015. American Indians and Alaska Natives suffered a greater increase in deaths over those years compared to any other demographic. And yet, we know that overdose deaths of Native people are under-reported. In spite of the harm that the opioid crisis brings to American Indian and Alaska Native communities, tribal governments—which are often required to work with state governments in order to obtain federal funds—have struggled to access the resources they need to combat the epidemic. Native Hawaiians are also hit hard by substance use disorders.
For Indian Country specifically, the bill would provide: 
  • $670 million per year for grants to tribal governments to help fight the opioid epidemic and invest in substance use prevention and treatment;
  • $7.5 million in additional funding for tribal nations and regional tribal epidemiology centers to improve data collection on drug overdoses;
  • $50 million a year to tribal colleges and universities, Indian Health Service-funded organizations, and medical training programs that partner with tribal nations and tribal organizations to train Native health professionals to improve substance use disorder treatment services; and
  • $100 million a year in funding to Native non-profits and clinics, including to urban Indian organizations, as well as Native Hawaiian organizations, and projects designed to test innovative service delivery and culturally-informed care models to tackle addiction. 
    The bill would also provide $500 million per year to expand access to the overdose reversal drug naloxone and provide this life-saving medicine to states to distribute to tribal nations, first responders, public health departments, and the public. 
    The legislation has been endorsed by over 200 organizations, including the National Indian Health Board, United South and Eastern Tribes Sovereignty Protection Fund, National Council of Urban Indian Health, Seattle Indian Health Board, Native American LifeLines, Papa Ola Lokahi, and the Navajo Nation. You can view the full list here.
    “The National Indian Health Board applauds the efforts of the CARE Act to respect the federal trust responsibility and recognize the urgent need for relief from substance and opioid misuse and overdose in Indian Country. We stand ready to work with you as the legislation moves through Congress. Thank you for your continued dedication to meeting the health needs of Indian Country,” wrote Victoria Kitcheyan, Chairperson of the National Indian Health BoardRead the full letter of support here.
    “In response to tribal concerns and priorities, the CARE Act of 2019 would ensure Tribal Nations, like other units of government, are well-equipped to combat the opioid epidemic and other substance use disorders in our communities…This level of funding and its method of delivery are reflective of a strong commitment to recognizing our governmental status and the unique relationship between the federal government and Tribal Nations,” wrote Kirk Francis and Kitcki A. Carroll, President and Executive Director of the United South and Eastern Tribes Sovereignty Protection FundRead the full letter of support here.
    “The opioid crisis has created the century’s most devastating emergency in a growing and disproportionate substance abuse problem affecting American Indian and Alaska Native (AI/AN) communities… The National Council of Urban Indian Health (NCUIH) appreciates that the CARE Act has detailed specific language that ensures urban Indian organizations are listed as an eligible entity in this important legislative act,” wrote Maureen Rosette, President of the National Council of Urban Indian HealthRead the full letter of support here.
    “The opioid epidemic poses one of the most significant public health threats in recent history and has devastated our American Indian and Alaska Native (AI/AN) communities. Addressing the opioid epidemic is a nationwide priority; however, access to critical opioid prevention and treatment dollars are not reaching any of the AI/AN communities that are in serious need of these funds…The CARE Act addresses this problem by providing urgently needed support to tribes throughout the country that have been disproportionately affected by the opioid epidemic,” wrote Esther Lucero and Aren Sparck, Chief Executive Officer and Government Affairs Officer of Seattle Indian Health BoardRead the full letter of support here.
    “On behalf of Native American LifeLines, a Title V Urban Indian Health Program serving American Indian and Alaska Native (AI/AN) communities in Baltimore and Boston, we write to express strong support for your legislation, the Comprehensive Addiction Resources Emergency (CARE) Act…We are gratified that the CARE Act intentionally addresses shortfalls that often leave tribal and Urban Indian communities behind,” wrote Kerry Hawk Lessard and Kiros A.B. Auld, Executive Director and President of the Board of Directors of Native American LifeLinesRead the full letter of support here.
    “Mahalo to Senator Warren and Congressman Cummings for being steadfast and inclusive leaders in the fight against the opioid epidemic.  We appreciate the incorporation of Native Hawaiian-specific provisions as it ensures the community has a voice and access as it works to improve their overall health and well-being,” said Dr. Sheri Ann Daniels, Executive Director of Papa Ola Lokahi.

    “The opioid epidemic has devastated many rural communities nationwide but has disproportionately impacted tribal communities….  We hold firm that this bill will provide tribal nations the tools and resources to combat the opioid epidemic. We thank you for your leadership and your efforts to pass this bill,” wrote Jonathan Nez and Myron Lizer, President and Vice President of the Navajo Nation. Read the full letter of support here