In a significant stride towards ensuring essential water and sanitation infrastructure throughout Indian Country, the U.S. Department of Health and Human Services’ (HHS) Indian Health Service (IHS) announced $700 million in funding allocation from President Biden’s Bipartisan Infrastructure Law (BIL) and a newly signed memorandum of understanding with the Bureau of Reclamation (BOR) at the first-ever White House Clean Water Summit today. This collaboration further supports President Biden’s Executive Order which directs federal agencies to work together to remove barriers and streamline Tribal access to resources.

“It is critically important that Tribal communities have clean drinking water sources, reliable sewage systems, and effective solid waste disposal facilities. Investing in critical infrastructure helps to improve health and safety for children and families, and advances economic opportunities throughout Tribal communities,” said HHS Secretary Xavier Becerra. “Thanks to President Biden’s leadership, we can help to repair and revitalize facilities throughout Indian Country. This is just one of the many ways HHS and the Biden-Harris Administration are partnering with Tribes to improve the health and wellbeing of Tribal people and communities.”

Building upon the momentum set by the Bipartisan Infrastructure Law, which provides $3.5 billion to the IHS between FY 2022 and 2026, this funding supports efforts to develop critical infrastructure, including robust drinking water sources, reliable sewage systems, and effective solid waste disposal facilities.

Through a whole-of-government approach, the memorandum of understanding between the Indian Health Service and the Bureau of Reclamation will allow the agencies to better collaborate to complete studies, planning, design, construction drawings and technical specifications that can be used to construct domestic water infrastructure projects. The purpose of this collaboration is to accelerate completion of Tribal facilities in communities that do not have reliable access to a domestic water supplies, and to promote resources available to Tribes, including through the BOR’s Tribal Domestic Water Supplies Program.

“The projects funded through the Bipartisan Infrastructure Law are making substantial improvements in clean water and sanitation systems in our Tribal communities,” said IHS Director Roselyn Tso. “To date, IHS BIL funding has supported over 765 projects across all IHS areas. As we enter the third year of BIL funding, the IHS is delighted to partner with the Bureau of Reclamation to ensure safe drinking water, reliable sewage systems, and solid waste disposal facilities are made available to Tribal communities throughout Indian Country.” 

Bipartisan Infrastructure Law Funding

The outcome of this funding is substantial – more than 36,000 American Indian and Alaska Native households will benefit by gaining access to essential services. Notably, improved sanitation facilities can reduce inpatient and outpatient visits related to respiratory, skin and soft tissue, and gastroenteric disease. Based on 2020 data, the IHS estimates each dollar invested in water and sewer infrastructure could yield savings of $1.18 in avoided direct health care costs for these diseases.

In FY 2024, the IHS will allocate approximately $653.4 million to support project construction, of which $613.8 million is FY 2024 BIL funding and $39.6 million is FY 2024 enacted appropriations, which includes Congressionally Directed Spending projects. When combined, the FY 2024 BIL funding and annual appropriations will enable IHS to fully fund construction costs for 91 projects. 

These allocations align with recommendations from Tribal leaders, prioritizing projects that have progressed through planning phases and can seamlessly transition into the design and construction stages. The commitment to securing adequate funding for planning and design activities remains paramount.

Partnership with Bureau of Reclamation                      

This historic partnership between IHS and BOR will support strategic collaboration to accelerate completion of Tribal facilities and more effectively promote awareness and access to resources available to Tribes. As part of the initial actions under the historic partnership between IHS and BOR, IHS launched an interactive website in April 2023 to furnish insights into projects funded through the BIL. This dynamic platform will continue to offer updated information, encompassing project-funding amounts, Tribes served, homes impacted, and project statuses. Projects funded through FY 2024 BIL and the FY 2024 enacted appropriations will be included after the funds are transferred to the IHS Areas.

A pilot project under this agreement has been identified with the Yakama Nation in Washington State. After an IHS engineering investigation confirmed high levels of arsenic in the water system of the small community of Georgeville, the Yakama Nation and IHS agreed to construct a treatment system to remove arsenic from the water supply using Bipartisan Infrastructure Law funding. The MOU allows the Bureau of Reclamation to seamlessly provide technical support for this and future projects.

Partnership with United States Public Health Service (USPHS) Commissioned Corps

The IHS also entered a partnership with the U.S. Public Health Service (USPHS) Commissioned Corps to expand the skilled workforce needed to address these critical needs within American Indian and Alaska Native communities. The USPHS Commissioned Corps is one of the nation’s uniformed services located within the HHS Office of the Assistant Secretary for Health with oversight by the Office of the Surgeon General. The service, comprised of almost 6,000 officers, is committed to the protection, promotion advancement of health throughout the nation. Together IHS and the USPHS Commissioned Corps, developed a seven-year strategic plan to improve recruitment and retention of Public Health Service officers with expertise in engineering, environmental health, and health services.

By increasing immediate support staff for the sanitation programs at IHS, the partnership will cultivate a talent pool that reflects the diversity and skills needed to address public health needs and improve wellbeing within American Indian and Alaska Native communities. It will also fortify a commitment to improve essential infrastructure, advance health equity and increase opportunities for communities to thrive.

The Indian Health Service, an agency in the U.S. Department of Health and Human Services, provides a comprehensive health service delivery system for approximately 2.8 million American Indians and Alaska Natives who belong to 574 federally recognized Tribes in 37 states. Follow the agency via social media on Facebook, Twitter, and LinkedIn.