National Council of Urban Indian Health

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National Council of Urban Indian Health Business
Plan 2007-2012
Alejandro Bermudez-Del-Villar, Development
Director September 18, 2007
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Who we areA national membership based
organization serving as a resource center for
urban Indian healthcare providers

• What we do
• Educate Policy Makers on Urban Indian health
  issues, Providing training and resources
  supporting and developing quality accessible
  healthcare programs for all through training,
  education and leadership development
• What we aim for (Mission )
• Healthy American Indian and Alaska Natives
  living in urban communities supported by fully
  funded and accessible healthcare centers governed
  by leaders in the Indian community

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Strategic Plan 2006-2011OUR FIVE-YEAR GOALS

• 1-Develop leadership at all levels within the
  urban Indian healthcare system.
• 2-Advocate for systems and policy changes that
  will improve the health condition of all urban
  Indians.
• 3-Educate and communicate effectively.
• 4-Build the NCUIH into a world class organization.

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Business Plan AREAS of Action

• Technical Assistance/Leadership
• Comprehensive Advocacy
• Development/Fundraising
• Agency Stabilizing Elements

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Overarching Goals and Areas of Action
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Customer Profile

• Direct Clients NCUIHs direct clients are all of
  the Urban Indian Health Programs constituting its
• Membership. Members provide an array of
  medical services to the urban Indian and
  metropolitan communities (in some cases, event to
  the larger community) in which they are located.
• Indirect Clients (patients) NCUIH also works to
  represent the health needs of all the American
• Indian/ Alaska Natives who live in urban
  settings. This population constitutes the
  majority of alleviants.

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The Urban Indian Health Market (target
identification)

• In compliance with the IHCIA mandate, any AI/AN
  who seeks services in their facilitiesand
  properly identifies him/herself as Native
  American or Alaska Nativeis eligible to receive
  healthcare.
• NCUIHs direct or primary market is its
  membership, which is limited and shall remain the
  same unless more UIHPs are created or a different
  category of organization is created under NCUIHs
  bylaws
• NCUIHs secondary market is comprised of by urban
  Indian communities themselves seeking healthcare
  assistance from NCUIHs membership.
• Potential Market Niche NCUIH acknowledges the
  existence of Urban Indian communities in states
  where UIHPs are not present (and their need for
  culturally appropriate healthcare services).
  NCUIH is aware of the existence of this
  unexplored market niche. However, given
  historical reasons and funding constraints, NCUIH
  has not yet had the chance to approach these
  opportunities.
• Moreover, there are a series of legal and
  regulatory issues that would have to be dealt
  with even before considering exploring
  opportunities for collaboration.

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Sectoral Environment

• SWOT Analysis of
• NCUIHs
• Strengths
• Weaknesses
• Opportunities and
• Threats

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Sectoral Environment SWOT AnalysisStrengths,
Weaknesses, Opportunities and Threats

• UIHs Strengths
• a) Indian Healthcare is a Federally Mandated
  Service
• b) Indian Values
• c) Urban Indian Trust and Loyalty in UIHP
• d) UIHPs Serve as Cultural Centers for the Local
  Urban Indian Communities
• e) Understanding and Solidarity of Indian
  Organizations in Regard to Federal Government-
• Indian Relations
• f) Leveraging Resources/Fundraising Experience
• g) Power in Numbers (a majority of AI/ANs reside
  in urban areas)
• UIHs Weaknesses
• h) Communication Flow Among Urban Indian Health
  Programs
• i) Urban-Tribal Divide and Misunderstandings.
• j) Lack of Information, Sources and Research
• k) Limited Number of Skilled Leaders
• l) Limited Managerial Reporting Skills
• m) Lack of Standardized Efforts in Regard to the
  Formation of Future Political Indian Leadership
• n) Limited Use of Technology to Leapfrog
  Developmental Stages

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SWOT- continuation

• Opportunities
• Use of this critical situation as laying the
  ground to bring together all of
• UIHPs
• Urban and Tribal Communities
• National and Regional Indian Organizations
• Get the attention of mainstream media and keep it
  as an ally in the fight for funding
• Make the USG and Tribal leaders aware that the
  future of Indian country is intricately connected
  to the urban communities
• Strengthen UIHPs as cultural and community
  gathering centers-UI Identity reinforcement.
• Get Major Private donors attention and pecuniary
  resources
• Laying the ground to use International
  Organizations funds and forum for UIHPs
  interests
• Use this critical situation to increase the
  partnership with Educational Institutions and
  other organizations sympathetic to the UIH
  cause.
• Increase influence on the Federal Government and
  Congress by creating stronger relations with
  critical staff.

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Sectoral Environment SWOT

• Threats
• Enrooted stereotypes about Indian Culture and
  Indian Life
• Political misuse of the Indian issues/information
• USG use of resources to further divide Indian
  Country
• USG misuse of studies/means to demonstrate that
  others can substitute Native Healthcare
• An actual zeroing-out of UIHPs and its
  consequences- major Indian healthcare crisis.
• Major Healthcare upcoming electoral debate to
  become politicized-leaving out the discussion on
  Urban Indian health

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Sectoral Environment SWOT

• External Influences
• Positive
• Current Administrations credibility fall-down.
• Democratic Partys relative power in Congress
• Presidential Campaign is a good time to increase
  awareness of social issues
• IHCIA Support
• Negative
• Lack of unified or standard reporting systems
• Limited coherence from Government on both funding
  as well as on reporting requirements
• Federal Govt. current Priorities- International
  Environment
• War in Iraq/N. Korea/Iran/Early Presidential
  Campaigning
• Mainstream Ignorance Indifference towards UIH
  issues
• Nation-wide purchasing power decrease
• General Economic slowdown
• Medical Inflation ongoing increase
• USG lack of vision inefficiency to allocate
  resources where needed

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Sectoral Environment SWOT

• Internal influences
• Positive
• Increasing awareness among UIHPs that a unified
  voice is needed to overcome the current stage.
• Indian identity and loyalty are main positive
  factors strengthening UIHPs
• Negative
• Urban Indian Health Programs Politics (
  politicking)
• Urban-Tribal gap
• Urban Indian ongoing Identity Struggle
• Lack of Urban Indian unified leadership and vision

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Summary Sectoral Assessment

• Overall Factors Affecting UIHPs NCUIH
• Threats and Weaknesses Most of NCUIHs current
  threats Weaknesses have been part of the sector
  for a long time (such as Urban-tribal divide,
  communication problems, etc) NCUIH should find a
  way around to make these negative factors an
  opportunity for improvement. Threats and
  Weaknesses are adverse but also can be used as
  ways to strengthen our position by allying with
  the right institutions
• Strengths and Opportunities NCUIH accounts for
  enough support from its base as well as there
  are a series of opportunities that have been
  completely underutilized or unexplored by past
  organizational administrations.
• Internal Communication and unity are the
  greatest obstacles
• External Most external situations, such as the
  US war on terror, medical inflation and other
  circumstances are beyond NCUIHs control however
  there are ways to use these situations as tools
  to leverage awareness, such as the political
  campaigns.

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• Demands
• Increasing need for UIHP Services as Indians are
  increasingly urban
• Technical Skills
• Managerial Skills
• Leadership Skills
• Research/Native Knowledge
• Use of Technology
• Media Awareness
• Proactively Educate Government
• Internal Communication Flow
• Partnership with associations/Universities/Think
  Tanks/Providers
• Urban-Tribal Common Vision
• Government
• Federal government/Congress/HHS Very poorly
  educated of urban Indian affairs
• Other health agencies (SAHMSA, HRSA, CDC) Aware
  of the situation but with limited power
• IHS/UIHO Playing a Double role as government
  grantor/UIHP liaison

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NCUIH Strategic positioning

• NCUIH is strategically positioned to be the voice
  of the urban Indian population before federal
  agencies as well as the major hub of information
  that is, a gravitational center of information
  and resources from which both the urban Indian
  population and varied institutions kinds can draw
  and transfer information into.
• As the membership organization for the Urban
  Indian Health Programs, NCUIH is today the link
  between policy and realitythe only legitimate
  representative of unique Urban Indian Programs
  before federal institutionsand as such it holds
  the potential of
• Bringing urban and tribal leaders together to
  establish a continuous flow of communication
  i.e. to diminish the urban-tribal gap.
• Cultivating and coordinating relationships
  between UIHPs and major mainstream health
  research centers and universities.
• Creating the necessary awareness among mainstream
  media outlets and broadcasting agencies.
• Fostering political and managerial leadership
  among urban Indian youth.
• Establishing connections between major private
  foundations and UIHPs
• As the only agency advocating from UIHPs, NCUIH
  has no legitimate competitors or substitutes.
  Immediate competition comes from other fronts
  such as funding, technical assistance and fake
  substitutions
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NCUIH Consolidation Projects

• NCUIH Offices Project
• BoD Fund
• Membership Travel Fund
• Employees Benefits package

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Minimum Required Level of Funding
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Staffing Projections ( needs )
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Short Term Strategy

• 6 months of intense
• ADVOCACY FUNDRASING
• Objective
• Improving Strengths
• Tackling Weaknesses
• Gauging Opportunities
• Preparing to combat Threats
• We will be building on previous efforts carried
  out throughout this year such as
• Knowledge Map Research Findings
• Press Release Documents
• Contacts and relationships built
• Databases and specific contact information for
  Partners, Universities, National Indian
  Organizations, Health Organizations, Mass Media,
  etc.

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How?
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• Development Fundraising
• Historically- and since its inception-, the
  National Council of Urban Indian Health has
  mainly been operating under funds provided by the
  Department of Health and Human Services channeled
  through a Cooperative Agreement with the Indian
  Health Service/Urban Indian Health Office.
• Government funds have barely covered NCUIHs
  basic operations. Especially since this funds
  purchase power has been increasingly diminished
  
• It is critical for NCUIH to embark on an ongoing
  search for funds to fully comply with
• A) providing with the highest quality TA/L
• B) trigger a real policy change in favor of the
  Urban Indian Health programs and their population
  served
• C) enlarge and improve our scope of work under
  the Five Year Strategic Planning Vision statement
  
• D) consolidate NCUIH as a steadily
  growing/improving agency.

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NCUIH has identified five main sources of funding

• National Granting Agencies (other than
  DHHS/HIS/UIHO) such as the Health Resources
  Services Administration (HRSA), the Substance
  Abuse and Mental Health Services Administration
  (SAMHSA), the National Cancer Institute and the
  Center for Disease Control and Prevention (CDC),
  among others ( for a full list of identified
  agencies please see the National Grant Makers
  database in Annex I of this Business Plan).
• Private Donors/ Foundations Major humanitarian
  private sources of funds such as the Ford
  Foundation, the Robert Wood Johnson Foundation,
  the Kellogg Foundation, the Markle Foundation,
  Nathan Cummings Foundation, the RGK Foundation
  and the Ittleson Foundation, among others ( for
  a full list of identified private funders please
  see the Major Donors database in Annex I of
  this Business Plan).
• Joint Collaboration/Partnerships organizations
  or institutions that would like to collaborate
  with NCUIH on specific projects that are in line
  with our Mission and projects. These
  partnerships will be an additional ( minor)
  source of funding. NCUIH will seek to collaborate
  with Private Voluntary Organizations (PVOs) such
  as The Academy of Educational Development,
  American Red Cross, Columbia University,
  Internews etc, among others ( for a full list
  of minor private funders please see the minor
  donors database in Annex I of this Business
  Plan).
• International Organizations Such as the World
  Health Organization, the InterAmerican
  Development Bank, the Pan American Health
  Organization and the United Nations Development
  Program, among others
• Wealthy Tribes Tribes such as the Shakopee
  Mdewakanton in MN have been economically
  successful by developing business models that
  incorporate philanthropic foundations. NCUIH
  shall approach these tribes to both collaborate
  in the strengthening of the urban-tribal
  relations as well as to seek funds to assist
  urban Indian populations access to health.

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• Fundraising Methods
• There are no records of fundraising activities
  during pervious administrations therefore, NCUIH
  has to start from scratch by collecting
  information and developing a relationship with
  each single source of funding. The databases
  found in the Annex 1 of this Business Plan are
  considered the first step towards establishing
  contact, building and maintaining the necessary
  relationship with each funder/donor. The latter
  entails the following products/deliverables
• Collecting Specific information on the right
  contact
• Learning general information on the
  organization/Institution
• Making contact, requesting a meeting
• Learning how their activities and granting
  opportunities align with our mission and
  principles.
• Learning their grant-making processes
• Follow up on the relationship
• Creating and submitting a proposal that
  supports one or more of our programs
• Other activities tailored to the specifics of the
  organization in question.
• NCUIH shall prepare accordingly to meet with
  each one of this potential sources of funding.

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Long Term StrategyTimeline review (sample)
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Programmatic Initiatives

• Technical Assistance Phase I
• The first Project to be implemented under this
  business plan is aligned with each one of the
  2007-2011 strategic Plan areas- as it lays the
  ground or basis for further organizational
  development.
• Available information on Urban Indian Health is
  both scarce as well as poorly disseminated. NCUIH
  shall carry out an integral assessment of the
  state of the UIHPs as a first step to collect
  information, get fully in touch with UIHPs
  realities and challenges, jointly analyze the
  circumstances faced and find solutions tailored
  to both the UIHPs different stages of
  development as well as to the precise
  combination of services offered by each one of
  them (i.e. ambulatory services, limited services/
  and or referral services). This program will be
  further designed to have a minimum of 10
  voluntary UIHPs (approx. 30 of Membership) of
  all sizes and kinds.
• A Technical Advisory Director (TAD), in
  collaboration with one or more Specialists will
  prepare a series of time-efficient, but
  comprehensive surveys to be filled out during
  TADs brief visit to each one of the voluntary
  programs. This Technical Assistance Project Phase
  I, or Information Springboard, will take into
  account all factors and actors of involved in the
  programs development- such as community census
  , epidemiology, pandemics, funding, education
  and leadership development, research, manpower,
  UIHP uniqueness, use of Native knowledge,
  technical and programmatic needs, information
  sharing systems, reporting, the use of media,
  advocacy, communications and outreach, among
  others.

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The end

• THANK YOU!