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IHS Announces the 4-in-1 Grant Opportunity to Enhance Health Services in Urban Areas

by Sherriann Moore, Acting Director, Office of Urban Indian Health Program

The Indian Health Service, Office of Urban Indian Health Programs and Division of Grants Management, will soon begin accepting new, competitive grant applications for the FY 2016 4-in-1 Grant Program. To be eligible to apply under this announcement, applicants must currently have a Title V Indian Health Care Improvement Act (IHCIA) contract with the IHS in place. Funding level available to an organization is based on specific criteria in the Indian Health Care Improvement Act to include size of urban Indian population, accessibility to and utilization of other health resources available to that population and identification of need for services.

The FY 2016 competing, continuation cycle of 4-in-1 grant funding, approximately $8.3M, will be used to promote urban Indian organizations' successful implementation of IHS priorities. Additionally, funding will be used to meet objectives for Government Performance and Results Act and the Government Performance and Results Modernization Act reporting; collaborative activities with the Veterans Health Administration; and four health programs that make health services more accessible to American Indians and Alaska Natives living in urban areas.

The four healthcare areas include:

  • Health Promotion and Disease Prevention Services
  • Immunizations
  • Alcohol and Substance Abuse Services
  • Mental Health Prevention and Treatment Services

These programs are integral components of the IHS improvement in patient care initiative and the strategic objectives focused on improving safety, quality, affordability and accessibility of health care.

Prior to the 1950s, most American Indians and Alaska Natives (AI/AN) resided on reservations, in nearby rural towns or in Tribal jurisdictional areas such as Oklahoma. In the era of the 1950s and 1960s, the federal government passed legislation to terminate its legal obligations to the Indian Tribes, resulting in policies and programs to assimilate Indian people into mainstream American society and the relocation of over 160,000 AIAN to selected urban centers across the country. Today, a majority of AI/ANs reside off-reservation. In response to efforts of urban Indian community leaders, Congress appropriated funds to study unmet urban Indian health needs. The findings of this study documented cultural, economic and access barriers to health care and resulted in Congressional appropriations under the Snyder Act to support emerging urban Indian clinics in several Bureau of Indian Affairs relocation cities including Chicago, Denver and San Francisco.

The IHCIA, permanently reauthorized by Congress in 2010, is considered health care reform legislation to improve the health and well-being of all AI/AN, including urban Indians. Title V specific funding is authorized for the development of programs for AI/AN residing in urban areas. Since passage of this legislation, amendments to Title V provided resources for urban Indian health programs in the areas of primary care services, alcohol abuse services, mental health services, HIV, immunizations and health promotion and disease prevention services.

For additional information about the Office of Urban Indian Health programs, visit

Sherriann Moore, an enrolled member of the Rosebud "Sicangu" Lakota Tribe in South Dakota, is the Acting Director of the Office of Urban Indian Health Programs. The IHS Office of Urban Indian Health Program supports contracts and grants to programs funded under Title V of the Indian Health Care Improvement Act.

Sherriann Moore, Acting Director, Office of Urban Indian Health Program