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Tribal Affairs

Dear Tribal Leader Letters

Dear Tribal Leader Letter (PDF - 47 KB) regarding HRSA's Shortage Designation Modernization Project related to Tribes and Urban Indian Organizations - September 15, 2021

Dear Tribal Leader Letter (PDF - 74 KB) regarding HRSA's October 2021 Annual Tribal Consultation - September 10, 2021

Dear Tribal Leader Letter (PDF - 33 KB) regarding the reorganization of HRSA's Tribal Health Affairs Team - August 31, 2021

More Tribal Leader Letters

HRSA’s Efforts

HRSA’s Office of Intergovernmental and External Affairs (IEA) leads HRSA’s Tribal Affairs work and serves as HRSA’s primary point of contact for tribal governments and tribal organizations. HRSA’s goal is to advance tribal health systems and resources, partnering with federal agencies and other organizations to increase access to HRSA programs. Working with the tribal communities, HRSA aims to increase opportunities to access and optimize the quality and performance of the tribal health system increasing the capacity of Indian Country to respond to the impact of disease burden among American Indians and Alaska Natives.

To help tribal organizations maximize the impact of key government programs, HRSA identified the following priorities:

  • Increase Urban Indian Health participation in the Health Center Program.
  • Improve usage of Health Professional Shortage Area (HPSA) designation to tribal populations.
    • Shortage Designation Criteria:
      • Members of Indian tribes are automatically designated as population HPSAs.
      • Outpatient health programs or facilities operated by a tribe or tribal organization under the Indian Self-Determination Act, or by an urban Indian organization receiving funds under Title V of the Indian Health Care Improvement Act, are considered Federally Qualified Health Centers, and thus automatically designated HPSAs.
  • Support the workforce through health professions programs and the National Health Service Corps.
  • Enhance participation in the HRSA competitive grants process.

HRSA Tribal Advisory Council (TAC)

In 2021, HRSA established a Tribal Advisory Council (TAC) as a forum for elected tribal officials and HRSA staff to exchange views, information, or advice about:

  • Emerging public health issues in Indian Country
  • Urgent public health resources and service needs
  • Collaborative approaches to address the issues and needs of American Indian and Alaska Native populations

TAC Resources

Dear Tribal Leader Letters

  • Dear Tribal Leader Letter (PDF - 130 KB) regarding the Substance Use Disorder and Treatment Loan Repayment Program (STAR LRP) - July 6, 2021
  • Dear Tribal Leader Letter (PDF - 33 KB) regarding $15 million in NHSC Loan Repayment Programs Earmarked for Indian Country - April 22, 2021
  • Dear Tribal Leader Letter (PDF - 31 KB) regarding new information related to tribes and urban Indian organizations on training for the HRSA 2021 National Shortage Designation Update 2.0 as part of the Shortage Designation Modernization Project - March 11, 2021
  • Dear Tribal Leader Letter (PDF - 34 KB) Regarding an Update to the Establishment of the HRSA Tribal Advisory Council - February 23, 2021

Tribal Health Resources

Policy Updates

If you have questions related to HRSA’s Tribal Affairs activities, you may contact HRSA IEA’s Tribal Affairs team at

Date Last Reviewed:  September 2021