Statement on the HHS Restructuring and the Creation of the Administration for a Healthy America

The California Consortium for Urban Indian Health (CCUIH) is deeply concerned about the U.S. Department of Health and Human Services’ (HHS) newly announced restructuring plan that would reduce staff by 25% and dissolve vital agencies such as the Health Resources and Services Administration (HRSA) and the Substance Abuse and Mental Health Services Administration (SAMHSA), incorporating them into a new entity: the Administration for a Healthy America (AHA).

This proposed change — which threatens to upend key health programs and redirect resources without Tribal or Urban Indian consultation — is both deeply troubling and legally questionable. HRSA and SAMHSA are more than bureaucratic agencies: they are lifelines for health equity, workforce support, and culturally centered services in Urban Indian communities across California and the nation.

We call on HHS to:

  • ● Immediately halt this restructuring until Tribal and Urban Indian consultation and confer takes place;
  • ● Ensure continued funding and support for Indian health programs under HRSA and SAMHSA.

CCUIH stands with our members, Tribal partners, and national organizations in demanding transparency, accountability, and protection for our communities. We urge Congress to exercise its oversight role and protect public health infrastructure for all — especially those already underserved.

If you’d like to make your voice heard, you are welcome to adapt and share the following templates:

Social Media Templates

Twitter/X 

BREAKING: HHS is planning to merge HRSA & SAMHSA in a major restructuring—without consulting Tribal or Urban Indian partners.
 This threatens critical health programs for Native communities.
 @CCUIH_ calls for immediate transparency & accountability.
 #ProtectNativeHealth #HRSA #SAMHSA

Instagram / Facebook Post

URGENT: HHS Restructuring Threatens Urban Indian Health
 HHS plans to mergeHRSA and SAMHSA, key agencies supporting public and Native health, without any consultation with Tribal or Urban Indian communities. These agencies fund vital services for mental health, workforce, and community care.

We call on HHS to:
🔹 Halt the restructuring
 🔹 Consult with Tribal and Urban Indian stakeholders
 🔹 Protect funding for Urban Indian Organizations

We deserve a health system built with us — not without us.
 #ProtectNativeHealth #UrbanIndianHealth #HRSA #SAMHSA #NativeHealthMatters #CCUIH

LinkedIn Post

The U.S. Department of Health and Human Services (HHS) has announced a sweeping restructure, merging HRSA and SAMHSA by merging them into a new agency — without Tribal or Urban Indian consultation. This threatens essential public health infrastructure and disproportionately harms American Indian and Alaska Native communities.

CCUIH is calling for:

  • A full halt to this process until proper consultation occurs
  • Clear legal justification from HHS
  • Protection for health programs relied on by Urban Indian Organizations

We stand in defense of culturally grounded care and equity for all communities.
 #PublicHealth #NativeHealth #HRSA #SAMHSA #UrbanIndianHealth #Equity #HealthJustice #CCUIH

Template Letter to Secretary Robert F Kennedy Jr.

Click Here for Downloadable Version

[UIO Letterhead]
[Date]

The Honorable Robert F. Kennedy Jr.
 Secretary of Health and Human Services
 U.S. Department of Health and Human Services
 200 Independence Avenue, SW
 Washington, DC 20201

Dear Secretary Kennedy,

On behalf of [Insert UIO Name], we are writing to express urgent concern regarding the Department of Health and Human Services’ March 27, 2025 announcement of its “Transformation to Make America Healthy Again.” Specifically, we are alarmed by the proposal to dissolve or absorb the Health Resources and Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and other public health agencies into a new entity, the Administration for a Healthy America (AHA), without Tribal or Urban Indian consultation.

As an Urban Indian Organization, we rely on HRSA and SAMHSA programs to sustain our health workforce, deliver maternal and child health services, address the mental health and substance use crisis in our communities, and build culturally grounded, equitable systems of care. These agencies are not redundant bureaucracies — they are vital components of the federal public health infrastructure created by Congress to meet urgent community needs, including those of American Indian and Alaska Native (AIAN) people living in urban areas.

We are deeply concerned that AHA, as described in the HHS press release, is being established to centralize administrative operations such as Human Resources, Information Technology, External Affairs, Procurement, and Policy. If this is the core focus of AHA, how is it legally or functionally appropriate to absorb agencies like HRSA and SAMHSA, which were established by Congress to carry out direct, mission-driven health services? Consolidating these agencies under an administrative framework appears inconsistent with their purpose and may exceed the authority of the Department to reorganize without congressional authorization or a formal rulemaking process.

Additionally, the Department has not conducted consultation with Tribes or Urban Indian Organizations as required under Executive Order 13175 and HHS’s Tribal Consultation Policy. This restructuring would directly impact federal programs serving AIAN communities, and thus cannot proceed without consultation and input from those who would be affected.

We urge HHS to immediately:

  • Suspend implementation of the restructuring plan until full Tribal and Urban Indian consultation is completed.
  • Publicly release the legal authorities under which this restructuring is being implemented, especially with regard to the consolidation of HRSA and SAMHSA.
  • Clarify whether programs that serve Urban Indian Organizations through HRSA and SAMHSA will continue, and under what leadership, structure, and budget authority.
  • Ensure that funding, technical assistance, and culturally responsive program design for Urban Indian communities are not disrupted or diminished in this transition.

The trust responsibility to AIAN people — including those living in urban areas — requires consultation, transparency, and stability in how federal health resources are administered. We remain committed to working in partnership with the Department to ensure programs are effective, efficient, and equitable — but we cannot support a process that bypasses our voices and jeopardizes vital services.

Thank you for your attention to this matter. We request a response and invitation to consultation at your earliest opportunity.

Sincerely,
 [Executive Director or Authorized Representative]
 [Urban Indian Organization Name]
 [Contact Information]

cc:
Acting Administrator, HRSA
Acting Administrator, SAMHSA
Assistant Secretary for Health
Chairs and Ranking Members, Senate HELP and House Energy & Commerce Committees
National Indian Health Board (NIHB)
National Council of Urban Indian Health (NCUIH)