[Senate Hearing 108-199] [From the U.S. Government Publishing Office] S. Hrg. 108-199 INDIAN HEALTH CARE IMPROVEMENT ACT ======================================================================= JOINT HEARING BEFORE THE COMMITTEE ON INDIAN AFFAIRS UNITED STATES SENATE AND THE COMMITTEE ON RESOURCES UNITED STATES HOUSE OF REPRESENTATIVES ONE HUNDRED EIGHTH CONGRESS FIRST SESSION ON S. 556 TO AMEND THE INDIAN HEALTH CARE IMPROVEMENT ACT TO REVISE AND EXTEND THAT ACT AND H.R. 2440 TO IMPROVE THE IMPLEMENTATION OF THE FEDERAL RESPONSIBILITY FOR THE CARE AND EDUCATION OF INDIAN PEOPLE BY IMPROVING THE SERVICES AND FACILITIES OF FEDERAL HEALTH PROGRAMS FOR INDIANS AND ENCOURAGING MAXIMUM PARTICIPATION OF INDIANS IN SUCH PROGRAMS __________ JULY 16, 2003 WASHINGTON, DC __________ Serial No. 108-41 __________ U.S. GOVERNMENT PRINTING OFFICE 88-462 WASHINGTON : 2003 _______________________________________________________________________ For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512-1800, DC area (202) 512-1800 Fax: (202) 512-2250 Mail: stop SSOP, Washington, DC 20402-0001 COMMITTEE ON INDIAN AFFAIRS BEN NIGHTHORSE CAMPBELL, Colorado, Chairman DANIEL K. INOUYE, Hawaii, Vice Chairman JOHN McCAIN, Arizona, KENT CONRAD, North Dakota PETE V. DOMENICI, New Mexico HARRY REID, Nevada CRAIG THOMAS, Wyoming DANIEL K. AKAKA, Hawaii ORRIN G. HATCH, Utah BYRON L. DORGAN, North Dakota JAMES M. INHOFE, Oklahoma TIM JOHNSON, South Dakota GORDON SMITH, Oregon MARIA CANTWELL, Washington LISA MURKOWSKI, Alaska Paul Moorehead, Majority Staff Director/Chief Counsel Patricia M. Zell, Minority Staff Director/Chief Counsel ______ COMMITTEE ON RESOURCES RICHARD W. POMBO, California, Chairman NICK J. RAHALL II, West Virginia, Ranking Democrat Member DON YOUNG, Alaska DALE E. KILDEE, Michigan W.J. ``BILLY'' TAUZIN, Louisiana ENI F.H. FALEOMAVAEGA, American JIM SAXTON, New Jersey Samoa ELTON GALLEGLY, California NEIL ABERCROMBIE, Hawaii JOHN J. DUNCAN, Jr., Tennessee SOLOMON P. ORTIZ, Texas WAYNE T. GILCHREST, Maryland FRANK PALLONE, Jr., New Jersey KEN CALVERT, California CALVIN M. DOOLEY, California SCOTT McINNIS, Colorado DONNA M. CHRISTENSEN, Virgin BARBARA CUBIN, Wyoming Islands GEORGE RADANOVICH, California RON KIND, Wisconsin WALTER B. JONES, Jr., North JAY INSLEE, Washington Carolina GRACE F. NAPOLITANO, California CHRIS CANNON, Utah TOM UDALL, New Mexico JOHN E. PETERSON, Pennsylvania MARK UDALL, Colorado JIM GIBBONS, Nevada, ANIBAL ACEVEDO-VILA, Puerto Rico Vice Chairman BRAD CARSON, Oklahoma MARK E. SOUDER, Indiana RAUL M. GRIJALVA, Arizona GREG WALDEN, Oregon DENNIS A. CARDOZA, California THOMAS G. TANCREDO, Colorado MADELEINE Z. BORDALLO, Guam J.D. HAYWORTH, Arizona GEORGE MILLER, California TOM OSBORNE, Nebraska EDWARD J. MARKEY, Massachusetts JEFF FLAKE, Arizona RUBEN HINOJOSA, Texas DENNIS R. REHBERG, Montana CIRO D. RODRIGUEZ, Texas RICK RENZI, Arizona JOE BACA, California TOM COLE, Oklahoma BETTY McCOLLUM, Minnesota STEVAN PEARCE, New Mexico ROB BISHOP, Utah DEVIN NUNES, California VACANCY Steven J. Ding, Chief of Staff Lisa Pittman, Chief Counsel James H. Zoia, Democrat Staff Director Jeffrey P. Petrich, Democrat Chief Counsel (ii) C O N T E N T S ---------- Page S. 556 and H.R. 2440, text of.................................... 2 Statements: Campbell, Hon. Ben Nighthorse, U.S. Senator from Colorado, chairman, Senate Committee on Indian Affairs............... 1 Carson, Hon. Carson, Hon. Brad, U.S. Representative from Oklahoma................................................... 674 Christensen, Hon. Donna M., U.S. Delgate from Virgin Islands. 675 Cole, Hon. Tom, U.S. Representative from Oklahoma............ 673 Culbertson, Kay, president, Denver Indian Health and Family Services................................................... 698 Faleomavaega, Hon. Eni F.H., U.S. Delegate from American Samoa...................................................... 672 Grijalva, Hon. Raul M., U.S. Representative from Arizona..... 673 Grim, Charles, director, Indian Health Service, Department of Health and Human Services.................................. 676 Hartz, Gary, acting director, Office of Public Health, Indian Health Service............................................. 676 Jimmie, Andrew, chief, Minto Traditional Council............. 697 Joseph, Rachel, cochair, National Steering Committee of the Reauthorization of the Indian Health Care Improvement Act.. 694 Kildee, Hon. Dale E., U.S. Representative from Michigan...... 671 Muneta, Dr. Ben, president, Association of American Indian Physicians................................................. 696 Murkowski, Hon. Lisa, U.S. Senator from Alaska............... 672 Nesmith, Steve, assistant secretary for Congressional and Intergovernmental Affairs, Department of Housing and Urban Development................................................ 679 Olson, Richard, acting director, Division of Clinical and Preventive Services, Indian Health Service................. 676 Pallone, Hon. Frank, Jr., U.S. Representative from New Jersey 674 Pombo, Hon. Richard W., U.S. Representative from California, chairman, House Committee on Resources..................... 671 Rhoades, Dr. Everett, Oklahoma City Urban Indian Clinic...... 700 Skeeter, Carmelita Wamego, executive director, Indian Health Care Resource Center of Tulsa.............................. 701 Snyder, Rae, acting director, Urban Health Office, Indian Health Service............................................. 676 Udall, Hon. Mark, U.S. Representative from Colorado.......... 673 Weaver, Steve, director, Division of Environmental Health and Engineering, Alaska Native Tribal Health Consortium........ 697 Appendix Prepared statements: Beaver, R. Perry, principal chief, Muscogee (Creek) Nation... 705 Culbertson, Kay (with attachment)............................ 708 Grim, Charles (with attachment).............................. 725 Guzman, Victoria, Walker River Paiute Tribe.................. 752 Jimmie, Andrew............................................... 705 Joseph, Rachel............................................... 760 Muneta, Dr. Ben (with attachment)............................ 778 Nesmith, Steve............................................... 785 Rhoades, Dr. Everett (with attachment)....................... 789 Skeeter, Carmelita Wamego (with attachment).................. 802 Sossamon, Russell, chairman, National American Indian Housing Council.................................................... 814 Weaver, Steve (with attachment).............................. 817 Zacharof, chairman, Alaska Native Health Board............... 705 Additional material submitted for the record: Letters: Citizens Potawatomi Nation................................... 839 Edwards, James Lee, Governor, Absentee Shawnee Tribe......... 841 Ration, Norman, executive director, National Indian Youth Council, Inc. (with attachment)............................ 842 Romberg, Carolyn, Health Director, AST Health Programs, Absentee Shawnee Tribe of Oklahoma......................... 841 INDIAN HEALTH CARE IMPROVEMENT ACT ---------- WEDNESDAY, JULY 16, 2003 U.S. Senate, Committee on Indian Affairs, Meeting Jointly With the Committee on Resources, U.S. House of Representatives Washington, DC. The committees met, pursuant to notice, at 10:15 a.m. in room 106, Dirksen Senate Office Building, Hon. Ben Nighthorse Campbell (chairman of the Senate Committee on Indian Affairs) presiding. Present from the Senate Committee on Indian Affairs: Senators Campbell, Inouye, Reid, Conrad, Dorgan, and Murkowski. Present from the House of Representatives Committee on Resources: Representatives Pombo, Mark Udall, Faleomavaega, Cole, Kildee, Grijalva, Pallone, Brad Carson, Christensen, and Napolitano. STATEMENT OF HON. BEN NIGHTHORSE CAMPBELL, U.S. SENATOR FROM COLORADO, CHAIRMAN, COMMITTEE ON INDIAN AFFAIRS The Chairman. We will now move to the joint hearing with the House Resources Committee and the Senate Committee on Indian Affairs bills to reauthorize the Indian Health Care Improvement Act. The two bills before our committee, S. 556 and H.R. 2440, reflect literally years of hard work by tribal leaders, the National Steering Committee and various Federal officials. Most members know the shameful state of Indian health. Senator Dorgan just reiterated that as did Senator Conrad, so I won't go through the litany of statistics this morning but they are common knowledge. Today is the second in a series of hearings on the reauthorization bill. We will receive testimony regarding one, health disparities; two, health facilities; and three, urban Indian health issues. In the interest of time, I'll place my full statement in the record but I will say this to the members of both committees. After years of work and countless hours of meetings and hearings, the time certainly has come for the tribes, Congress and the Administration to roll up our sleeves and do what we need to do to move this bill and get the act reauthorized this year. To achieve that goal I look forward to working with my colleagues on both committees. [Prepared statement of Senator Campbell appears in appendix.] [Text of S. 556 and H.R. 2440 follow:]![]()
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