[Senate Hearing 108-60] [From the U.S. Government Publishing Office] S. Hrg. 108-60 FISCAL YEAR 2004 BUDGET ======================================================================= HEARING BEFORE THE COMMITTEE ON INDIAN AFFAIRS UNITED STATES SENATE ONE HUNDRED EIGHTH CONGRESS FIRST SESSION ON OVERSIGHT HEARING ON THE PRESIDENT'S BUDGET REQUEST FOR INDIAN PROGRAMS FOR FISCAL YEAR 2004 __________ FEBRUARY 26, 2003 MARCH 5, 2003 WASHINGTON, DC ____________________________________________________________________________ For Sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpr.gov Phone: toll free (866) 512-1800; (202) 512�091800 Fax: (202) 512�092250 Mail: Stop SSOP, Washington, DC 20402�090001 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 (ii) C O N T E N T S ---------- Page February 26, 2003 Statements: Campbell, Hon. Ben Nighthorse, U.S. Senator from Colorado, chairman, Committee on Indian Affairs...................... 1 Cheek, John, executive director, National Indian Education Association, Alexandria, VA................................ 27 Conrad, Hon. Kent, U.S. Senator from North Dakota............ 19 Culbertson, Kay, president, Denver Indian Health and Family Services, Denver, CO....................................... 23 Davis-Wheeler, Julia, chair, National Indian Health Board, Denver, CO................................................. 21 Edwards, Gary, CEO, National Native American Law Enforcement Association, Washington, DC................................ 8 Hall, Tex, president, National Congress of American Indians, Washington, DC............................................. 2 McNeil, Ron, chairman, President's Board of Advisors on Tribal Colleges and Universities, Sitting Bull College, Fort Yates, ND............................................. 29 Sossamon, Russell, chairman, National American Indian Housing Council, Washington, DC.................................... 5 Appendix Prepared statements: Cheek, John.................................................. 131 Culbertson, Kay.............................................. 121 Davis-Wheeler, Julia......................................... 35 Edwards, Gary................................................ 64 Hall, Tex.................................................... 41 Inouye, Hon. Daniel K., U.S. Senator from Hawaii, vice chairman, Committee on Indian Affairs...................... 35 McNeil, Ron (with attachments)............................... 74 Sossamon, Russell............................................ 58 Additional material submitted for the record: DeWeaver, Norman C., national representative, Indian and Native American Employment and Training Colaition, letter.. 146 March 5, 2003 Statements: Campbell, Hon. Ben Nighthorse, U.S. Senator from Colorado, chairman, Committee on Indian Affairs...................... 149 Dorgan, Hon. Byron L., U.S. Senator from North Dakota........ 163 Erwin, Donna, acting special trustee, Department of the Interior, Washington, DC................................... 153 Grim, Charles W., M.D., interim director, Indian Health Service, Rockville, MD..................................... 156 Hartz, Gary, acting director, Office of Public Health........ 156 Jones, Lonna B., acting director, Elementary Secondary, and Vocational Analysis Division, Budget Service, Office of Deputy Secretary, Department of Education, Washington, DC.. 161 Kincannon, Louis, director, Bureau of the Census, Suitland, MD......................................................... 150 Lincoln, Michael E., deputy director, Indian health Service, Rockville, MD.............................................. 156 Martin, Aurene, acting assistant secretary, Indian Affairs, Department of the Interior, Washington, DC................. 153 Martin, Cathie L., group leader, Office of Indian Elementary and Secondary Education, Department of Education, Washington, DC............................................. 161 Murkowski, Hon. Lisa, U.S. Senator from Alaska............... 160 Russell, William, deputy assistant secretary, Public and Indian Housing, Department of Housing and Urban Development, Washington, DC................................ 159 Vanderwagen, Craig, M.D. acting chief medical officer........ 156 Vasques, Victoria, director, Office of Indian Education, Department of Education, Washington, DC.................... 161 Appendix Prepared statements: Carlson, Ervin, president, Inter-Tribal Bison Cooperative (with attachment).......................................... 580 Daniels, Deborah J., Assistant Attorney General, Office of Justice Programs (with attachment)......................... 175 Grim, Charles W. (with attachments).......................... 511 Kincannon, Louis (with attachments).......................... 180 Martin, Aurene............................................... 500 Russell, William (with attachments).......................... 538 Vasques, Victoria (with attachments)......................... 558 Note: Other material submitted for the record will be retained in committee files. FISCAL YEAR 2004 BUDGET ---------- WEDNESDAY, FEBRUARY 26, 2003 U.S. Senate, Committee on Indian Affairs, Washington, DC. The committee met, pursuant to notice, at 10:05 a.m. in room 485, Senate Russell Building, Hon. Ben Nighthorse Campbell, (chairman of the committee) presiding. Present: Senators Campbell, Inouye, and Conrad. STATEMENT OF HON. BEN NIGHTHORSE CAMPBELL, U.S. SENATOR FROM COLORADO, CHAIRMAN, COMMITTEE ON INDIAN AFFAIRS The Chairman. The Committee on Indian Affairs will be in order. This morning we have a business meeting with three pending bills. Unfortunately, Senator Inouye is going to be late; probably that murderous weather that is already accumulating out there, but he will be along. So what we are going to do is reverse the order and go ahead with the hearing part on our fiscal year 2004 budget request and then come back when Senators show up to second the motion for the business part of our meeting. This will be the first of our two oversight hearings on the President's fiscal year 2004 budget request for Indian programs. As we all know, our Nation is now on the verge of a major conflict. All of us hope that is not going to happen, but unfortunately it appears very close. This effort has cost, and will cost, billions of dollars. We are also engaged in a coast-to-coast effort to protect our homeland with the building up of the national defense program. The President's fiscal year 2004 budget reflects those realities and, at the same time, provides for a modest increase in a number of Indian accounts. The Department of the Interior's budget is pegged at $10.7 billion with more than one-quarter of the entire Department's budget dedicated to Indian accounts, including $2.314 billion for the BIA, and $275 million for the Special Trustee. The Indian Health Service account would receive $2.89 billion, an increase of $68 million over fiscal year 2003. I won't recite the litany of all of the accounts, but all of the dollar figures, as we will hear today, are for the major Indian programs. Next week we will hear from the Federal departments and the agencies on the budget request. I will be paying particular attention to the Homeland Security budget, and the committee will be most interested in seeing the degree to which it involves Indian tribal governments, law enforcement, and medical personnel in our security efforts. When Senator Inouye gets here, we will take a break so he can make his statement. With that, I would like to welcome our guests in their order of appearance. We have Tex Hall, president of the National Congress of American Indians, Russell Sossamon, the chairman of the National American Indian Housing Council, and Gary Edwards, the CEO of the National Native American Law Enforcement Association. Welcome we will go ahead and proceed with your testimony. As in other committee hearings, if you want to insert your written testimony, all of that will be included in the record and you are welcome to abbreviate your testimony. STATEMENT OF TEX HALL, PRESIDENT, NATIONAL CONGRESS OF AMERICAN INDIANS, WASHINGTON, DC Mr. Hall. Thank you, Mr. Chairman. Thank you, Chairman Campbell, and members of the Senate Committee on Indian Affairs. My comments today will be brief as our written testimony provides the details of our concerns about the President's budget request for fiscal year 2004. I invite you to consider our written testimony carefully. [Prepared testimony of Mr. Hall appears in appendix.] Mr. Hall. I thank you for this opportunity to speak before you and to continue to foster a good government-to-government relationship between the United States and the Indian Tribal Nations. For the past several years I have served on the BIA Budget Advisory Council representing the needs of my region of the Aberdeen area of the Bureau of Indian Affairs, as well as the agenda of the National Congress of American Indians. During many of these sessions, representatives of OMB, the Office of Management and Budget, have been present at these meetings. This has always been a painful experience because our national needs are so great. Yet, we are repeatedly told that we will have to do much with less. Once again, we are faced with tremendous shortfalls for the most vital programs that serve our people. This is especially true in health care, housing, education, and public safety. Further, in my BIA region in Aberdeen, the President's budget for fiscal year 2004 allocates zero for our water development needs. Let me talk about health care first. Last weekend we sat down with the acting director, Charles Grimm, of the Indian Health Service. He told us that under the ``PART'' methodology, which is the Program Assessment Rating Tool that OMB uses for efficiency rating, the Indian Health Service and IHS Sanitation Services scored the highest of any programs of the Department of Health and Human Services. Yet, despite this high praise, the fiscal year 2004 IHS budget request does not even keep pace with medical inflation. At the same time, the IHS budget at $3.6 billion is barely one-third of the estimated annual need of $10 billion. So if the PART methodology that OMB uses is really intended to award the most effective and efficient programs, then where is the increased budget for IHS? In further talking with Charles Grimm, we learned that the VA, the Veterans Administration's health programs, were exempted from the PART methodology, which is good. But if the PART program is such an effective tool for evaluating our Federal Governments, then why is it not universally applied to all agencies? Our health status, Mr. Chairman, as you know, are well known, but deserve mentioning again. The diabetes rate on our reservation is more than ten times the national average. It is at epidemic levels, as we know, and many of our children are now being diagnosed with juvenile diabetes. And yet the requested fiscal year 2004 IHS budget again does not keep pace with inflation. Our life expectancy in the Northern and Great Plains of this country for men is still 12 years less than the national average. And yet again the requested fiscal year 2004 IHS budget does not keep pace with medical inflation. Funding is not available to our people to receive simple tests for cancer screening. I, for one, can attest that my mother died prematurely because she did not receive a simple mammogram. And yet the 2004 IHS budget again does not keep pace with medical inflation and will deny many other women a chance for a mammogram or cancer screening tests that they so most importantly need. These abysmal statistics do not, in many ways, permit our tribal nations to achieve the health status we need to truly achieve our economic development goals for healthy tribal people. Without good health, our tribal members cannot work as hard or as long. This makes it more difficult for our reservations to attract good paying job in strong businesses as this affects our work force. It makes it harder for our people to contribute as taxpayers to our country. It makes it harder for our people to avoid the need to be on welfare assistance. It also makes it harder for our people to complete their education. The Supreme Court of the United States has recognized the health care trust obligations of the United States. So, Mr. Chairman, we ask Congress to adopt the same position and appropriate the funds that will fulfill this Trust with the obligation of the United States for the health care of its indigenous people. Housing is another severely under-funded trust function. In the Great Plains, as elsewhere in this Nation, our members wait as long as 20 years on a housing waiting list. And while we are taking steps to improve our housing capacity on each of our reservations through our own means, the budget in this area does not significantly reduce the waiting time our members to have houses and rental units. The President's elimination of the Rural Housing and Economic Development Program in fiscal year 2004 budget compounds this problem even more. Housing funding is another reason, as we mentioned in our written testimony, that Indian programs should be exempt from OMB's PART methodology. Shortly after his election, President Bush announced a bold new education plan: Leave no child behind. We applaud these efforts, but the President must put real resources behind that goal. Nowhere is this more true than an Indian education. Tribes do not have a local property tax base. We are like the military. Reservations are largely dependent on the Federal Government for education funding. Our schools are still falling apart faster than the Government is appropriating funds to fix them. This has to stop. Another area under funded is public safety, including funding under the recently enacted Homeland Security legislation. Tribes should be able to directly receive grants from the Federal Government and from Homeland Security for the purpose of protecting our tribal homelands just as States do. The one area of growth in the BIA budget has been trust reform. Yet the Department itself has communicated that it has had to scramble to find funds for this purpose. Throughout Indian country, I continue to hear worries that the money to fix the Trust Fund's management mess is being taken from other core Trust Service functions of the Department of the Interior and other agencies. Additionally, tribes continue to communicate to me that there is a genuine lack of consultation on trust reform issues that are critical for the beneficiaries, the Indian tribal governments, and the individual Indian beneficiaries. Congress should ensure that other BIA services are in no way impacted by the need to comply with trust reform orders from the Court. I also call for Congress to comply with the American Indian Trust Funds Management Reform Act of 1994 and adequately consult with tribes in foregoing a trust reform solution. On a regional note, it is critical that we get all possible assistance in the Great Plains States for the Rural Water Distribution projects that have been promised to us for more than 50 years. The fiscal year 2004 budget proposed by the President eliminates all construction funds for programs like the Mni Wiconi and the Dakota Water Resources Act which authorizes the completion of our Rural Water Distribution Systems on those reservations in the Great Plains. Under the President's plan, similar projects in South Dakota, Montana, North Dakota, and other States that are greatly affected by our tribal nation's budget have been zeroed out. We have been waiting patiently for the United States to fulfill its responsibilities and promises to us for good, clean drinking water to our tribal homes. We have been waiting for this since the hydroelectric dams authorized in the 1944 Pick- Sloan Act were built along the rivers in the early 1950's flooding our tribal homelands. This has not yet happened and yet the President's budget says that the effectiveness of these programs is not demonstrated under the PART analysis I described earlier. I do not understand how a project is not deemed effective that delivers good water to households where water has been hauled in by hand for the past 50 years. So this is of great importance to us on trying to put those dollars back in. Finally, I want to close with a few thoughts of what has been a main theme of both my presidency of NCAI as well as my chairmanship of the Mandan, Hidatsa, and Arikara Tribes on the Fort Berthold Reservation in North Dakota. That is economic development. We must have adequate funding for as many of our economic development initiatives as possible in the 2004 budget. Senator Campbell, you have supported and reintroduced a number of our initiatives in the 108th Congress. Some of our ideas do not cost any money, if they cost anything at all. It will be more than made up for in the increased economic activity these initiatives will bring to Indian reservations. Examples of such initiatives are reenacting the Indian Investment Act, providing for energy development incentives on reservations, supporting economic development technical assistance centers, and raising the ceiling on loans under the Indian Finance Act. Still another idea that should be given consideration by this committee is the extension of the 5 percent set-aside rule by the Department of Defense for Native American contractors to all U.S. Departments; not just the Department of Defense. Tribes are now banding together to take advantage of Government and private contracting opportunities. My tribe is part of this new consortium, but any help this committee can provide is very welcome indeed. We hope that as this committee considers economic development issues, the appropriate budget dollars that were put in place to make these incentives and ideas, will be a reality for this session of Congress. Throughout this process, we hope that we are consulted on a government-to-government basis as these ideas are developed further. Again, Mr. Chairman, I want to thank you for all of your support on these very important issues. I want to thank you for the opportunity to provide testimony today on the needs of Indian Tribal Nations in this great country of ours. Thank you. The Chairman. Thank you. Just for your information, Tex, one of the big thrusts of the committee this year is going to be to try to get a number of bills passed that will be designed to improve the economic situation and improve the opportunity for jobs on reservations. That is one of the things that we are really interested in trying to get through this year. Sometimes, as you know, you have to do these bills two or three times in a row before we get them passed. It has been a personal interest of mine for a good number of years, as you know. Mr. Hall. Absolutely. The Chairman. Thank you for bringing up a number of important points in your testimony. Some of those I will ask specifically next week of the Administration when they appear before the committee. Mr. Hall. Thank you. The Chairman. We will now go to Mr. Sossamon. Please proceed. STATEMENT OF RUSSELL SOSSAMON, CHAIRMAN, NATIONAL AMERICAN INDIAN HOUSING COUNCIL, WASHINGTON, DC Mr. Sossamon. Thank you, Chairman Campbell, and the members of the committee. My name is Russell Sossamon and I am the chairman of the National American Indian Housing Council, an organization that represents the interests of over 400 tribes and their tribally- designated housing entities. I am also the executive director of the Housing Authority of the Choctaw Nation of Oklahoma. I appreciate the opportunity to testify before you today on the President's fiscal year 2004 budget for Indian housing and related community and infrastructure programs. I have submitted a written statement which I asked to be included in the hearing record which will provide clarification on the issues I bring before you today. The Chairman. It will be included in the record. [Prepared testimony of Russell Sossamon appears in appendix.] Mr. Sossamon. In the brief time allotted to me today, I would like to focus on seven areas of the budget with two additional items that we feel require Congress' urgent attention and support. We were disappointed with this budget. It again did not include an increase for tribal housing. I understand there is a return to budget deficits and a need for homeland security. But that does not make our members in inadequate housing feel any more safe or secure in their situation. This would be the fourth straight year of flat-line funding for the Indian Housing Block Grant, despite inflation, the increased cost of construction, and the growing native population. A letter signed by many of our members was sent earlier this week to the members of this committee, the President, other members of Congress, and the Administration with the information I would like to share with you today. I thank this committee for all the work that it has done into passing and improving the NAHASDA during the past three Congresses. But that effort will not fully be realized without adequate funding for the programs. We request that you support an increase for the NAHASDA block grant on the track to a total of $1 billion by fiscal year 2007, and appropriating at least $700 million for fiscal year 2004. The President's request is $646.6 million. If inflation were applied to the past 4 years of stagnant funding, this year's budget amount would be $700 million. We are requesting at least that much to cover the current unmet need of 200,000 housing units, and increases in the Indian Community Development Block Grant from 1.5 percent to 3 percent of the total CDBG allocation to an increase in the amount of $150 million, since this program has been so successful in aiding the development of tribal economies. The President has requested $72.5 million. The next item is the Rural Housing and Economic Development Program. It is a very important tool for building the capacity of the tribes and should be funded again in fiscal year 2004, although it was zeroed out by the President's budget. Tribes generally receive about one-half of these grants for capacity building and job creation. The BIA Housing Improvement Program has also been funded at the same level for many years. This program assists tribes in rehabilitation of homes and fills in the gaps of many under- funded tribes. We would like to see this increased to at least $35 million for 2004. Mounting water and sewer infrastructure costs must be considered by the tribes when planning for housing development. We oppose current Interior report language that precludes tribes from using sanitation facility construction funds in conjunction with HUD funded homes. It is causing complicated accounting and engineering issues for the tribes back homes. Since HUD no longer fully subsides infrastructure development, we feel the tribe and not the Indian Health Service should decide where the funds are going since it is all for the same recipient. We are requesting that this committee investigate the situation of infrastructure funding for tribes and make a recommendation as to the best policy. Tribes seem to be caught in an Agency turf battle. Please refer to my written testimony for more information on this matter. We applaud the $20 million increase to sanitation facilities construction in this budget, but feel the need is much larger, and an increase of up to $180 million would be more appropriate. We are told that the Administration will be using performance-based budgeting, and that 45 percent of all Indian housing funds under the IHBG remain unspent, implying that a cut to IHBG could be in the future. We have never seen any data to back this up, but we are willing to make the efforts to reach out to HUD and understand their interpretation of the data and make the improvements where warranted. The allocation does not take into account the following issues: The figure is both obligated and unobligated funds. Tribes must spend their funds within 72 hours of drawdown. Tribes have 2 years to obligate these funds. HUD often takes several months to make the funds available after appropriation, meaning most of this funding is likely from the past two years and within the regulatory authority of obligation. HUD collects data and Indian housing plans in annual performance reports but seems never to have compiled that data to assist in documenting the progress or difficulties of the tribes. We hope this committee will join us in working with HUD in demanding a full and complete accounting on these funds. Technical assistance funds were cut in this budget. NAIHC has been receiving over $4 million a year to conduct technical assistance and training for the past several years to assist tribes in implementing Federal housing programs. The portion of this funding normally taken as set-asides out of IHBG has been cut out of this year's budget. Why threaten to cut funding based on capacity and then cut technical assistance which is used to improve capacity? NAIHC did over 150 on-site visits to tribes last year, and served over 1,300 students who attend our training courses. We are requesting full funding for technical assistance and training for NAIHC in fiscal year 2004, which ideally would all be out of a CDBG set-aside rather than out of the Indian Housing Block Grant set-aside. Mr. Chairman, we believe that in the scheme of things these are modest requests and we hope that the Subcommittee and Congress will address these. We recognize that funds are scarce and tough decisions lie ahead. However, the needs of Indian country are great, and without an expended level of support of Congress and the Administration, the problems will only grow worse. Thank you, Mr. Chairman, for this opportunity to present the views of NAIHC. I will be happy to respond to any questions. The Chairman. Thank you. My intention now that Senator Inouye here is to give him time for his opening statement. Senator Inouye. I would like that be inserted in the record. [Prepared statement of Senator Inouye appears in appendix.] The Chairman. We will go to Mr. Edwards. Then we will go back to our Business Meeting. We will then hear from our second panel on the fiscal year 2004 budget. Mr. Edwards, please proceed. STATEMENT OF GARY EDWARDS, CEO, THE NATIONAL NATIVE AMERICAN LAW ENFORCEMENT ASSOCIATION, WASHINGTON, DC Mr. Edwards. Mr. Chairman, Mr. Vice Chairman, and members of the committee. My name is Gary L. Edwards. I am the chief executive officer of the National Native American Law Enforcement Association. I am also the vice chairman of the Native American National Advisory Committee for Boys and Girls Clubs of America. I am also an Advisory Board Member for the Helen Keller Worldwide Child Sight Program. Today my testimony will focus on three categories of Indian programs. The program categories are Native American Youth Programs, Native American Law Enforcement Training Programs, and Indian country Homeland Security Training Programs. The Boys and Girls Clubs of America will be the group that I address first. Currently, we have 140 Boys And Girl Clubs that are open in Indian country today. We serve over 60,000 Native American Youth across Indian country. In January of this year we had the 2003 Summit for Clubs serving Native American youth. Our focus was expanding the circle, and continuing the legacy of our children. It infused our attendees with the hope that by the year 2005 we will be able to open 200 clubs in Indian country to serve our youth. It also embedded within our hearts the need to sustain the clubs that we opened, and that we hope to open in the future. Senior members of the Boys and Girls Clubs of American, like Robby Callaway, are committed to sustaining these clubs. Another way that we are looking to sustain the clubs is through partnerships--partnerships through organizations such as the U.S. Secret Service, the Department of Justice, Office of Community-Oriented Policing, the Bureau of Indian Affairs, Office of Law Enforcement Services, and the Alcohol, Tobacco, Firearms and Explosives Division through their Great Program. A highlight of these partnerships that I would like to bring forward to you is the Great Program. Currently, the National Native American Law Enforcement Association has entered into partnerships with the groups that I just mentioned to develop six pilot programs in Indian country Boys and Girls Clubs. These are clubs in areas where we have high rates of violence among all age groups and income categories of people that live in the areas. We also have a growing gang problem within these areas. What we have done with the Great Program on the six pilot sites is that we have brought law enforcement officers into the programs to work hand-in-hand with the children. This has created a dynamic where the children no longer look at the law enforcement officers in an adversarial role, but they look at them as partners. They look at them as avenues to solve some of the problems they face on a daily basis, and they look at them as role models. This Great Program serves not only the community and the Boys and Girls Clubs by sustainability, but it also serves our Nation in putting people in closer contact through community and police working together. This program, the Boys and Girls Clubs of America, if we are going to be able to reach our goal of 200 clubs by the year 2005, we will need additional funding, and we will also need to have programs such as the Great Program to be expanded to more than just the six clubs in the pilot program. We want to sustain those and take it to all the clubs in Indian country. Another exciting program that is coming for our youth this year to Indian Country is the Helen Keller Worldwide Child Sight Program. The Child Sight Program has committed to giving 32,000 free eye examinations and free designer eyeglasses to children in need. The Child Sight Program has committed 60 percent of these eye exams and eye glasses for Indian country youth. Our first pilot program in Indian country will be held in April of this year at the Pueblo of Laguna in New Mexico. If additional funding becomes available, we will be able to expand this program, not only in Indian country, but throughout the United States. We hope to establish a deliverable through the Boys and Girls Clubs of America. The great thing about the Child Sight Program is that it is not a one-stop visit. The idea is to provide a vision health care program within the communities. When they come to the communities, they will be sustainable. With the support of Congress and the White House, additional partnerships such as the ones just mentioned, will help us to serve America's youth and to develop our communities and prepare them as we look into the future and the needs with regard to homeland security. The next program I would like to discuss briefly is the National Native American Law Enforcement Association's training program. For the last ten years, the National Native American Law Enforcement Association, NALEA, has been bringing Federal law enforcement training to Indian country law enforcement officers throughout the United States. We have done this on a partnership basis by bringing together Federal law enforcement agencies that actually provide the training, as well as state, local, and community programs that also support training and also help us bring the people to the conference. We would like to thank you, Senator Campbell, for being a keynote speaker at last year's conference on the Indian country homeland security summit. This year, NALEA is looking to develop an unique program for Indian country law enforcement. The program is going to be a program that will be a center for academic excellence in Indian country law enforcement training. This is something that we feel is greatly needed. We are partnering, and attempting to partner, with many colleges and universities across the country as well as all Federal, State, and local law enforcement agencies and many tribal agencies. Some of the colleges that we are working to partner with is the Central University of Oklahoma, Western Oregon University, Fort Lewis College of Colorado, and also the Federal Law Enforcement Training Center, which is now part of the newly formed Department of Homeland Security. The concept that we are going to utilize in this law enforcement training is an uniquely Native American concept that I don't think has been tried in Indian country before. We are entitling the new program, ``Wearers of the Shirt.'' The idea of this particular program is that we will go back to the different tribal leaders and elders from across the country. We will get their perspectives of how tribal order was achieved prior to the European intervention on this continent. From those ideas and methods and theories, we will work with educators across the country to develop a program that is uniquely for Indian country law enforcement officers, and that will be applied to the modern technologies of today. Some of the problems that our Indian country law enforcement officers are having is a very high dropout rate before graduation at our national police academies. We want to also take a strong look at that and see what we can do to remedy that particular problem. As we look at going into the future, in Indian country we need to work very hard to bring our Indian country law enforcement and first responders to parity with communities of reservations and trust lands. Another very exciting opportunity that we are looking at in this particular unique law enforcement training is E-Learning. As I mentioned before, one of our partners is the Federal Law Enforcement Training Center, FLETC. They are currently developing a distributive learning program. That program has in it over 2,100 particular courses that deal with all types of administration, law enforcement, first responder techniques, and current state-of-the art training that is of importance to events that are happening today. FLETC has agreed to work with NALEA to create programs that are uniquely designed for Indian country law enforcement officers. Also, as a result of this distributive learning program, we look to go satellite and utilize dishes to connect remote areas of Indian country. This not only will help the ability of our law enforcement officers to take a wide variety of training which could lead to certifications and college degrees, but it could also connect them on-line in-time with programs and classes that are currently going on in different parts of the country. To give one example, we have major problems with regard to communications and officers--as I am sure you are aware, having been a former police officer in Indian country--with maybe one officer in a remote area that doesn't even have cell phone connection to his office. Through this remote satellite connection, he could actually be on-line with the computer. For example, he could be on one side of a large dam, like on the Covell Reservation, and be talking at the same time with an officer on the other side of the reservation via his lap top computer. We hope to coordinate these particular dynamics that we bring to Indian country--again through the Boys and Girls Clubs of America--by providing additional computers and training labs. This will also provide training for our children. As we look to the community, we can bring tribal leaders and elders to the community to also take courses of interest in that particular program. Next, I would like to briefly discuss homeland security in Indian country. Mr. Chairman and Senator Inouye, I believe our Nation, as well as tribal lands, have a three-part approach to homeland security. We must realize the reality of today, define our vision of homeland security for tomorrow, and act to make that vision a reality of the future. When we look at the realities of today, and in particular in Indian country, we must realize that we have certain vulnerabilities on tribal land that affect the security not only of our tribal lands, but of the Nation as a whole. Specifically, some of the primary vulnerabilities that we have on Indian lands is the border and port security of tribal lands, the critical infrastructure located on tribal lands, such as dams, water impoundments, reservoirs, electrical generation plants, and waste systems. There is also the existence of nonintegrated law enforcement and the minimum emergency response for the medical capacity planning and implementation, in case we did have a terrorist attack. Unfortunately, these vulnerabilities exist because tribal communities lack the resources to address these vulnerabilities. The lack of the resources is a direct result of inadequate funding. Inadequate funding has created the lack of law enforcement and first responder personnel, giving rise to insufficient training of existing human capital and greatly reducing technical assistance and resources. As such, inadequate funding is a major road block to the elimination of vulnerabilities in tribal lands. Further complicating the matter is the jurisdictional issues that our tribal officers and courts have to face in Indian Country. These vulnerabilities need to be addressed as indicated by AUSA Tom Heffelfinger who is with the Attorney General's Subcommittee on Indian Programs. He suggests that certain laws, rules, and regulations governing jurisdictions in Indian country must be changed. Next, as we look to define our vision of homeland security in Indian country for tomorrow, we must look to the President and the Department of Homeland Security for their basic guidance. The President has identified three strategic areas of terrorism and to minimize the damage and recovery from attacks that do occur. Accomplishing these missions at an affordable cost will take time and require all levels of government, tribal, state, local, and private industry to cooperate as they never have before. There are some concepts that should drive our vision of the future. Homeland security must be a locally-organized, grassroots-developed efforts that requires people providing the security to know three things. They need to know what they are protecting. They need to know who they are protecting it against. And they need to be thoroughly familiar with their local territory. Equipment and services that will improve the daily health and safety issues in tribal lands should be funded as a priority over the single use items and services. Duplicative services should not be funded, but complementary services should be. Every proposal for funding should include the criteria that will be used to determine whether or not the program is effective or not effective. Programs that have failed and have not been completed should no longer be funded. Funding programs should be directly to the priority programs. We should encourage adjacent jurisdictions to partners to define our partners in tribal, law enforcement, and tribal governments, to gain Memorandums of Understandings and Mutual Agreements to support each other with our assets. We should encourage homeland security planners to think outside the box, to prepare America for the next terrorist attack, not for the last one. We should teach chemical, biological, radiological operations, and decontamination procedures at the local level. We need to be prepared to respond to denial of service attacks as well as chemical, biological, and radiological attacks of weapons of mass destructions. We must act to make our vision a reality of the future. The 50 million acres of tribal lands are replete with military, energy, water, and other facilities that significantly affect the American economy and American living outside the reservations. Potential targets that lie with Indian lands include the dams, oil fields, oil and gas pipeline, coal slurry lines, communications towers, casinos, other tourist attractions, power generating stations and transmitters, radios, ports, and international borders. These critical infrastructures on tribal land, if compromised by terrorists, will produce a devastating impact that will reach far beyond the reservations and Trust lands, tearing into the very heart of America. We must act to prevent this from happening. Some conclusions that we have drawn from the NALEA tribal lands homeland security summit and other research, have produced the following recommendations for the Department of Homeland Security. First, establish a coordination unit within the Department to provide a single point of contact for the Indian nations. We envision this unit being the conduit for providing the Indian share of homeland security funding directly to the Nations involved, thereby recognizing Indian rights of sovereignty and self determination. Next, deliver a comprehensive list of targets within the Indian nations as well as the rest of the country. Also, apportion homeland security funds based on the cost of reducing specific priority vulnerabilities, not on population or other non-related criteria. Next, develop a homeland security emergency communication system and frequency that all levels of government--Federal, tribal, State, and local--have access to, and with which to provide two-way communication of terrorist alerts, notifications, and national and man-made disasters and relevant operational intelligence. Next, encourage State and local jurisdictions to enter into mutual support agreements with Indian nations, to share complementary resources in times of crisis. And finally, encourage state and local governments to establish cross- deputization agreements that provide certified Indian police officers equivalent status as all other police departments. We have three suggestions for the Department of Justice. Develop legislative language that clarifies the right of Indian nations to arrest, detain, and prosecute non-Indian Americans committing crimes on reservations and trust areas. Next, support uniform national standards for law enforcement officer training and certification, and actively encourage states to enter into cross-deputization agreements to facilitate the mutual sharing and support of peace officers, particularly in times of crisis. Mr. Chairman, you have said it best. Native people are Americans and want to stand shoulder-to-shoulder with the rest of their countrymen in defending American lives and homelands from threats now before us. NALEA will take its place providing training and technical assistance in inventive ways for Native American law enforcement to lead by service to our communities and to the United States of America. I would thank you very much for letting me speak here today. I would be happy to answer any questions that you might have for me. I would ask that my written testimony be entered into the record. The Chairman. Your complete testimony will be included in the record. [Prepared statement of Gary Edwards appears in appendix.] The Chairman. Where did I say those profound comments? Was that out in Reno? Mr. Edwards. No, sir; they were in a speech that you gave to Indian Country Today. But you did say some great remarks out of Reno, as well. The Chairman. Frankly, most of the profound comments in this committee come from my colleague, Senator Inouye. Let me ask you a few questions before we go back to our Business Meeting. Since you spoke last, Mr. Edwards, let me tell you that I am a big supporter, as most of us are I think in this committee, of some of the programs you mentioned, like the G.R.E.A.T. Program, and the Boys and Girls Clubs. I think we recognize very well that you have a choice in this business. You put some resources ahead of the curve by helping young people. A fundamental question is: Are we going to build more cells and more prisons and all that later on which is much more expensive to say nothing of the trauma that families and communities are driven through because we don't have the foresight to recognize that we need to help the youngsters more often? You mentioned several programs that you are working with now in different parts of the country. One you mentioned was with Fort Lewis College. I didn't know they had anything at Fort Lewis College in Colorado that had anything to do with law enforcement. What are you doing there? Mr. Edwards. Well, they have Southwestern Studies Programs, as I am sure you are aware. The Chairman. Yes. Mr. Edwards. We have made an initial contact with them to help us to study and analyze problems in Indian country law enforcement. Just to give you a brief example. When we look at this tremendously high dropout rate, in particular with one of the national training facilities for Indian country law enforcement, it is approaching 50 percent. Well, whenever we in Federal law enforcement have problems that we think is well out of line with what it should be and what the rest of the country is, then we do a study. From that, then we make adjustments. What I don't think has ever really been done is that we have gone back and we have looked at our particular tribal communities and we have looked at seen exactly what our needs are for the recruits' applications, courses, and to deal with community specialized issues, problems, and traditions. We thought that we could use two of the schools that have one of the highest populations of Native Americans in them, such as Fort Lewis and also at East Central University--they both have close to 1,000 Native American students enrolled in each one independently. We feel that if we can give them the information that we gather, that they can better help us, based upon their experience, to develop a meaningful program for Indian country, and where we can cut this dropout rate and improve our basic policing. It is imperative that we bring our policing levels up to a parity with the rest of the United States communities before we can really start truly addressing critical infrastructure on Indian land for homeland security. The Chairman. Fort Lewis college is the only public college in the country that I know of that gives free tuition to Indian students, too, as you probably know. So I commend you on that and hope there is some progress made in that area. You mention a number of things on Indian reservations including strategic assets, natural resources, borders, and so on. We know we have to do a lot more to make sure that the Homeland Defense Agency is working well with the Indian reservation communities. It is a huge job. We have to start somewhere. Where would you start as a strategic plan to start improving the security of the Nation that is bounded by reservation lands? Mr. Edwards. Well, sir, I think that we have already made the first step. When you brought people together to discuss the problems that we are going to be facing in homeland security back about a year ago, we followed that up with the Tribal Lands Homeland Security Summit in Reno, Nevada where we developed an eight-step training program that the people of the conference could train the trainers. We are not looking for a wish list from them. Each community is individual and different. So we developed a program that we could take back to each individual community that we could define what terrorism is to the local people. We can then look to see what assets that we have in our particular communities that might be of interest to a terrorist attack. Once we have defined these potential vulnerabilities in our areas, then we have to look at how we can protect them. Once we look at how we protect them, then we go back and we start looking at partners that we can call upon to help us protect them. The Chairman. When you had your conference in Reno, though, we didn't have a Homeland Security Department set up yet. It was still bits and pieces. Mr. Edwards. Yes, sir. The Chairman. At your Reno convention, was there interaction between the Federal Government dealing with the interaction between homeland security agencies and tribal governments? Mr. Edwards. Yes, sir; within the program that I was describing, we had different sections on each days where we actually had discussions between Federal law enforcement programs. We had a representative there from the Office of Homeland Security at that time that was part of that. We also had people from Secret Service, FBI, FEMA, ATF, and the Border Patrol. All of these people talked and interacted with tribal leaders as they tried to develop stages and plans for preparing their communities for homeland security. At the end of that particular meeting, we decided that we would do a publication, which we are nearing completion now, that will be widely distributed. I think that will give a lot of enlightenment as to the current situation in homeland security on tribal lands. As I mentioned, I think the next and most important step that we must do is within the Department of Homeland Security, to develop a special office just for Native American programs and nations. I feel that this should be, at a minimum, at the Assistant Secretary's level so that they can interface and deal with the particular divisions and offices and agencies within the Department of Homeland Security. I think it is critical to start there. Then from there it is a step-by-step program of actually going out, assessing each community, seeing what infrastructures we have there, and to bring up the important fact that our first responders and law enforcement officers traditionally lag behind the rest of the American communities in their ability to deal with just the police work challenges on a day-to-day basis. These priorities have to be brought up to parity with the rest of the American communities before that we can really effectively protect much of this infrastructure. We have some tribes that have some resources, and they are doing the best that they can with them. We have other tribes that are not addressing this at all. We have to bring this awareness to the people. We have to have the people to help us identify problems we have. We have to be able to relate that to homeland security. Homeland Security, through the guidance of the White House and Congress, needs to direct funds to these specific areas of high vulnerability so that we can secure our homeland, and that Indian country can fit seamlessly into the fabric of the National Homeland Security strategy. The Chairman. Thank you. Homeland security, obviously, is going to have to deal with hospitals and health, too, in the case of internal attacks. Let me go to Mr. Sossamon. Let me start by saying that you mentioned in your testimony the average infant mortality rate for American Indians and Native Alaskans is 25 percent higher than the national average of American infants. A study in the Aberdeen area indicated that education and outreach programs focused on both of those. Sudden infant death syndrome and fetal alcohol syndrome can significantly decrease infant mortality. I don't know very much about sudden infant death syndrome, but I know quite a bit about fetal alcohol syndrome. Reducing infant mortality is only part of the real problem with FAS. Some of the youngsters that are born, even if they are born and have relatively good health, because of the high degree of alcohol in their mothers' system, those youngsters are born incapable of functioning to the level they would had that alcohol not been in their system. Some of them, in fact, are to the point where they literally have to be institutionalized for life. They almost cannot function by themselves. Would you like to address that a little bit? I don't quite understand. You reduce the infant mortality--which I am very supportive of, by the way--but it doesn't get to the long-range problem of what happens to those youngsters then throughout their life. Mr. Sossamon. Mr. Chairman, if I may, I believe that testimony was submitted by Mr. Hall. The Chairman. Oh, was it? Excuse me. I got all my notes mixed up here. Did you do that? Mr. Hall. Yes; I talked about the need for health care, Mr. Chairman. I think that you hit the nail on the head. The real issue is the alcohol abuse itself. So clearly there has to be funding to prevent alcohol abuse. Then for treatment there is intervention, and then finally for those people who are affected by SIDS or FAS, there needs to be funding, in some cases, unfortunately for long-term care. Sometimes permanent institutionalization is needed for these individuals. But clearly an intervention would have the resources to make a broadbased effect to really protect against alcohol abuse, especially during the pregnancy years. That education effort really has to be a broadbased educational effort. I think the tribal colleges and alcohol and drug programs in a coordinated effort can really address that issue. But we really have to have a targeted focused approach. The Chairman. Targeted toward mothers? Mr. Hall. Exactly. The Chairman. Since you have the microphone there, you did talk about the budget requests for contract support costs. That level of funding--$135.3 million--is the White House's proposal. Each year the tribes are assuming more responsibility for more programs under the Self Governance Act. Do you, as NCAI, have an estimate of how many more BIA programs that tribes will take over this year? Mr. Hall. I think we have an estimate that's pretty close. Actually, I think we're funded at about 70 percent. So there is probably close to 30 percent more additional that will be coming into the system. The Chairman. I see. Let me now ask Senator Inouye if he has some questions. Senator Inouye. I just want to make a few general statements. On homeland security, if the provisions of the present law are permitted to stand, then the application of U.S. Supreme Court's ruling in Nevada v. Hicks may be further expanded because the present act says, ``Tribal governments are local governments.'' Therefore, we are working on a measure which we hope to introduce sometime this week or early next week, that will recognize the inherent authority of tribal governments to exercise jurisdiction--criminal, civil, and regulatory--over any person who violates homeland security laws. In other words, to reorganize your sovereign authority to do this. Otherwise, you may have to do whatever the county or the State tells you to do. The funding that you will under the current act receive would be whatever is left over. It would be up to the State or the local government to decide whether you get a nickel or five dollars. Therefore, I hope that the bill we are working on will be well received by the Members of the Congress and passed. We will have to, someday soon, enact a measure that will overturn Nevada v. Hicks because that is a basic matter before us because it concerns sovereignty. As long as Nevada v. Hicks is the law of the land, you, and this Committee, will have a lot of problems. I just want to ask President Hall a question. It has been suggested by authorities in the Department of the Interior that funds that are set aside for Indian programs be used to pay for trust reform out of other Indian programs. Do you favor that? Mr. Hall. Absolutely not, Senator. We feel that those are trust core functions, like home improvement. Russell Sossamon will further attest to that. It is completely underfunded. Road maintenance is one-fourth of the funding. TPA is underfunded. Contract support costs are underfunded. The list goes on. Those core functions are underfunded. If we were to transfer those precious few dollars to trust reform for that initiative, would really be an under-service and further deplete and jeopardize those departments from carrying out that Trust responsibility. We strongly oppose that initiative. Senator Inouye. President Hall, as you know, the chairman and I have many things in common. One thing that we believe in is that Indian country paid their dues a long time ago. They gave their sons and daughters and shed their blood for our Nation. They gave their lands. They gave their resources. It is about time the U.S. Government met its obligations. Anything that will underfund these basic things, I can assure you, we are not in favor of. We will not stand for any attempt to pay for trust reform. I don't suppose you had anything to do with making trust management the way it is. Mr. Hall. Absolutely not, Senator. I just want to add that one of the reasons I wore the war bonnet today was that because of what you just stated. The eagle feather represents the highest honors politically and militarily for our people in the Northern Plains. It saddens me to see that water appropriation dollars are zeroed it. It saddens me to see that trust core functions may be depleted for the Bureau of Indian Affairs to carry out its trust responsibility. It saddens me to see that our colleges, like the United Tribes College in Southwestern polytechnicals are zeroed out. It saddens me to see that these are 3 years of IHS medical bills for individuals. One of our tribal members, a young mother in her thirties, is afflicted with diabetes and she needs a transplant. But she is on this list. She won't be able to get a transplant because IHS doesn't have the resources in contract health to pay for her unpaid medical bills back 3 years. The health care vendor has gone after her personally. She will be subject to State court because she now resides off the reservation to be close to a regional health care facility. There are many people in her shoes. We just have to have the dollars. For some of our people, it really is a matter of life and death. We really appeal to the committee to increase these dollars in all of the budgets for BIA, for IHS, for education college, and for all of those programs that so most deservedly need those dollars. Our people were promised those things for the last 150 years now. I thank you for that comment, Senator Inouye. Senator Inouye. When I saw your eagle feathers I assumed that you were not here to beg for anything. Mr. Hall. No; I wasn't. That Trust responsibility disturbs me and the PART methodology, which is the Program Assessment Rating Tool, that OMB is using. In a meeting yesterday with OMB officials, I felt that that was being insinuated that I was here to beg for those dollars. I showed a picture of our tribal council in the 1953 Garrison Dam legislation where the chairman was crying. It is one of the pictures that our sociologists use for socioeconomic trauma on forced removal of our people as many of our reservations were forced to moved, giving up 156,000 acres of land and basically our economic engine. This did lead to the Equitable Compensation Act which Senator Conrad sponsored. One of the things it said was ``Free quality drinking water because we are going to dam up your river and it's going to create Lake Sacajawea.'' When that legislation was signed in 1953 that responsibility was promised to those who today are in their seventies and eighties. Today they are the ones still having to haul water. They told me to demand that the Federal Government, the Bureau of Reclamation, the U.S. Congress, and the Administration live up to that Trust responsibility of replacing these kinds of dollars. They told me, ``That is our right since we did live up to our end of the bargain.'' I was disappointed in some of the discussions. Maybe there were some young CPAs that didn't really understand the history of what our people had to give up. So thank you for that question. Senator Inouye. I just want to note something here. Senator Conrad is the ranking member on the Budget Committee. The chairman and I are members of the Appropriations Committee. I will become a new member of the Homeland Security Subcommittee. Mr. Hall. Very good. Mr. Sossamon. He and I will be members of the new Subcommittee on Homeland Security. Mr. Hall. That's excellent. Senator Inouye. We are going to do our level best to make certain you get your money. [Applause.] The Chairman. I can only second that and add my voice to Senator Inouye's. We both are on some committees that I think are crucial to Indian country. We work together very well, Tex. Mr. Hall. Absolutely. Senator Conrad. We will do our very best. One thing I want to ask you. The land you said you lost. That is really the land that is now under water in the Garrison Dam; is that correct? Mr. Hall. 156,000 acres under water. The Chairman. One other thing. It would be an interesting debate at some other forum. But what kind of transplant is the lady waiting for that you mentioned? Mr. Hall. Kidney. The Chairman. Sometime, perhaps not today, I would like to talk with you, not necessarily in this format, about the belief of Indian people as opposed to modern medicine. I bet there are some interesting debates going on about whether transplants of organs are within the keeping of what the traditional beliefs are of Indian people. It is not for this hearing. It has interested me as scientific knowledge moves ahead more and more in medical science, how we interact that with the traditional beliefs about healing. We will deal with that some other time. Mr. Hall. There is, Senator. I would be happy to discuss that. The Chairman. Senator Conrad, do you have an opening statement, comments, or questions? You have always been such a great champion for Indian people. I certainly want to give you an opportunity. STATEMENT OF HON. KENT CONRAD, U.S. SENATOR FROM NORTH DAKOTA Senator Conrad. I thank the chairman. I thank the vice chairman as well. First of all, I want to send a message to OMB that the comments yesterday that were made that have been passed on to me are totally inappropriate. Frankly, I am angered by it. To suggest that the settlement of the outstanding claims around the Garrison project are a Federal handout is insulting. And it's wrong. The Federal Government took land to build a reservoir to protect downstream areas and downstream States from flooding. We understood the necessity for doing that, and we supported it. Now the question is: Does the Federal Government keep its word with respect to the promises that were made. That is what the settlement was about. Promises were made that were never kept. This isn't just my opinion. This is the conclusion of a commission from the Reagan administration, appointed by President Reagan, that came back and reported that the promises were not kept. The Federal Government owed hundreds of millions of dollars to the Indian people at two reservations in North Dakota, Three Affiliated Tribes that Chairman Hall leads, and the Standing Rock Sioux Reservation. We achieved a settlement based on money that is owed, due and owing, to these people. For the people to OMB to suggest that this is some kind of welfare, that we are here begging for something, they have it all wrong. This is money we owe based on a conclusion of a commission, the Joint Tribal Advisory Commission, from the Reagan era. It was headed by very distinguished Americans on a bipartisan basis who came back with the conclusion that this money was clearly owed. I apologize for taking this time of the committee, but the OMB needs to straighten out their attitude. They ought not be insulting people who come here. That's not appropriate. I want to especially extend my greetings to Tex Hall, who is president of the National Congress of American Indians and as I indicated, chairman of Three Affiliated Tribes, we are proud of the job that you are doing. I think you have just done splendid work. We appreciate it. I also want to recognize Ron McNeil, the president of Sitting Bull College, and chairman of the President's Board of Advisers on Tribal Colleges. He has been a leading advocate. Ron is here for increased funding for tribal colleges. Let me just say briefly, if I could, Mr. Chairman, there are a number of parts of this budget that give me deep concern. First, the United Tribes Technical College. It has been funded in every budget of every President since 1981. This President pulls the plug. No warning. No rationale. No justification. That cannot be the conclusion as we move through the work of this committee and the institutions of Congress. United Tribes is a unique institution. It is the only intra-tribally controlled vocational institution in the United States. It provides valuable educational opportunities to students from 40 tribes across the Nation. The president has told me that they are going to have to shut down if this funding is pulled as the President has proposed. That just cannot be the result. It is not fair. It makes no sense. Tribal colleges have a 10-percent cut. I have seen first hand the profound difference the tribal colleges are making in my State. I will never forget the look on the faces on graduates as I have attended the graduation of these schools. There is the sense of accomplishment, and the opening of the doors of opportunity for people who have had them shut in their face for generations. This is going exactly in the wrong direction. Let me just say that we are providing $9,000 per full-time student for other public institutions, and $3,900 for tribal colleges. That disparity cannot be justified. The President's proposal to cut the funding is without merit. On Indian water projects I was frankly shocked by the elimination for projects in North Dakota. This is what people are expected to drink. This is water from western North Dakota. The Chairman. Has that been analyzed, Senator? What's in that? Senator Conrad. About 20 million carcinogens are in here. These are coal seams and the water is on top of the coal seams and they soak up things that are in those coal seams, known carcinogens. They cut the funding to get decent quality water to these people? That is inexplicable. That is outrageous. I must say I don't know what these people are thinking of. On housing, we have families who get their running water from a garden hose run through a hole in the wall. We have homes in North Dakota insulated with duct tape, cardboard, and hay bales. This is reality. To see these conditions it is difficult to believe you are in the United States and not in a Third World country. I have just come from Cuba where the average income is $13 a month. You talk about a failed economic system. That's it. But we've got a failed system here, too. You go to the Indian reservations of my State. It's desperate. The National American Housing and Self Determination Act has been a good step forward but this budget provides only level funding when the need is over $1 billion. Now, this is our responsibility. We can't duck this and say, ``No, it's the State's responsibility.'' No, no. This is the Federal Government's responsibility. We can't duck it and we can't suggest it's not there. There is not a person with eyes in their head that could come to my State and say that this isn't a travesty. Finally, on health care, on contract care a patient must now fall within the Priority 1 category which means the patient has to have a life-threatening illness or injury to receive care from a contract carrier. That's wrong. It's immoral. If people want to start talking in moral terms, let's start talking in moral terms. This is immoral. It's wrong. We have to change it. Mr. Chairman, I have much more but I wanted to at least make those remarks. I thank you very much for your patience. The Chairman. Thank you for that very strong statement. We will be looking forward to working with you, particularly on those issues such as the United Tribes College. I agree that if there is going to be a future for Indian people, a good portion of it has to come through education. I can't see how we can get them to that venue if we are going to cut off the bridge that they have to travel across. Thank you very much. I would like to thank this panel for being here today. We will take a short recess. [Recess taken.] The Chairman. The committee will be in order. We will now proceed with our second panel. Julia Davis-Wheeler, Kay Culbertson, John Cheek, and Ron McNeil, would you please come forward? All of your written testimony will be included in the record. I will tell you that we are running a little close on time. So if you can be direct with your spoken statements, the chair would appreciate it. Why don't we start as I listed them. Ms. Davis-Wheeler. STATEMENT OF JULIA DAVIS-WHEELER, CHAIR, NATIONAL INDIAN HEALTH BOARD, DENVER, CO Ms. Davis-Wheeler. Thank you, Senator Campbell and Vice Chairman Inouye. Thank you for this opportunity to comment on the President's fiscal year 2004 Indian Health Service budget request. I am here today on behalf of the National Indian Health Board. The Board of Directors send their regards and their congratulations for doing this hearing. As you know, I am on the tribal council for the Nez Perce Tribe. I serve as Secretary, but I also serve as chair of the Northwest Portland Area Indian Health Board. My compliments and support go to Tex Hall, Mr. Sossamon, and Gary Edmonds on their testimony previous to ours. You have our written testimony, but I want to be very specific about our budget concerns. You may be aware that the Administration and the Department needs to tweak the actual fiscal year 2004 request a bit to reflect the enacted fiscal year 2003 budget that was not available when the President submitted this fiscal year 2004 budget which he did last Thursday. So we don't really have exact numbers to work with at this time. It is my hope that the Administrative can revise the 2004 budget now that they have the President's 2004 budget. The Northwest Portland Area Indian Health Board always does an analysis on the President's budget, and we are going to do that the second week in March. We will analyze his budget and send you a copy of the analysis. First of all, I would like to talk about the goal of the Administration to reduce health disparities. The best way to do this is to adequately fund the Indian Health Service. A minimum of $325 million increase is needed to maintain the current program funded by the IHS budget. The Administration is requesting an increase that will create a $250 million shortfall in funding. The fiscal year 2003 budget signed by the President contains a 3.3-percent increase, or $90 million. This was about $220 million less than needed to maintain our health programs. So you can see in just two short years we are facing nearly one-half million dollars in funding shortfall for Indian Health Service funded programs. It is also a strong principle of this Administration to hold governments to their treaty obligations. Most tribes will have to fill in the funding shortfall with their own funds to maintain the Federal obligation for health care services to Indian people. Unfortunately, some tribes cannot do this, and services will cut. Every tribe will now have to spend money on health that they had hoped to spend on other priorities, such as economic development, education, or training for our people. States are cutting back on their Medicaid programs, and the first cuts will affect our dental programs and our pharmacy programs which are high-cost services that are going to be cut by the State programs. This has already happened in Idaho. It will also be the case in Oregon on March 1. These State Medicaid cuts are very significant and they call into question the wisdom of depending on States to honor the Federal obligation to Indian tribes. It isn't working in my State. I would like to give you an example on how the President's request falls shorts of reasonableness even in this time of war and poor economic performance. The contract health service line item is $475 million this year. Medical inflation is about 12 percent. This means we need $50 million added to the budget to buy specialty and hospital services. The President is requesting a $25 million increase just one-half of what we need to stay even. The $1.2 billion hospitals and clinics line item does not even sufficiently fund the pay-out cost increases and the increases needed for paying staff and new facilities. There is no money for the Indian Health Care Improvement Fund unless that money is taken from other parts of the program that need inflationary increases. There is no increase for contract support costs at all. This means mature contractors will get no increase to keep in pace with inflation, and anyone wishing to expand or enter into new contracts, like the Navajo Nation, will have to forget their plans and get in line and hope for funding in the future. Self governance is a successful example of contracting that we think deserves continued support. Facilities funding remains inadequate, but we welcome the $20 million increase for sanitation facilities, which has been a long time coming. Last year the urban programs only received a 1.2 percent increase, far less than the 10 percent required to keep pace with medical inflation. My 5 minutes are over, but I very much would like to answer any questions you have. I look forward to coming back to testify on the Indian Health Care Improvement Act. At this time, I would like to thank your staff, namely Patricia Zell, for working with our technical people on getting that Indian Health Care Improvement Act. I want you to know that we are pursuing to get that bill completed by the end of March and introduced into the 108th. Thank you. The Chairman. Your written statement will be placed in the record. [Prepared statement of Julia Davis-Wheeler appears in appendix.] The Chairman. Ms. Culbertson, you may proceed. STATEMENT OF KAY CULBERTSON, PRESIDENT, DENVER INDIAN HEALTH AND FAMILY SERVICES, DENVER, CO Ms. Culbertson. Good morning, Honorable Chairman Campbell, Vice Chairman Inouye, and committee members. My name is Kay Culbertson. I am the president of the National Council of Urban Indian Health, and more importantly I am a member of the Fort Peck Assiniboine and Sioux Tribes from Poplar, MT. Right now I am also serving as the executive director of Denver Indian Health and Family Services. On behalf of NCUIH, I would like to express our appreciation for the opportunity to address the committee on the fiscal year 2004 President's budget request and its impact on the off-reservation Indian population. Before I begin, Chairman Campbell, I want to make special mention of your article in Indian Country Today entitled, ``Charting a New Course for Indian Health Care.'' This article addressed the full spectrum of Indian health both on and off reservations. NCUIH is thankful to you for your acknowledgment and support of urban Indian health needs. NCUIH is a membership organization representing urban Indian health programs. Our programs provide a range of health care services and referrals in 41 cities throughout the Nation. Our programs are often the main source of health care and health information for urban Indian people. The urban Indian health programs have achieved extraordinary results despite the great challenges that we face, mainly the lack of funding. As you know, the 2000 Census reports that 66 percent of the American Indians live in urban areas. We realize that not all of that 66 percent lives in the 41 cities that we serve, but there are 66 percent of the Indian people who are going without services throughout this country. As opportunities for employment, education, and housing become more strained on reservations, we anticipate that these percentages will continue to increase over the next ten years. It should be added that the American Indian population is widely considered the most under-counted group in the Census overall. Although the total number of Indians may actually be low, our experience is that the percentage of Indians living on reservations compared to those who reside off reservations is accurate. The fiscal year 2004 President's budget request for the Indian Health Services is $3.6 billion, a net increase of $130 million. However, if the budget request keeps spending, the urban Indian health programs are flat. Of course, NCUIH supports any increase to the IHS budget, but that same increase should be reflected in the budget line item specifically for urban Indian health programs. Much like the on-reservation programs, urban Indian health programs have experienced a continual increase in the need for our services. In fact, the increase of the Indian population residing in urban areas is likely greater than the increase than it is on the reservations. The Indian Health Service budget funds, and the urban Indian health programs, are only a small percentage of the total number of Indians eligible for those services in most cities. In fiscal year 2003, urban Indian health programs received 1.12 percent of the total Indian Health Service budget. Although urban Indians constitute well over one-half of the total Indian population, in 1979 at a time when urban Indians made a much smaller percentage of the overall Indian population, the urban Indian programs received 1.48 percent of the Indian Health Services budget. These figures indicate a dramatic decline of the level of funding for urban Indian health programs and off-reservation tribal members. As a result of this less funding, urban Indian health programs can only service 95,767 people of the 605,000 urban Indians that are currently eligible to receive services in our area. In providing these services we have encountered barriers that the tribes do not face. Unlike tribal facilities, urban Indian health programs are not extended by the Federal Tort Claims Act for medical malpractice insurance. We are facing a malpractice crisis, much the same as the surgeons that are in Florida where they have walked out because malpractice insurance is so high. We face those same costs in the urban Indian health care programs because of our lack of the Federal Tort Claims Act leverage. We have been quoted rates for malpractice insurance that range from $5,500 to over $10,000 for one general practitioner. This is one person. The malpractice insurance costs, especially for obstetrics and psychiatry, are cost prohibitive to most of the urban Indian health programs. One of the clinics in our membership has malpractice costs in excess of $50,000. That is more than we pay probably a nurse-practitioner in my clinic at this time. Recruitment and retention continue to be difficult for urban Indian health programs. Although our professional staff are eligible for the loan repayment and the scholarship payback, we continue to compete with tribes and the private sector in the cities where we live. As nonprofit 501(c)(3) organizations, our salaries and benefits differ greatly from the Indian Health Service and the tribes and the private sector. I can give you an example. I had a job open for probably six months because I couldn't bring on a diabetes educator. The diabetes educators in the general market in the Denver area get around $65,000-$70,000. Indian Health Services will pay between $50,000-$65,000. I could only offer $45,000. So it was very difficult finding a qualified person that could come in and do the work that we needed with our diabetics. So I can honestly say to you that the staff who are working in these urban Indian health care programs have a true sense of commitment to bettering the health of Indian people across the country regardless of where they live. We also need money in order to enhance program data collection and funding from third-party collections. It is imperative that urban Indian programs utilize an accurate data system much like the Resource Patient Management System for Indian Health Service, RPMS, as it is formally know. Although RPMS software is provided at a minimal cost, the cost associated with the use of it can exceed over $500 a month. Now this may seem like a small amount, but that can be the difference between buying medications for a diabetic, or buying medications for someone with hypertension. So it is a strain on us. Then you incur additional costs through trainings and updates and additional hardware. Many of the urban programs have also gone to other commercial software packages to other commercial software packages to do their data collection. Those are expensive; we have heard between $25,000-$75,000 for those sources. We need to have something that meets the needs of the urban Indian health programs and can collect all of the data from all of the other funding sources that we have. Some programs have as many as 25 different funding revenues to their programs. One of the greatest needs that we have are dental services for Indian health programs. I know that we have talked about this before. Currently we see people in Denver who are in need of extensive dental work. We brought a small package plan so that we could promote dental prevention and hygiene. We have not had one person that has just only need of cleanings. We have had people that come in that need root canals. Children as young as 5 years old need root canals. They are young--30 years old--and they have dentures. Dental care for urban Indians is just nonexistent. Many of the private doctors do not take Medicaid so our patients are pretty much stuck out there without dental work. We must also address the medical inflation rate. Considering these factors, we are actually getting a decrease in the amount of funding. Urban programs already experience severe limitations as a result of inadequate funding. I want to give you an example of a patient of mine that came in to our clinic. He is 40 years old. He is a member of the Sisseton-Wahpeton Tribe with diabetes and hypertension. He presented to our clinic for routine management of his diabetes and hypertension. We saw him. We were able to provide him with medications and exams. While we were trying to control his diabetes with medications and diet, his hypertension went out of control and his lab work suggested the beginning stages of renal failure. Attempts were made to improve the patient's renal function through diet and medication modification. Despite these attempts, the patient's renal function continued to decline and he was in need of a renal consult. This was a difficult situation. The patient was fully employed but he did not have health insurance and yet he could not pay for a specialist to look at his kidneys. Assessing the State-funded programs became very difficult. The patient needed to work, and continued to work to support his family, but his income was too high to qualify for any assistance. He moved to Denver because of the influences that surrounded him at home were having a negative effect on his health and well being. He came to Denver looking for work and for opportunity. He felt that returning to the reservation to access care at the IHS facility was not an option for him. Thus begins the search for services. We were able to contact a nephrology clinic at the University of Colorado Health Sciences Center. This facility will see uninsured patients with the understanding that they will be required to pay a $300 deposit, which he did not have and which we did end up paying, and then be billed later for services. We tried to work with the contract health care back at his home reservation without success. We were unable to get calls returned. We were unable to provide services for him. Ultimately the patient couldn't afford it. He moved back to the reservation and now he has qualified for contract health care which we have heard is already in severe shortages. Then he has to look for a job. If not, he will go to the tribe and look to them for further assistance. There have been multiple instances of this where we have had to send people to the emergency room because of cardiology referrals. We just can't access them in a timely manner. Many of our patients who benefit from stress tests are unable to pay for and access such services. That is critical when you are looking at diabetes prevention and hypertension as far as the complications that go along with it, and being able to set up an exercise program or a diet program for them. To access the urban Indian health planning disparity in an amount that urban Indian programs could effectively put to use, NCUIH recommends a $6-million increase to President Bush's fiscal year 2004 budget for urban Indian health programs. This would lift our funding from $29,947,000 to $3,947,000. While we realize this will not address the total need, we believe that it will be a beginning for us to start closing the gap of health disparities for people living off-reservation. The proposed increase would have a huge impact on the provision of health care. A $6 million increase for urban Indian health would find much needed resources to allow for the recruitment and retention of personnel essential to the provision of health care in urban settings, and would enhance the integration of clinical expertise for medical and behavioral health. Substance abuse is very big issue for us. Ms. Culbertson. Am I almost out of time? The Chairman. Unfortunately, we are going to need to move along, please. Ms. Culbertson. Okay. Needless to say, the Indian Health Service really has not provided us with the money that we need to provide services to urban Indian health programs. We would like to thank you for letting us testify today. We look forward to seeing you hopefully at our conference in March. I would ask that my written testimony be inserted in the record. [Prepared statement of Kay Culbertson appears in appendix.] The Chairman. Thank you. John, why don't you proceed. STATEMENT OF JOHN CHEEK, EXECUTIVE DIRECTOR, NATIONAL INDIAN EDUCATION ASSOCIATION, ALEXANDRIA, VA Mr. Cheek. Good morning, Chairman Campbell and Vice Chairman Inouye. My name is John Cheek. I am executive director with the National Indian Education Association. We are a membership organization of almost 4,000 members. I bring greetings from our President, Robin Butterfield, who could not be here today. Today's hearing focuses on the fiscal year 2004 funding for Indian programs. This is a period of tremendous challenge in all schools, but especially in Indian schools across the country. The requirements of the ``No Child Left Behind Act'' mandate much more from students and schools than they have ever had to produce before. Since Indian students as a group tend to score lower than other groups, the challenges they face are going to be much harder to achieve. The ``No Child Left Behind Act'' assumes all students leave the starting line at the same location and reach the finish at the same time. This is simply unrealistic when you factor in economic status, access to resources, family income, etc. The ``No Child Left Behind Act'' requires all students to reach proficiency levels, and sanction schools when students do not make substantial progress. Indian schools and administrators are under the gun to produce results or risk losing their students, their schools, and their jobs. How does a school change to create such substantial increases in achievement? We hear that students are being subjected to more homework. Will that increase achievement? Schools that do not have a new idea are going to try more the same. We do not think that is a successful approach. Resources are needed if the ``No Child Life Behind Act'' is to be fulfilled. Resources for curriculum development, resources for innovation, resources for new and better use of technology, and resources for staff development are also needed. The Department of Education budget has some increases but not nearly enough. The BIA school system gets a little more than pay cost adjustments, but yet has the same challenges and responsibilities as the State system. There was a promise of substantial new resources for schools in the act. For example, title I, the largest title in ``No Child Left Behind'' was authorized at a level of $18.5 billion in fiscal year 2004. But the request falls short by $6 billion. Across the board there is funding to maintain the status quo. Pay increases are generally provided for, but this is law is requiring much more than the status quo. This law mandates substantial increases in achievement. NIEA's concern, of course, is focused on funding for Indian education. Most program for American Indians are located in the Departments of Interior and Education. Within the Education Department funding is being requested at the same level as 2003. The request of $122 million provides educational services for over 460,000 K-12 Indian students and 1,200 public schools in 43 States. NIEA is requesting a nominal increase to $129 million to include additional funding for the American Indian Administrator's Corps, the National Advisory Council on Indian Education, and the travel departments of education and Indian fellowships. With the exception of travel education departments, all of these programs have a successful track record of meeting the educational needs of Indian country. One innovation provided for in the ``No Child Left Behind Act'' is the authorization for tribes to assume more control over their educational programs. Through the development of tribal educational departments, which would operate in a manner similar to State departments of education, the authority is there but the funding is not. We believe that a tribally-controlled educational system would be more likely to motivate students and achieve the success required if they are allowed to do so. Funding for travel education departments is a step toward true self determination. Another program is the American Indian Administrator's Corps authorization. It is the companion program alongside the American Indian Teacher Corps. Today, the Teacher Corps program is on its way to adding 1,000 new Indian teachers to the teaching force in Indian schools across the country. While teachers are greatly needed, they equal only part of the equation. Without inspired and effective school leaders at these schools, we will likely continue to see high turnover rates of Indian teachers that plague Indian schools today. NIEA strongly recommends that funding be restored to the Administrator's Corps, and to support the Indian teachers exiting the program in the next few years. In 2002, the program was funded at over $3 million, but in 2003 the program was recommended for only $360,000. No funding is requested in 2004. NIEA is recommending at least $1 million be refocused on this program. Education funding for the Department of the Interior's Bureau of Indian Affairs is more costly since it covers the full spectrum to assist over 50,000 students, numerous tribal college students, teachers, and ancillary personnel. The total direct education allocation for BIA for K-12, tribal colleges, higher education scholarships, and construction is over $930 million for fiscal year 2004. While this may seem like an enormous amount, you must consider that the funding covers the students, the class room, and everything else associated with it, such as transportation, construction, and personnel. I want to mention one very positive thing that is happening, however. The bipartisan initiative begun by this committee a few years ago to replace and repair the facilities of the Bureau of Indian Affairs continues with no reduction in funding levels. Both the Administration and the Congress are staying the course. The facilities, and the schools funded by the BIA are greatly improving. In closing I did want to make a couple of requests of the committee. This year there is a pretty heavy education agenda for the Congress. We have three major education reauthorizations occurring this year: The Individuals with Disabilities Education Act, the Higher Education Act, and the Head Start reauthorization. NIEA is requesting that an oversight hearing be held on each one of these authorizations, the sooner the better, so we can make sure Indian county's concerns are included in these reauthorization bills as they move forward. In closing, I would just thank the committee for inviting NIEA to present testimony on the fiscal year 2004 funding request. I would be happy to answer any questions the committee may have. Thank you. I would ask that my statement be included in the record. [Prepared statement of John Cheek appears in appendix.] The Chairman. I am told by staff that we are going to do oversight hearings on all the things you suggested. Mr. McNeil. STATEMENT OF RON McNEIL, CHAIRMAN, PRESIDENT'S BOARD OF ADVISORS ON TRIBAL COLLEGES AND UNIVERSITIES, SITTING BULL COLLEGE, FORT YATES, ND Mr. McNeil. Chairman Campbell, Vice Chairman Inouye, and distinguished members of this committee, on behalf of the Nation's 34 Tribal Colleges and Universities, which comprise the American Indian Higher Education Consortium, I thank you for extending to us the opportunity to testify today on the President's fiscal year 2004 budget. I am honored to be here. My name is Ron McNeil. I am Hunkpapa Lakota from the land known as the Standing Rock Reservation. For the record, I am here in my capacity only as the President of Sitting Bull College and as a representative of the American Indian Higher Education Consortium. For 9 of the past 11 years, I have served as president of my tribe's college, Sitting Bull College. Sitting Bull College is my alma mater. I attended school there in 1982 and 1983 and went on from there to achieve my juris doctorate degree and then returned home in 1988 to be employed with the College. I say that because if it wasn't for my beginnings at Sitting Bull College, I don't think I would be here to testify today. Sitting Bull College is one of the first and oldest tribal institutions of higher education. My tribal leaders founded the college in 1973 for a simple reason: The near complete failure of the higher education system in the United States to meet the needs or even include American Indians. For the past 30 years the idea of tribal institutions of higher education has spread throughout Indian country. Today despite decades of severe funding inequities and Federal budget cuts, 34 tribal colleges and universities in 12 States are educating upwards to 30,000 Indian students from 250 federally recognized tribes. I must emphasize that point because I know that at some point in time, Senator Dorgan of this committee was asked by another Senator why should he support tribal colleges when there was no tribal college in his State. The idea is that 250 recognized tribes are not all in the 12 States that we serve. Many of those students come from States that do not have tribal colleges. I am going to skip a lot of the history about tribal colleges and move on very quickly to say that most of our institutions are located on Federal Trust land. States, therefore, have no obligation to fund tribal colleges. Most States do not even provide funding for non-Indian State resident students who attend tribal colleges and account for approximately 20 percent of our enrollments. In other words, funding for tribal colleges and Indian students are helping support the education for non-Indian students at our colleges. Despite trust responsibilities and treaty obligations resulting from exchange of millions of acres of land, the Federal Government has, over the years, not considered funding American Indian higher education a priority. For the past 21 years since the initial funding of the Tribal College Act, our institutions have been chronically underfunded. Our fiscal year 2003 estimated funding level for title I of the Tribal College Act is about $3,900 per Indian student, which is still less than the two-thirds of the authorized level of $6,000 per Indian student. I emphasize that point as well because in 1988 all we received for our Indian students was $1,800 per student. I would like to see a State-supported institution keep its doors open on $1,800 per student. But our situation could be even worse this next year. If enacted, the President's fiscal year 2004 budget request for basic operations of the tribal college would result in a $4 million cut from the 2003 level recently approved by Congress. This marks the second year in a row that the Administration has recommended a cut in our funding and has zeroed out funding for United Tribes Technical College and Crownpoint Institute of Technology. Simply put, this is unconscionable and shortsighted. We respectfully urge the members of this committee to lead the Senate in rejecting this number and appropriating a more reasonable level of funding. For 2004 we respectfully request $49.2 million for titles I and II of the Tribal College Act. This increase would bring funding for basic operations at existing eligible tribal colleges to $4,500 per Indian student count which still represents just three-fourths of the authorized amount of $6,000 per student, and also to restore funding to United Tribes Technical College and Crownpoint Institute of Technology. Last month the President announced that he was increasing title III programs by 5 percent. However, the President's fiscal year 2004 budget recommendation of $19 million for tribal colleges under Title III would actually decrease funding from the 2003 level by $4 million. We request that funding for the tribal college title III program be funded at $27 million, an increase of $4 million over fiscal year 2003, and $8 million over the President's request. One hundred and forty years ago, Congress enacted legislation establishing the Nation's first land grant institutions. Nine years ago, Congress established tribal college and universities as land grant institutions. We call them the 1994's. Congress created four very modest programs specifically for the 1994 land grant institutions. We urge your careful attention to them. Funding details are provided in my written remarks. Finally, Mr. Chairman, for fiscal year 2001, a bipartisan group from the Administration and Congress came together to launch a modest, but direly needed facilities initiative for our colleges. With help from many members of this committee, several small competitive grant programs were established to help the infrastructure problems that plague our institutions. Programs of $3-$4 million were established in the Department of Housing and Urban Development, the Department of Defense, and the Department of Agriculture's Rural Community Advancement Program, called RCAP. These programs, together with the Department of Education's Title III program, have helped tribal colleges address the critical need for new enhanced facilities on our campuses. Unfortunately, annual appropriations for these programs has not grown in the past 3 years. In its fiscal year 2004 budget request, the Administration would eliminate entirely tribal college facilities under the USDA's RCAP program. We urge the committee to join with other members of the Senate to preserve the RCAP program and to strengthen the other programs which have enabled our schools to build classrooms, computer and science laboratories, child care centers, and even a veterinarian clinic. Mr. Chairman, I am grateful for this opportunity to present our recommendations to help bring equality in education and economic opportunities in Indian Country to the tribal colleges and universities. Thank you. I ask that my testimony be included in the record. [Prepared statement of Mr. McNeil appears in appendix.] Senator Inouye. I have been on this committee now for many, many years. I have had the privilege of serving as chairman and Ranking Member during most of those years. It is always sad to listen to testimony such as this because I know it is true. For example, as you indicated, the per capita amount that the Federal Government provides tribal colleges would be $1,800 per student? Mr. McNeil. In 1988; yes, sir. Senator Inouye. For Howard University, for African- Americans, it is nearly $20,000. I have been working on a Native American university proposal. It has been a slow process. I hope that sometime in the next 12 months I will be able to conduct consultation hearings in about four regions to get the views of tribal educators to tell me, and to tell the committee what they hope to have as a Native American university. There are many concepts and ideas. But as you have pointed out, the way we have responded to the needs of education in tribal colleges is obscene. I can assure you that we will keep on doing what you think should be done. The other thing that I should note is that history indicates that whenever this Nation is faced with some crisis, such as war, that becomes the priority. And as such, other programs begin to get hurt. I can assure you that this committee will do its utmost to make certain that your priorities do not get diminished or disappear because they are very important. I have just one question. You qualify as a land grant college. There is an obligation and Trust responsibility on the part of the Federal Government for the education of Indian children. Why is it that many States refuse to provide assistance when you provide education to non-Indian students in tribal colleges? About 20 percent of the student body is non- Indian; isn't that correct? Mr. McNeil. Twenty percent are non-Indians, yes. Senator Inouye. Can you tell me why the States are reluctant to provide assistance. They do it for other colleges. Mr. McNeil. I can answer that in terms of North and South Dakota. That is where Sitting Bull College and Standing Rock Reservation is located. In North Dakota we have approached the State legislative body a number of times. The last time that we approached them, their response to us was that since the North Dakota tribes have casinos and many non-Indians go to those casinos, that is how they are making their contribution to Indian education. They go to our casinos and spend their money. That was, in fact, one of the comments that we heard back from the Senators of South Dakota. Senator Inouye. Which Senators told you that? Mr. McNeil. North Dakota. South Dakota did appropriate $50,000 for the tribal colleges for the non-Indian students attending there. However, the Governor at that time said that he thought that it was unconstitutional to give money to a special group within the State, and therefore, refused to release the $50,000. Our comment back was every group that comes to the State legislative body, whether it be farmers, ranchers, handicapped personnel, veterans--anybody is a special group that goes there. So they should have released the money. Senator Inouye. Well, we've got problems. [Laughter] Homeland security is one of the top priority matters. Has the Indian Health Service consulted with tribally-controlled hospitals and clinics on matters relating to homeland security and emergency response preparedness? Ms. Davis-Wheeler. We, as tribes, Senator Inouye, have individually looked at homeland security. We have a very progressive tribe in Oregon, the Confederated Tribes of Warm Springs, that have Commission Corps public health service that have pushed their way into county meetings and State meetings regarding homeland security. That has pretty much been an initiative that that tribe has done. So each tribe is basically doing our own thing. The National Indian Health Board, on the other hand, has been following that homeland security legislation and the whole workings on that very closely. We do have some information that we have been sending our tribes. But as for Indian Health Services, truthfully, they are just looking at their budget and how less money they have besides looking at homeland security. They are dealing with their own. That is my perception. Senator Inouye. So they haven't done anything? Ms. Davis-Wheeler. Not that I know of. Senator Inouye. What about urban Indian clinics? Ms. Davis-Wheeler. Yes; not a coordinated effort. Ms. Culbertson. And the same goes for the urban Indian health programs. I know that one of the programs in Kansas had been working with homeland security and was called upon by the State. Unfortunately, when she went to the meeting, they said, ``No, we are supposed to be working with the tribes; so you need to leave.'' So as far as the urbans go, we are just working within the counties and States that we are in, and are hoping that we will able to dovetail with some of their things. But officially, no, Indian Health Services has not looked at homeland security for urban Indian health programs. Senator Inouye. I have so many questions but every time I ask one it makes me sad. [Laughter.] I have discussed this matter with the chairman before he left, and I can assure you that this committee, whether it be on education, health, or any other program, we will seek the highest funding possible. If there are going to be any cuts, it will not come from this Committee. If we should decide to put in a lower figure, then you can be assured that when the appropriating committees get into action, they will go below that. So, frankly, we are going to increase the Indian program budget to the extent possible. Otherwise, your priority will be low. We don't want to see that happen. Ms. Davis-Wheeler. Senator Inouye, if I may, I would like to thank you. As a tribal leader I have been familiar with many of our tribes across the United States. All of us have a constitution and bylaws that we go by that we rule our people with. I really hope that we can see a better budget in fiscal year 2004. Because it is in our constitution and bylaws to take care of our people through health, education, and welfare, I want to thank you from the bottom of my heart that you will make sure that doesn't happen. Senator Inouye. The other matter that I think is very important--and this is something that we have to work with you--is the Indian Health Care Improvement Act. We have been working on this for too long. It is about time it became law. If it should become law, then your problems with malpractice may be addressed. So let's get down to work on this one. I think we are getting close to the point of introducing the measure. If we are, we should do it as soon as we can so we will have at least 1 year. The bill will have to go to several other committees. The sooner we get it done, the better. I will instruct the staff to get into action now and see what we can do. Ms. Culbertson. Thank you, Senator. Senator Inouye. The Department of Education, because of priority fundings, has suggested a decrease in impact aid of about $300 million--$289 million. How would that affect schools or any other programs in Indian country? Mr. Cheek. I think in terms of the cut, that is a substantial cut given what that program has received in 2003 and 2002. It is almost a $300 million cut. I believe that cut is occurring under the B category of students that are funded under the Impact Aid Program. To the best of my knowledge, a lot of the students that are going to be impacted, are those students that have parents that live or work in military installations. I think, given the fact that we have a pending war on the horizon, I think the Administration took an unwise move, to move money out of that category in light of the military build up and all of the resources that are heading in that direction. In terms of the impact on Indian students, I think it is probably a minimal effect since most of the dollars that go for Indian students come out of category A. Actually, American Indian students generate the majority of funds under Impact A. But typically what I have seen over the past several years, the Administration will ask for a lower amount and then I think that outside voices will bring the funding back into it. So this may be the same thing that they are trying this year. But I think the fact that it is affecting military people is unconscionable. Senator Inouye. Personally I would hate to get involved in any process that would reduce the funding for Indian programs. But the reality of political life would suggest to me that will happen in the budget and appropriating process. That being the case, could you provide the chairman, and provide me with a list of those things that all of you would consider absolute musts? Mr. Cheek. Yes; we will be happy to provide that, Senator. Senator Inouye. Otherwise, there is a tendency in the Congress to have across-the-board cuts--a 10-percent cut across the board. When you do that, you would be cutting absolutely essential measures and cutting some that are not that essential. So if you can provide the leaders of this committee a list of those programs that you consider musts, we would be most appreciative. Then we can secure some guidance from you. With that, I will have to adjourn this hearing because of the time element here. But may we submit questions to you for your response? Ms. Davis-Wheeler. Yes. Ms. Culbertson. Yes. Mr. Cheek. Yes. Mr. McNeil. Yes. Senator Inouye. The subject matter that we are involved in now is so essential that we would like to get responses in detail. With that, I thank all of you for your attention. Thank you all for your testimony. The hearing is adjourned. [Whereupon, at 12:04 p.m., the committee proceeded to further business.] ======================================================================= A P P E N D I X ---------- Additional Material Submitted for the Record ======================================================================= Prepared Statement of Hon. Daniel K. Inouye, U.S. Senator From Hawaii, Vice Chairman, Committee on Indian Affairs Mr. Chairman, I am pleased to join you in this hearing today as we receive testimony from the tribal organizations that represent the interests and concerns of Indian country. I am certain that, as they have in the past, these organizations have studied the Presidents Budget Request for Indian programs for fiscal year 2004 carefully and that they will provide this committee with information on the impacts of the President's Request that can be anticipated in Indian country. ______ Prepared Statement of Julia Davis-Wheeler, Chairperson, National Indian Health Board Chairman Campbell, Vice Chairman Inouye, and distinguished members of the Senate Indian Affairs Committee. I am Julia Davis-Wheeler, chairperson of the National Indian Health Board. I am an elected official of the Nez Perce Tribe, serving as Secretary, and also chair the Northwest Portland Area Indian Health Board. On behalf of the National Indian Health Board, it is an honor and pleasure to offer my testimony this morning on the President's Fiscal Year 2004 Budget for Indian Programs. The NIHB serves nearly all Federally Recognized American Indian and Alaska Native (AI/AN) Tribal governments in advocating for the improvement of health care delivery to American Indians and Alaska Natives. We strive to advance the level of health care and the adequacy of funding for health services that are operated by the Indian Health Service, programs operated directly by Tribal Governments, and other programs. Our Board Members represent each of the 12 areas of IHS and are elected at-large by the respective Tribal Governmental Officials within their regional area. As we enter the 108th Congressional session, we Gall upon Congress and the Administration to address the funding disparities that continue to hamper Indian country's efforts to improve the health status of American Indians and Alaska Natives. No other segment of the population is more negatively impacted by health disparities than the AI/AN population and Tribal members suffer from disproportionately higher rates of chronic disease and other illnesses. Indian country has continuously advocated for equitable health care funding. Health care spending for AI/AN's lags far behind spending for other segments of society. For example, per capita expenditures for AI/ AN beneficiaries receiving services in the IHS are approximately one- half of the per capita expenditures for Medicaid beneficiaries and one- third of the per capita expenditures for VA beneficiaries. Sadly, the Federal Government spends nearly twice as much money for a Federal prisoner's health care that it does for an American Indian or Alaska Native. The failure of the federal government to provide equitable health funding for American Indians and Alaska Natives reflects a tragic failure by the United States to carry out its solemn Trust responsibility to American Indian and Alaska Native Tribal governments. Further exacerbating the current funding situation are the challenges our Nation faces relating to the war on terrorism, a sluggish economy and probable military action in Iraq, which has further shifted fiscal priorities away from American Indian/Alaska Native health-related initiatives. While we certainly realize the significance of these challenges, we must also ensure that the health needs of American Indians and Alaska Natives are protected during this time. At this point in my testimony, I would like to illustrate the challenges we face as tribal leaders as we desperately fight to improve the status of our people. According to the Indian Health Service, American Indians and Alaska Natives have a life expectancy 6 years less than the rest of the U.S population. Rates of cardiovascular disease among American Indians and Alaska Natives are twice the amount for the general public, and continue to increase, while rates for the general public are actually decreasing. American Indians die from tuberculosis at a rate 500 percent higher than other Americans, and from diabetes at a rate 390 percent higher. Public health indicators, such as morbidity and mortality data, continue to reflect wide disparities in a number of major health and health-related conditions, such as Diabetes Mellitus, Tuberculosis, alcoholism, homicide, suicide and accidents. These disparities are largely attributable to a serious lack of appropriated funding sufficient to advance the level and quality of adequate health services for American Indians and Alaska Natives. Recent infant mortality data indicates that the infant mortality rate for American Indians and Alaska Natives is 25 percent greater than all other races in the United States. Recent studies reveal that almost 20 percent fewer American Indian and Alaska Native women receive pre-natal care than all other races and they engage in significantly higher rates of negative personal health behavior, such as smoking and alcohol and illegal substance consumption during pregnancy. The greatest travesty in looking at the deplorable health of American Indians comes in recognizing that the vast majority of illnesses and deaths from disease could be preventable if funding was available to provide even a basic level of care. It is unfortunate that despite two centuries of treaties and promises, American Indians are forced to endure health conditions and a level of health care funding that would be unacceptable to most other U.S. citizens Cancer is the third leading cause of death for American Indians of all ages, and is the second leading cause of death among American Indians over age 45. According to the IHS, American Indians and Alaska Natives have the poorest survival rates from cancer of any other racial group. Also, our women have disproportionately high incidences and mortality rates for cervical cancer, and it occurs at a younger age than it does in other racial groups. Oral health is also a great problem. Nearly 80 percent of Indian children aged 2-4 years have a history of dental decay, compared to less than 20 percent of the remaining U.S. population. Further, 68 percent of our adults and 56 percent of our elders have untreated dental decay and gum disease. Trust Obligations of the Federal Government The federal responsibility to provide health services to American Indians and Alaska Natives reflects the unique government-to-government relationship that exists between the Tribes and the United States. The importance of this relationship is reflected in the provisions of Article I, Sec. 8, clause 3 of the United States Constitution, which gives the Federal Government specific authorities in its dealings with Indian Tribes. Article VI, Sec. (2) of the United States Constitution refers to all treaties entered into under the Authority of the United States as the ``Supreme Law of the Land''. Treaties between the Federal Government and our ancestors--negotiated by the United States Government in return for the cession of over 400 million acres of Indian lands established a Trust obligation under which the Federal Government must provide American Indians with health care services and adequate funding for those services. Additional Treaties, Statutes, U.S. Supreme Court decisions and Executive Orders have consistently reaffirmed this Trust responsibility. The Snyder Act of 1921 has been the foundation for many federal programs for Tribes that have been instituted since its enactment, including programs targeting Indian health. It gives broad authority to Congress to appropriate funds to preserve and improve the health of American Indians and Alaska Natives. Since 1964, three public laws have dramatically changed the delivery of health care to the tribes. First, the Transfer Act of 1954 removed responsibilities for health care of American Indians and Alaska Native from the Federal Department of the Interior to the, then, Department of Health, Education and Welfare. Essentially, one major Indian program was excised from a Department that had been responsible for a number of key programs for the tribes. The subsequent transfer of Indian health to a Department with equal standing in the Federal system elevated the health and welfare of American Indians and Alaska Natives to a status in which they became a primary focus of Department efforts. Second, the Indian Self Determination and Education Assistance Act of 1975 changed forever the nature of relationships between Tribal organizations and the Federal Government and revolutionized the manner in which health services were delivered in Indian country. The Act provided guidance and direction to IHS to enable it to work with Tribes to develop Tribal based health systems in which Tribal organizations were given tools with which to operate their own health programs. With approximately half of all service funding through IHS now going to programs that are operated directly by Tribes, health care systems offering locally accessible, coordinated services that are capable of being more responsive to the needs of individual Tribal members are now widely available and expanding. In the 1998 NIHB study ``Tribal Perspectives on Indian Self Determination and Self Governance in Health Care Management'', 94 percent of the Tribal leaders and health system directors surveyed reported plans to enter into Self Determination or Self Governance agreements with the IHS. Tribally operated systems, reported significantly greater gains in the availability of clinical services, community-based programs, auxiliary programs and disease prevention services. In most cases, Tribes contracting or compacting with IHS reported improved and increasingly collaborative relationships With the agency, with both IHS Area Offices and Tribal organizations working together to facilitate the transfer of program management. Finally, with its comprehensive, far-reaching provisions, the Indian Health Care Improvement Act of 1976 created opportunities for enhancement of services to Tribes through innovative interventions that are responsive to the health needs of the Tribes and their members. Areas in various Tribes and the IHS have intervened to achieve positive changes under the Act include: Virtually every component of service delivery; health profession training, recruitment and retention; targeted disease prevention and treatment; funding of health systems; and, mechanisms for integrating Tribal systems with federal programs, such as Medicaid and Medicare. Additionally, through periodic Reauthorizations, authority is given by Congress for IHS and Tribes to develop new strategies to improve components of programs in response to administrative, technical and professional trends and advances. Yet, despite these acts to achieve critically needed improvements in health systems serving Tribes, easily preventable health problems continue to plague the 1.6 million Americans being served by the Indian Health Service and Tribal health providers. The President's FY 2004 IHS Budget Request As you know the FY 2003 Budget was just signed by the President last Thursday, February 20, 2003. I understand that some of the numbers we are using for FY 2004 will be modified based on the enacted budget of last week. The IHS FY 2004 budget request is $2.89 billion, an increase of $40 million over the FY 2003 enacted amount for the Indian Health Service. Even if the $50 million dollar increase for diabetes funding is included the budget request is still over $200 million short of what is needed to maintain current services. It is estimated that a $325 million increase is required provide the same level of health care services provided in FY 2003. This amount would be Sufficient to cover pay act costs, population growth. The President's budget includes $114 million for sanitation construction, an increase of $20 million over the FY 2003 Budget Request. This 20 percent increase represents the largest increase provided for sanitation construction in over a decade. This provision and significant increase is applauded and demonstrates the Administration's commitment to providing safe water and waste disposal to an estimated 22,000 homes, an increase of 2,600 over the number of homes served in 2003. Proper sanitation facilities play a considerable role in the reduction of infant mortality and deaths from gastrointestinal disease in Indian country. The President's budget request also reflects the $50-million increase in the Special Diabetes Program for Indians funding approved during the 107th Congress. We are grateful to the Administration and Congress for recognizing the success and effectiveness of the Special Diabetes Program for Indians as a tool to reduce the incidence and harmful effects of Diabetes in Indian country. As a result of the Special Diabetes Program, today there are over 300 diabetes prevention and treatment programs serving American Indians and Alaska Natives. The funding allows Tribal governments to develop and improve wellness centers, purchase newer medications which are effective in preventing Type II diabetes, establish education programs, and other activities. It is not only an effective tool in preventing and treating diabetes, it also provides opportunities to reduce the incidence of diabetes related blindness, amputations, and end stage renal disease. We ask that the increase in funding for the Special Diabetes Program does not come at the expense of other vitally important IHS programs. Health Facility Construction: The budget includes a total of $72 million for construction of new health facilities allowing IHS to replace its priority health care facility needs with modern health facilities and to significantly expand capacity at its most overcrowded sites. The request will complete outpatient facilities at Pinon (Navajo Reservation, Arizona) and Metlakatla (Annette Island, Alaska); continue construction of the Red Mesa Outpatient Facility (Navajo Reservation, Arizona) and begin construction of a new outpatient facility to replace the Sisseton hospital (Sisseton-Wahpeton Sioux Tribe, South Dakota). When the Sisseton hospital is closed, IHS will purchase inpatient and emergency care from non-IHS facilities such as the nearby Coteau Des Prairies hospital. Pay Costs: The budget includes an additional $35 million to cover increased pay costs for IHS's 15,021 FTE's and to allow tribally run health programs to provide comparable pay raises to their own staffs. Approximately 1 year ago, tribal leaders' came together to develop a ``Needs-Based Budget'' for Indian Health Service funding. The needs- based budget was developed through a careful and deliberate process to ensure that it was reflective of the health needs of Indian country. The budget documented the IHS health care funding needs at $18.2 billion. President Bush's proposed appropriation of $2.89 billion falls well short of the level of funding that would permit Indian programs to achieve health and health system parity with the majority of other Americans. Failure to adequately increase the Indian Health Service clinical services budget will force numerous Tribal health providers to cut back services, worsening the plight of an already severely at-risk population and jeopardizing greater public health. Staff cuts would also result, increasing waiting periods to get appointments, as well as reducing clinic hours. Also, without adequate funding, several successful programs throughout Indian country would have to be eliminated, such as patient outreach, nutritional programs, preventive care, referral services, dental and optometric services. Funding for the Indian Health Service has failed to keep pace with population increases and inflation. While mandatory programs such as Medicaid and Medicare have accrued annual increases of 5 to 10 percent in order to keep pace with inflation, the IHS has not received these comparable increases. Current Indian Health Service funding is so inadequate that less than 60 percent of the health care needs of American Indians and Alaska Natives. As we have carefully reviewed the President's FY 2004 IHS Budget Request, several provisions would seriously affect the agency's ability to carry out its responsibilities pertaining to the health and welfare of American Indians and Alaska Natives. Below, I will briefly discuss several of these provisions. Contract Health Service Funding The President's Budget Request includes $493 million, which provides an additional $25 million or 5 percent increase over the previous year's request, for Contract Health Services. While are very thankful for any increase, the proposed level of funding is so limited that only life-threatening conditions are normally funded. In most other cases, failure to receive treatment from providers outside the IHS and Tribal health system forces people in Indian country to experience a quality of life that is far below the level normally enjoyed by non-Indian Americans. The documented need for the Contract Health Service Program in Indian Country exceeds $1 Billion. At present, less than one-half of the CHS need is being met, leaving too many Indian people without access to necessary medical services. We recommend an increase of $175 million, which would raise American Indian and Alaska Native tribes to approximately 60 percent of need. Contract Support Costs The President's FY 2004 Budget Request includes $271 million, the same as the FY 2003 enacted budget, to support tribal efforts to develop the administrative infrastructure critical to their ability to successfully operate IHS programs. An increase in Contract Support Costs is necessary because as Tribal governments continue to assume control of new programs, services, functions, and activities under Self-Determination and Self-Governance, additional funding is needed. Tribal programs have clearly increased the quality and level of services in their health systems fairly significantly over direct service programs and failing to adequately fund Contract Support Costs is defeating the very programs that appear to be helping improve health conditions for American Indians and Alaska Natives. We strongly urge reconsideration of this line item in the proposed budget. As Tribes increasingly turn to new Self Determination contracts or Self Governance compacts or as they expand the services they have contracted or compacted, funding necessary to adequately support these is very likely to exceed the proposed budgeted amount. We ask you to fund contract support costs at a level that is adequate to meet the needs of the Tribes and to further the important Trust responsibility charged to the federal government. We recommend an additional $150 million to meet the shortfall for current contracting and compacting. Tribal Management/Self-Governance Funding According to the President's FY 2004 Budget, the number of tribally managed IHS programs continues to increase, both in dollar terms and as a percentage of the whole IHS budget. Tribal governments will control an estimated $1.6 billion of IHS programs in FY 2004, representing 53 percent of the IHS's total budget request. Because of this, it is critical that funding for self-governance be provided in a manner reflective of this. Therefore, we feel it is necessary to provide funding over and above the proposed amount of $12 million. The enacted FY 2003 budget cut the office of Self-Governance funding by 50 percent without any notice to tribes. Proposed IHS Management Initiatives/Administrative Reductions The President's budget includes savings of $31 million from administrative reductions and better management of information technology. The IHS proposes to achieve these savings primarily by reducing the use of Federal staff. IHS also plans to reduce administrative costs and to achieve efficiencies through the development, modernization and enhancement of IHS information systems. The National Indian Health Board and Tribal governments have long been concerned about "cost-saving" provisions contained in the President's Budget Request, both in FY 2003 and FY 2004. The result will be the elimination of potentially hundreds of full-time staff at the headquarters and area levels, which would add new burdens to the provision of health care to American Indians and Alaska Natives, rather than addressing the widespread health disparities throughout Indian country. Over the last several years, the IHS has made significant efforts to streamline the agency. IHS has previously reduced upper and middle management positions by 60 and 58 per cent, respectively, and streamlined the Headquarters organizational structure from 140 to 40 organizational units. The restructuring was made in accordance with the IHS Tribal consultation policy and the resources gained through the reductions were reinvested into front-line health delivery positions, which increased by 12 percent. This achievement ought to be rewarded rather than ignored. Given the ongoingrestructuring efforts at IHS, any further reductions would severely hamper the ability of the IHS to carry out its mission. In order to fully explore the possible effects and potential advantages of any reorganization efforts put forth by the Administration, we feel it is appropriate that the President's Management Initiatives be delayed for a period of one year in order for the IHS Restructuring Initiative Workgroup to create feasible alternatives, which will be developed through a comprehensive tribal consultation process. Additionally, any savings derived from such restructuring should be exclusively reinvested in IHS mission-related activities. The Need for Homeland Security Funding in Indian Country The President's FY 2004 budget request for the Department of Health and Human Services (DHHS) reflects the priorities of the United States with regard to health and safety concerns relating to Homeland Security. It reflects the Administration's commitment to anticipating future threats to America's public health care, health infrastructure and human services systems. It is important to note that, along with the Department of Defense and Veteran's Affairs health systems, the Indian Health Service occupies a unique position within the Federal Government as a direct health care provider. Therefore, we are requesting funding be added during FY 2004 to help the Indian Health Service and Tribal governments prepare for and respond to potential terrorist attacks, including increases for Data Systems Improvements and much needed funds to expand the capacity of tribal epidemiology centers. Conclusion On behalf of the National Indian Health Board, I would like to thank the committee for its consideration of our testimony and for your interest In the improvement of the health of American Indian and Alaska Native people. If we are ever to reduce the terrible disparities between the health of American Indians and Alaska Natives compared to other Americans, we need to properly fund the Indian Health Service and we urge the Senate to significantly increase the IHS funding level during this fiscal year. IHS and the Tribes are continuing to work diligently to develop health systems of sufficient quality and with levels of services that our people desperately need. We are deeply concerned about the Administration's proposed IHS budget and trust you will share our concern and we look forward to working with you on this budget. 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The committee met, pursuant to other business, at 10:10 a.m. in room 485, Senate Russell Building, Hon. Ben Nighthorse Campbell (chairman of the committee) presiding. Present: Senators Campbell, Inouye, Johnson, Inhofe, Hatch, Murkowski, and Dorgan. STATEMENT OF HON. BEN NIGHTHORSE CAMPBELL, U.S. SENATOR FROM COLORADO, CHAIRMAN, COMMITTEE ON INDIAN AFFAIRS The Chairman. The Committee on Indian Affairs will be in session. We will now move to the second of our two oversight hearings on the President's fiscal year 2004 budget request for Indian programs. Today we are joined by representatives of five Federal agencies whose business affects the lives of Native people across the United States. As I said last week, the President's budget request reflects what unfortunately looks like a major conflict in the Middle East in our Nation's efforts to protect our homeland and our people. The request for the BIA is $2.314 billion, with an additional $275 million for the Special Trustee. The Indian Health Service account would receive $2.89 billion, an increase of $68 million over fiscal year 2003. The Indian housing grant request includes $647 million which is level funding compared to 2003. Unfortunately, the need has grown considerably and there may not be enough money that is in that program. There are specific increases in several Indian accounts, notably Trust reform, substance abuse, school operations, and a continued effort to eliminate the backlog of BIA school construction. I want to assure the members and the audience that these hearings are only the beginning of the fiscal year 2004 appropriations process, and that this Committee will be involved for the duration, paying particular attention to the homeland security budget, and the degree to which it involves tribal governments, law enforcement, and medical personnel for our security efforts. With that, I would like to turn to Senator Inouye. But I would ask Senator Inouye if Senator Inhofe may make a request first? Senator Inouye. Yes; certainly. Senator Inhofe. Mr. Chairman, I was trying to get down here to help make a quorum for the appointment of Mr. Swimmer. I would like to be shown in voting in support of his nomination. The Chairman. For the record we will reflect you were here in person. Senator Inhofe. Thank you. The Chairman. Senator Inouye. Senator Inouye. Mr. Chairman, I am pleased to join you this morning to welcome the witnesses from the executive branch. I look forward to receiving their testimony. The Chairman. Senator Johnson, do you have an opening statement? Senator Johnson. None, Mr. Chairman. The Chairman. Mr. Inhofe. Senator Inhofe. None, Mr. Chairman. The Chairman. We will now proceed with our witnesses. We will now have Louis Kincannon, director of the Bureau of the Census, from Suitland, MD; Aurene Martin, acting assistant secretary for Indian Affairs for the Department of the Interior; Charles Grim, interim director the of Indian Health Service, from Rockville, MD; Bill Russell, deputy assistant secretary for Public and Indian Housing, Department of Housing and Urban Development; and Victoria Vasques, director of the Office of Indian Education, Department of Education. We will start in that order. I need to tell the witnesses that I have a fierce cold and may be here only part of the time. So if you would like to abbreviate your comments, your full written testimony will be included in the record. We will start in the order that I introduced you. Mr. Kincannon, would you please start? STATEMENT OF LOUIS KINCANNON, DIRECTOR, BUREAU OF THE CENSUS, SUITLAND, MD Mr. Kincannon. Good morning, Mr. Chairman. Thank you, Mr. Chairman, and thank you, Mr. Vice Chairman. On behalf of the Census Bureau, I would like to express our appreciation for the opportunity to testify before the committee. The Census Bureau does not operate ``Indian Programs'' in the traditional sense of the word. Our mission is to provide the most timely, relevant, and accurate data about the people and the economy of the United States. It is our task, in part, to cooperate with this committee in making sure that the right kind of information is available to help support its work in reviewing programs for American Indians and Alaska Natives. This morning I will focus on information from the Economic Census, the Survey of Business Owners, the Decennial Census of Population, and the American Community Survey. The Economic Census is conducted every 5 years for years ending in ``2'' and ``7.'' We are currently receiving and processing information for 2002. The Economic Census is a detailed profile of the economy from the national level, to the local level, and industry-by-industry. It provides information on over 23 million businesses and 96 percent of the Nation's economic activity. It is used in determining the gross domestic product estimates, of course, as well as other indicators that measure the national economy. Moreover, the detailed data inform economic, and financial decisions in the private sector, as well as the Federal, tribal, State, and local levels. With each Economic Census we also collect data in a follow- on survey to provide a detailed portrait of minority and women- owned businesses. This Survey of Business Owners paints a portrait of American Indian and Alaska Native owned businesses, that is used by agencies such as the Commerce Department's Minority Business Development Agency to evaluate program needs and opportunities. In the last available results from this survey for 1997, it shows that almost 200,000 firms were owned by American Indians and Alaska Natives, and that the sales from these firms totaled more than $34 billion annually. The data also suggest that American Indian and Alaska Native economic activity is diverse with significant activity across each of the major industrial sectors. However, the most useful data at the local and tribal government levels comes directly out of the Economic Census. The 2002 Census will show the number of businesses and the employment and sales for businesses by type of activity at the State, county, city, and frequently at the zip code level. These data will be used by tribal government leaders and planners as well as entrepreneurs to outline potential opportunities for economic development. By combining data from the Economic Census and the Decennial Population Census, tribal governments and businesses, as well as this committee, can provide a profile rich with detail to encourage investors and development. The Census of Population is the great national catalog of human capital collected every 10 years. To collect these data we visit every reservation, as well as every off-reservation tribal Trust land, tribal designated statistical area, and State-recognized reservation in the Nation. Beginning with the 2000 Census, respondents were allowed to check more than one race. This contributed significantly to the number of people who identified themselves as American Indian or Alaska Native. In Census 2000, when asked about their race, almost 2\1/2\ million persons reported American Indian or Alaska Native alone. An additional 1\1/2\ millions persons reported that they were American Indian or Alaska Native in connection with one or more other races. Combining these two totals means that there were over 4 million persons who reported that they were American Indian or Alaska Natives. According to the 1990 Census, fewer than 2 million persons reported that they were American Indians or Alaska Natives. The 1990 Census respondents were only allowed to mark one box in the race question. So these data are not strictly comparable. According to the 2000 Census, the largest tribes and tribal groupings were Cherokee, Navajo, Sioux, Chippewa, and Choctaw. In addition to population data, the Decennial Census also collects a wide range of social, economic, and housing characteristics. The Decennial Census long form provides the most comprehensive and in-depth profile of American Indian and Alaska Natives that's available every 10 years. This data is used throughout the Federal Government, as well as by tribal governments to make decisions, allocate funds, and otherwise. Among the key data that were collected in 2000 about American Indians and Alaska Natives, we found that over 800,000 were enrolled in schools at every level from preschool to colleges. There were almost 200,000 veterans among this population. Over 1 million were participating in the labor force. The median income for households was slightly over $30,000 per year. The median property value for owner-occupied housing units was $81,000. According to the Census 2000, of 765,000 American Indian and Alaska Native households, 90,000 did not have telephones, 34,000 lacked complete plumbing facilities, and 30,000 lacked kitchen facilities. The Decennial Census offers a comprehensive and in-depth snapshot of conditions as of census day. These data are invaluable to the tribes and the government as it tries to work through planning and evaluating programs. It is not, however, the best tool for continuing measurement of progress or program outcomes. As one moves further away from census day, the data becomes stale and, therefore, less accurate. As late as last summer, tribal governments were still using 1990 decennial long-form data to try to meet the needs of their members. The good news is that we have a plan that will dramatically improve the way we deliver these data to tribal governments. With the American Community Survey, we plan to eliminate the long form in the census in 2010 and to collect these data every year. The real difference is that we will be able to publish data equivalent to the long form every year for every county, reservation, tribal Trust land, tribal statistical area, home land area, and the census tracts therein. This will allow tribal governments to measure change, to plan better to manage their programs more effectively, and take better advantage of potential opportunities. We have embarked on this path because it will improve the data that this Nation uses to meet the needs of all Americans, day-in and day-out. In summary, entrepreneurs and tribal governments can use these data to make the case for investments, strengthening the length between possibility and reality. The Economic Census is the catalog of economic resources. The Decennial Census and the American Community Survey are catalogs of human capital. These data express the tremendous potential for progress, growth, and opportunity that exists within the United States for every American Indian and Alaska Native. I do have longer testimony that I will submit for the record, Mr. Chairman. I appreciate once again the opportunity to appear. I would be pleased to answer any questions, of course. The Chairman. Your testimony will be inserted in the record in its entirety. [Prepared testimony of Louis Kincannon appears in appendix.] The Chairman. I understand this is the first time you have appeared before this committee. I am sure impressed with all the places you have had to go to find these numbers. Mr. Kincannon. Well, I can't believe we were as successful in the 2000 Census as we were without closer advice from this committee. So I hope that will continue. The Chairman. Thank you. Mr. Kincannon. Thank you, sir. The Chairman. Ms. Martin, welcome. STATEMENT OF AURENE MARTIN, ACTING ASSISTANT SECRETARY FOR INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, WASHINGTON, DC, ACCOMPANIED BY DONNA ERWIN, ACTING SPECIAL TRUSTEE, DEPARTMENT OF THE INTERIOR, WASHINGTON, DC Ms. Martin. Good morning, Mr. Chairman, Mr. Vice Chairman. Thank you for the invitation to discuss the fiscal year 2004 budget for Indian programs in the Department of the Interior with you today. I am accompanied today by Donna Erwin, acting special trustee for the Department of the Interior, who will assist me in answering questions with regard to that office. The fiscal year 2004 budget submitted to Congress represents large increases in funding for Indian Trust reform and related programs, and includes funding to address the past, present, and future of Trust reform. We are addressing questions about the past by implementing the Department's historical accounting plan. We are dealing with present management challenges by reorganizing the Department's Trust operations to provide better Trust management. Finally, we are planning for the future by expanding the Land Consolidation Pilot Program to reduce future fractionation and land ownership, a root cause of many of the challenges we now face as an institution. In total, the fiscal year 2004 budget request for the Department of the Interior is $10.7 billion. This budget represents an increase of over $340 million over fiscal year 2003 enacted appropriations. Over one-half of this increase is dedicated to the Indian Trust budget. The BIA mission is to fulfill its trust and other statutory responsibilities and promote self-determination on behalf of tribal governments, American Indians, and Alaska Natives. President Bush has proposed a $2.31 billion budget for the Bureau of Indian Affairs for fiscal year 2004, an increase of over $48.6 million over the fiscal year 2003 enacted levels to improve the Department of the Interior's management of individual Indian and tribal Trust accounts, to operate new tribally operated detention centers, and to develop tribal economies. The request also maintains the President's commitment to eliminate the school maintenance backlog and to provide tribes with greater opportunities to directly operate BIA schools. The Office of the Special Trustee is responsible for the oversight and coordination of the Department's Trust asset management and reform efforts to effectively discharge its Trust responsibilities. The President's fiscal year 2004 budget for the Office of the Special Trustee for American Indians is $274.6 million, an increase of $134.3 million, or 96 percent above the fiscal year 2003 enacted level. The $134.3 million increase will support many of the reforms discussed in this statement and will be used for Trust records, administration, management, storage, and accessibility to meet document production and related litigation costs and to provide improvements to the Trust fund's accounting system. The fiscal year 2004 budget for Indian Trust programs includes $554 million for Trust operations and reform. This is 50 percent higher than the enacted levels for fiscal year 2003. Fulfilling our Trust responsibilities remains one of the Department's greatest challenges. In July 2001, the Secretary created the Office of Historical Trust Accounting within the Office of the Secretary. The mission of OHTA, as we call it, is to coordinate all activities relating to historical accounting. On January 6, 2003, the Department presented a plan entitled ``The Historical Accounting Plan for Individual Indian Money Accounts,''[IIM] to the District Court in the Cobell v. Norton litigation for the historical accounting for about 260,000 IIM accounts. The work described in the January 6th Historical Accounting Plan is expected to take five years to complete, and is preliminarily estimated to cost approximately $335 million. The budget includes $130 million for these historical accounting activities. These funds will also be used to provide historical accounting activities related to tribal accounts. Under Interior's reorganization proposal, the Bureau of Indian Affairs retains all natural resource trust asset management. The management of the Trust functions at the BIA regional and agency levels has been separated by creating separate lines of authority for Trust and tribal services. Within the Office of the Special Trustee for American Indians, the reorganization proposal has given it additional operating authority which will be supported by new positions intended to be filled by skilled staff who are specifically trained for responsibilities with regard to their Trust responsibility. A regional staff will oversee Trust officers and Trust account managers in field locations under this plan. The fiscal year 2004 budget provides an increase of $15 million to support the new organization, which together with base funding available in both BIA and OST, will provide resources needed for the new organization. Another challenge we continue to face is the land fractionation problem. Today there are approximately four million owner interests in the 10 million acres of individually-owned Trust lands, a situation the magnitude of which makes management of trust assets extremely difficult and costly. Fractionated interests in individual Indian allotted land continue to expand exponentially with each new generation. The BIA has conducted a pilot fractionated interest purchase program aimed at reducing fractional interests in the Midwest region and in fiscal year 2002 alone, acquired 10,699 fractionated interests. In 2004, BIA will aggressively ramp up the Indian Land Consolidation Program. The fiscal year 2004 budget proposes $21 million for Indian land consolidation, an increase of $13 million. The BIA is designing a nationally coordinated and targeted purchase program. This program will be managed by a national program staff. We are implementing and undertaking a number of other Trust reform efforts. We are currently developing re-engineered business processes based on a meticulous review of all of our current processes. We are improving our information technology. The proposed $183.8 million increase for Trust management reforms includes funding to help rebuild the Bureau of Indian Affairs Information Technology infrastructure to support both Trust and non-Trust programs. We are improving our recordkeeping. The fiscal year 2004 budget also proposes an increase of $4.5 million to accelerate a new strategy to administer, manage, search, retrieve, and store Trust records. No task is more important to us than the education of our children. We are responsible for educating nearly 48,000 students in 23 States at the 185 elementary and secondary schools that form the BIA school system. The Bureau of Indian Affairs is committed to the President's promise to improve Indian education in America. In January 2002, the President signed into law the ``No Child Left Behind Act'' of 2001, a landmark education bill that will help strengthen the BIA funded schools. Flexibility and local control of schools are among the pillars of the President's Education Reform Plan. The budget encourages tribes to assume management of their schools by providing a $3-million increase in administrative cost grants to support their programs. During the year 2000 Presidential campaign, President Bush promised to provide safe and structurally sound schools for Indian students. The BIA's request for education construction continues the President's initiative to repair and replace schools that are outdated and in need of structural improvement. The budget includes a request to invest $141.4 million to replace buildings at a minimum of seven schools. Funding for school construction reflects an increase of $16.2 million above the fiscal year 2003 levels, resulting from an internal transfer of funding from education facilities improvement and repair program, and includes $10 million for the planning and design of future projects. Other budget highlights include an increase of $7.6 million to improve the management of Trust land and natural resources assets, an increase of $1 million to leverage $20 million in additional guaranteed and insured loans, and $51.4 million for payment of authorized Indian land and water claim settlements in Oklahoma, Colorado, Nevada, New Mexico, and Utah. In summary, with this budget request, the President has made clear his firm commitment to improving the lives of Indian people through Trust reform, education, and economic development. The BIA and OST are prepared to meet these goals with Congress' support. I ask that my written statement be entered into the record. I would be happy to answer any questions you might have. The Chairman. Your complete statement will be in the record. [Prepared statement of Aurene Martin appears in appendix.] The Chairman. We will now go to Dr. Grim. Before you make your statement, Dr. Grim, have you ever heard of Indian bear root? Dr. Grim. No, sir. The Chairman. When I used to get a sore throat some of the old ladies up home would make me chew bear root. It worked great. I didn't know if you brought any with you or not. Dr. Grim. I could probably see if we could find you some, though. [Laughter.] The Chairman. I hate to resort to NyQuil but I guess I am going to have to. Go ahead with your testimony. [Laughter.] STATEMENT OF CHARLES W. GRIM, M.D., INTERIM DIRECTOR, INDIAN HEALTH SERVICE, ROCKVILLE, MD, ACCOMPANIED BY: MICHEL E. LINCOLN, DEPUTY DIRECTOR; GARY HARTZ, ACTING DIRECTOR, OFFICE OF PUBLIC HEALTH; AND CRAIG VANDERWAGEN, M.D., ACTING CHIEF MEDICAL OFFICER Mr. Grim. Mr. Chairman, Mr. Vice Chairman, and members of the committee. Good morning. My name is Charles Grim. I am Interim Director of the Indian Health Service. I am accompanied this morning by Michel E. Lincoln, our deputy director of Indian Health Services, Gary Hartz, our acting director for the Office of Public Health, and Craig Vanderwagen, our acting chief medical officer. We are pleased to be here this morning and have the opportunity to testify before you on the President's fiscal year 2004 budget. It's a personal honor for me that my first appearance before a Congressional committee be the Senate Committee on Indian Affairs. I am a member of the Cherokee Nation of Oklahoma, and as the interim director of the Indian Health Service appointed by the President, I also represent the primary health program for 1.6 million American Indians and Alaska Natives nationally. I am here to provide information on behalf of the President, the Secretary, and the Indian Health Service for programs that are critical to achieving our shared goals of eliminating health disparities among all Americans. This budget request reflects the priorities of this Administration for the health of the American Indians and Alaska Natives. It also reflects the Administration's commitment to honoring the government-to-government relationship between the Federal Government and the 562 sovereign Indian Nations because this budget request was developed in consultation with Indian tribes and organizations. It also reflects the personal interests and commitments of the Department leadership to meeting the health needs of Indian people and honoring the Federal Government's treaties with Indian Nations to provide health care services. This is the third budget proposed by President Bush for the Indian Health Service. While the Nation faces unprecedented challenges worldwide and at home, the President has proposed an IHS budget that is 2.6 percent higher than the budget proposed last year and which still represents an increase even when compared with the fiscal year 2003 enacted budget. The collaboration in developing this request ensures that it is relevant to the needs of Indian Country for public and personal health services and the infrastructure necessary to provide them. In addition, beyond the IHS budget request, I make note that the collaboration between the operating divisions of the Department of Health and Human Services also has renewed emphasis and vitality because of Secretary Tommy Thompson's initiatives to eliminate health disparities, and ask that all those within the Department act as one department. Secretary Thompson and Deputy Secretary Claude Allen and their staff have visited and met with tribes across the Nation and during tribal visits to Washington, DC. They know first- hand of the health disparities and access to care issues that many of our tribal nations face. They are committed to ensuring that the Department programs that benefit all people also help to meet the needs of Indian country. They also ensure that the decisions that would affect the Indian Health Service tribal and urban Indian health delivery programs are considered before they are implemented. One recent decision resulted in a waiver that would have cost the Agency approximately $30 million immediately and $17 million annually. Meeting the health needs of the Indian country is also possible because of the commitment of the members of this committee. I begin my testimony today with the gratitude and appreciation for your hard work and the outstanding staff who support you in your efforts to make a difference in the lives of American Indians and Alaska Natives. The recent enactment of a 3.3 percent increase in the fiscal year 2003 budget appropriation will help us carry out our important work and allow us to expand or maintain clinical and dental services. It will allow us to continue construction of eight health facilities, and continue to provide health profession scholarships for 716 American Indian and Alaska Native students and loan repayment for 480 health professionals, along with maintaining our many other critical and necessary programs. So let me say thank you for your help on that. Improving the health of the American Indian and Alaska Native population overall, providing health care to individuals in the population are important and challenging goals. Comparing the 1997 through 1999 Indian age adjusted death rates with the United States all races population in 1998, the death rates in the American Indian and Alaska Native population are 7.7 times greater for alcoholism, 7.5 times greater for tuberculosis, 2.7 times greater for diabetes, and 2.8 times greater for unintentional injuries. The fiscal year 2004 President's budget request and associated performance plan represent a cost-effective public health approach to make sure that American Indians and Alaska Natives have access to health services. Our performance has been validated by our documented Government Performance and Results Act Achievements, and most recently by our scores from the Office of Management and Budget Program Assessment Rating Tool which were some of the highest in the Federal Government. The President proposes an increase of $97 million in program level funding above the fiscal year 2003 enacted level. Program level funding includes an increase of $50 million for the special diabetes program for Indians, which was reauthorized last year, and amounts that we expect to collect through our third party billing activities in the dollar amount of approximately $6 million. The request provides $19.6 million for Federal pay cost increases and $16 million for tribal pay cost increases. Funds for staffing newly constructed health care facilities and operating the new facilities that will open in fiscal year 2004, or have recently opened, are requested in the amount of $25.5 million. It also provides program increases of $18 million for contract health care and $21 million for sanitation facilities projects. The budget request also includes $70 million for health care facility construction to be used for replacement of existing health care facilities. This amount will complete construction of the health centers in Pinon, AZ and Metlakatla, AK, and partially complete the health centers at Red Mesa, AZ, and Sisseton, SD. The fiscal year 2004 budget request incorporates savings in support of the President's management agenda, and those cost savings to the Federal budget include $21.3 million in administrative efficiencies, and $9.3 million through better management of information technology. The increases requested are essential to maintaining IHS, tribal, and urban Indian health programs capacity and infrastructure to provide access to high quality primary and secondary medical services, and begin to slow down the recent declines in certain health status indicators. The IHS has demonstrated the ability to maximize the use of available resources to provide services to improve the health status of the Indian people. In 2002, the IHS exceeded the healthy people 2010 goal of increasing by 50 percent the number of annual diabetic hemoglobin A1c tests. In addition, the health data is now showing a steady increase in the percentage of American Indian and Alaska Native diabetic patients who have achieved ideal blood sugar control. I am confident that these achievements will translate into decreased diabetic mortality rates in the future. The requests that I have just described reflect the continued investment by the President and the Secretary to maintain and support the IHS tribal and Urban Indian public health system. The President and the Secretary are also committed to national defense, homeland security, and increasing our ability to respond to bioterrorism or health threats to the Nation. However, while there will be sacrifices the country will be asked to make during this war on terrorism, sacrifices at the expense of the health of the American Indian and Alaska Natives is not acceptable to the Administration, the Secretary, the IHS, or tribal or urban leadership. As I mentioned earlier, there are significant disparities in mortality rates for a variety of conditions between American Indians and Alaska Native people in the United States general population. What's particularly alarming is the pattern is continuing to worsen. The overall mortality rate for the Indian population increased by 4.5 percent from the period of 1994 through 1996, to 1997 through 1999, while during the same timeframe the United States all races rate declined by over 6 percent. While future requests for increases will be affected by national priorities, the budget requests for the IHS will always be mindful that this health disparity gap for Indian people will widen if we are unable to maintain and improve access to high quality medical and preventive services. I want to thank you for this opportunity to discuss the fiscal year 2004 President's budget request for the Indian Health Service. I would be pleased to answer any questions you might have. I would ask that my full statement be inserted in the record. The Chairman. Your prepared statement will be placed in the record in its entirety. [Prepared statement of Charles Grim appears in appendix.] The Chairman. Thank you, doctor. Mr. Russell. STATEMENT OF WILLIAM RUSSELL, DEPUTY ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT, WASHINGTON, DC Mr. Russell. Mr. Chairman, Mr. Vice Chairman, and members of the committee, thank you for inviting me today to provide comments on President Bush's fiscal year 2004 budget for HUD's Indian Housing and Community Development Programs. My name is William Russell and I am Deputy Assistant Secretary for Public and Indian Housing at HUD. I am speaking today on behalf of Assistant Secretary Michael Liu. I have prepared a statement for Mr. Liu that I would ask be entered into the record, an abbreviated version of which I will provide you today. The Chairman. Your complete testimony will be entered into the record. [Prepared statement of William Russell appears in appendix.] Mr. Russell. It is a pleasure to appear before you. I would like to express my appreciation for your continued efforts to improve the housing conditions of American Indian, Alaska Native, and Native Hawaiian peoples. HUD's Native American programs are available to over 550 federally-recognized and a limited number of State-recognized Indian tribes. We serve these tribes directly or through tribally-designated housing entities by providing grants and loan guarantees designed to support affordable housing and community and economic development activities. Our tribal partners are diverse. They are located on Indian reservations, Alaska Native villages, other traditional Indian areas, and most recently on the Hawaiian homelands. The Department of Housing and Urban Development supports the principle of government-to-government relations with Indian tribes. For fiscal year 2004 the President's budget for HUD proposes a total of $738.7 million, specifically for Native American and Native Hawaiian housing, community and economic development, and education programs. The 2004 budget includes $646.6 million for the NAHASDA program. This is the same as the 2003 request. As with last year's request, reducing set-asides will actually allow for an increase in grant dollars available to tribes. The training and technical assistance set-aside has been increased to $5 million, which is $2 million more than last year's request. In the coming year, ONAP is planning to provide additional training and technical assistance to tribes. The title VI loan guarantee set-aside is funded at $1 million to continue program activities. The total program is more fully subscribed. It is more effective to allocate the funds by a formula directly to grantees. There is over $207 million in carry-over of unused budget authority in this program. The $1 million requested in the 2004 budget for the section 184 loan guarantee program will provide an additional $27 million in loan guarantee authority. In this program there is over $7 million in carry-over of unused budget authority. The President's 2004 budget request for the Indian Community Development Block Grant Program is $72.5 million. This is identical to the 2003 request and an increase of $1.5 million over the amount appropriated in 2003. The Department is requesting $10 million for the Native Hawaiian Housing Block Grant Program. This program addresses the housing needs of Native Hawaiian families eligible to reside on Hawaiian homelands. An interim regulation implementing this new program was published in the Federal Register on June 13, 2002. This allowed us to distribute funds and implement the program while public comments are being considered and incorporated into the final regulations. The budget also requests that $1 million be allowed to the Section 184(a) Native Hawaiian Loan Guarantee Program which will provide up to $35 million in loan guarantee authority. The President's budget request includes $3 million from competitive grants to tribal colleges and universities, and $2.4 million to assist Alaska Native and Native Hawaiian serving institutions. As of September 30, 2002, $885.6 million remains unexpended in the NAHASDA program since fiscal year 1998. I would note that grant recipients have two years from the initial awarding of the grant to obligate 90 percent of such grant. Combining all the production numbers reported for the first four years of funding under NAHASDA there have been 25,819 new and rehabilitated housing units constructed through the end of fiscal year 2002. The President's budget request for HUD's Indian housing, community development, and education programs supports the progress being made by tribes in providing housing and housing- related activities in Indian country. Thank you, again. I would be happy to answer any questions you may have. The Chairman. Thank you. Before we proceed because I don't how long the Senators are going to be able to stay when they come in, I would to yield to Senator Murkowski, a new member with the committee, who incidentally replaces a Senator Murkowski. Did you have an opening statement, Senator Murkowski? STATEMENT OF HON. LISA MURKOWSKI U.S. SENATOR FROM ALASKA Senator Murkowski. Thank you, Mr. Chairman. I appreciate the opportunity to speak and to address the President's fiscal year 2004 budget for Indian programs. First, let me say that 119,000 Alaska Natives or American Indians currently call Alaska home which makes it the highest per capita concentration in the country. Many of these residents live in communities lacking essential services such as running water and basic health care. As I am sure you are aware, construction and health care costs in Alaska tend to be far higher than anywhere else in the United States. Alaskans must also contend with poor weather conditions in extreme remoteness, although you guys have had worse weather here than we have up North. [Laughter.] I will work to provide the needed funding for Indian projects to address the discrepancy. I have no control over the weather so far as I know. While the President's budget reflects the need for increased security both at home and abroad, I am encouraged that overall Indian program funding has increased. I look forward to working with the rest of the Committee and with the various agencies to use this funding to further improve the lives of the 4.1 million American Indians, Alaska Natives, and Native Hawaiians across the country. Thank you for the opportunity. The Chairman. Thank you. We will now proceed with your testimony, Ms. Vasques. Welcome. STATEMENT OF VICTORIA VASQUES, DIRECTOR OF THE OFFICE OF INDIAN EDUCATION, DEPARTMENT OF EDUCATION, WASHINGTON, DC, ACCOMPANIED BY CATHIE L. MARTIN, GROUP LEADER, OFFICE OF INDIAN ELEMENTARY AND SECONDARY EDUCATION; AND LONNA B. JONES, ACTING DIRECTOR, ELEMENTARY, SECONDARY, AND VOCATIONAL ANALYSIS DIVISION, BUDGET SERVICE, OFFICE OF DEPUTY SECRETARY Ms. Vasques. Thank you. Good morning, Mr. Chairman, Mr. Vice Chairman, and other members of the committee. I am pleased to appear before you to discuss the fiscal year 2004 budget request for the Department of Education programs that serve American Indians, Alaska Natives, and Native Hawaiians. I request, Mr. Chairman, that my written statement be entered for the record. The Chairman. Your complete statement will be in the record. [Prepared testimony of Victoria Vasques appears in appendix.] Ms. Vasques. Thank you. Since this is my first opportunity to testify before this committee, I would like to begin by briefly mentioning my background. I am proud to say that my understanding of the Indian culture and Indian issues began with my upbringing, and more importantly with my father who served for almost 20 years as tribal chairman of the San Pasqual Band of Mission Indians. I have a strong commitment to education, especially Indian education, and have no doubt that this an historic time to be in the education arena. This past September I was appointed as the director of the Office of Indian Education. Prior to that, I served as the Executive Director of the White House Initiative on Tribal Colleges and Universities. The principles of ``No Child Left Behind'' represent a milestone for the education of over 600,000 Indian students. The act focuses on improving academic achievement by ensuring that all children can read by the end of third grade, improving teacher quality through high quality professional development, increasing accountability for student achievement, and placing a stronger emphasis on teaching methods. The 2004 request for the Department's Indian education programs is $122.4 million. These programs include formula grants to school districts, competitive special programs, and national activities. We are requesting $97.1 million for the Indian education grants to local education agencies. This program is the Department's principle vehicle for addressing the unique educational and culturally-related needs of Indian children. Grants supplement the regular school program, helping Indian children improve their academic skills, raise their self- confidence, and participate in enrichment programs and activities that would otherwise be unavailable. The requested level would provide an estimated $206 per pupil payment for approximately 471,000 students including 41,000 students in BIA schools. Our request for special programs for Indian children is $20 million; $10.8 million would support demonstration grants that promote school readiness for Indian preschool children and increase the potential for learning among all Indian students. In addition, the 2004 request will provide $9.1 million to continue the American Indian Teachers Corps program, which trains Indian college students to become teachers, places them in schools with a concentration of Indian students, and provides professional development and in-service support as they begin teaching. We are requesting $5.2 million for national activities including research, evaluation, and data collection activities related to Indian education. The Department developed a comprehensive research agenda for Indian education through an Indian consultative process. We are beginning a new large scale study this year that will establish baseline data on academic achievement and retention of American Indian and Alaska Native students. The fiscal year 2004 funds would be used to continue this study as well as to continue research grants and data collections initiated in earlier years. In addition to the Indian education programs that I just mentioned, which are administered by my office, the Department also supports the education of Indians through several other programs. My written statement describes our proposal for each of them, but I would like to touch on a few examples. The title I education for the disadvantaged program provides supplemental education funding to local educational agencies and schools to help some 15 million disadvantaged students, including an estimated 250,000 Indian children, learn at the same high standards as other students. The Department is requesting $12.4 billion for title I grants in fiscal year 2004, a 41 percent increase since 2001. Under the statute, the BIA in outlying areas receive 1 percent of title I grants, which is approximately $85 million. Reading First is a comprehensive effort to implement the findings of high quality, scientifically-based research on reading and reading instruction. It is one of the Administration's highest priorities for education. Providing consistent support for reading success from the earliest age has critically important benefits. Under this formula program, the BIA will receive approximately $5.25 million. The Higher Education Act for Strengthening Tribally Controlled Colleges and Universities program authorizes grants that enable these institutions to improve and expand their capacity to serve American Indian students. Under the budget request, the Department would award $19 million for activities to strengthen tribal colleges. The Special Education Grants to States program provides formula grants to meet the excess costs of providing special education and related services to children with disabilities. Under the budget request of $9.5 billion, the Department would provide approximately $82.5 million to BIA to help serve approximately 8,600 Indian students. The 2004 budget request for Department of Education programs serving Indians supports the President's overall goal of ensuring educational opportunities for all students. I thank you for the opportunity to appear before this committee. I would be happy to answer any questions you may have. The Chairman. Thank you. Before we go to our first round of questions, I would like to invite Senator Dorgan to make any opening statement. STATEMENT OF HON. BYRON L. DORGAN, U.S. SENATOR FROM NORTH DAKOTA Senator Dorgan. Thank you, Mr. Chairman. Just briefly, I have been in an appropriations subcommittee hearing that I have to return to. I have had a chance to review much of the testimony for this morning. It probably is not surprising that I think that the budget request for many of these accounts is woefully inadequate. For example, the proposal to take action that would essentially close the United Tribes Technical College makes no sense at all. Underfunding in a range of education, health care, and housing accounts is a very serious mistake. Tribal colleges which, in my judgment, are the core of some very important progress on Indian reservations are going to see additional funding problems as a result of this budget. The hearing that I am attending on my appropriations subcommittee, we hear exactly the same testimony. But with respect to our Trust responsibilities for Native Americans, the circumstances that exist in both housing, health care, and education, I think are emergency circumstances. I think it's a full blown emergency in many areas. My hope is that as we work through this on this committee, that we can make recommendations to both the authorizing and appropriations committee, to begin making some significant progress in these areas. We have four Indian reservations in North Dakota. I have visited them a great deal. I want to see us make significant progress in dealing with the health care needs that exist that are unmet, particularly the needs of children that are unmet. We need to make progress dealing with the needs of these children and education, Mr. Chairman. I visited a school that had 150 kids with one water fountain and two toilets. A little girl named Rosie Two Bears looked at me and she said, ``Senator, will you help build us a new school?'' She was sitting in a classroom whose desks were one inch apart in a 90-year-old building, part of which had been previously condemned. Well, that's not the way to give a child a good start in life. Every young child that walks through a classroom door ought to be able to go into a room that we think is going to give them a first rate education. That is not the case in many areas and in particular some reservations these days. So we have a bundle of challenges. No one is more acutely aware of that than you, Mr. Chairman and Senator Inouye. Both of you have provided significant leadership with this committee. I appreciate being a part of this. I regret that I can't stay for the entire hearing. I look forward to working with you, Mr. Chairman and Senator Inouye, and my colleagues as well to see if we can't make some real progress. We have to turn back some of the recommendations of the President's budget, build upon them, and make significant investments in human potential in many of these very important accounts. Thank you for calling on me, Mr. Chairman. The Chairman. Thank you. You have been a very consistent and strong voice in support of Indian country. I look forward to working with you, particularly on finding a way we can keep the United Tribes Technical College open. I think, as you do, that it is extremely important. As I said earlier, I am going to leave to go find a medicine man. I have a number of questions for each of you. I am going to submit those and ask you to get those back in writing before me before we close the hearing in a couple of weeks. There is one I would like to ask Ms. Vasques because it is something that has been on my mind for a good number of years. You may not be prepared to answer it, but I would like you to look into it. Are you familiar with Fort Lewis College in Colorado? It is a 4-year liberal arts college that is a State college? Ms. Vasques. Somewhat, but I have not been there. The Chairman. Well, it is the only State college in the United States that gives free tuition for Indian students. I think there are about 500 students there, if I am not mistaken. Of course, it costs the State of Colorado about $5 or $6 million to reimburse the college to offset that free tuition for Indian youngsters--which I support, by the way. The College came into being because it had been a fort. It was called Fort Lewis. It had been a fort in the old days. When it was deactivated by the Federal Government, the land was given to the State of Colorado on condition that they would educate young Indian people and that there would be no cost for tuition to do it. That has been going on. It is a very nice, fine little school. But almost all of the other Indian colleges get some funding through a variety of sources, through Interior, Education, Agriculture, or some other agencies. It is never enough, by the way, as you know. But at least they get some. I have been concerned for some time about that little State college that gets no reimbursement whatsoever. I don't suppose you are prepared to talk about it at all. Ms. Vasques. I do not have an answer for you right now. But I will look into it at the Department and see if that has ever come up and if there has been a request from the Fort Lewis College. The Chairman. There never has been a request from Fort Lewis College. But there has been a number of times from the State government. They get off-set by the money that has to come from the State. Every State is running a deficit this year, as you know. I know that has become a bigger point of contention. About 15 or 18 years ago, somebody in the State legislature ran a bill to revoke that reimbursement. Of course, they ran head-on into the Federal Government who said, ``If you do that, you are apt to lose the land because that was the original agreement.'' So the State finds itself in this very uncomfortable situation where they don't have the money to off-set it in many cases, and yet they are obligated to by the Federal Government. Could you try to see if you can find any information on that to see if anything ever has been done through the Education Department and supply that information to the committee? Ms. Vasques. Certainly. [Material supplied follows:] Tuition Waivers for Indian Students We have no information that would indicate whether or not the tuition waiver and State reimbursement for American Indian students at Fort Lewis College are unique or whether other colleges and States have similar policies. However, we are aware that many institutions of higher education, foundations, and corporations provide special scholarships for Indian students. Information on specific scholarships can be found on a variety of websites. For example, the American Indian College Fund website includes one such listing at the following web address: www.collegefund.org. Ms. Vasques. Mr. Chairman, it might be a new initiative we might want to pursue for my office, as well. The Chairman. Well, I would appreciate it if that could be done. Ms. Vasques. Okay. The Chairman. With that, I will submit questions and would ask if Senator Inouye could continue with the hearing. Senator Inouye. Thank you very much, sir. Dr. Kincannon, I note that the Census numbers for Indian country has grown considerably in the last two decades. I am certain you are aware that tribes have different standards of citizenship or enrollment. For example, in some tribes if one can trace his ancestry to an original tribal roll, that would suffice. In some tribes, there are blood quantum requirements. If I should approach you and I said to you, ``I am a Sioux,'' even if I am just one-fourth Sioux, what am I listed as? Mr. Kincannon. Mr. Chairman, you are listed in accordance with how you respond. We don't have a way to individually quiz people or to know the percent of blood or individual tribal rules that apply that in a national context. We ask people to identify their race, and if they are American Indian or Alaska Native, to identify the tribal membership that predominates. We accept their word. They are obliged by law to report honestly to the best of their ability. We accept their word. Senator Inouye. So if I am proud of my German ancestry, and I respond German, that is what is listed. Mr. Kincannon. You couldn't respond German to the racial question. Senator Inouye. Well, I mean to the ethnic question. Mr. Kincannon. Yes. Senator Inouye. You will be conducting your survey with Native Hawaiians. What technique will you follow there? Mr. Kincannon. You are speaking of the American Community Survey? Senator Inouye. Yes. Mr. Kincannon. Yes; we will be conducting that survey on a similar basis, but we have made special plans. We will conduct a certain number of interviews in households throughout the country every month if the full funding of that survey comes about for fiscal year 2004. We have made plans for special sampling provisions to ensure coverage to the extent possible of this rather small population that is important for us to cover. We have discussed that with representatives of the community and with the Advisory Committee to the Census on Native Hawaiians and Pacific Islanders. I will be visiting the Hawaiian homelands later this month. I learn better if I can see it. I will be visiting with community leaders and Hawaiian homelands in your State later this month. Senator Inouye. All political polling organizations have a caveat saying, ``Three percent, plus or minus.'' What sort of caveat do you have for your work? Mr. Kincannon. Any survey result that is based on a probability sample will have a range of error. The range of error will depend on the sample size, the population size, and the characteristic being measured. I can provide some estimates of that for the record, if you would like. But it will be an analogous kind of measure of a plus or minus so many percentage points. Senator Inouye. Your numbers are very important because they not only impact upon economic development but on all the programs that these other witnesses have mentioned. Often times it is either per capita or per group. Your numbers are the determinate. Could you provide us with those variations? Mr. Kincannon. We can provide you with whatever statistics we have collected. We can be guided by the needs of the committee to the extent feasible in shaping future data collection and tabulation. [Material to be supplied follows:] Mr. Kincannon. We use either Confidence Interval (CI) or a Coefficient of Variation (CV) for each data item we publish from our surveys. The term ``margin of error'' has a variety of meanings and is most commonly used by the media. There is a direct relationship between margin of error and confidence intervals, and it is synonymous with the ``plus or minus'' quantity in a confidence interval. A confidence interval gives an estimated range of values that, with some level of certainty, contains the value of the estimate that would be obtained from the complete population. The width of the confidence interval gives us some idea of how certain we are about the estimate. For example, from the American Community Survey (ACS), the median age in Hawaii in 2001 was estimated at 36.7 years with a confidence interval of +/- 0.2. This means that 90 percent of the time the estimate of the median age would be between 36.5 and 36.7 years. The median household income in Hawaii in 2001 was $49,960 with a confidence interval of +/- $2,632, that is, 90 percent of the time the estimate of the median income will be between $52,592 and $47,328. The Coefficient of Variation (CV) is the ratio of the standard error of the estimate to the value of the estimate. It is usually expressed in terms of a percentage. The lower the CV the higher the relative reliability of the estimate. The estimates developed from a specific sample survey may differ from the results of a comparable, complete coverage survey. This difference is estimated by the standard error. The Annual Survey of Manufactures (ASM), shows the number of manufacturing employees in Hawaii for 2001 at 14,382 with a CV of 6 percent. This means that there is about 95 percent confidence that the interval, 12,656 to 16,108, includes the true value the estimate is approximating. Senator Inouye. I would like to ask Ms. Martin a few questions. I have one question, and I may submit the rest of my questions. We were made to understand that there were two new tribal colleges that will begin operations this year. We also understood that the Department of the Interior is aware of these colleges, but no funds were requested. Why is that? Ms. Martin. Sir, I am not aware of the two new tribal colleges. I don't know right now why funds were not requested for them. I will check into that. Senator Inouye. I will give you the names. I will submit them to you. Ms. Martin. Thank you. According to press reports, in her testimony before the Senate Energy Committee, Secretary Norton indicated that the increase in funding in the budget for Trust reform will come at the cost of reductions in funding in other department programs for Indians. Have you heard that? Ms. Martin. I was not specifically aware of her statement at that hearing, but I have heard in press reports that statement was made. Senator Inouye. Well, her testimony has been rather widely disseminated. However, it seems clear that existing problems with the Trust management have been caused, not by Indian beneficiaries, but by the Government. This goes back in history. Under these circumstances, do you think it is fair to take funds from other Indian programs to address a problem that may be the Government's sole making? Ms. Martin. We are in a position now where we must fund our Trust programs. We are doing our very best to prevent the funding of those programs from affecting our other tribal services and programs. I regret that to some extent our tribal services programs may be affected. We are doing everything we can to minimize that. Senator Inouye. Well, as you know, I cast my vote in favor of Mr. Swimmer because we want this matter resolved as soon as possible. I hope everything turns out well. You have included in your request $15 million to reorganize the Office of the Special Trustee for new Trust offices located in the field. Do you have duties that have been set forth for these Trust offices? Ms. Martin. We do have some duties that have been set forth for the Trust officers. Donna Erwin, the Acting Special Trustee for American Indians, is accompanying me today. I will defer to her to answer questions you might have about that. Ms. Erwin. Mr. Chairman, we do have duties. We have position descriptions. The main purpose of putting fiduciary trust officers in the field is to be able to give the beneficiaries one point of contact. We are not shifting them all over within the Agency trying to answer questions. It also will avoid the disruption of the day-to-day operations of the people that are performing the operation duties. The other thing is that these people will be there to add an additional resource to the BIA and expand resources on fiduciary duties to make sure we are meeting our responsibilities and we are representing those beneficiaries, as well as looking out for the land as we are moving forward in preserving and conserving land. Senator Inouye. Have you selected these Trust officers? Ms. Erwin. No; we have not. Senator Inouye. Do you have any requirements or standards that you have set for these new officers? Ms. Erwin. Yes; we have. We have been working with the BIA. We have had meetings, in fact, as recently as last week, on setting out standards and setting out training for both BIA and the Trust officers in: ``How do you represent the loyalty to that beneficiary? How do you represent and make sure that you are meeting your Trust responsibilities?'' So one of the things that we want to be able to do is look for people that have a fiduciary background, but in addition to that, to be able to provide this training. We have even discussed holding these training programs at tribal colleges so that we can develop Indian people to be able to come into these positions. Senator Inouye. Have you advertised this in Indian country? Ms. Erwin. Pardon me? Senator Inouye. Have you advertised the need for these Trust officers? Ms. Erwin. No; we are just completing the reorganization and those job descriptions. They will be advertised throughout Indian country. We have discussed including them in the American Bar, the Indian Bar, and tribal colleges. We do want to be able to bring, as we said, the Indian people trained into those types of positions. Senator Inouye. I note in your budget request that you have established a cap for historical accounting at $130 million. What is the justification for this number? Ms. Erwin. I don't believe that is a cap. I think that is the request for this fiscal year; $100 million of that would be for the individual Indian historical accounting and $30 million of that would be toward tribal. We do not have anyone here that can talk to the specifics today, but if you have additional questions we can certainly get those back to you in writing. Senator Inouye. But will you be able to spend more than that if you do not have it? Ms. Erwin. I would like to defer that to the experts in that field. Senator Inouye. When you set a cap limitation of this sort, how can the Secretary fulfill the requirements of court orders? Ms. Erwin. I believe, if you refer to the plan that was submitted on January 6, it will outline how that funding would be spent during fiscal year 2004. As I said, I would like to give you details on that in writing so that we can give you the specifics. Senator Inouye. This next question I do not expect a response, but I would hope you can do it in writing. I would like to know what we can do in Congress to assist the Department and the Administration in reaching a settlement in the case of Cobell? Ms. Erwin. I think we would appreciate those efforts. I believe, as the Secretary has previously testified, there is a disparity in numbers currently. One of the things that you will be seeing in that historical accounting expenditures, would be to try to document some of the higher dollar amounts so that figure could become closer to something that we could settle. So I think everyone would appreciate moving toward that. Senator Inouye. Ms. Martin, I will be submitting many more questions, if I may. Ms. Martin. Thank you. Senator Inouye. Doctor, about 10 years ago the committee took a trip to Alaska. Like most of our trips to Indian country, the picture is rather sad because the statistics and what you see is not pretty unless you travel to just casino places. For example, in Alaska we were told that at that time, which was about 1990, of the men in the age group of 18-23, the suicide rate was 14 times greater than the national average. Are you aware of those numbers? Mr. Grim. Not those specific numbers, sir. But yes, I am aware of the disparity between suicide rates in our population and the general population. Senator Inouye. What is it now? Mr. Grim. It is 2.7 percent higher right now in our population. It varies by tribe and by region. But the overall average is 2.7 percent greater. Senator Inouye. That is for all age groups? In other words, it has improved? Mr. Grim. It has gotten better. There is still the disparity. We are not happy with that. Senator Inouye. Is that for Alaskan Natives or all Indians? Mr. Grim. That number was for all Indians. Senator Inouye. So it is 2\1/2\ times the national norm? And the numbers that you gave on diabetes is the same as the national norm? Mr. Grim. Yes, sir. Senator Inouye. Seven times. Mr. Grim. The diabetes rates are 2.7 times greater. Senator Inouye. We were told about 10 years ago that if an Indian man reached the age of 50, the odds were that he would be diabetic. At least half were diabetic. Is that the ratio today? Mr. Grim. I can't answer that specifically. But our rates are still high. We are not expecting a decrease in the near future. We have seen some indicators, as I mentioned in my oral statement, that would lead us to believe that in the not-to- distant future, the special moneys that have been put out to tribes in grants, are making an impact on the prevention side. We are seeing a lot of the clinical markers and laboratory markers that are increasing in the right direction. But it is going to take years before the actual diabetes prevalence or incidence starts to shift in the right direction. Senator Inouye. The Census Bureau provided us some information of the number of homes with telephones and the number of homes with toilet facilities. Obviously it is very much lower than the American norm. What sort of health impact would that have on Indian country? Mr. Grim. It has a huge impact on Indian country. In the early days of Indian Health Service, as we saw the numbers increase in the number of homes that we were able to install safe water and sanitation facilities, we saw a corresponding decrease in gastrointestinal and neonatal deaths. So it makes a huge impact. We still have huge disparities in the number of Indian homes that don't have safe water. Our recent statistics show approximately 7-8 percent of Indian homes still do not have safe water supplies. The corresponding U.S. rate, I believe, is around 1 percent. So we still have a huge disparity there. That is one of the reasons we are very excited about the $21 million increase that has been proposed for our 2004 budget in sanitation facilities. It will help us to make a greater impact in that arena. But we still have needs that are far greater than that, as you are aware. Senator Inouye. $81 million will make a greater impact. What do you mean by ``greater impact?'' Is that 10 percent or 5 percent? Mr. Grim. We have some specific numbers for you, Senator. The numbers that we would be able to serve with that increase in funding is about 765 additional first service homes. Senator Inouye. Six hundred. Out of how many? Mr. Grim. About 21,500 that we have on our list now. Senator Inouye. Six hundred out of 20,000. Mr. Grim. Yes, sir. Senator Inouye. At that rate it might take us 30 years. Mr. Grim. It would take a number of years. Right now we estimate our unmet need in that arena for sanitation facilities as $1.6 billion. But there is a number that are unfeasible. We look at the ones that are feasible as costing around $900 million. Senator Inouye. The American populace has become accustomed to different color ratings--dangerous, safe, acceptable, et cetera. Where would you place this? Unacceptable, dangerous, or moderate acceptable? Mr. Grim. I think, Senator, for those locations that have some of the greatest disparities, the families, and the people that have to live with them, would place them as unacceptable. I know the Secretary in one of his recent trips to Alaska also was able to see some of the needs that the Alaskan Natives have relative to safe water and sewer. He was very supportive of our $20 million increase that is being proposed in the President's budget. Senator Inouye. Are there any plans to limit eligibility for health care services to only those enrolled members, of federally-recognized tribes? Dr. Grim. No, sir; we have no such plans. Senator Inouye. Are there any plans to privatize or out- source Indian health care services? Mr. Grim. If you refer to privatization as in the business private sector, we have no such plans. But as you are aware, through Public Law 93-638, anytime the tribe wishes to take over their health care programs or operations from us, we are fully supportive of that. In a sense, we look at that as privatization to the local community. We are not looking for any great privatization to the private business sector, but we are still very supportive of tribes taking over their own programs. Senator Inouye. Two words have become very important in the American vocabulary--homeland security. Yesterday, the U.S. Senate established a new Appropriations Subcommittee on Homeland Security. Has your Agency begun any negotiations or discussions with Indian country as to what can be done to prepare Indian country for emergency response to some of these problems? Mr. Grim. There are a couple of things that have been going on around that, Senator. When the Centers for Disease Control and the Health Resources and Services Administration put their grants out around preparedness, some of our staff were involved in the reviewing of those grants and ensuring that the American Indian and Alaska Native tribes were included as part of the State planning and implementation process. A lot of comments went back indicating a need to ensure that there was inclusion. The other thing we have been hearing is anecdotal evidence from a number of tribes relative to the resources necessary to ensure that all of our tribal homelands are safe and secure. This also includes the special needs of those on the borders, the U.S./Mexico border and the United States/Canadian border, as well as some of the port tribes that are on or near ports. One of the things that the Indian Health Service is looking at doing in the near future, is working with the new Department of Homeland Security. I know that our two Departments, HHS and Homeland Security, will work closely to coordinate things. One of the things the Indian Health Service is doing above and beyond that is we are planning in the spring for a conference to be held with the tribes. That conference will be looking at homeland security issues and general security issues. In essence, we are trying to get prepared to work with tribes, to hear what they have to say, and where they think we, as a health care system, tribal health care systems, and urban health care systems, can fit into the homeland security arena. We don't have a set date right now. We are looking at the spring. We have some tribal organization representatives that will be helping us plan that agenda. Senator Inouye. Would I be correct in suggesting that there are no tribal or IHS hospitals or clinics that are presently prepared to cope with bioterrorism or chemical attacks? Mr. Grim. No; I wouldn't go that far to say that there are none prepared. In fact, most of our hospitals and clinics do get accredited by an organization called the Joint Commission on the Accreditation of Health Care Organizations, or other similar external accrediting bodies. Part of that process requires that they all have a disaster preparedness plan that they practice on a regular basis. We have gone further with the development at both headquarters and regional levels to develop what are called ``Continuity of Operations'' plans to ensure that if any of our offices are shut down, we are able to operate. So I think that much like the rest of the Nation, the Indian Health Service and Indian tribes are in a better place than they were 1 year or two ago relative to that sort of preparedness. There is still a long way to go and a lot that needs to be done. Senator Inouye. A few years ago one of the proudest moments of the Health Service was to announce that infant mortality in Indian country has now become equal to the national norm. What is it now? Mr. Grim. Right now our ratio is just slightly above that, 1.2. It is a little bit higher. Senator Inouye. But it is still within range? Mr. Grim. Yes; very close. Senator Inouye. Now, if I may go to housing, you have testified that approximately 38 percent of all Indian housing funds appropriated since the beginning of NAHASDA have remained unspent. Did I hear wrong? Mr. Russell. Actually, that percentage represents unspent funds since 1998. So not since the beginning of NAHASDA which was 1996. Senator Inouye. Since 1998? Mr. Russell. Yes. Senator Inouye. Are the tribes aware of this? Mr. Russell. I believe they are. What we are trying to do is work more diligently to collect tribe-by-tribe data, actually on the obligations status of those funds. As you know, it is an unexpended amount of money. Maybe much of that money has already been obligated. So we are trying to ascertain how much of it has been obligated and break that down by tribes so we can have a better idea of where the tribes stand on that. Senator Inouye. When were these tribes notified that we had these funds were available for obligation? I was told yesterday; is that correct? Mr. Russell. I am not exactly sure when they were notified, sir. I can look into that. Senator Inouye. I have been on the Appropriations Committee now for over 30 years. So I am well aware that in the process you begin with what you consider to be priorities and then by the time it gets through your Department and goes to OMB, you may be lucky if you have half. For the 2004 budget request, if I may ask Ms. Vasques, some 45 education programs will be eliminated; is that correct? Ms. Vasques. Yes, sir. Senator Inouye. Now, in your budget request, did you request that they be eliminated? Ms. Vasques. Yes; in keeping with the President's priorities, they looked at many of our programs that have been in existence. I think the exact number is 45 that were targeted for elimination. Senator Inouye. Subject to the President's priorities. Ms. Vasques. Title I, special education. Senator Inouye. What were your priorities? Would you have wanted those programs to continue? Ms. Vasques. I am not familiar with all 45 of them, but I know for the Office of Indian Education, which is where I am the biggest advocate, I constantly am at the table to make sure our priorities are heard in the Office of Indian Education. Senator Inouye. So as far as your program, you don't think you are wasting money? Ms. Vasques. We are not wasting money. We would like some more money. We have $122 million in the Office of Indian Education and approximately $97 million of that goes to the local educational agencies that are serving our Indian students in the public schools. Senator Inouye. In order to carry out your mission in the proper fashion, how much more money would this Congress have to appropriate? Ms. Vasques. To the Office of Indian Education? Senator Inouye. Yes. Ms. Vasques. I wasn't prepared to answer that question. I think the exact amount we are asking for is $122 million. I am shooting for that in my budget. Senator Inouye. You are requesting that because you were told to request that, or because you think it is enough? Ms. Vasques. We worked together within the Office of Elementary and Secondary Education. We sat down and focused on our needs. Senator Inouye. Do you think that amount is enough? Ms. Vasques. Well, for the Department of Education, yes, it is enough. If you are asking me personally, I can always advocate for more. Senator Inouye. What is the dropout rate for high school students now? Ms. Vasques. I can't recall the dropout rate for American Indian students in high school. Senator Inouye. Is it worse than the national norm? Ms. Vasques. Yes, it is. I am sure I have it here in my notes. I can get that exact number for you for the record and submit it to the committee. [Material to be submitted follows:] Dropout Rates of American Indians Data pulled together from the 2000 Census indicate that about 16.1 percent of 16 to 19 year old American Indians are not enrolled in, and did not graduate from, high school. In comparison, the rate is 8.2 percent for whites, 11.7 percent for blacks, 21 percent for Hispanics, and 9.8 percent for the general population. The percentages are based on responses from individuals who identified themselves with a single race and do not include those who identified themselves with more than one race. Senator Inouye. You would like to reduce that dropout rate, wouldn't you? Ms. Vasques. Absolutely. Senator Inouye. At least to make it equal the national norm? Ms. Vasques. We would like to have no dropouts. Senator Inouye. Do you think this program can resolve that? Ms. Vasques. Well, I think it is working in concert with many of our programs at the Department--the Safe and Drug Free Schools, Title I, and other school improvement programs. Senator Inouye. If I may, I would like to submit questions not only for myself but on behalf of the other members. Can we secure a response from you in 2 weeks? Would that be okay? Ms. Vasques. Yes. Senator Inouye. With that, and on behalf of the chairman of the committee, I thank you very much for your presence here today and your answers. Thank you very much. [Whereupon, at 11:26 a.m., the committee was adjourned, to reconvene at the call of the Chair.] ======================================================================= A P P E N D I X ---------- Additional Material Submitted for the Record ======================================================================= Prepared Deborah J. Daniels, Assistant Attorney General, Office of Justice Programs, Department of Justice Chairman Campbell, Vice Chairman Inouye, and members of the committee: The Department of Justice appreciates the opportunity to submit this statement to the committee to discuss the Justice Department's proposed fiscal year 2004 budget priorities for Indian country. As the committee is aware, and as we at the Justice Department are aware, the needs of Indian tribal governments in combating crime and violence continue to be great. As the Department stated to this committee last year, the President and the Attorney General remain committed to addressing the most serious law enforcement problems in Indian country, including substance abuse, domestic violence, and other violent crimes, and to ensuring that Indian tribes are full partners in this effort. The Justice Department's Office of Justice Programs [OJP] continues to be the Department's primary resource for funding and other assistance in Indian country. Through OJP and its component bureaus, the Department identifies emerging criminal and juvenile justice system issues, develops new ideas and tests promising approaches, evaluates program results, collects statistics, and disseminates these findings and other information to Federal, State, and local units of government, Indian tribes, and criminal justice professionals. OJP works to prevent and control crime and help crime victims by providing funding to and assisting State and local governments, Indian tribes, law enforcement, prosecutors, courts, corrections, and other service providers. During the past fiscal year, OJP continued its support to American Indian and Alaskan Native tribes. OJP has done this through grants to support innovative approaches to breaking the cycle of drugs, delinquency, crime and violence and through technical assistance and training to provide tribal leaders with the knowledge and skills required to address these issues. Many of the committee members are aware of OJP's efforts with the Comprehensive Indian Resources for Community and Law Enforcement, or CIRCLE, Project. As was discussed with this committee last year, the CIRCLE Project recognizes that the most effective solutions to the problems experienced by tribal communities come from the tribes themselves. The three tribes that participate in the CIRCLE Project have each undertaken efforts to combat crime and violence. These tribes designed their own strategies, while we provided support through direct funding, training, and technical assistance. With the conclusion of another fiscal year we continue to see results from the three CIRCLE Project tribes. We at OJP are hopeful that the lessons obtained through the CIRCLE Project will be taken as both examples and possible roadmaps for other tribes to follow as they attempt to deal with their own unique needs and requirements. For example, gang activity and domestic violence continue to be a major problem for many tribal communities. Under the CIRCLE Project, the Oglala Sioux have seen reduced gang activity and domestic violence since implementing CIRCLE. We believe that the methods followed by the Oglala Sioux can be used by other similarly situated tribes. Juvenile delinquency also continues to plague tribal communities. Under the CIRCLE project the Northern Cheyenne continue to make progress in this area with several promising youth programs. Meanwhile the Pueblo of Zuni continues its efforts to adopt community policing practices to its community. The Administration's continued commitment to American Indian communities is reflected in the President's Fiscal Year 2004 request of $50.7 million for OJP tribal programs, part of the Department's overall effort to assist tribal governments in addressing criminal justice issues in Indian country. This plan will allow us to continue most of our tribal programs near fiscal year 2003 levels. As the committee is aware, many of OJP's tribal programs focus on alcohol and drug abuse, which continue to be major problems in Indian country. During the last fiscal year, OJP's Bureau of Justice Assistance [BJA] issued a solicitation and awarded grants for the Indian Alcohol and Substance Abuse Demonstration Program, an effort to improve the enforcement of alcohol and drug laws in tribal lands and provide treatment and other services to American Indian or Alaskan Native offenders with substance abuse problems. Under this initiative, recipients are focusing on law enforcement, services, or both. For fiscal year 2003, we received $4.9 million for this initiative. For fiscal year 2004, the President requested an additional $4.9 to continue the effort. BJA will also address the issue of drug abuse in Indian country through continued assistance to Indian communities under its Drug Courts Program, which provides funds for local drug courts that provide specialized treatment and rehabilitation for non-violent substance abusing offenders. While this is not solely a tribal program, OJP has always ensured that tribal governments were included as Drug Court grantees. Last fiscal year alone, we awarded 16 Drug Court grants totaling over $2.7 million to Indian tribes. In the last 2 years, OJP has awarded nearly $6 million in drug court grants to tribal governments and has established 37 new drug courts in Indian country. We anticipate that American Indian and Alaskan Native tribes will continue to apply for drug court funding again this year and that they will be well-represented among new grantees. For fiscal year 2003, we received $44.7 million for the overall Drug Courts Program, and for fiscal year 2004 we have requested $68 million for the overall program. Further, Mr. Chairman, it continues to be a sad fact that American Indian and Alaskan Native women still suffer disproportionately from domestic violence and sexual assault. Since 1994, our Office on Violence Against Women [OVW] has administered the STOP Violence Against Indian Women Discretionary Grants Program, which support tribes' efforts to investigate and prosecute violent crimes against women and to strengthen services for victims of these crimes. During fiscal year 2002, OJP awarded 43 grants totaling over $5 million under this program. In fiscal year 2003, we received $9.1 million for this effort. For fiscal year 2004, we have requested an additional $9.1 million. During fiscal year 2002, we were pleased to launch the Tribal Domestic Violence and Sexual Assault Coalitions Grant Program, a new program authorized under the Violence Against Women Act of 2000 that is designed to help non-profit tribal coalitions improve systemic and community responses to victims in Indian country. We have high hopes that this program will help tribal communities identify gaps in services so that no domestic violence or sexual assault victims fall through the cracks. During fiscal year 2002, OJP awarded six grants totaling over $1.7 million under this initiative. For fiscal year 2003, we received $3.3 million for this effort. For fiscal year 2004, we have requested the same amount. For fiscal year 2004, we are requesting a total of $20.1 million for all of our tribal Violence Against Women Act programs, virtually maintaining the fiscal year 2002 and fiscal year 2003 funding levels. Similarly, OJP's Office for Victims of Crime [OVC] works with Indian tribes to provide services for crime victims in areas that are often under-served. OVC provides direct support through its Victim Assistance in Indian Country Discretionary Grant Program. Tribes can use these funds for many different services, including emergency shelters, mental health counseling, and immediate crisis intervention. This program is supported through the Crime Victims Fund, which comes from Federal criminal fines, forfeited bail bonds, penalty fees, and special assessments. Further, and aside from funds that will become available through OVC's Crime Victim Fund, the President has also requested an additional $1.6 million specifically to support victim assistance programs in Indian country for fiscal year 2004. OVC also administers grants under the Children's Justice Act to improve the investigation, prosecution, and handling of child abuse cases in Indian country. Tribal communities nationwide have used these grants for activities such as training law enforcement and court staff on how to work with child abuse victims, and establishing protocols for handling these cases. We are requesting $3 million for this program in fiscal year 2004, maintaining the current funding level of $2.9 million received for fiscal year 2003. During fiscal year 2004, as during fiscal years 2003 and 2002, OJP continues its work to help American Indian and Alaskan Native youth through the Tribal Youth Program, which is administered by OJP's Office of Juvenile Justice and Delinquency Prevention [OJJDP]. The Tribal Youth Program supports accountability-based sanctions, training for juvenile court judges, strengthening family bonds, substance abuse counseling, and other efforts to improve justice operations in Indian country. Further, with OJJDP funding, American Indian Development Associates provides training and technical assistance to Tribal Youth Program grantees. Also, OJP will continue to dedicate funds to support tribal-related juvenile justice research activities. For fiscal year 2003, OJP received $12.3 million for this program. For fiscal year 2004, the President has requested $12.5 million to allow these efforts to continue. In addition to focusing on specific offender or victim populations, tribes have expressed a need for overall improvement of their justice systems. Tribal justice systems have existed for hundreds of years, but lately their workload has grown markedly, while the available resources have not. OJP has worked to help ease this burden through the Tribal Courts Assistance Program, which assists tribes in the development, enhancement, and continuing operation of tribal judicial systems. It provides resources to help tribes sustain safer and more peaceful communities. For fiscal year 2003, we received $7.9 million for this effort. For fiscal year 2004, we have requested $5.9 million. Another important tool to help tribes enhance their law enforcement and criminal justice systems is technology. This past September, OJP's Bureau of Justice Assistance [BJA] awarded funds to the National Center for Rural Law Enforcement for the first phase of the Inter-tribal Integrated Justice Pilot Project, a part of OJP's Information Technology Initiative. The Inter-tribal Integrated Justice Pilot Project will increase electronic information sharing among the Navajo Nation, Hopi Tribe, and Pueblo of Zuni in order to improve 24-hour emergency services and enforcement of drunk driving violations and protection orders. We look forward to continuing this project and to providing training and technical assistance to other tribes that seek to undertake similar efforts. One of the many challenges that American Indian and Alaskan Native tribes face is collecting reliable data on arrests, victimizations, and other criminal justice-related issues. Last year OJP awarded a grant to the Justice Research and Statistics Association to create the Tribal Justice Statistics Assistance Center, which became operational late last month. The Center will work with tribal justice agencies to develop and enhance their ability to generate and use criminal and civil justice statistics. It will provide support specifically tailored to the tribal community requesting assistance. Among other activities, the Center will offer tribes training in the use of criminal justice data to help inform. justice decisionmaking in Indian country. Not only will improved data gathering help tribes make better policy decisions, it will also help them to better share and receive information with the broader criminal justice community, as well as to participate in national criminal justice data gathering efforts, such as the National Incident Based Reporting System [NIBRS], the Uniform Crime Reporting [UCR] program, and other data collections related to corrections, criminal victimization, court processing, and juvenile justice. In addition, the Center will provide for tribal participation and access to national law enforcement data systems, such as the National Criminal Information Center [NCIC] and the National Protection Order File. For fiscal year 2003, we targeted $2 million in Bureau of Justice Statistics [BJS] funds for the Tribal Justice Statistics Assistance Center and other tribal-related statistics activities, maintaining the current funding level. For fiscal year 2004, we plan to dedicate a similar amount. Through OJP's National Institute of Justice [NIJ], we at OJP continue to engage in a number of research efforts to better understand criminal and juvenile justice problems in Indian country and the many challenges tribal justice agencies face. We consider this type of research critical to helping us understand what approaches and techniques will best serve tribal governments as they work to improve conditions within their communities. In the past this research has produced valuable resources such as Policing on American Indian Reservations, which was developed through a grant to the John F. Kennedy School of Government at Harvard University. We consider continuing these types of projects an essential part of our assistance to tribal governments. Mr. Chairman, so far I have outlined some of our broader efforts to work with American Indian and Alaskan Native tribes, but there is also a need for day-to-day assistance. In September 2000, with OJP support, the National Tribal Justice Resource Center opened its doors. Located in Boulder, Colorado, the Resource Center is operated by the National American Indian Court Judges Association and provides tribal justice systems with assistance that is comparable to that available to Federal and state court systems. The Resource Center offers onsite training and technical assistance, a calendar of seminars and conferences, and a free searchable data base of tribal court opinions. It also features a ``justice system mentoring project,'' which partners a developing tribal court with a more experienced one. The Resource Center makes information available through a toll-free number [1-877/976-8572] and a comprehensive searchable website [www.tribalresourcecenter.org]. OJP plans to continue our support of this project in fiscal year 2004. Mr. Chairman, Attorney General Ashcroft has pledged to honor our Federal trust responsibility and to work with sovereign Indian Nations on a government-to-government basis. The Attorney General, the Justice Department, and OJP will honor this commitment and continue to assist tribal justice systems in their effort to promote safe communities. We also recognize that the most effective solutions to the problems facing tribes come from the tribes themselves, and that our role is to help the tribes develop and implement their own law enforcement and criminal justice strategies. We are confident that our current activities and our fiscal year 2004 proposed budget reflect these priorities. This concludes my statement. Mr. Chairman, I have attached a budget chart to assist the committee, and I would welcome the opportunity to answer any questions you or members of the committee may have. 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