<DOC> [109 Senate Hearings] [From the U.S. Government Printing Office via GPO Access] [DOCID: f:98864.wais] S. Hrg. 109-9 FISCAL YEAR 2006 BUDGET ======================================================================= HEARING BEFORE THE COMMITTEE ON INDIAN AFFAIRS UNITED STATES SENATE ONE HUNDRED NINTH CONGRESS FIRST SESSION ON OVERSIGHT HEARING ON THE PRESIDENT'S FISCAL YEAR 2006 BUDGET REQUEST FOR INDIAN PROGRAMS __________ FEBRUARY 16, 2005 WASHINGTON, DC U.S. GOVERNMENT PRINTING OFFICE 98-864 WASHINGTON : 2005 _____________________________________________________________________________ For Sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512-1800; (202) 512ÿ091800 Fax: (202) 512ÿ092250 Mail: Stop SSOP, Washington, DC 20402ÿ090001 COMMITTEE ON INDIAN AFFAIRS JOHN McCAIN, Arizona, Chairman BYRON L. DORGAN, North Dakota, Vice Chairman PETE V. DOMENICI, New Mexico DANIEL K. INOUYE, Hawaii CRAIG THOMAS, Wyoming KENT CONRAD, North Dakota GORDON SMITH, Oregon DANIEL K. AKAKA, Hawaii LISA MURKOWSKI, Alaska TIM JOHNSON, South Dakota MICHAEL D. CRAPO, Idaho MARIA CANTWELL, Washington RICHARD BURR, North Carolina TOM COBURN, M.D., Oklahoma Jeanne Bumpus, Majority Staff Director Patricia M. Zell, Minority Staff Director/Chief Counsel (ii) C O N T E N T S ---------- Page Statements: Beaulieu, David, president, National Indian Education Association................................................ 25 Boyd, Roger, deputy assistant secretary, Office of Native American Programs, Department of Housing and Urban Development................................................ 9 Carl, Chester, chairman, National American Indian Housing Council.................................................... 20 Cason, Jim, acting assistant secretary, Indian Affairs, Department of the Interior................................. 7 Coburn, M.D., Hon. Tom, U.S. Senator from Oklahoma........... 5 Conrad, Hon. Kent, U.S. Senator from North Dakota............ 6 Corwin, Thomas, director, Division of Elementary, Secondary and Vocational Analsis, Budget Service, Department of Education.................................................. 11 Dorgan, Hon. Byron L., U.S. Senator from North Dakota, vice chairman, Committee on Indian Affairs...................... 3 Grim, Charles W., director, Indian Health Service, Department of Health and Human Services............................... 8 Hall, Tex, president, National Congress of American Indians.. 18 Hartz, Gary, acting deputy director, Indian Health Service, Department of Health and Human Services.................... 8 Johnson, Hon. Tim, U.S. Senator from South Dakota............ 4 Liu, Michael, assistant secretary, Office of Public and Indian Housing, Department of Housing and Urban Development 9 Martin, Cathie, deputy director, Office of Indian Education, Department of Education.................................... 11 McCain, Hon. John, U.S. Senator from Arizona, chairman, Committee on Indian Affairs................................ 1 Petherick, John Thomas, executive director, National Indian Health Board............................................... 22 Thomas, Hon. Craig, U.S. Senator from Wyoming................ 4 Swimmer, Ross, special trustee for American Indians, Department of the Interior................................. 7 Vasques, Victoria, assistant deputy secretary and director, Office of Indian Education, Department of Education........ 11 Wright, Tom, director, Office of Native American Programs, Office of Loan Guarantee, Department of Housing and Urban Development................................................ 9 Appendix Prepared statements: Beaulieu, David (with attachment)............................ 117 Carl, Chester (with attachment).............................. 108 Cason, Jim (with attachment)................................. 35 Grim, Charles W.............................................. 33 Hall, Tex (with attachment).................................. 86 Liu, Michael (with attachment)............................... 71 MacDonald-Lonetree, Hope, delegate, Navajo Nation Council.... 130 Smith, Sally, chairman, National Indian Health Board......... 136 Swimmer, Ross (with attachment).............................. 35 Vasques, Victoria (with attachment).......................... 51 FISCAL YEAR 2006 BUDGET ---------- WEDNESDAY, FEBRUARY 16, 2005 U.S. Senate, Committee on Indian Affairs, Washington, DC. The committee met, pursuant to notice, at 9:34 a.m. in room 485, Senate Russell Building, Hon. John McCain (chairman of the committee) presiding. Present: Senators McCain, Coburn, Conrad, Dorgan, Johnson, Murkowski, and Thomas. STATEMENT OF HON. JOHN McCAIN, U.S. SENATOR FROM ARIZONA, CHAIRMAN, COMMITTEE ON INDIAN AFFAIRS The Chairman. The committee will come to order. I recognize the need to balance the Federal budget and agree that cuts in discretionary spending programs are warranted. As a fiscal conservative, I expect to support a budget resolution that keeps discretionary spending down. That said, I object to many of the decreases in funding that are proposed in the President's fiscal year 2006 budget for Indian programs. The Federal Government has continually reneged on its trusts and moral obligations to meet the educational, health care and housing needs of Indians. These needs far outweigh the imperceptible contribution that the proposed cuts will make to reducing the deficit. Some of the proposed reductions that are ill-advised are to those programs such as BIA's Tribal Priority Allocation Program and HUD's Native American Housing Block Grant Program that are managed and administered by the tribes themselves. A recently released study by the Harvard Project on Indian Economic Development examined 10 years of socio-economic change experienced by Indians living on Indian lands. It concluded that Indians' economic growth and improvements in social well being far exceed progress being made by the overall population. The study attributes this progress to the policies of self- governance. Despite this improvement, however, the report notes that tremendous disparities continue to exist between our country's Indian populations, both gaming and non-gaming tribes, and all other people. These findings support the need for consistent Federal funding for programs that help Indian tribes achieve self-determination and that allow local decision makers, not Federal administrators, determine how best to address local needs. While the proposed budget cuts many Indian programs, a notable exception to this is in the Office of the Special Trustee, within which the budget for historical accounting is slated to grow by $77.8 million or 40 percent, while all around it programs such as those funding education and substance abuse prevention have been drastically cut or eliminated. It is lamentable that we are in a situation that the funding for an accounting appears to have come directly from programs that affect the daily lives of Indians. No doubt this request for funds to conduct a historical accounting is a result of the Cobell v. Norton litigation. By proposing only $34.5 million for land consolidation, however, the Administration seems to have under-valued another means of addressing its trust administration problems. The BIA currently administers hundreds of thousands of individual Indian money accounts, many of which cost more to maintain than the value of the funds moving through them. Last year, Congress amended the Indian Lands Consolidation Act to permit the Department of the Interior to buy up highly fractionated land interests in order to reduce BIA's administrative burden and increase the size of tribal land holdings. Those amendments authorized $95 million for land consolidation in fiscal year 2006, and $145 million a year for several fiscal years thereafter. The primary reason for these funding authorizations was to eliminate the very conditions that gave rise to the Cobell litigation. I understand that the Administration's rationale for some of the program cuts is they did not perform well in the OMB's program assessment rating tool, or PART, evaluations. I would like to examine this. The accountability problems at the BIA, however, are not helped by the sweeping prohibition on the department's use of the internet that remains in effect by court order in the Cobell case. The BIA has always been a troubled agency, but it is unreasonable to expect it to overcome this with one hand tied behind its back. While I appreciate the need to provide security for computerized Indian trusts, and support the efforts of both the plaintiffs and the Department to improve IT security, I cannot help but wonder whether confining the Bureau and much of the rest of the Department of the Interior to paper transactions in this electronic age is doing more harm than good to the Indian people, and the rest of the public that the Department is supposed to be serving. Unfortunately, the Budget Committee has given us only until Friday to submit our views and estimates letter on the proposed budget. Senator Dorgan and I intend to circulate a draft letter to all offices by noon tomorrow. We ask that all comments on this draft be submitted by 5 p.m. tomorrow so we can submit the letter, at least this first one, to the Budget Committee on Friday. I look forward to hearing from the witnesses. I hope that is the longest opening statement that I will ever make as chairman of this committee. [Laughter.] The Chairman. But I would like to reemphasize to my colleagues that the Cobell issue impacts everything else that we do in our programs concerning Native Americans. We have to get this resolved or say that we will leave this to the courts in the years and perhaps decades to come for them to settle. It is an issue that impacts everything else that we do, and one that I think therefore has to have a very high priority. Senator Dorgan. STATEMENT OF HON. BYRON L. DORGAN, U.S. SENATOR FROM NORTH DAKOTA, VICE CHAIRMAN, COMMITTEE ON INDIAN AFFAIRS Senator Dorgan. Mr. Chairman, thank you very much. Let me just say that I agree with much of what you have said this morning, especially on the issue of the trust situation. It threatens to overwhelm all of these other issues. We must find a way to use some commonsense to address it and deal with it because otherwise we will grapple with that for a long, long time and it will affect all the other things that all of us believe we ought to do. Let me also say I agree with you that much in this budget is not adequate, and that is not a very good description, to say not adequate. We have many in this country living on reservations that live in third world conditions. We do not want to talk about it very much, but let me just in a few seconds tell you that Avis Little Wind, who hung herself at age 14 recently on a reservation, did so in a circumstance where there was no mental health capability available to her. She laid in bed in a fetal position for 90 days missing school. Everyone should have been alerted to it, and yet she died. Sarah Swift Hawk died in bed. She was a grandmother. She laid down and froze to death. Yes, she froze to death in this country on the Pine Ridge Reservation in South Dakota. Rosie Two Bear is in a school with 150 kids, two toilets and one water fountain; 30 kids in a room; desks one inch apart. Rosie says, Mr. Senator, can you build us a new school? The fact is, we have circumstances on the reservations in this country that are desperate. We have bona fide emergencies in housing, health care and education, and we must get about the business of addressing them. You go to a reservation and find one dentist working out of a trailer house, serving 5,000 people, and you ask yourself, is this what we hoped to have happen or can we do better? My fervent hope is that on this committee working with the Chairman and so many other members of the committee, that we can do much, much better. For years, Administrations have not provided the budgets that we need in order to address these issues. It is a matter of resources when you deal with these issues of housing, health care and education. Finally, in the education area, I would say this budget says once again that the two colleges that I think are standout colleges, the United Tribes Technical College, and the Crownpoint Institute of Technology are not worthy and really should be de-funded. What on earth are these priorities about? I mean, who decides these priorities? Why should the tribal colleges, which represent the step ladder up and out of poverty for so many people have their budgets cut substantially at a time when we already provide only about 50 percent of the support for those Indian students than we do for community college students. So we have so much to do. We can do much, much better. I hope that this committee is a source of hope and inspiration to deal with these issues. Mr. Chairman, I look forward to working with you and my colleagues on the committee. The Chairman. Thank you. Senator Thomas. STATEMENT OF HON. CRAIG THOMAS, U.S. SENATOR FROM WYOMING Senator Thomas. Thank you, Mr. Chairman. I certainly agree with you that we have to hold down the budget. On the other hand, we have to look at these issues. I also agree with you on the length of opening statements. I am glad to see that this budget does deal with health care. It does deal with secondary and elementary schools. It does deal with vocational things. But we need to really overlook this and see what we can do. Unfortunately, I have to go the Floor, but I appreciate your holding this hearing. The Chairman. Thank you, Senator Thomas. Senator Johnson. STATEMENT OF HON. TIM JOHNSON, U.S. SENATOR FROM SOUTH DAKOTA Senator Johnson. Chairman McCain and Vice Chairman Dorgan, thank you for holding this hearing on the vital issue of funding for Indian programs. The President's budget proposals almost universally throughout every agency that affects Indians are an abomination. This budget proposal is out of sync with values shared by Americans who care about children, education, strong communities, adequate law enforcement and the opportunities to share in America's blessings. This budget especially hurts those with the greatest needs, those in the poorest communities served by the weakest infrastructures, with the least access to economic opportunity and basic government services. Just this past weekend, I took a dirt road from Red Shirt, SD, a tiny community located on the Pine Ridge Indian Reservation. The folks of Red Shirt do incredibly well considering the lack of Federal contributions. They do the best they can, but this community struggles, and sadly there are hundreds of these communities like Red Shirt that exist in Indian country that need basic essential services and opportunity. Despite the Federal treaty and trust responsibilities owed to Indians, the President has proposed that Indians make enormous sacrifices to help provide the tax breaks the President is so passionately committed to give to the wealthiest Americans. Indians are happy to do their part to help their Nation with its essential needs, such as fighting the war on terror and keeping our Nation safe. As we all know, Native Americans serve in the armed forces at a higher rate than any other group. But this budget tries to scrape pennies from the programs that serve the poorest Americans, while it fails to ask the wealthiest Americans to make similar sacrifices. Needless to say, I am profoundly disappointed with the President's priorities. As an example, the BIA Indian school facilities budget, despite the fact that we have condemned facilities, as is the case at the Crow Creek Sioux Tribe in South Dakota, the President is proposing a reduction of $89.5 million, more than 33 percent from fiscal year 2005, for school construction. The President zeroed out the entire Community Development Funding Initiative Program, a portion of which was targeted to Indian country. He proposes a decrease in funding for Indian housing through the block grant program by over $100 million. How can tribes develop their economies without economic development programs? Important to my South Dakota tribes is the President's request pertaining to the tribal priority allocation funding. TPA funds are used for various programs such as Johnson O'Malley, the Tribal Work Experience Program and others. I am also concerned about the budget pertaining to the Office of Special Trustee. OST's budget is growing and while I understand the need to fund historical accounting and the Indian Land Consolidation Program, I am concerned that OST's budget is hemorrhaging at the cost of Indian program funding. To add insult to injury, the Department of the Interior's across-the-board rescission that occurs every year takes off the top cut of all our program funding. As testimony today will reflect, every aspect of Indian funding is hurting. I am concerned in particular about the school construction and again an enormous cut in tribal college and university funding being proposed by the President. At a time when we ought to be trying to find ways to empower Native Americans to succeed economically in a competitive world, the very means, the very ladder that needs to be there to allow that to happen is being destroyed by this Administration's priorities. We need to do better and I look forward to working in a bipartisan fashion on this committee and on the Appropriations Committee and on the Budget Committee to do better. Thank you, Mr. Chairman. The Chairman. Senator Coburn. STATEMENT OF HON. TOM COBURN, M.D., U.S. SENATOR FROM OKLAHOMA Senator Coburn. Mr. Chairman and Mr. Vice Chairman, I appreciate the opportunity to be here. I do not have an opening statement other than to say it is an obligation to us to make sure the money that is spent is spent efficiently. I will work to help you put that forward. I will be leaving for another committee meeting, and I would ask that I have some written questions that I would like to be submitted to the witnesses and answered by letter. The Chairman. Without objection, they will be made and entered. Senator Conrad. STATEMENT OF HON. KENT CONRAD, U.S. SENATOR FROM NORTH DAKOTA Senator Conrad. Thank you, Mr. Chairman. I especially want to welcome you and our new Ranking Member, my excellent colleague, Senator Dorgan, to these new responsibilities. The Chairman. Thank you. Senator Conrad. I am very much looking forward to working with the two of you. I think this is going to be excellent for the committee. Let me just say with respect to the budget, about 1 year ago I went to Standing Rock Sioux Tribe in North Dakota and went to the high school. In the high school, which was designed by an architect from the southwestern part of the United States, Mr. Chairman, I love the Southwest, but this particular architect did not understand North Dakota winters. In one part of that building in February, it was 75 degrees; in another part of that building, it was 50 degrees. This was in a February winter. It was about 10 below outside. It really made it very, very hard to have an environment for learning. To add to the difficulty, the school was built on an open classroom concept, so there were no walls separating the classrooms. Mr. Chairman, Senator Dorgan knows this story well, you could not hear yourself think there, much less listen to a teacher to learn. When I look at this budget and I see school construction cut 57 percent, and I see tribal colleges cut nearly 20 percent, I see United Tribes Technical College have its funding eliminated, which is really one of the bright spots in our State in Indian country. This college is reaching out to young people and giving them a chance. The best thing that I see happening in Indian country are in these tribal colleges, in these institutions of learning. It is the one bright spot. It is the one place I go where you can see people having a sense of achievement and a sense that they can make a difference. I remember attending the graduation of a number of the tribal colleges, and for the first time in my own career feeling a sense of hope about what could occur. I look at this budget and it is not building on hope; it is destroying hope. That should not be what we are about. Goodness knows, nobody has given more speeches about the need to reduce deficits than I have. I do not think that anybody feels it any more passionately than I do. I believe we are on the wrong course. But a budget is also about priorities. This budget for Indian country really must be fixed. We are talking about a modest amount of money and the needs are great. I thank the Chair. I thank the Ranking Member. The Chairman. I thank my friend from North Dakota. I know that we will have ample opportunity to engage in discussions of priorities. I think we are in agreement that these budget cuts are probably really both unfair and unsustainable, but I would also hope that we would realize over the years that we have enormous waste and mismanagement. You just described it. That is why this Harvard study on self-governance is an important document. If the tribe had been governing itself, I doubt if they would have built that school like you just described. The more self-governance that the tribes will adopt, and I think Mr. Swimmer here, who has been involved in this for many years would agree with it, the more efficiently they will conduct themselves and the more progress they will achieve. It is the old welfare dependency situation, and I hope that working together we could make that a priority since it seems to be the only way the tribes have been able to improve, or the most significant way that tribes can improve is through self- governance. I think we will have plenty of time for hearings and discussion on that. I thank my colleague from North Dakota. Please, go ahead. Senator Conrad. Mr. Chairman, if I could just comment. The Budget Committee is set to meet in just a few minutes, so I would like to excuse myself and ask that my full statement be made part of the record. The Chairman. Without objection. I think our Native American friends think they need you more there than here. Thank you. Our first panel is Jim Cason, acting assistant secretary for Indian affairs of the Department of the Interior, accompanied by Ross Swimmer, special trustee for American Indians; Charles W. Grim, director of Indian Health Service, Department of Health and Human Services, accompanied by Gary Hartz, the acting deputy director of Indian Health Service; Michael Liu, assistant secretary of the Office of Public and Indian Housing, Department of Housing and Urban Development, accompanied by Roger Boyd, the deputy assistant secretary, Office of Native American Programs [ONAP's], and Tom Wright, the director of ONAP's Office of Loan Guarantees, Department of Housing and Urban Development; and Victoria Vasques, assistant deputy secretary and director of the Office of Indian Education, Department of Education, accompanied by Cathie Martin, deputy director, Office of Indian Education, and Thomas Corwin, director, Division of Elementary, Secondary and Vocational Analysis of the Budget Service of the Department of Education. Welcome to all. Mr. Cason, we will begin with you, sir. STATEMENT OF JIM CASON, ACTING ASSISTANT SECRETARY FOR INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, ACCOMPANIED BY ROSS SWIMMER, SPECIAL TRUSTEE FOR AMERICAN INDIANS Mr. Cason. Thank you, Mr. Chairman, for the opportunity to discuss the Administration's fiscal year 2006 budget for Indian programs in the Department of the Interior. Ross and I are providing a joint statement to reflect our joint approach to managing Indian programs within the Department of the Interior. The Administration's fiscal year 2006 budget reflects historical commitments and reflects the dialog regarding current priorities for Indian tribes, Interior and OMB. Some of the noteworthy elements of our budget are the impacts of the Cobell litigation that you mentioned already, which shifts significant resources to trust programs, historical accounting, and litigation support. It reflects the recognition of work completed and settlements that have been implemented, a continued strong commitment to the construction of Indian schools, but a recognition of the increased balance of unobligated funds in that program. When combined, the Indian affairs and OST's budgets reflect about the same level of funding that Congress provided in fiscal year 2005. Ross and I have been working closely together during the past 3 years on improving the performance and results associated with our Indian trust programs. I am looking forward to the opportunity to work on other important Indian affairs programs. Mr. Chairman, let me apologize in advance for the need to leave about 1 hour from now. I have been requested to testify in the House Resources Committee on the Cobell litigation and the prospects for fashioning a full and fair settlement of the issues there. I know that that is of great interest to this committee as well, and Ross and I are committed to working with this committee to explore that issue further. Thank you. [The prepared statement of Mr. Cason follows:] The Chairman. Dr. Grim, welcome. STATEMENT OF DR. CHARLES W. GRIM, DIRECTOR, INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES, ACCOMPANIED BY GARY HARTZ, ACTING DEPUTY DIRECTOR Mr. Grim. Good morning. Thank you, Mr. Chairman and members of the committee. I would like to add my congratulations to Senators McCain and Dorgan for assuming these leadership roles, and I look forward to working with you on Indian health issues. We are pleased to have the opportunity to present the President's fiscal year 2006 budget request for Indian Health Service. I will summarize my written statement and ask that it be entered into the record please. The Chairman. Without objection. Mr. Grim. As part of the Federal Government's special relationship with tribes based on treaties, executive orders, judicial determinations and statutes, the IHS delivers health services to more than 1.8 million American Indians and Alaska Natives. Care is provided in more than 600 health care facilities throughout the country. We also fund Indian health organizations in 34 sites in urban areas across the country. The budget before you today is a result of tribal and urban Indian consultation during the past year. In fact, the Department has been consulting with tribes and urban Indian organizations for 8 years no on budget formulation and we have found the process quite useful not only to the tribes and urban Indian organizations, but for the Department as well. The Department has a better understanding of the health needs of Indian country based on the input provided by tribes and urban Indian health organizations through this process. The President's budget request for the IHS totals $3.8 billion, a net increase of $72.1 million above the fiscal year 2005 enacted level. The request will allow the IHS, tribal and urban Indian health organizations to maintain access to health care by providing $31.8 million to fund pay raises for Federal tribal and urban employees; $79.6 million to cover inflationary cost increases that are experienced by the health delivery systems; and to address the growing American Indian and Alaska Native population. We will also be staffing and operating costs within this budget for six newly constructed health centers in the amount of $34.8 million. Once these health centers are fully operational, primary care provider visits will increase by 75 percent over what they were prior to the construction. In addition, we will be able to provide more comprehensive health services in those locations. Additional tribal contracting under the Indian Self- Determination Act is supported by an increase of $5 million for contract support costs for new contracts estimated to be received in fiscal year 2006. Consistent with HHS-wide policy, the IHS fiscal year 2006 request for facilities focuses on maintenance of existing facilities, and no funding is requested to initiate new construction projects. A total of $3.3 million is included to complete the construction of staff quarters at Fort Belknap service unit in the Billings area. Upon its completion, the project will provide 29 units of staff quarters for Harlem and Hayes outpatient facilities in Montana. American Indian and Alaska Natives will also benefit from several provisions in the Medicare Prescription Drug Improvement and Modernization Act that was enacted in 2003. The Medicare Part D prescription drug coverage program when implemented in January 2006 will extend outpatient prescription drug coverage to American Indian and Alaska Native Medicare beneficiaries and increase Medicare revenues at our ITU facilities. Other sections of the Act expand benefits covered under Medicare Part B and allow the IHS and tribal health programs to pay for additional medical care by increasing its bargaining power when buying services from non-IHS Medicare hospitals. The proposed budget reflects the Federal commitment to providing high-quality medical and preventive services as a means of improving the health status of American Indians and Alaska Natives. Thank you and I will be pleased to answer any questions that the committee might have. [Prepared statement of Mr. Grim appears in appendix.] The Chairman. Thank you very much. Mr. Liu. STATEMENT OF MICHAEL LIU, ASSISTANT SECRETARY. OFFICE OF PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT, ACCOMPANIED BY ROGER BOYD, DEPUTY ASSISTANT SECRETARY, OFFICE OF NATIVE AMERICAN PROGRAMS; AND TOM WRIGHT, DIRECTOR OF OFFICE OF NATIVE AMERICAN PROGRAMS, OFFICE OF LOAN GUARANTEE Mr. Liu. Thank you, Mr. Chairman, Mr. Vice Chairman and members of the committee. I want to thank you for inviting me to provide comments on the fiscal year 2006 Administration budget for HUD's Indian housing and community development programs. Let me say that progress in the area of housing in Indian country is being made through HUD programs. For example, during fiscal year 2004, tribes and their TDHEs used their IHBG grants to build 2,115 new housing units. Each new housing unit gave shelter to a family. If all of this building were used to relieve overcrowding, then it would have reduced the incidence of overcrowding in Indian country by 4.5 percent. This is based on the 2000 census showing over 47,000 Indian families living in overcrowded conditions. The Department is working on a measure to precisely track reduction in overcrowding, and we are committed to working with Indian housing block grantees to establish a set of measures that illustrate the program's outcomes. While there is still a long way to go, we expect to see overcrowding reduced by at least one additional percentage point in the coming year, allowing approximately 450 additional Indian families to have decent housing. We need to sustain this momentum and we believe that the 2006 budget helps us do that. For several years now, I have updated you on the progress tribes and tribally designated housing entities, or TDHEs, have made toward the obligation and expenditure of funding. For fiscal year 2005, the Office of Native American Programs has enhanced its performance measures and continues its expansion of the access information system to ensure we are able to accurately report on the rate of fund obligations and expenditures. The Department is consulting with tribally elected leaders and TDHEs for their input so we may improve and streamline the data collection through the required Indian housing plan, the annual performance report, and the annual status and evaluation report for the ICDBG program. I am now more confident than ever that the majority of tribes and their TDHEs are obligating and spending their grants in an expeditious manner. The Department's electronic line of credit control system shows that more than 82 percent of all grant funds appropriated between 1998 and 2004 have been expended by grantees. Now, as for an overview of the budget request for 2006, the President proposes a total of $594.9 million specifically for HUD programs that serve Native Americans, including American Indians, Alaska Natives, and Native Hawaiians. Of this total, $582.6 million is authorized under the Native American Housing Assistance and Self-Determination Act. Of the NAHASDA funds, approximately $517.7 million is for direct formula allocations through the Indian Housing Block Grant Program; $4.8 million is proposed for NAHASDA's Title VI Tribal Housing Loan Guarantee Fund for credit subsidy and administrative expenses. This will leverage in one fiscal year $37.9 million in loan guarantee authority. The NAHASDA allocation also includes $57.8 million for the Native American Housing and Community Development Block Grant Program. Finally, there is $2.458 million available under NAHASDA for training and technical assistance to support these programs. There is also $2.65 million in credit subsidy for the section 184 Indian Housing Loan Guarantee Fund, which will provide $99 million in that one fiscal year in loan guarantee authority. The Native Hawaiian community will receive through the Department of Hawaiian Homelands $8.8 million for the Native Hawaiian Housing Block Grant Program and $882,000 for the section 184(a) Native Hawaiian Home Loan Guarantee Fund, which will leverage approximately $35 million in new loan guarantees. As for technical assistance and training, there is a set- aside of $2.7 million which will provide the initial training and technical assistance to most grantees, enabling them to function effectively under NAHASDA. The President's request also includes $353,000 to provide the management and oversight of the Native Hawaiian Housing Block Grant Program. Specifically, on the issue of the National American Indian Housing Council training and technical assistance, tough decisions had to be made, priorities had to be made. No funds were requested under the Indian Housing Block Grant training and technical assistance set-aside for the NAIHC, as the Department believes they have sufficient funding. The NAIHC's current balance from the Indian housing block grant set-aside is $5.35 million. In addition, the NAIHC has a $4.56 million balance from prior budget set asides for technical assistance and training. We are working closely with the NAIHC to put these resources to work in a more expeditious manner. We have a very positive story to tell about our loan guarantee programs, especially for the section 184. The in effect carryover and combined amounts for fiscal year 2006 will provide for over $250 million in loan authority for that program, more than sufficient for the volume that we anticipate. In fiscal year 2004, we in fact increased the number of mortgage loan guarantees to 622, up from 271 in fiscal year 2003. The loan volume also increased at a similar rate from $27 million to $67 million, all in 1 year. In total, we have done over 2,000 section 184 loan guarantee mortgages, over $212 million to provide homeownership for Native American families throughout the country. We believe the section 184 program will continue to play a vital role in keeping the President's commitment to create 5.5 million new minority homeowners by the end of 2010. To assist us in this process we have been working very closely with the Bureau of Indian Affairs and the Department of Agriculture's Rural Development Office to formulate new agreements and partnerships to facilitate the title processing of required documents in Indian country. With that, Mr. Chairman, I will conclude. I am available to answer any questions. Thank you very much. [Prepared statement of Mr. Liu appears in appendix.] The Chairman. Thank you. Ms. Vasques, welcome. STATEMENT OF VICTORIA VASQUES, ASSISTANT DEPUTY SECRETARY AND DIRECTOR OF THE OFFICE OF INDIAN EDUCATION, DEPARTMENT OF EDUCATION, ACCOMPANIED BY CATHIE MARTIN, DEPUTY DIRECTOR, OFFICE OF INDIAN EDUCATION; AND THOMAS CORWIN, DIRECTOR, DIVISION OF ELEMENTARY, SECONDARY AND VOCATIONAL ANALYSIS, BUDGET SERVICE Ms. Vasques. Thank you, Mr. Chairman and Mr. Vice Chairman and members of the committee. On behalf of Secretary Spellings, thank you for this opportunity to appear before you to discuss our fiscal year 2006 budget request for Department of Education programs that serve our American Indian and Alaska Native students. I also request that my written statement be entered for the record. The Chairman. Without objection. Ms. Vasques. I am Vickie Vasques, the assistant deputy secretary and director of the Office of Indian Education. As you stated earlier, I am accompanied by my colleagues Tom Corwin and Cathie Martin. I am proud to say that my passion and personal commitment to education began with my father, former tribal chairman of the San Pasqual Band of Mission Indians. In April of last year, the President signed an Executive order to assist American Indian and Alaska Native students in meeting the challenging student academic achievement standards of the No Child Left Behind Act in a manner that is consistent with our tribal traditions, languages, and cultures. The Department's work on implementing this Executive order will be highlighted at a national conference this coming April 6 and 7 at Santa Ana Pueblo in New Mexico. This conference will focus on issues affecting the implementation of NCLB within Indian country. I would also like to invite the members and the staff of this committee to please join us at this national conference. As you know, 3 years ago the President launched the most important reform of public education by signing into law the No Child Left Behind Act. This law is based on stronger accountability, more choices for parents and students, greater flexibility for States and school districts, and the use of research-based instructional methods. The overall goal is to ensure by the year 2013-14 school year every student, including our American Indian and Alaska Native students, will be proficient in reading and math. States, school districts and schools are working hard to implement NCLB, and the early returns are promising. A study from the Education Trust showed that in States with 3 years of comparable data, 23 of the 24 States increased student achievements in reading. We are also moving in the right direction for our Indian students. The gap between Indian students and white students in reading achievement grew smaller in 13 States and remained the same in 2. In math, that gap narrowed in 14 States, widened in 2, and remained the same in 2. The President's fiscal year 2006 budget builds on the NCLB Act by extending its principles and reforms to the high school level. In too many schools across the Nation, the longer students stay in school, the more they fall behind, with far too many students dropping out. The 2006 budget request includes almost $1.5 billion for a new high school initiative which will help to ensure that every student, including our Indian students, not only graduates from high school, but graduates prepared to enter college or the workforce with the skills he or she needs to succeed. This is especially important for Indian students who continue to be disproportionately affected by poverty, low educational attainment, and fewer educational opportunities than our other students. The 2006 budget request for the Department supports the President's commitment to provide resources to help improve educational opportunities for all students. Indian students will continue to benefit from the implementation of NCLB, as well as new initiatives to improve the quality of secondary education. Overall, our estimates show that the Department programs would under this fiscal year proposed budget in 2006 provide approximately $1 billion in direct support specifically for American Indian and Alaska Native students. In addition, significant funds are provided to Indian students who receive services through our broader Federal programs such as ESEA Title I grants to LEAs and our IDEA state grants. The Department recognizes the implementation challenges facing some of our Indian students in our rural communities and is committed to working with our local, state and tribal governments to resolve these issues and has provided flexibility to rural districts in implementing the provisions of the law. The President's budget request for the Department's Office of Indian Education programs is $119.9 million. These programs include formula grants to school districts, competitive grants, and national activities for research and evaluation on the education needs of our Indian students. I thank you for the opportunity to appear before this committee, and my colleagues and I will be happy to respond to any questions you may have. [Prepared statement of Ms. Vasques appears in appendix.] The Chairman. Thank you very much. Mr. Cason, why are you proposing to take a pause in Indian school construction? Mr. Cason. Mr. Chairman, it is a reflection of the escalating of unobligated funds in the school construction program. Over the last 4 or 5 years, counting the 2005 budget, Congress has been very gracious to provide about $1.5 billion of additional funds to the Department of the Interior for the purpose of school construction. At the pace that the Department of the Interior has actually constructed schools has left us with an unobligated balance just under $200 million. So the thought on the part of the Department was to basically continue our commitment, but at a lower level while we worked our way out of the unobligated balance problem. The Chairman. There is a cut in Indian water settlements despite the fact that there have been several of them that have been made, agreements. Mr. Cason. It is my understanding, Mr. Chairman, that in the cut on the water settlements, that was a reflection of settlements that had actually been implemented. We are in continuing discussions with a variety of Indian tribes about other claims for water settlements. Once we reach a position where a settlement is agreed to, we will have to ask for appropriations for those. The Chairman. Mr. Swimmer, in the case of the $135 million for historical accounting activities, about $95 million will be expended on individual Indian money accounts that are involved in the Cobell lawsuit. Is that correct? Mr. Swimmmer. Yes. The Chairman. What will Indian country get for the $95 million? Mr. Swimmer. The continuation of the historical accounting, according to the plan that the Department submitted to the court in January 2003. This plan which is a comprehensive accounting is we believe the statute-required. It is an accounting for individual account holders that had accounts with the Department with the Indian Affairs, that went back to the time of the 1994 Reform Act, and from the time that those accounts were set up. The money is used for a transaction-by- transaction accounting, to develop an account statement for each individual Indian account holder, and then at a certain level of accounting, that accounting would be we would use a statistical sampling to get there. But we had estimated that the cost of that accounting would be approximately $335 million. The money that we are asking for is simply to go to the next phase of the accounting and complete certain accounting that we are engaged in now. The Chairman. Do you agree with me about self-governance? Mr. Swimmer. Absolutely, Senator. As you may recall in my previous period at the Department, I was one of the proponents of the Self-Governance Act itself, and strongly support self- governance, as does the current Secretary. The Chairman. Thank you. Dr. Grim, as you know, this committee expended a lot of effort last year to reauthorize the Indian Health Care Improvement Act and we intend to pick up that again this year. I would like you, if you would, for the record to provide me with the recommendations that you think need to be made in the legislation so we can get full Administration support. Mr. Grim. Yes, sir; okay, we will do that. The Chairman. Thank you. Ms. Vasques, the budget proposes a reduction in the Department of Education of about 2.9 percent from 2005. How will the tribal and BIA schools be affected by this cut in light of the requirements of the No Child Left Behind Act? Ms. Vasques. Sir, most of our Indian students that are in our BIA schools are being served by our title I and our Special Education Program. Those two particular programs have received an increase of about a total of $1 billion that goes directly to the BIA to serve those students. The Chairman. So they will have no trouble having sufficient funding to comply with the No Child Left Behind Act? Ms. Vasques. Yes, sir; I feel it is sufficient. The Chairman. Mr. Liu, you want to move the CDBG from HUD to Commerce. That is the Administration's proposal. Under the law, 1 percent of CDBG moneys are reserved for Indians. Does the Administration propose to continue the 1 percent set-aside? Mr. Liu. We are planning to continue approximately $58 million as part of the Indian housing block grant set-aside, as part of HUD's budget. Because of the nature of the change, I do not think the percentage still would hold, but the administration of the program would stay within HUD within the Office of Native American Programs as it is currently being managed right now. The Chairman. Senator Dorgan. Senator Dorgan. Mr. Chairman, thank you very much. I also thank the witnesses for appearing. Let me ask a series of questions of the witnesses. The testimony, Mr. Cason, that you offered indicated that the Administration has a continued commitment to Indian schools. Let me ask a question first, I guess, about something I mentioned in my opening statement, the recommendation that we abandon the funding for the Crownpoint Institute of technology and the United Tribes Technical College [UTTC]. As you know, the Interior Secretary has visited UTTC at my request and found it to be a wonderful institution, but each year the budget that is sent to us, or the appropriation request that is sent to us from the President, eliminates the funding for United Tribes Technical College. Can you tell us why? Mr. Cason. Yes, Mr. Vice Chairman; UTTC and Crownpoint are schools that receive funding from other sources, the Department of Education. When we take a look at our budget and the priorities that we have, the Department of the Interior takes a look at the 27 tribal colleges and universities that are funded through our programs. We also take a look at Crownpoint and UTTC. They end up having funding from other sources, the Department of Education. When we take a look at the comparable funding between what the tribal colleges and universities get under our lines authorities and what UTTC and Crownpoint get under theirs, it is our sense that we need to prioritize the funds that come through our appropriations for the tribal colleges and universities. Senator Dorgan. But you have also requested a decrease in funding for tribal colleges. Is that not correct? Mr. Cason. I am not positive, Mr. Vice Chairman. It is my understanding that the amount of funding that we are looking for is about stable. I am not sure if there is a small change in one direction or the other. Senator Dorgan. Mr. Cason, I am positive. Mr. Cason. Okay. Senator Dorgan. You are requesting a cut in funding for tribal colleges. The reason I mention that is you describe the commitment to tribal colleges as a basis for suggesting you perhaps do not have the money for UTTC and Crownpoint. I must say that the evidence is that we are, I believe, only at about 50 to 60 percent of that which we commit in support for people that are attending community college, versus those who are attending tribal colleges. I would agree with my colleague Senator Conrad that it is a wonderful investment, the tribal college investment. Senator Burns and I have pushed very hard on the Interior Subcommittee to increase some funding requests in recent years for tribal colleges. It is a fact that the tribal college funding request is down. Let me just say again that I think from a priority standpoint, I think that the investment in tribal colleges is proving to pay dividends. I think Senator Domenici would say, and I would certainly say, that UTTC and Crownpoint are evidence of those great successes as well. While I believe we will be able to put the funding in for those two institutions, I hope that at some point in the future the Administration will see fit to include funding requests in their budget. Let me ask Dr. Grim, let me say that I deeply appreciate the commitment of so many people working at the Indian Health Service. I go around to these clinics and facilities and you have some very committed people. I understand why all of you are here, and that your job is to support the President's budget request. That is why you are here. Yet, I know from my observations, and I know from evidence, that we are required to provide funding for health care for two groups of populations. One is our trust responsibility for American Indians, and the other responsibility is for Federal prisoners. I also know that we spending about twice as much on a per capita basis for health care for Federal prisoners as we are for meeting our trust responsibility for American Indians. I think you see that when you go around and take a look at the IHS and tribal clinics and the conditions, despite the valiant effort of some wonderful professional people out there. So I look at that, and I say we are really underfunded with respect to health care. I mentioned Avis Little Wind, who hung herself, a poor child that really lost hope and had serious emotional problems, but there was not enough mental health capability available. There were not the skilled people available to be able to provide services to her, so a young girl dies. How do we deal with that? You are obviously, you cannot be satisfied that we are meeting the needs with this funding, are you? Mr. Grim. I actually am very pleased with the 2006 budget request that came forward for the Indian Health Service. As I said earlier in my oral remarks that it really represents I think the requests of tribal leadership across the Nation. We consulted with them and have for some years. One of the things that they have told us is that the population growth in the Indian communities, as well as the inflation that each of our budget sub-line items has had to absorb over the years, is something that they felt was higher priority, as well as making sure that the pay increases for all the employees were in there. I think if you take a look at the 2006 budget for the Indian Health Service and you look at it line item by line item, you will see some fairly significant increases for programs that in past years have had relatively flat budgets. So I think it is a good budget this year. Many programs are going to have increased capabilities because of it. Senator Dorgan. So you are well satisfied that we are meeting those needs. I talked to the chairman some while ago. We are going to do some work I hope especially on the issue of teen suicide. A reservation not far from my home had three teen suicides recently. I mentioned Avis Little Wind. As I went up and met on that reservation where Avis Little Wind lived, I discovered that there just were not the resources available, the psychologists, the psychiatrists, not available. They had to beg and borrow a car to take somebody to a clinic someplace because there was no vehicle available, let alone a health care professional. I am a little surprised that you are well satisfied with the request level of funding because I deeply admire your work and the work of the service, but, I am not satisfied that the resources are available to deal with the issues. I hope we can talk about that at some point later. Mr. Liu, on the housing issues, the chairman asked the question about the block grants. When all is said and done, where are we with respect to housing, this budget versus previous budgets, in terms of housing on Indian reservations? Mr. Liu. For the Native American Housing Block Grant Program, relative to the intense competition within HUD for the housing dollar, the Native American Housing Block Grant Program was not at the bottom rung. There was a cut, no doubt about that. Senator Dorgan. How big is the cut? Mr. Liu. It is about 6.3 percent, but if you compare it to another program I manage within HUD, the Public Housing Program, the capital fund for public housing took almost an 11 percent hit. Some of the context of this has to do with our section 8 tenant-based program within the Department, which has escalated at such a pace that frankly it has eaten into every other program area of HUD. Congress recognized this at the end of 2005. It had to cut every program at HUD except for section 8 by over 4 percent. We hope to get reform this year so that we can alleviate to some extent the pressure within our housing area. Senator Dorgan. But there is a cut in housing of 6 percent? Mr. Liu. Yes; 6.3 percent in the block grant. Senator Dorgan. I mention it again, I really think again from my tours of reservations, we have a real serious problem with respect to Indian housing. I think it is almost a crisis. I have toured housing units again that are third world condition. When we look at this, the priorities that I see are comparing needs here to needs elsewhere. I will finish up, Mr. Chairman, by telling you that this morning I was looking at a little project in the budget that was recommended to have double funding. It is called Television Marti to broadcast television signals into Cuba. They want to double the funding for it now. We have spent close to $200 million on it, and we send television signals to Cuba to tell the Cuban people how wonderful things are in America, and Castro jams all the signals. So we send signals no one can receive. We have done it for about 15 years and we are going to double the funding for it. When you look at that sort of thing, and then you say, okay, they want double the funding to send television signals no one can receive in Cuba, and you want to cut funding for housing on Indian reservations, I say, well, there is something really screwy about this, to use a term of art. So look, all of you are here representing a budget. I understand that. There are some things in this budget that I think make sense; some that I think are vastly shorted in terms of the priorities. Mr. Swimmer, I am with the chairman. We really need to find a way to get our arms around this issue and find a way to put it behind us in a way that is fair to everybody so that we can get on with some of these other significant priorities. I hope that we can make progress. I know the chairman is very committed to that, as am I, but you have to have all the stakeholders involved and find a way to negotiate and reach a consensus. So let me thank the panel. Mr. Chairman, thank you for the opportunity. The Chairman. Thank you. Let me just say again that we intend to give this Cobell issue a shot. If it does not work, we are going to move on. We are not going to have it drag out. I am serving notice to all parties and participants if they want to go 10, 15, 20 years in court, that is fine with me, but we are going to give them a one shot opportunity because I am not going to let it tie up this committee the way it has in years past. I have great confidence in Mr. Swimmer and others who are involved in this issue. Mr. Cason, I think we are about 2 minutes from your hour. So I thank the panel and I thank you, and I am confident we will be seeing you a number of times in the future as we address these issues. Thank you for appearing here today. Our second panel is Tex Hall, president of the National Congress of American Indians; Chester Carl, chairman of the National American Indian Housing Council; John Thomas Petherick, executive director of the National Indian Health Board; and David Beaulieu, president of the National Indian Education Association. Let us begin with an old friend of the committee's, Tex Hall, the president of the National Congress of American Indians. Welcome back. STATEMENT OF TEX HALL, PRESIDENT, NATIONAL CONGRESS OF AMERICAN INDIANS Mr. Hall. Mr. Chairman, Mr. Vice Chairman and members of the committee, thank you for the opportunity to appear to testify before the Senate Committee on Indian Affairs and present the views of the National Congress of American Indians on the Administration's fiscal year 2006 budget request for Indian programs. This is my first opportunity to speak publicly with the new leadership of this committee. I would like to say publicly how much all of the member tribes of the National Congress appreciate both of your service. Chairman McCain, it is an incredible honor for Indian Country to once again have your leadership on this very important committee to us. Vice Chairman Dorgan is from my home State of North Dakota, and I cannot tell you how proud all of us in North Dakota that you are on this committee and this leadership position, and representing not only us, but Indian country as well. We are very glad you are having a hearing on this topic, Mr. Chairman, and look forward to working with you and Vice Chairman Dorgan to ensure that the critical programs and initiatives authorized and supported by Indian country and this committee are funded at levels which will ensure their effectiveness. As we know, on February 7, President Bush submitted a budget to Congress that included numerous proposed cuts for Indian programs. The budget would continue to trend of consistent declines in Federal per capita spending for Indians compared to per capita expenditures for the population at large. This year's budget request reduces effective funding for tribal governments and instead funds a trust reorganization that tribes have opposed, with proposed reductions for programs such as TPA, which is tribal priority allocations; education; contract support for self-governance; housing; infrastructure; land consolidation; and the elimination of funding for tribal colleges such as what you mentioned, Senator Dorgan, United Tribes College of Bismarck and Crownpoint Institute in New Mexico. The President's proposed budget is $108 million below the fiscal year 2005 budget for BIA programs. The request cuts $86.9 million from BIA construction. Overall, the Indian programs targeted for reduction include Indian housing would receive the largest cut of $105 million in Indian housing. Native American housing block grants would be cut overall by $44 million and section 184 home loans cut by more than 50 percent. And the request cuts $85 million from Indian health service facilities construction budget. While Congress has authorized important projects such as the Dakota Water Resources Act, Mni Wiconi. These projects have been underfunded or not funded at all. My friend from North Dakota, Congressman Earl Pomeroy put it like this: Indian nations are the last to get funded and the first to get cut. Mr. Chairman and Mr. Vice Chairman, on behalf of Indian country, I am asking for your leadership to put an end to this practice of cutting and this Federal trend of reducing Indian budgets. At NCAI, we are all too aware that discretionary domestic programs such as ours are often seen as the easiest to cut, but when these cuts are made, they are made with our money, and that is wrong. The United States, as we all know, has a solemn and moral duty to honor its treaties and fulfill the trust responsibility from the United States. The tribes of NCAI are deeply disappointed this budget does not support strong self- government and self-determination. As you know, many tribal governments are exactly like State and municipal governments, providing critical services, shaping values, and promoting jobs and growth in Indian country. Though Federal spending for Indians has lost ground compared to the U.S. population at large, tribal self-governance has proven that the Federal Government that invests with the tribes pays off. As Senator McCain mentioned, the Harvard Project on American Indian Economic Development, this study shows that reservation communities have made remarkable gains in the last decade, and these gains are attributed to self-determination. However, substantial gaps remain per capita on income of Indians living on reservations, is still less than half of the national average. Indian unemployment is still double the rest of the country, and there is a lot of work that self- determination, which has made progress, has still yet to do. In short, tribes have prove success in addressing the long enduring social and economic disparities on Indian reservations. This warrants continued investment into our self- determination. Health care and housing services, like law enforcement, were guarantee to us by a treaty. We already paid for that, as we know, with the 3 billion acres of ceding of land. As Congress reshapes its 2006 budget, NCAI continues to urge its commitment. We have recently launched a National Center for American Indian Research and Policy to deal with the part of the program assessment rating tool that OMB is requiring. I do want to conclude with three key areas in the budget that the tribes have targeted. First, tribal leaders have identified law enforcement, justice and homeland security as key concerns in the 2006 budget. As DOJ implements drastic programmatic changes, NCAI calls on Congress to ensure law enforcement activities in Indian country are supported through sufficient funding essential for full realization of the tribes' government. Second, tribal resources continue to be diverted to the Department of the Interior's reorganization which tribes have opposed and which fail to take into account the need for local flexibility and the results of the 2(b) study which was recently completed by the Department of the Interior. Until a better plan which reflects true consultation with tribes who know best what works with trust management at the local level, a moratorium must be placed on funding further reorganizations. A much more effective use of funds would be focused on funding of ILCA, the Indian Land Consolidation Act. No increases were requested for the ILCA fund from the 2005 enacted level, which would be about one-third of the authorized 2006 level. The investment in land consolidation would do more to save on future trust administration costs than any other item in the trust budget. Finally, self-determination programs throughout the budget, initiatives that Congress and the Administration have expressed consistent support for, have not only failed to receive needed funding increase, but face cuts which will deeply hurt tribes' ability to effectively assume local control and the shrinking TPA, tribal priority allocation, budgets; inadequate 638 pay cost increase; insufficient contract support funding; and grossly underfunded administrative cost grants. I look forward to answering any questions you may have at the conclusion. [Prepared statement of Mr. Hall appears in appendix.] The Chairman. Thank you very much. Mr. Carl, welcome. STATEMENT OF CHESTER CARL, CHAIRMAN, NATIONAL AMERICAN INDIAN HOUSING COUNCIL Mr. Carl. Thank you very much, Mr. Chairman, Chairman McCain and Vice Chairman Dorgan and other distinguished members of this committee. My name, as noted, is Chester Carl. I am happy to be back before this committee once again as chairman of the National American Indian Housing Council. On behalf of the members of National American Indian Housing Council and its board of directors, I would like to thank you for this opportunity to address you today on the President's proposed budget for fiscal year 2006. There is not much I can say that has not already been said, or anything I could present that would better illustrate the need of Indian country. Everyone here knows the crisis that we as Native Americans face and Native Americans are three times more likely to live in overcrowded conditions than any other Americans in the United States. Native Americans are more likely to lack sewage, water systems; more like to lack telephone lines and electricity than other Americans. We have pleaded our case over and over with statistics and heartrending stories. Today, what has it come to? The last time I testified at an Indian Affairs budget hearing was 2002. That was the first year we began to see a decline in the Indian housing budget after several year of surplus and growth. Today, it is much different. The President's fiscal year 2006 budget proposes the smallest amount of funding for Indian housing programs since the implementation of NAHASDA. The tribes' access to funding for basic housing would be reduced by more than $100 million. I heard the assistant secretary say the budget will be cut by 6 percent, but in doing my simple math, I am coming up with $108 million that would be reduced from the NAHASDA allocation. John F. Kennedy once said, man holds in his mortal hands the power to abolish all forms of human poverty, and to the third world nations, developing nations struggling to break the bonds of misery, JFK pledged our best efforts to help themselves. The world has not changed in the last 40 years, as we see in the current efforts in Iraq. But how disturbing that the Federal Government had to look outside its own borders to identify human need, to justify continued dedication of billions and billions in funding to improve living conditions of the Iraqi people, when so many of our American Indian and Alaska Natives daily endure the same third world conditions. Where are the best efforts to help Native Americans help themselves? Certainly not in this budget. We understand the need to protect our borders. Native Americans have made significant patriotic commitments to ensuring the freedom of all people as Native Americans have the highest percentage of military service of any ethnic group in the Nation. Our proposed initiative today will seek to honor the dedication of our Native American veterans. But I believe I speak for all members of the National American Indian Housing Council when I express my frustration and anger at the national priority shift to aid people 8,000 miles away, being paid for by those Americans who least can afford it. While assistance to the Middle East is admirable, America seems to never have understood the urgency of the need to lift people from poverty and ignorance and despair here at home in order to strengthen this country. The poverty rate for Native Americans continues to hover at 26 percent, over 50 percent in my own Indian nation, is more than double the poverty rate for the general American population. We understand that fiscal year 2006 will be the tightest budget in history, but we also understand that in making these decisions, Congress has to keep in mind that inflation has steadily risen over the last 4 years. For the Native American housing block grant, the President has proposed $582.6 million for fiscal year 2006. This is a devastating blow, particularly in light that the proposed set-aside for Indian community development block grant is now identified as a set-aside of the NAHASDA block grant. In enactment of NAHASDA, I do not believe there was ever other authorization by Congress to have a set-aside authorized in the community block grant. I believe also that, Mr. Chairman, you thought in the enactment of NAHASDA that negotiated rulemaking be part of that legislation. I believe that you stood behind the tribes to recognize the government- to-government relationship. Not only is the Indian community block grant not authorized under NAHASDA, the Federal agency failed to even consult the tribe on making that move. From day one on the enactment of NAHASDA, we have yet to consult with HUD on how the Act could be implemented. I stand by Tex Hall in modeling NAHASDA after Indian Self- Determination Act for this very simple reason. Yesterday, we met with OMB and HUD officials. They basically said, in order for you to succeed, you have to measure social changes; how NAHASDA has made social changes. But we are faced, Mr. Chairman and honorable committee, many of the housing authorities will be facing shutdowns of their doors if there is not increased funding. So what we are asking is that we model NAHASDA on the Self- Determination Act, and I suggest to you today that housing funds be restructured similar to in the Indian Housing Self- Determination Act, Education Assistance Act, Public Law 93-638, which would streamline the funding and the tribes can identify how they make those social changes, rather than having to comply with the strict requirements of the HUD paternalistic- type program. Also, Mr. Chairman, I would also like to offer as a recommendation on behalf of the Native American veteran a new opportunity called the Native American Veteran Housing Opportunity Initiative. Indian tribes take great price in the role that Indian men and women play in the United States armed forces, particularly those serving in this time of war. I ask you to keep in mind the families they leave behind and the millions of dollars the President has proposed to cut from Indian housing programs that directly affect those families. The funding helps provide basic infrastructure in housing to some of the most remote, isolated areas of our Nation. We are deeply concerned that our warriors are returning home from Iraq to housing conditions that are as bad or worse than they left in Iraq. They also face chronic unemployment and lack of meaningful economic opportunities. So thus, Mr. Chairman and honorable committee, I ask for a set-aside of $150 million to be distributed in allocation formula out of the Defense budget to help, as a small price to pay to honor the sacrifice of these brave men and women. The President on Monday proposed $82 billion to help the commitment, not only to the Iraq conflict, but replacement of the equipment for the war, the Tsunami, the Palestine, different types of initiatives. For what we ask today is a very, very small price. Mr. Chairman, I call on you as the commander to the chief commander of the United States, and the people of this country to join in a vast cooperative effort to satisfy the basic needs of not only the Iraq people, but also the Native American people. Thank you very much. [Prepared statement of Mr. Carl appears in appendix.] The Chairman. Thank you very much. Mr. Petherick. STATEMENT OF JOHN THOMAS PETHERICK, EXECUTIVE DIRECTOR, NATIONAL INDIAN HEALTH BOARD Mr. Petherick. Good morning, Chairman McCain, Vice Chairman Dorgan and distinguished members of the Indian Affairs Committee. On behalf of Chairman Sally Smith of the National Indian Health Board, who could not be here this morning because she was unable to travel from Dillingham, AK, I will present on behalf of the National Indian Health Board. Before I begin, my remarks are going to be brief this morning. I ask, Senator, that Sally's full written statement be entered in the record. The Chairman. Without objection. Mr. Petherick. Senator Dorgan, thinking about one of the first issues that you brought up, as far as the Federal per capita expenditures for prisoners as opposed to American Indians and Alaska Natives, I think that is something that Indian country has heard about for a long time, but I do not think that message really resonates to the general population. When we start looking at it in real terms, when we start thinking about, I am from Oklahoma and the thought of Terry Nichols, who is serving a life sentence in Federal prison receives twice as much health care expenditures as my grandmother or various other American Indians or Alaska Natives across this country, that is incomprehensible. Also, when we think about over in Northern Virginia, we have Zacarias Moussaoui, who is in Federal custody. He also has those same opportunities where our elders and children do not. And even an example of Martha Stewart, who is a multi- millionaire or billionaire even, and has the opportunity for guaranteed health care that the American Indians and Alaska Natives do not necessarily get, that is a trust responsibility of the Federal Government. I think that that is something that we want to work toward changing and make sure that that message resonates beyond this committee to other members of Congress and the Administration. But going into the 109th Congress, we knew that things were going to be tough, given the fiscal situation the country is facing. Kind of going back to the tribal consultation sessions that the Department of Health and Human Services and Indian Health Service conducted, especially the Indian Health Service, and now the Department has a tribal consultation policy, it is a very valuable process and they really do work with tribes to develop priorities. But we knew it was going to be tough, and once the President's request came out, it was not really a surprise. But we realized that there were some tough decisions to make and the Department and OMB and the Administration and IHS did try to make an effort to make sure that population increases, as well as inflation, were taken care of. In saying that, though, and they did make a substantial effort to do that, we have to really look at the trends. Even though they made an effort to make sure that inflation and population increases were at least looked at and at least tried to address them, given the limited funding, it really cannot be done with just a 1-year increase. You have to look at the trends over the last several years of how we have gotten here, and we are in a hole. There are programs such as Medicare and Medicaid which have fixed increases every year based on population growth, based on several other factors. Indian country does not get that, and that continues to be an issue, like I said, with the trends over time and those kind of continually being underfunded. Also on top of that, we also want to think about the fact of a few of the highlights of the President's budget request. Again, with the fact that we are looking at limited funding and only a $63-million increase, which is about 2.1 percent over fiscal year 2005 enacted, even though we have fared much better than several other agencies who are facing substantial cuts this Congress, it is really not enough to serve our population. So what is going to happen is we are going to have diminished services and people are not going to be getting the care that they desperately need. In looking at those tough decisions that were made, and in looking at the President's budget request, a few things did stick out that I would like to address this morning. The first, obviously, is the health care facilities construction line item, which took a substantial hit. I believe it was in the neighborhood of about $85 million, leaving a little over $3 million for that line item. One of the things as we were discussing and preparing for this testimony, it became clear that the rationale for this was the 1-year pause or moratorium or building new facilities. Health care in Indian country, diseases and illnesses, do not take a 1-year pause. If indeed this is only a one-year pause, it is going to take another decade at least for us to try to get out of the effect of this 1-year pause. Honestly, once facilities are built in Indian Country, they are already too small. They are already outdated. That would be a substantial blow to Indian country if those funds were not restored. So Indian country feels very strongly that those funds are indeed restored. Also looking at one other item that I wanted to bring up as well is the issue of rescissions. We feel that Indian Health Service should be exempt from any rescissions. We foresee that they will be coming this year, as they have over the last several years. Because of the fact that looking at the Indian Health Service, along with the Department of Defense, along with the Veterans Health Administration, the Indian Health Service is a direct service provider. They provide health care directly to American Indians and Alaska Natives. By virtue of that, they should be exempt from any rescissions. We would ask that you as members of this committee support that effort. Again, if I could just make one more point about health facilities construction line items. I think one of the other issues that Indian Country has concern is looking at the PART scores that President Hall had mentioned. When looking at the PART scores and looking at health facilities construction for the IHS, which they were measured for fiscal year 2006, they scored very well. They scored an effective rating. It really kind of goes against our thoughts of effectiveness and efficiency to cut a program that has been deemed effective. So we feel that should be rewarded, rather than punished, and we would hope that you all would work with IHS. The Chairman. If they are not efficient or effective, we should increase funding? Mr. Petherick. Well, honestly, that is how I think that, in looking at---- The Chairman. So we reward inefficiency and ineffectiveness? Mr. Petherick. I think that partially some of the efforts have been, well, I guess from a tribal perspective, the fact that a program is deemed effective, they have not really gotten any sort of reward or anything for that. The Chairman. I have to tell you, it argues for me to change the program or eliminate it. I do not think the taxpayer should increase funding for programs that are both inefficient and ineffective. Mr. Petherick. And I think this is something that Indian country has grappled with. Indian country has done a tremendous job, especially within the Indian Health Service to make sure that they are utilizing dollars in the most efficient way. The Chairman. So you disagree with the rating process then? Mr. Petherick. I think not necessarily the rating process, but I think Indian country views that there should be some sort of, I do not know if you want to call it an incentive system or something, but there needs to be some protections built in place if we are indeed showing that we are effective, then it is contrary to just commonsense to cut programs that are efficient. The Chairman. Again, in all due respect, the supposedly objective rating system rates some of these programs as ineffective and inefficient. So I am sure if I was running a program, I would never view them that way. That is why we have objective assessments of programs. And there comes your assistant to give you a very effective rebuttal to that statement. [Laughter.] Mr. Petherick. Pardon us. The Chairman. Go ahead if you would like to say more. Seriously. Mr. Petherick. I think what we were mentioning is the fact that the health care facilities construction program within IHS has been deemed effective, according to the PART assessment. But at the same time while they are being judged effective, they are being cut by $83 million. The Chairman. That is a point well made. Thank you. [Prepared statement of Sally Smith appears in appendix.] The Chairman. Mr. Beaulieu. STATEMENT OF DAVID BEAULIEU, PRESIDENT, NATIONAL INDIAN EDUCATION ASSOCIATION Mr. Beaulieu. Chairman McCain and Vice Chairman Dorgan, my name is David Beaulieu. I am president of the National Indian Education Association and a member of the Minnesota Chippewa Tribe from the White Earth Reservation in Minnesota. And also, I have recently joined the faculty at Arizona State University this July. It is a pleasure to be there and to be working in Indian education at ASU. It is my pleasure to be able to offer the ideas and opinions of the National Indian Education Association before this committee on the fiscal year 2006 President's budget request. Founded in 1969, the National Indian Education Association is the largest organization in the Nation dedicated to Indian education advocacy. It embraces the membership of over 3,000 American Indian, Alaska Native, and Native Hawaiian educators, tribal leaders, school administrators, teachers, parents and students. NIEA makes every effort to advocate for the unique educational and culturally related academic needs of Native students, and to ensure the Federal Government upholds its immense responsibility for the education of American Indian and Alaska Natives through the provision of direct educational services incumbent in the trust relationship of the U.S. Government, including the responsibility of ensuring educational quality and access. Although National Indian Education Association supports the broad-based principles of No Child Left Behind, there is widespread concern about the many obstacles that the NCLB presents to Indian communities, who often live in remote, isolated, and economically disadvantaged communities, particularly in rural areas. There is no one more concerned about accountability and documented results than our membership. But the challenges many of our students and educators face on a daily basis make it difficult to show adequate yearly progress and to ensure teachers are the most highly qualified. We support generally looking into the specifics of the statute and looking for flexibility that makes sense to Indian education and to meeting the goals of this statute, and to funding it so that we can indeed accomplish those objectives. President Bush's budget proposes $529 million, or a .9- percent decrease in education, equaling $69.4 billion in total budget authority for the Department of Education. The request for Alaska Native Education Equity and Education for Native Hawaiians is reduced by 5 percent and 8 percent, and Indian education program funding remains at the same level as fiscal year 2005 at $119.9 million, and down from fiscal year 2004 and fiscal year 2003 levels. Inadequately funding Indian education programs will diminish, if not undo, any progress we have made. Within the No Child Left Behind Act is the Indian Education Act, Title VII. That particular section requires unique purposes which speak to meeting the language and culture needs of American Indians and Alaska Natives, and also using culturally based education approaches to accomplish achievement. Also within title III there are provisions that allow for Native language teachers to be trained and for Native language programs. We believe the broad implementation of this statute is threatening language and culture programs, and the broad intention of making sure that our students' unique educational needs regarding language and cultures are being eliminated from our schools. Increasing the Department of Education budget for Native education programs by 5 percent would provide a step forward in helping Native students to achieve the same high standards as other students nationwide, while at the same time preserving and protecting the integrity and continuity of our cultural traditions. We realize that 5 percent will not address all of the needs, but we find the request to be reasonable and sensitive to the current budget environment. Proposed programs for elimination have a direct impact or effect upon Native students, including TRIO Talent Search, TRIO Upward Bound, Even Start, Perkins Loans, and Student Dropout Prevention, to name a few. While these programs may have not had the desired results across the board, they have provided enormous benefit to Native students and served their intended purposes in Indian communities. To eliminate these programs would cause a desperate impact upon Native students and upon our progress as those programs have assisted them. Nearly 90 percent of approximately 500,000 Indian children attend public schools throughout the Nation. Indian students who attend these schools often reside in economically deprived areas and our impacted by programs for disadvantaged students. The President's fiscal year 2006 budget fails to fully fund the Title I Low Income School Grants Program critical to closing the achievement gap. A modest increase of $602.7 million for this program still leaves more than $7 billion below the authorized levels for NCLB. If the fiscal year 2006 budget is enacted, this will be the first cut in education in a decade, and would completely disregard Native students' critical needs. Within the Department of Education budget, tribally controlled post-secondary vocational and technical institutions and strengthening tribally controlled colleges and universities' request remain level with the fiscal year 2005 levels at $23.8 million. While the strengthening of Alaska Native and Native Hawaiian institutions receive a 45-percent decrease from 2005 levels at $26.5 million. Tribally controlled colleges and universities receive just under $3,000 annually per student, less than one-half the amount annually provided for students in other community colleges, and do not have access to other state or local dollars, increasing or exacerbating this situation of underfunding. NIEA requests a 10-percent increase in funding to tribal colleges to meet core operational needs. BIA's budget has historically been inadequate to meet the needs of Native Americans, and consequently our needs have multiplied over the years. The fiscal year 2006 BIA budget fails to fund tribes at a rate of inflation, increasing the hardships faced by Native students. Perhaps the clearest example of unmet needs among Native Americans is the disparity between the amounts spent per student in BIA schools as compared with public schools. BIA schools will spend less than half the amount that public schools nationally will spend. The amount currently spent per student at BIA schools is the equivalent to public school per student expenditures during the 1983-84 school year. BIA schools will spent an amount per student the public schools were spending 20 years ago, while expecting our students to perform at levels in 2006. The Chairman. I would ask you to summarize, Mr. Beaulieu. Mr. Beaulieu. Okay. Many of the other cuts mentioned have been mentioned by witnesses. In summary, the overall education funding is receiving a 10-percent decrease, $114 million, while overall discretionary spending within the budget is receiving a 2-percent increase. This is a direct violation, we believe, of the trust responsibility for Indian education. We respectfully urge this committee to truly make Indian education a priority and to work with congressional appropriators and the Administration to ensure that Indian education programs are fully funded. Thank you very much. [Prepared statement of Mr. Beaulieu appears in appendix.] The Chairman. Thank you, Mr. Beaulieu. The cut is about 10 percent, right? Mr. Beaulieu. Total. The Chairman. Yes; and what is the population growth, percentage-wise? Mr. Beaulieu. I do not know the exact number, Senator. The Chairman. Do you know, Tex? I think it is about 2 or 3 percent. Mr. Hall. I think it is close to 3 percent, Mr. Chairman. The Chairman. So we are really looking at 13 percent, roughly. Mr. Hall. Right. Exactly. The Chairman. I thank the witnesses for being here. Thank you for your testimony. Your testimony acknowledges the need for Federal spending and program accountability. For years, I have heard that tribes are reluctant or refuse to share specific data with Federal agencies. Currently, how do tribes measure the impact or success of federally funded programs administered by self-determination contracts or self-governance compacts, and how do you propose overcoming this problem? Mr. Hall. Mr. Chairman, clearly the Federal agencies like BIA for example require quarterly reports or SF269s required under your 638 contract. Really, you have to report how you are doing in your scope of work and so on and so forth. Tribes have been doing that for a long time. I do have a concern with the school construction and Indian Health Services my friend J.D. was talking about. You get a good score, but you lose $85 million in health construction dollars. It just does not make sense. So at the end of the day, the NCAI, as I presented in my testimony, has created a national data center. We really need to get that funded to really look at data, because a lot of times we ask a Federal agency on law enforcement on how do you reduce crime. Well, we get different messages on what the statistics are. So we really need our own center, and that is why NCAI has proposed a national Indian data center to really take charge of our own data because it is our data that is getting cut, Mr. Chairman. The Chairman. And share that information with the Federal Government? Mr. Hall. Yes; we have. The Chairman. I mean, this center would do that? Mr. Hall. Oh, excellent, excellent. Yes, it would. The Chairman. Back to you, Mr. Beaulieu. Do you have an estimate yet on the impact that the No Child Left Behind Act has on tribal schools? Mr. Beaulieu. An estimate on the impact it has? We believe that the implementation of the Act is not working, that many of the impacts that exist there in terms of the ways in which the annual yearly progress is occurring, the fact that we have schools being measured year to year on a single test without documenting the actual progress being made. We think we are making incredible progress actually, but it is not being accounted for in many ways. The Chairman. So what do we need to do? Mr. Beaulieu. We need to create greater flexibility to recognize unique circumstances of those schools within the statute to allow for indicators of progress, to allow for improving the definition of ``highly qualified.'' Rural areas, you know, having a subject matter specialist in every single subject often does not work. We realize that we also need teachers that are competent and qualified to teach, improving professional development so that they are better able to teach would be a great assistance, and improving the funding level to accomplish that as well would be important. There is so much focus on testing that the heart and soul of the programs are often being eliminated. We think that is damaging to the quality of our educational programs at the same time. The Chairman. Mr. Carl, sort of along the lines of what I was talking with Mr. Petherick about, how did the Native American Block Grant Program fare under the program assessment rating tool evaluation, PART evaluation? Mr. Carl. Mr. Chairman, I am very glad to answer that question. A couple of years ago, HUD gave a report to the committee that tribes were not expending their money. Indian tribes became very alarmed and came back with its own report that there was really no money tied up in the pipeline. The tribes were expending their money. The tribes are very diligent in not only performing an Indian housing plan that shows in detail how the money is being expended, but also the scope of work. At the end of each year we are required to do an annual performance report. The annual performance report that tribes diligently and work very hard to submit as part of the program requirement unfortunately we found does not make its way to OMB. The performance measures that are set out for this particular grant year, OMB and the tribes do not connect. In this case, the performance measure that it set out now by OMB and further by HUD requires that the NAHASDA grants bring out social changes of what the NAHASDA grant has provided. But that is like trying to put a square bolt in a round hole because the requirement of NAHASDA as administered by HUD does not have the same criteria. So I believe in our own research, we have been able to measure not only building homes, but changes in the lives of Native Americans. The Chairman. Would you provide that information to the committee, please? Mr. Carl. Yes; I can. The Chairman. Thank you. I thank the witnesses. Senator Dorgan. Senator Dorgan. Mr. Chairman, thank you very much. Dr. Beaulieu, you heard Mr. Cason say that this budget is a continued commitment to Indian schools. That statement seems to be at odds with your statement. Give me your assessment of that. Mr. Beaulieu. Did I write that it was a continuing commitment? Senator Dorgan. No; I am saying that Mr. Cason when he testified said that the President's budget is a continued commitment to Indian schools. That is vastly at odds with your testimony. Mr. Beaulieu. It certainly is, Senator. We do not believe it is a commitment to Indian schools. The reduction in construction, I mean, one has to have a place to learn. The schools often do not meet safety and health standards. The quality of going to school in places that currently exist are disastrous. That is a major issue. It has long been a major issue, as has been the need for repairs in schools. There is a continuing increase in the amount of improvements that have not been met in the existing schools. Senator Dorgan. That is the point that has not been made. We talk about construction for new schools that are necessary and need to be built, but there is a massive amount of deferred maintenance that is necessary on schools that already exist. That is not a luxury. That is a necessity. You have to do this maintenance to keep those facilities up to date. Mr. Chairman, we in North Dakota are very proud of the leadership of Tex Hall, who is serving as you know in his second term as president of the National Congress of American Indians, and he has provided some very effective leadership. We are all very proud of the work you have done, Tex, and are pleased that you are here with us once again. Let me ask, if I might, what kind of consultation does the BIA undertake, when they begin to put together a budget and evaluate an assessment of the needs in a budget. What kind of consultation has existed there? Mr. Hall. There is a difference in opinion on what that word means for tribes and for the Administration and the Bureau officials. Each region probably has a budget consultation meeting. Nationally, we have formed a tribal BIA Budget Advisory Council which is meeting in Phoenix Thursday and Friday at the San Marco Resort or something. It is a real nice place. I look forward to going there, Mr. Chairman. The Chairman. Very nice. [Laughter.] Mr. Hall. But on the other hand, getting back to education for example, one of our items is we believe in self- determination and yet the Administration has put a moratorium on any tribes that want to contract their schools. That is against what the consultation with the tribes. On reorganization, the tribes are against reorganization, yet we see hundreds of millions of dollars that are taken from our school construction budgets, put into the Office of Historical Accounting, and we all know, and the Cobell plaintiffs know, the records are not there. So why are we putting it there? Again, that is an example of there is just a complete difference on what consultation means. So it seems like we talk about it, but we just go in different worlds. Senator Dorgan. Chairman Hall, you heard the statement by Chairman McCain this morning. I feel as he does about the trust issue. We really need to get this addressed and then move on, but it needs to be addressed in a fair and thoughtful way. But if we spend the next 10 years spending billions of dollars doing historical accounting, it is going to detract from needed investments in health care, education, housing, that we just have to find a way to invest in. Tell me your assessment of Chairman McCain's comments this morning. As the Chairman of the National Congress of American Indians, do you feel there is a way for all the stakeholders to understand the urgency of finding a commonsense approach to solve this? Mr. Hall. I do. I must be a perennial optimist, I guess, but I am encouraged. I have talked with many of the stakeholders, including, I believe Chief Jim Gray is in the audience today. He is the chairman of the Intertribal Monitoring Association, 50 tribes that have large trust accounts. Of course, I am from the Great Plains, Senator Dorgan, from Mandan Hidatsa Arikara. Great Plains has 33 percent of all the accounts. I have talked to members of the Montana-Wyoming, and they are about 20 percent of the accounts. I have talked to the Navajo Nation and with ITMA and the Cobell plaintiffs. I believe all these folks that I mentioned have a big dog in the fight, and they want to resolve it. So we are actually going to be meeting and discussing this tomorrow night at that nice resort at 7 o'clock, talking about this very important issue. Senator Dorgan. There may be cases where not every stakeholder has a feeling that this needs to be solved now, or that there is any urgency. Some feel that perhaps some years can go by and you exhaust all the last options for them. This, I think, and I would guess the chairman would agree, this is going to take some real leadership in Indian country as well. I think that in order to have a consensus emerge and develop, it cannot be imposed, it has to be a developed consensus that comes from Indian leadership across the country. So I am pleased to hear your response to the chairman's discussion this morning, because that is the only way this is going to get solved. Mr. Hall. Senator Dorgan, I am reminded of a lady that has passed on. Her name is Carol Young Bear. I am glad both you and the chairman are concerned about teen suicides. She had diabetes and she had her legs amputated. She was waiting for her IM account check. This is a couple of years ago. Because of the suit and all the litigations, all she wanted was the $1,200 that was in her IM account. Because she had her legs amputated, she wanted to go to town. She wanted to visit her relatives, and she probably wanted to play bingo. Well, she did not get that check and she passed on. So all she wanted was a used van with a lift to get her to be able to go into her wheelchair and get into that van. Those are the stories that remind me that with the continued delays, there will be many other Carol Young Bears out there that are not able to live their full quality of life, especially when they are senior citizens. These are their moneys. So it reminds and I think it reminds all of us in this room that this very important issue must be addressed sooner than later. Senator Dorgan. I think that is an approach that makes a lot of sense. A person that was a member of your tribe, the late Rose Crows Flies High, used to, when she would hear something good from someone in an audience, she would make a unique sound. You might have a name for the sound that Rose Crows Flies used to make. Mr. Hall. Rattling her tongue. Senator Dorgan. She would rattle her tongue. She did it very well. I loved Rose Crows Flies High. But if she were here this morning, she would have rattled her tongue when the chairman made his comments, and I think when you just made your comments, because we need to get to the end of this in a way that makes sense. Mr. Chairman, let me thank those who testified with respect to housing and health care as well. I appreciate the testimony of all four witnesses. I think they contribute to a better understanding of these issues today. Thank you very much. The Chairman. Thank you for being here, witnesses. I am sure we will be seeing you often. Thank you very much. This hearing is adjourned. [Whereupon, at 11:15 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 Statement of Charles W. Grim, D.D.S, M.H.S.A., Assistant Surgeon General, Director, Indian Health Service Mr. Chairman and members of the committee: Good morning. I am Dr. Charles W. Grim, Director of the Indian Health Service. Today I am accompanied by Gary J. Hartz, Acting Deputy Director of the IHS. We are pleased to have the opportunity to testify on the President's fiscal year 2006 budget request for the Indian Health Service. As part of the Federal Government's special relationship with tribes, the IHS delivers health services to more than 1.8 million American Indians and Alaska Natives (AI/ANs). Care is provided in more than 600 health care facilities throughout the country. For all of the AI/ANs served by these programs, the IHS is committed to its mission to raise their physical, mental, social, and spiritual health to the highest level, in partnership with them. This mission is supported by the Department of Health and Human Services (DHHS); and, to better understand the conditions in Indian country, senior Department and IHS officials have visited tribal leaders and Indian reservations in all 12 IHS areas. And, the Administration takes seriously its commitment to honor the unique legal relationship with, and responsibility to, eligible AI/ANs served by providing effective health care services. It is Department policy that consultation with Indian tribes occur before any action is taken that significantly affects them. I have the pleasure of serving as the vice chair of the Intra-departmental Council on Native American Affairs (ICNAA) which plays a critical role in the execution of this policy. Budget is an important area of consultation. The Department holds an annual budget consultation session to give Indian tribes the opportunity to present their budget priorities and recommendations to the Department. This year, during the budget consultation process, tribal leaders provide us with their top priorities--inflation and population growth. We heard them and I am proud to say that this budget reflects these clear priorities. Through the government's longstanding support of Indian health care, the IHS, tribal, and Urban Indian health programs have demonstrated the ability to effectively utilize available resources to improve the health status of AI/ANs. The clearest example of this is the drop in mortality rates over the past few decades. More recently, this effectiveness has been demonstrated by the programs' success in achieving their annual performance targets as well as by the intermediate outcomes of the Special Diabetes Program for Indians. The agencys management of the wide array of IHS programs has also been found to be effective through evaluations using the Office of Management and Budget's Program Assessment Rating Tool (PART). The IHS PART scores have been some of the highest in the Federal Government. Although we are very pleased with these achievements, we recognize that there is still progress to be made. American Indians and Alaska Natives mortality rates for alcoholism, tuberculosis, motor vehicle crashes, diabetes, unintentional injuries, homicide, and suicide are higher than the mortality rates for other Americans. Many of the health problems contributing to these higher mortality rates are behavioral. For example, the rate of violence for AI/ANs youth aged 12-17 is 65 percent greater than the national rate for youth. In trying to account for the disparities, health care experts, policymakers, and tribal leaders are addressing many factors that impact the health of Indian people by increasing preventive services and health screening throughout the Indian health care delivery system. To support this effort, the President has requested an 8 percent increase in funding for preventive health services. As partners with the IHS in delivering needed health care to AI/ ANs, Tribal and Urban Indian health programs participate in formulating the budget request and annual performance plan. The I/T/U Indian health program providers, administrators, technicians, and elected tribal officials, as well as the public health professionals at the IHS Area and Headquarters offices, combine their expertise and work collaboratively to identify the most critical health care funding needs for AI/ANs people. Currant services funding, especially funding for inflation and population growth, has been their highest priority for several years. The budget request for the IHS is responsive to those priorities by including the increases necessary to assure that the current level of services for AI/ANs is maintained in fiscal year 2006, including an increase in services for a growing population. The President's budget request for the IHS totals $3.8 billion, a net increase of $72.1 million above the fiscal year 2005 enacted level. The request will allow I/T/U Indian health programs to maintain access to health care by providing $31.8 million to fund pay raises for Federal and tribal employees, and $79.6 million to cover the inflationary cost increases experienced by health delivery systems and to address the growing AI/ANs population. Staffing and operating costs for six newly constructed health centers are also included in the amount of $34.8 million. Once they are fully operational, these facilities will increase the number of primary care provider visits at can be provided at these sites by nearly 75 percent, in addition to providing more comprehensive health care services. Additional tribal contracting is supported by an increase of $5 million for contract support costs. This increase will cover the contract support costs of new contracts estimated to be received in fiscal year 2006. The budget proposes savings of $3.1 million from increased efficiencies in implementing information technology and reducing administrative costs. Similar savings are included in the budget requests of the other HHS Agencies. Consistent throughout HHS, fiscal year 2006 requests for facilities funding focus on maintenance of existing facilities. A total of $3.3 million is included for IHS facility construction, sufficient to fully fund the Fort Belknap staff quarters project which will provide 29 units of new and replacement staff quarters for the Harlem and Hayes outpatient facilities in Montana. Available decent local housing makes it easier to recruit and retain health professionals at remote sites. American Indians and Alaska Natives will also benefit from several provisions in the recently enacted Medicare Prescription Drug, Improvement, and Modernization Act. The transitional assistance credit of $600 per year for low-income Medicare beneficiaries, including AI/ ANs could provide additional Medicare revenue for prescription drugs dispensed at IHS facilities in fiscal year 2005. The Medicare part D prescription drug benefit program, when implemented in January 2006, will extend outpatient prescription drug coverage to AVAN Medicare beneficiaries and increase Medicare revenues at I/T/U facilities. Other sections of the act expand the benefits covered under Medicare part B for AI/AN beneficiaries and allow the IHS and Tribal Health Programs to pay for additional medical care by increasing its bargaining power when buying services from non-IHS Medicare-participating hospitals. The proposed budget that I have just described provides a continued investment in the maintenance and support of the I/T/U Indian public health system to provide access to high quality medical and preventive services as a means of improving health status. It reflects a continued Federal commitment to AI/ANs. Thank you for this opportunity to present the President's fiscal year 2006 budget request for the IHS. We are pleased to answer any questions that you may have. 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