[Senate Hearing 117-530]
[From the U.S. Government Publishing Office]





                                                        S. Hrg. 117-530
 
                    S. 4104, S. 4439, AND H.R. 5221

=======================================================================

                                HEARING

                               before the

                      COMMITTEE ON INDIAN AFFAIRS
                          UNITED STATES SENATE

                    ONE HUNDRED SEVENTEENTH CONGRESS

                             SECOND SESSION

                               __________

                             JULY 20, 2022

                               __________

         Printed for the use of the Committee on Indian Affairs
         
         
         
         
         
    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]      
    
    
    
    
   
              U.S. GOVERNMENT PUBLISHING OFFICE 
50-110PDF             WASHINGTON : 2022 
  
         


                      COMMITTEE ON INDIAN AFFAIRS

                     BRIAN SCHATZ, Hawaii, Chairman
                 LISA MURKOWSKI, Alaska, Vice Chairman
MARIA CANTWELL, Washington           JOHN HOEVEN, North Dakota
JON TESTER, Montana                  JAMES LANKFORD, Oklahoma
CATHERINE CORTEZ MASTO, Nevada       STEVE DAINES, Montana
TINA SMITH, Minnesota                MIKE ROUNDS, South Dakota
BEN RAY LUJAN, New Mexico            JERRY MORAN, Kansas
       Jennifer Romero, Majority Staff Director and Chief Counsel
        Lucy Murfitt, Minority Staff Director and Chief Counsel
        
                            C O N T E N T S

                              ----------                              
                                                                   Page
Hearing held on July 20, 2022....................................     1
Statement of Senator Hoeven......................................    29
Statement of Senator Lankford....................................     5
Statement of Senator Murkowski...................................     1
Statement of Senator Padilla.....................................     3
Statement of Senator Schatz......................................     1
Statement of Senator Sinema......................................     2
Statement of Senator Smith.......................................     4

                               Witnesses

Attebery, Hon. Russell, Chairman, Karuk Tribe....................    18
    Prepared statement...........................................    19
Clarke, Hon. Damon, Chairman, Hualapai Tribe.....................    13
    Prepared statement...........................................    15
Freihage, Jason, Deputy Assistant Secretary of Management, U.S. 
  Department of the Interior.....................................     5
    Prepared statement...........................................     7
Rock, Dr. Patrick, CEO, Indian Health Board......................    20
    Prepared statement...........................................    22
Smith, Benjamin, Deputy Director, Indian Health Service, U.S. 
  Department of Health and Human Services........................    11
    Prepared statement...........................................    12

                                Appendix

Cooke, Theodore C., General Manager, Central Arizona Water 
  Conservation District, prepared statement......................    31
Letters submitted for the record submitted by:
    Sandy Fabritz, Director, Water Strategy, Freeport-McMoRan....    34
    Scott Harding, Stewardship Associate and Theresa L. Lorejo-
      Simsiman, California Stewardship Director, American 
      Whitewater.................................................    35
    Hon. Joseph L. James, Chairman, Yurok Tribe..................    33
    Brian J. Johnson, California Director, Trout Unlimited.......    33
    Lisa Ronald, National Coordinator, Wild and Scenic Rivers 
      Coalition..................................................    32
Response to written questions submitted by Hon. Brian Schatz to:
    Hon. Russell Attebery........................................    37
    Hon. Damon Clarke............................................    38
    Jason Freihage...............................................    41
    Dr. Patrick Rock.............................................    36
    Benjamin Smith...............................................    40
Response to written questions submitted by Hon. Tina Smith to 
  Benjamin Smith.................................................    40
U.S. Department of Agriculture, prepared statement...............    31


                    S. 4104, S. 4439, AND H.R. 5221

                              ----------                              


                        WEDNESDAY, JULY 20, 2022


                                       U.S. Senate,
                               Committee on Indian Affairs,
                                                    Washington, DC.
    The Committee met, pursuant to notice, at 2:53 p.m. in room 
628, Dirksen Senate Office Building, Hon. Brian Schatz, 
Chairman of the Committee, presiding.

            OPENING STATEMENT OF HON. BRIAN SCHATZ, 
                    U.S. SENATOR FROM HAWAII

    The Chairman. Good afternoon. During today's legislative 
hearing, we will consider three bills: S. 4104, the Hualapai 
Tribe Water Rights Settlement Act of 2022, S. 4439, the 
Katimiin and Ameekyaaraam Sacred Lands Act, and H.R. 5221, 
Urban Indian Health Confer Act. S. 4104, introduced by Senators 
Sinema and Kelly, would authorize and ratify the Hualapai Tribe 
Water Rights Settlement Agreement between the tribe, certain 
allottees, and the State of Arizona, and would transfer certain 
lands into trust for their benefit.
    H.R. 5221, passed by the House in November last year, would 
require the Department of Health and Human Services to confer 
with Urban Indian Organizations, or UIOs, on matters impacting 
healthcare for American Indians and Alaska Natives living in 
urban areas. I will note that Senators Smith and Lankford 
introduced an identical Senate companion bill in May.
    Lastly, Senator Padilla's bill, S. 4439, would transfer 
approximately 1,031 acres from the U.S. Forest Service to the 
Department of Interior to be placed into trust for the benefit 
of the Karuk Tribe to allow for traditional and customer uses.
    Before I turn to Vice Chair Murkowski, I would like to 
extend my welcome and thanks to our witnesses for joining us 
today. I look forward to your testimony and discussion.
    Vice Chair Murkowski?

               STATEMENT OF HON. LISA MURKOWSKI, 
                    U.S. SENATOR FROM ALASKA

    Senator Murkowski. Thank you, Mr. Chairman, I appreciate 
the hearing today on these three bills. I think you have 
detailed them appropriately.
    With regard to the legislation sponsored by Senators Sinema 
and Kelly, S. 4104, I think it is important to recognize that 
this settlement is a decade in the making. I am looing forward 
to hearing more about the details. We know that settling water 
rights through negotiated settlements approved by Congress 
continues to be the best way to deliver wet water to tribes.
    I am pleased that we were able to include in our bipartisan 
infrastructure law $2.5 billion in an Indian Water Rights 
Settlement Completion Fund to fulfil the Federal Government's 
commitment to our tribes for Congressionally approved water 
rights. So it is good to see how this is playing out.
    With regard to S. 4439, introduced by Senators Padilla and 
Feinstein, I would note that while the Department of Interior 
is intending to testify in support of taking this land into 
trust for the tribes, I do think it would be prudent, Mr. 
Chairman, that the Committee also receive testimony from the 
Forest Service, particularly on what impacts this bill may have 
on their current administration of these lands and waters. I 
would suggest that the Committee seek the testimony in writing 
as we continue to consider this bill.
    Then with the legislation sponsored by Congressman 
Grijalva, I would note that Senators Lankford and Smith are 
sponsoring an identical Senate companion. While we have no UIOs 
in Alaska, it is my understanding these organizations in the 
lower 48 have found the Confer process with IHS to be 
beneficial with regard to providing healthcare services to 
American Indians and Alaska Natives living in our urban areas. 
So I am interested in learning how this confer process may help 
address other important health-related issues, too, as well as 
the missing and murdered indigenous peoples crisis.
    So I look forward to the testimony and hearing from our 
witnesses.
    The Chairman. Thank you very much, Vice Chair.
    We will turn to our witnesses. First, we have Mr. Jason 
Freihage, Deputy Assistant Secretary of Management, of the 
Office of the Assistant Secretary, Indian Affairs, at the 
Department of Interior. Mr. Benjamin Smith, Deputy Director of 
the Indian Health Service, U.S. Department of Health and Human 
Services. And I would now like to introduce Senator Sinema to 
introduce her guest and testifier.

               STATEMENT OF HON. KYRSTEN SINEMA, 
                   U.S. SENATOR FROM ARIZONA

    Senator Sinema. Thank you. Good afternoon, Chairman Schatz 
and Vice Chair Murkowski. I am honored to speak about the 
importance of the Hualapai Tribe Water Rights Settlement Act of 
2022, legislation that I have introduced with my colleague, 
Senator Mark Kelly.
    Our legislation provides long-term stability to the 
Hualapai Tribe's water needs in northern Arizona, which is 
especially important as Arizona and the southwest face historic 
drought conditions. Our legislation is the result of 
collaboration between the State of Arizona, the Hualapai Tribe, 
and the Department of the Interior. It has broad support among 
Arizona water stakeholders, including Mojave County, Salt River 
Project, the Arizona Department of Water Resources, the Central 
Arizona Water Conservation District, and Freeport-McMoRan.
    Currently, the Hualapai Tribe relies on groundwater alone 
to meet their water needs, which in today's climate and with 
our forecasted water future is not a permanent or sustainable 
solution. The Hualapai Tribe Water Settlement Rights Act will 
provide the tribe a permanent allocation of Colorado River 
water and the funding to construct the infrastructure needed to 
deliver that water from the Colorado to the tribe's main 
residential and commercial centers, Grand Canyon West and Peach 
Springs, Arizona.
    I now have the incredible honor to introduce the chairman 
of the Hualapai Tribe, Dr. Damon Clarke, who will be able to 
explain the legislation in further detail and how it will 
benefit the tribe in Arizona. Chairman, thank you for being 
here today.
    The Chairman. Thank you very much, Senator Sinema.
    Now we have Senator Padilla to introduce his guest and 
explain his legislation.

                STATEMENT OF HON. ALEX PADILLA, 
                  U.S. SENATOR FROM CALIFORNIA

    Senator Padilla. Thank you, Chair Schatz and Ranking Member 
Murkowski, for allowing me to join you today to introduce 
Russell Attebery, Chairman of the Karuk Tribe in California. It 
is an honor to introduce Chairman Attebery, who is here 
virtually, to testify on a bill that I am leading with Senator 
Feinstein in this house and Congressman Huffman on the House 
side that will transfer 1,000 acres of sacred lands from the 
Forest Service to the Interior Department to place those lands 
into trust for the tribe. The lands covered by this bill are 
considered to be the center of the Karuk world and sit at the 
heart of the tribe's culture, religion, and identity.
    Chairman Attebery is currently serving his third 
consecutive term as chairman, and has been a key leader in 
championing this effort. During his 11 years as chairman, he 
has also served on the Department of Interior's Tribal Interior 
Budget Council, the Executive Council of the California Tribal 
Chairmen's Association, and was recently selected as one of the 
seven primary tribal representatives to the Department of 
Interior's Progress Act negotiated rulemaking committee.
    Chairman Attebery was also appointed by Governor Jerry 
Brown to the California Native American Heritage Commission. 
Before serving as chairman, Mr. Attebery worked for the Reading 
and Siskiyou School Districts, and he holds a lifetime clear 
teaching credential from Humboldt State University.
    The Karuk Tribe have lived and conducted ceremonies on the 
sacred lands known as Katimiin for centuries. These sacred 
lands, which are used for the tribe's World Renewal Ceremony 
represent the center of the Karuk world and serve as an 
integral part of tribal culture, religion, and identity. 
Currently 95 percent of the Karuk aboriginal territory is 
managed by the Federal Government, and the tribe has a special 
use permit from the Forest Service to access the land for 
prayers and ancestral ceremonies.
    However, in recent years, the tribe has struggled to access 
the site and conduct their sacred ceremonies privately, without 
interruption. So it is a moral imperative to restore these 
lands to tribal ownership. Placing these lands in trust would 
allow the Karuk to further their mission to enhance and restore 
the natural world, and allow them to preserve their traditional 
practices.
    I thank Senator Feinstein for introducing this legislation 
with me in the Senate, and Congressman Huffman for championing 
this effort in the House. I also want to thank Chairman 
Attebery for his testimony today, and for his leadership in 
working to advance the long overdue effort. His approach to 
Federal-tribal relationships has been one that says 
collaboration is always the best first step in building 
partnerships, and his testimony today is a testament to that.
    I look forward to working with my colleagues to enact this 
bill as quickly as possible and return these sacred lands to 
their originals stewards. Thank you again, Mr. Chairman.
    The Chairman. Thank you, Senator Padilla. Now I would like 
to turn it over to Senator Smith to introduce her guest.

                 STATEMENT OF HON. TINA SMITH, 
                  U.S. SENATOR FROM MINNESOTA

    Senator Smith. Thank you so much. Thank you, Chair Schatz 
and Vice Chair Murkowski, for holding this hearing today and 
for including the Urban Indian Health Confer Act.
    Senator Lankford and I introduced the Senate version of 
this bill which would require every agency within the 
Department of Health and Human Services to confer with Urban 
Indian organizations when policies affect healthcare for urban 
Native communities. This measure is an important step towards 
parity for urban Native communities, and something that I think 
we should all be able to agree on. So I look forward to working 
with the Committee to get this bill across the finish line this 
year.
    To help us understand the impact of this bill, I am very 
glad to welcome Dr. Patrick Rock, Chief Executive Officer of 
the Indian Health Board of Minneapolis, and a member of the 
Leech Lake Band of Ojibwe. Dr. Rock is a family physician and 
has been serving patients at IHB for over 25 years. He is a 
tireless advocate for the urban indigenous community in 
Minneapolis, and his leadership has helped IHB grow into the 
distinguished institution that it is today.
    I recently had a chance to visit the Indian Health Board to 
hear about their work on mental health, reproductive care, and 
comprehensive health services for urban indigenous Minnesotans. 
Under Dr. Rock's leadership, they are also working on an 
expansion that will expand their capacity and incorporate 
indigenous cultural components into the facility. So I am very 
proud to work on behalf of the Indian Health Board and 
Minnesota's urban indigenous communities here in Washington on 
this bill. I hope to see us move this forward and get it done.
    Thank you, Mr. Chair.
    The Chairman. Thank you very much.
    And to Senator Lankford, for an opening statement.

               STATEMENT OF HON. JAMES LANKFORD, 
                   U.S. SENATOR FROM OKLAHOMA

    Senator Lankford. Thank you, Mr. Chairman. Thanks for the 
time on this, and thanks for taking up this bill as you work 
through this.
    I would like to first start off by saying thank you to the 
leadership and to the individuals that serve in the two 
Oklahoma Urban Indian Clinics in Tulsa and in Oklahoma City for 
their continued service to the urban Indian population. 
Oklahoma Urban Indian Clinics serve the second largest 
population next to California, and Senator Padilla knows we are 
right behind him on that one. Leaders like Robyn Sunday-Allen 
and Carmelita Skeeter in Tulsa and in Oklahoma City, they are 
the reason that all this works so well. They work incredibly 
hard and they are absolutely the gold standard for health care 
and clinic operations.
    I was proud to sponsor and help pass into law two Urban 
Indian Clinic focused bills with Senator Smith. We helped pass 
the coverage for Urban Indian Health Providers Act and the 
Facilities Improvement Act. Both ensure greater parities for 
UIOs and the Indian health system. Both bills were the first 
ever standalone UIO bills passed in Congress. So it is a big 
deal. We are continuing to be able to build on that.
    I am proud to be able to cosponsor with Senator Smith the 
Senate companion to the Urban Indian Health Confer Act. This 
simple legislation will ensure that UIOs are brought into 
important conversations in Confer at HHS. We talk a lot about 
consultation with tribes. But currently, HHS is not doing 
consultation with our Urban Indian Clinics. That needs to 
start. So we would like to be able to bring that into line 
right now on that.
    I look forward to the full consideration and quick passage 
of the bill in this Committee. We have a lot more to do to be 
able to bring parity to UIOs and this is another really 
important step. I thank the Chairman and Ranking Member for 
bringing this to the attention today.
    The Chairman. Thank you very much.
    We welcome all of our testifiers and thank all the members 
for their leadership. I want to remind our witnesses that your 
full, written testimony will be made part of the official 
hearing record. Please keep your statements to no more than 
five minutes, so that members may have time for questions.
    Mr. Freihage, you may begin.

         STATEMENT OF JASON FREIHAGE, DEPUTY ASSISTANT 
          SECRETARY OF MANAGEMENT, U.S. DEPARTMENT OF 
                          THE INTERIOR

    Mr. Freihage. Good afternoon, Chairman Schatz, Vice 
Chairman Murkowski and members of the Committee. My name is 
Jason Freihage, and I serve as the Deputy Assistant Secretary 
of Management for Indian Affairs at the U.S. Department of the 
Interior. Thank you for the opportunity to present the 
department's testimony on S. 4104, the Hualapai Tribe Water 
Rights Settlement Act of 2022, and S. 4439, the Katimiin and 
Ameekyaaraam Sacred Lands Act.
    The Biden Administration strongly supports the resolution 
of Indian water rights claims through negotiated settlements. 
Congress plays an important role in approving water rights 
settlements, and we stand ready to work with this Committee and 
the members of Congress.
    Negotiations regarding potential settlement of the tribe's 
water rights claims have been ongoing since 2011. The first 
phase addressed reserve water rights, the several off-
reservation tracts in the Bill Williams River Basin, and 
resulted in the Bill Williams River Water Rights Settlement Act 
of 2014. The second phase addressed in S. 4104 covers 
additional water rights in the Bill Williams River Basin as 
well as the remainder of the tribe's water rights in the 
Colorado River Basin and the Verde River Basin.
    S. 4104 would resolve the tribe's remaining water rights 
claims in Arizona, ratify and confirm the Hualapai Tribal Water 
Rights Settlement Agreement among the Hualapai Tribe, the 
United States, the State of Arizona, and others, and authorize 
funds to implement the settlement agreement. The bill would 
reallocate 4,000 acre feet of fourth priority Central Arizona 
Project, non-Indian agricultural priority water, to the tribe 
to be used for any purpose on or off reservation within the 
lower Colorado River Basin in Arizona.
    S. 4104 establishes a trust fund of $180 million that the 
tribe can use to develop water infrastructure on its 
reservation. It also authorizes a $5 million fund for the 
Secretary of the Interior for settlement implementation, 
including for ongoing groundwater monitoring and modeling.
    The department supports S. 4104. The bill is a result of 
over a decade of good faith negotiations. Rather than 
committing the tribe or the United States to construct specific 
water infrastructure projects, S. 4104 allows the tribe to make 
decisions regarding how, when, and where to develop water 
infrastructure on its reservation. This approach to settlement 
is consistent with tribal sovereignty and self-determination.
    Environmental compliance and issuance of a record of 
decision by the Secretary are conditions precedent to 
construction of tribal projects with the trust fund. The 
environmental compliance process will allow for the 
identification and mitigation of any adverse impacts of a 
project, including adverse impacts to the Grand Canyon National 
Park.
    Previously introduced bills to approve the settlement 
included provisions prohibiting the tribe and the United States 
from objecting to any use of groundwater outside the boundaries 
of the reservation. Recent negotiations have produced 
compromise language tailored to the unique facts and 
hydrogeology on and around the reservation. The department 
believes that S. 4104 would protect the groundwater resources 
available on the reservation while providing certainty to 
surrounding communities that also rely on the Truxton Aquifer.
    However, we caution that the compromises reached in this 
settlement are not a one-size-fits-all, and should not be 
considered a precedent for other settlements. As a final 
matter, the department notes that S. 4104 contains restrictions 
on taking lands into trust in Arizona. This restriction is a 
significant limitation on the authority of the United States 
under existing Federal law, and is contrary to the 
Administration's strong support for returning ancestral lands 
to tribes. The department does not seek to contradict the 
tribe's decision that the benefits provided by S. 4104 justify 
this compromise.
    The department supports the tribe's exercise of its 
sovereignty while strongly disfavoring restrictions on taking 
of lands into trust. The department is pleased to support S. 
4104.
    S. 4439 would transfer approximately 1,031 acres of Federal 
land in Siskiyou and Humboldt Counties, California, from the 
United States Forest Service to the Department of Interior, and 
directs the Secretary to take that land into trust for the 
benefit of the Karuk Tribe. The transfer of the administrative 
jurisdiction and transfer into trust is subject to the 
condition that the Chief of the Forest Service continues to 
manage the National Wild and Scenic Rivers System that flows 
through the Katimiin and Ameekyaaraam land.
    Additionally, the bill directs the Secretary of Agriculture 
to enter into a memorandum of understanding with the Karuk 
Tribe to establish mutual goals to protect and enhance the 
river values of any components of the National Wild and Scenic 
River System that flows through the land. Gaming on the land 
would be prohibited.
    The Department supports this legislation. The Katimiin and 
Ameekyaaraam land is sacred to the Karuk Tribe and vital to 
their culture and traditions. We appreciate the difficulty and 
uncertainty the tribe faces in relying on special use permits 
for ceremonial access.
    The Department strongly supports returning traditional and 
sacred lands back to tribes, and supports agreements with 
Indian tribes to collaborate and co-stewardship of Federal 
lands and waters under the jurisdiction of the Department of 
the Interior and Department of Agriculture.
    Chairman Schatz, Vice Chairman Murkowski and members of the 
Committee, thank you for the opportunity to provide the 
department's views on these important bills. I look forward to 
answering any questions.
    [The prepared statement of Mr. Freihage follows:]

  Prepared Statement of Jason Freihage, Deputy Assistant Secretary of 
              Management, U.S. Department of the Interior
    Hello and good afternoon, Chairman Schatz, Vice Chair Murkowski, 
and members of the Committee. My name is Jason Freihage, and I serve as 
the Deputy Assistant Secretary of Management for Indian Affairs at the 
U.S. Department of the Interior (Department).
    Thank you for the opportunity to present the Department's testimony 
on S. 4104, The Hualapai Tribe Water Rights Settlement Act of 2022, a 
bill to approve the settlement of water rights claims of the Hualapai 
Tribe and certain allottees in the State of Arizona, to authorize 
construction of a water project relating to those water rights claims, 
and for other purposes and S. 4439, The Katimiin and Ameekyaaraam 
Sacred Lands Act, a bill to take certain Federal land located in 
Siskiyou County, California, and Humboldt County, California, into 
trust for the benefit of the Karuk Tribe, and for other purposes.
    The Department supports both S. 4104 and S. 4439.
S. 4104--Hualapai Tribe Water Rights Settlement Act of 2022
I. Introduction
    The Biden Administration recognizes that water is a sacred and 
valuable resource for Tribal Nations and that long-standing water 
crises continue to undermine public health and economic development in 
Indian Country. This Administration strongly supports the resolution of 
Indian water rights claims through negotiated settlements. Indian water 
settlements help ensure that Tribal Nations have safe, reliable water 
supplies; improve environmental and health concerns on reservations; 
enable economic growth; promote Tribal sovereignty and self-
sufficiency; and help fulfill the United States' trust responsibility 
to Tribes. At the same time, water rights settlements have the 
potential to end decades of controversy and contention among Tribal 
Nations and neighboring communities and promote cooperation in the 
management of water resources. Congress plays an important role in 
approving Indian water rights settlements and we stand ready to work 
with this Committee and Members of Congress to advance Indian water 
rights settlements.
    Indian water rights settlements play a pivotal role in this 
Administration's commitment to putting equity at the center of 
everything we do to improve the lives of everyday people--including 
Tribal Nations. We have a clear charge from President Biden and 
Secretary Haaland to improve water access and water quality on Tribal 
lands. Access to water is fundamental to human existence, economic 
development, and the future of communities--especially Tribal 
communities. To that end, the Biden Administration's policy on 
negotiated Indian water settlements continues to be based on the 
following principles: the United States will participate in settlements 
consistent with its legal and moral trust responsibilities to Tribal 
Nations; Tribes should receive equivalent benefits for rights which 
they, and the United States as trustee, may release as part of the 
settlement; Tribes should realize value from confirmed water rights 
resulting from a settlement; and settlements should contain appropriate 
cost-sharing proportionate to the benefits received by all parties 
benefiting from the settlement. In addition, settlements should provide 
finality and certainty to all parties involved.
    The Infrastructure Investment and Jobs Act provided a significant 
boost toward meeting our commitments to Tribal Nations for water rights 
by providing $2.5 billion in the Indian Water Rights Settlement 
Completion Fund (referred to as the Completion Fund) for enacted Indian 
Water settlements. In February, the Department announced allocations 
totaling $1.7 billion for enacted Indian water rights settlements that 
have outstanding federal payments necessary to complete their terms. 
All of this funding has been allocated by the Bureau of Reclamation for 
settlement project implementation or by the BIA into settlement trust 
funds where they are earning interest until the Tribes are able to pull 
down the funds for settlement uses. In order to complete allocations of 
remaining funding, BIA is engaging with Tribes to finalize indexing 
costs which are necessary to determine their final settlement payments 
over the coming months. The Bureau of Reclamation will continue to work 
with the Department to identify project specific allocations from the 
Completion Fund to meet implementation needs.
II. Historical Context
A. The Hualapai Reservation and the Hualapai Tribe
    The Hualapai Tribe's aboriginal homeland is located in the Grand 
Canyon and plateau region to the south of the Grand Canyon. The Tribe's 
main Reservation was established on January 4, 1883, by Executive 
Order, and is comprised of approximately 992,462 acres of tribal trust 
lands in northwestern Arizona. The tribal headquarters is Peach 
Springs, Arizona, near the southern boundary of the Reservation. The 
northern boundary of the main Reservation is 108 miles along the 
Colorado River in the Grand Canyon. There is also a 60-acre Executive 
Order Reservation located in the Big Sandy River Basin, approximately 
40 miles south of the main Reservation.
    The primary sources of employment on the Reservation are 
recreation, tourism, and tribal and federal government services. The 
Grand Canyon is the primary source of tourism on the Reservation, with 
activities at the Tribe's tourism center, Grand Canyon West, and river 
rafting in the Colorado River. The Tribe also owns and operates the 
Hualapai Lodge, located in Peach Springs.
    In 2007, the Tribe completed Grand Canyon West, which includes the 
Skywalk, a horseshoe-shaped glass-bottom walkway that extends out from 
the rim of the Grand Canyon. Pre-pandemic, annual visitation at Grand 
Canyon West exceeded one million visitors, making it the primary 
economic driver on the Reservation.
B. Water Resources of the Hualapai Reservation
    The main Reservation is located primarily in the Colorado River 
Basin with a small portion in the Upper Verde River Basin. Most on-
Reservation streams are ephemeral. Several springs discharging from the 
regional aquifer at the bottom of canyons can provide baseflow for 
short perennial reaches, which ultimately discharge to the Colorado 
River. The largest of these perennial streams are Diamond Creek and 
Spencer Creek, with mean annual flows of over 3,700 acre-feet per year 
(afy) and 4,600 afy, respectively. The springs that feed these streams 
are located in remote portions of deep canyons and are not readily 
accessible for use by the Tribe. Smaller springs on the plateaus 
provide water for livestock purposes.
    Groundwater is the primary water supply on the Reservation and is 
available in varying degrees of magnitude, depending on the type and 
location of water-bearing zones. The major water use on the Reservation 
occurs in two locations: the town of Peach Springs and Grand Canyon 
West. Three wells serve the Peach Springs public water supply system 
and are located approximately 6.5 miles southwest of the town. These 
wells produce water from the Truxton Aquifer, an aquifer in the Truxton 
Valley that extends off the Reservation.
    For over a decade, Grand Canyon West relied entirely on groundwater 
pumped and then transported by way of an approximately 35-mile-long 
pipeline. In 2019, the groundwater well supplying Grand Canyon West 
went dry. To keep this cornerstone of the Tribe's tourist economy 
operational, the Tribe has had to haul water approximately 30-miles 
from a well near Peach Springs to the now-dry well site. The hauled 
groundwater is then piped to Grand Canyon West. For it to thrive as the 
Tribe has envisioned, Grand Canyon West needs improved access to water.
III. Proposed Hualapai Tribe Settlement Legislation
    The Tribe claims water rights in the Colorado, Verde, and Bill 
Williams River basins. Negotiations regarding potential settlement of 
the Tribe's water rights claims have been ongoing since 2011, when the 
United States established a team to negotiate a comprehensive 
settlement of all the Tribe's water rights within Arizona. The 
settlement was divided into two phases; the first phase addressed 
reserved water rights to several off-reservation tracts in the Bill 
Williams River Basin and resulted in the Bill Williams River Water 
Rights Settlement Act of 2014, P.L. 113-223. The second phase, 
addressed in S. 4104, covers additional water rights in the Bill 
Williams River Basin, as well as the remainder of the Tribe's water 
rights in the Colorado River Basin and the Verde River Basin.
    S. 4104 would resolve the Tribe's remaining water rights claims in 
Arizona; ratify and confirm the Hualapai Tribe water rights settlement 
agreement among the Hualapai Tribe, the United States, the State of 
Arizona, and others; and authorize funds to implement the settlement 
agreement. The bill would reallocate 4,000 acre-feet of fourth-priority 
Central Arizona Project (CAP) non-Indian agriculture priority water to 
the Tribe to be used for any purpose on or off the Reservation within 
the lower Colorado River basin in Arizona. S. 4104 establishes a Trust 
Fund of $180 million, to be indexed, that the Tribe can use to develop 
water infrastructure on its Reservation as it determines necessary and 
on its own timeframe. S. 4104 also authorizes a $5,000,000 fund for the 
Secretary of the Interior for settlement implementation, including for 
ongoing groundwater monitoring and modeling.
    As discussed below, S. 4104 is the product of negotiations among 
the Tribe, the United States, the State of Arizona, and other 
interested parties, to resolve Departmental concerns expressed in prior 
testimony.
IV. Department of the Interior Position on S. 4104
    The Department is pleased to support S. 4104. This bill is the 
result of over a decade of dedicated, good-faith negotiations to reach 
consensus on key issues. The Department appreciates that each 
settlement is unique, and its terms must be tailored to meet the needs 
of the settling Tribe and other parties.
    S. 4104 is drafted to meet the Tribe's current and long-term needs 
for water by providing a Trust Fund to be used by the Tribe according 
to its needs and determinations. Rather than committing the Tribe or 
the United States to construct specific water infrastructure projects, 
S. 4104 allows the Tribe to make decisions regarding how, when, and 
where to develop water infrastructure on its Reservation. This approach 
to settlement is consistent with tribal sovereignty and self-
determination.
    S. 4104 provides that the Tribe can use the Trust Fund to plan, 
design, and construct a water project in the lower Colorado River basin 
in Arizona at locations on or directly adjacent to the Hualapai 
Reservation. Environmental compliance and issuance of a record of 
decision by the Secretary are conditions precedent to construction of 
such a project. The environmental compliance process will allow for the 
identification and mitigation of any adverse impacts of a project, 
including adverse impacts to the Grand Canyon National Park.
    Previously introduced bills to approve the settlement included 
provisions prohibiting the Tribe and the United States from objecting 
to any use of groundwater outside the boundaries of the Reservation, 
even if those uses interfere with acknowledged Federal reserved 
groundwater rights. The Department testified repeatedly against such 
restrictions. Recent negotiations, however, produced compromise 
language tailored to the unique facts and hydrogeology on and around 
the Reservation. The Department believes that S. 4104, as introduced, 
would protect the groundwater resources available on the Reservation 
while providing certainty to surrounding communities that also rely on 
the Truxton Aquifer for their development. However, we caution that the 
compromises reached in this settlement are not a ``one size fits all'' 
and should not be considered a precedent for other settlements.
    As a final matter, the Department notes that S. 4104 contains 
restrictions on taking lands into trust in Arizona. The State of 
Arizona takes the position, as a matter of policy, that Indian water 
rights settlements must include the restriction that, as of the date of 
enactment, the settling Tribe may have additional lands taken into 
trust only if specifically authorized by Congress. This restriction is 
a significant limitation on the authority of the United States under 
existing Federal law and is contrary to this Administration's strong 
support for returning ancestral lands to Tribes. The Department does 
not seek to contradict the Tribe's decision that the benefits provided 
by S. 4104, including the addition of certain lands to the Reservation 
as part of the settlement, justify this compromise. The Department 
supports the Tribe's exercise of its sovereignty while strongly 
disfavoring restrictions on the taking of lands into trust.
V. Conclusion
    The Department appreciates the dedication of all parties, including 
the Tribe and the State of Arizona, to these prolonged negotiations and 
the willingness of all the parties to reach consensus on contentious 
issues. The Department is pleased to support S. 4104.
S. 4439--Katimiin and Ameeky araam Sacred Lands Act
    S. 4439 would transfer approximately 1,031 acres of Federal land, 
including improvements and appurtenances thereto, in Siskiyou and 
Humboldt Counties, California, from the United States Forest Service to 
the Department of the Interior and direct the Secretary of the Interior 
to take that land into trust for the benefit of the Karuk Tribe. The 
transfer of administrative jurisdiction and transfer into trust in the 
bill is subject to the condition that the Chief of the Forest Service 
continues to manage the National Wild and Scenic Rivers System that 
flows through the Katimiin and Ameeky araam land. Additionally, the 
bill directs the Secretary of Agriculture to: (1) provide to the 
Secretary of the Interior a survey of the land, and (2) enter a 
memorandum of understanding with the Karuk Tribe to establish mutual 
goals to protect and enhance the river values of any component of the 
National Wild and Scenic Rivers System that flows through the land. 
Gaming on the land would be prohibited.
    The Department supports this legislation. The Katimiin and Ameeky 
araam land is sacred to the Karuk Tribe and vital to their culture and 
traditions. We appreciate the difficulty and uncertainty that the Tribe 
currently faces in relying upon a Special Use Permit for ceremonial 
access. The Department strongly supports returning traditional and 
sacred lands back to Tribes and supports agreements with Indian Tribes 
to collaborate in the co-stewardship of Federal waters under the 
jurisdiction of the Department of the Interior and the Department of 
Agriculture. As set forth in Joint Secretarial Order 3403, signed by 
the Secretaries of both the Department of the Interior and the 
Department of Agriculture, we will continue to support Tribal 
opportunities to consolidate Tribal homelands and empower Tribal 
stewardship of those resources. As an example of the multiple 
strategies the Administration is advancing, the FY 2023 President's 
budget includes $14.8 million for land acquisition efforts on and off 
current reservations.
Conclusion
    Chairman Schatz, Vice Chairman Murkowski, and Members of the 
Committee, thank you for the opportunity to provide the Department's 
views on these important bills. I look forward to answering any 
questions.

    The Chairman. Thank you very much.
    Mr. Smith, please proceed.

         STATEMENT OF BENJAMIN SMITH, DEPUTY DIRECTOR, 
       INDIAN HEALTH SERVICE, U.S. DEPARTMENT OF HEALTH 
                       AND HUMAN SERVICES

    Mr. Smith. Good afternoon, Chairman Schatz, Vice Chair 
Murkowski, and members of the Committee. Thank you for the 
opportunity to testify on H.R. 5221.
    H.R. 5221 would amend the Indian Health Care Improvement 
Act to establish and Urban Indian Organization confer policy 
for the Department of Health and Human Services. The bill would 
require the Department of Health and Human Services to ensure 
its agencies and offices confer with Urban Indian Organizations 
in carrying out laws relating to Indian health care.
    I would like to first start off by underscoring the unique 
and political relationship we do have with Indian tribes before 
I move on to this bill in particular. Because in the integral 
component of the government-to-government relationship is our 
commitment to regular and meaningful consultation with 
federally recognized Indian tribes.
    The Department of Health and Human Services takes its 
responsibility to consult with tribal governments seriously. It 
first established the department's Tribal Consultation Policy 
in 1997. This policy specifically establishes the unique 
political status of tribal governments, and it is upon that the 
status of the government-to-government relationship is affirmed 
through the HHS tribal consultation policy.
    The Indian Health Service Tribal Consultation Policy was 
last updated on January 18th, 2006. Likewise, it was developed 
in consultation with Indian tribes and outlines that 
consultation with Indian tribes will occur to the extent 
practicable and permitted by law before any action is taken 
that will significantly affect Indian tribes.
    Other statutes and policies exist that allow for Federal 
consultation with Indian organizations and confer with Urban 
Indian Organizations that by the nature of their business serve 
Indian people and might be affected if excluded from the 
consultation and confer process.
    As part of the Patient Protection and Affordable Care Act, 
Congress reauthorized and amended the Indian Health Care 
Improvement Act, and added a requirement that the Indian Health 
Service confer to the maximum extent practicable with Urban 
Indian Organizations in carrying out the Indian Health Care 
Improvement Act.
    In 2014, the Indian Health Service established its first 
policy on conferring with Urban Indian Organizations. The 
policy serves as a guide when the agency seeks input from Urban 
Indian Organization leaders on urban Indian health matters. The 
IHS urban confer policy strives to assure that urban Indian 
heath care needs are considered at the local area and national 
levels when implementing and carrying out the Indian Health 
Care Improvement Act.
    The Indian Health Service confer policy has been used since 
its implementation to ensure that the highest possible health 
status for urban Indians occurs. The Indian Health Service is 
the only Federal agency in the Federal Government to implement 
this formal process. It is a best practice and critical 
partnership opportunity.
    The Indian Health Service has consistently heard from Urban 
Indian Organizations through the confer process that they would 
like the opportunity to confer with other HHS operating 
divisions and staff offices. They have also expressed that the 
need to confer with other HHS agencies is even more critical 
due to the pandemic and need for interagency collaboration.
    The Indian Health Service conferring process works to 
ensure that health care priorities for urban Indian populations 
are being heard and addressed at the local, area, and national 
levels. We look forward to continuing our work with Congress on 
this bill, and welcome the opportunity to provide technical 
assistance as requested by the Committee or its members.
    I am happy to answer any questions that you may have. Thank 
you.
    [The prepared statement of Mr. Smith follows:]

 Prepared Statement of Benjamin Smith, Deputy Director, Indian Health 
         Service, U.S. Department of Health and Human Services
    Good afternoon Chairman Schatz, Vice Chair Murkowksi, and the 
Members of this Committee. Thank you for the opportunity to testify on 
H.R. 5221, Urban Indian Health Confer Act.
    The Indian Health Service (IHS) is an agency within the Department 
of Health and Human Services (HHS) and our mission is to raise the 
physical, mental, social, and spiritual health of American Indians and 
Alaska Natives to the highest level. This mission is carried out in 
partnership with American Indian and Alaska Native Tribal communities 
through a network of over 687 Federal and Tribal health facilities and 
41 Urban Indian Organizations (UIOs) that are located across 37 states 
and provide health care services to approximately 2.6 million American 
Indian and Alaska Native people annually.
H.R. 5221
    H.R. 5221 would amend the Indian Health Care Improvement Act 
(IHCIA) to establish a UIO confer policy for HHS. The bill would 
require HHS to ensure its agencies and offices confer with UIOs in 
carrying out laws relating to Indian health care.
    An integral component of the government-to-government relationship 
is our commitment to regular and meaningful consultation with 
Federally-recognized Indian Tribes. The importance of Tribal 
Consultation has been affirmed through an Executive Order in 2000 and 
Presidential Memoranda in 1994, 2004, 2009, and 2021.
    HHS takes its responsibility to consult with Tribal governments 
seriously and first established the Department's Tribal Consultation 
Policy in 1997, with multiple revisions since its creation, most 
recently updated in 2012 and evaluated in 2021. Each time the policy 
has been updated, it was in collaboration with Tribal governments, 
recognizing that HHS and Indian Tribes share the goal to establish 
clear policies to further the government-to-government relationship 
between the Federal government and Indian Tribes. As such, the policy 
specifically recognizes the unique political status of Tribal 
governments and it is upon that status that the government-to-
government relationship is affirmed through the HHS Tribal Consultation 
Policy.
    HHS has a long-standing commitment to working on a government-to-
government basis with Indian Tribes and in partnership with American 
Indians and Alaska Natives. HHS is also committed to strengthening this 
relationship and enhancing coordination and collaboration across its 
Divisions to address Tribal issues within the context of each 
Division's mission. Each Division shares in the Department-wide 
responsibility to coordinate, communicate, and consult with Indian 
Tribes on issues that affect Tribes. All Divisions are responsible for 
conducting Tribal consultation to the extent practicable and permitted 
by law on policies that have Tribal implications.
    The IHS Tribal Consultation Policy, updated January 18, 2006, was 
developed in consultation with Indian Tribes. The IHS Tribal 
Consultation Policy outlines that consultation with Indian Tribes will 
occur, to the extent practicable and permitted by law, before any 
action is taken that will significantly affect Indian Tribes. Such 
actions refer to policies that have Tribal implications and substantial 
direct effects on one or more Indian Tribes or on the distribution of 
power and responsibilities between the Federal Government and Indian 
Tribes. The consultation process is triggered with the identification 
of a critical event, which is defined as a planned or unplanned event 
that has or may have a substantial impact on Indian Tribes or Indian 
communities, including but not limited to the development of new or 
revised policies or programs or funding/budget requests. Part of this 
process includes facilitating collaboration between HHS Divisions, 
Regional Offices, and the Indian Tribe(s) to assist with consultation 
and address any identified issue(s), such as access to HHS programs and 
services, that could be provided directly to an Indian Tribe(s). IHS 
has also developed special Tribal advisory committees to provide 
leadership, advocacy, and guidance to the Director on policy and 
program matters.
    Although the unique Federal relationship with Indian Tribes is 
based in part on the fundamental concept of government-to-government 
relations, other statutes and policies exist that allow for Federal 
consultation with Indian organizations and confer with UIOs that, by 
the nature of their business, serve Indian people and might be affected 
if excluded from the consultation and confer process. The IHS enters 
into limited, competing contracts and grants with 41 non-profit 
organizations to provide health care and referral services for Urban 
Indians in 22 states and 11 IHS Areas. UIOs are defined by 25 U.S.C.  
1603(29) as a nonprofit corporate body situated in an urban center, 
governed by an Urban Indian controlled board of directors, and 
providing for the maximum participation of all interested Indian groups 
and individuals, which body is capable of legally cooperating with 
other public and private entities for the purpose of performing the 
activities described in 25 U.S.C.  1653(a).
    On March 23, 2010, as part of the Patient Protection and Affordable 
Care Act, Congress reauthorized and amended the IHCIA. 25 U.S.C. 
 1601, et seq. Congress added a requirement that the IHS 
``confer,'' to the maximum extent practicable, with UIOs in carrying 
out the IHCIA. 25 U.S.C.  1660d(b). ``Confer'' means engaging in an 
open and free exchange of information and opinions leading to mutual 
understanding and comprehension and emphasizing trust, respect, and 
shared responsibility. 25 U.S.C.  1660d(a). HHS supports conferring 
with UIOs as set forth in the declaration of national Indian health 
policy in the IHCIA.
    On September 22, 2014, the IHS established the policy on 
``Conferring with Urban Indian Organizations,'' in Part 5, Chapter 26, 
of the Indian Health Manual, consistent with the new IHCIA authority. 
The policy serves as a guide when the Agency seeks input from UIO 
Leaders on Urban Indian health matters. The IHS urban confer policy 
strives to ensure that Urban Indian health care needs and priorities 
are considered at the local, area, and national levels when 
implementing and carrying out the IHCIA.
    The IHS policy has been used since its implementation in carrying 
out the IHCIA to ensure the highest possible health status for Urban 
Indians. The IHS is the only agency within the Federal government to 
implement this formal process, and it is a best practice and critical 
partnership opportunity. The IHS has consistently heard from UIOs that 
they would like the opportunity to confer with other HHS Divisions. 
They have also expressed that the need to confer with other HHS 
Divisions is even more critical due to the pandemic and need for inter-
agency collaboration. The IHS continues to implement its urban confer 
policy, measure the level of satisfaction of the urban conferring 
process, and confer with UIOs when necessary to improve the process to 
bring about the desired results.
    We look forward to continuing our work with Congress on this bill 
and welcome the opportunity to provide technical assistance as 
requested by the Committee or its Members. We are committed to working 
closely with our stakeholders and understand the importance of working 
with partners to address the needs of American Indians and Alaska 
Natives.

    The Chairman. Thank you very much.
    Dr. Clarke, please proceed with your testimony.

    STATEMENT OF HON. DAMON CLARKE, CHAIRMAN, HUALAPAI TRIBE

    Dr. Clarke. Thank you, Chairman Schatz, and Vice Chairwoman 
Murkowski and members of the Committee.
    I am Damon Clarke, Chairman of the Hualapai Tribe. The 
Hualapai Tribe strongly supports S. 4104, the Hualapai Tribe 
Water Rights Settlement Act of 2022.
    The Hualapai Reservation encompasses approximately one 
million acres in the northwestern Arizona. The Colorado River, 
we call Hakataya, forms a 108-mile northern boundary of the 
reservation through a portion of the Grand Canyon. Our 
reservation has no significant surface streams other than the 
Colorado River. It has very limited groundwater resources.
    The tribe's groundwater wells are being depleted and water 
levels on the reservation have been dropping for years. The 
tribe's residential community at Peach Springs relies 
exclusively in three groundwater wells in the Truxton Aquifer, 
near the reservation's southern boundary. Those wells were 
installed in 1975, so the piping for the well system is 47 
years old and has failed in the recent past, leaving our 
community without water for several days.
    One of the wells has also suffered episodes of dangerous E-
coli contamination. We are very vulnerable to the short-term 
interruptions in supply from these wells, and also to the long-
term decline in the water levels in the aquifer.
    The situation is even worse elsewhere in the reservation. 
There are two wells at West Water which has provided all the 
water for tourist development 35 miles away at Grand Canyon 
West on the western rim of the Grand Canyon. But three years 
ago, those wells suddenly failed because of the drought. The 
collapse of these wells has forced us to limit our operations 
at Grand Canyon West, thus threatening our tribal economy and 
the main source of employment for our members.
    As an emergency measure, we have resorted to pumping more 
water from the Truxton Aquifer and hauling it 15 miles by truck 
on a gravel road to get to Grand Canyon West. The patchwork 
system is insecure and expensive. But it is the only way that 
we can continue our remaining operations at Grand Canyon West.
    The Colorado River is the only feasible solution to these 
problems, and the only water supply that can satisfy the long-
term needs of our population living in Peach Springs and on the 
rest of our reservation. This settlement would give our tribe 
an allocation of 4,000 acre feet a year of Colorado River water 
and funding for the pipeline system to deliver that water to 
the reservation in order to serve our needs at both Peach 
Springs and Grand Canyon West.
    Passage of this legislation is essential for our tribe if 
it is to have a secure future on our reservation. We have done 
everything possible to provide jobs and income to our people in 
order to lift them out of poverty. But the lack of a secure 
water supply is a major obstacle we still face. This 
legislation would very much help us to overcome this obstacle.
    This legislation is strongly supported by the State of 
Arizona and other important State parties, including the CAP, 
the Salt River Project, and it also has the support of our 
neighbor, Mohave County. Finally, for the first time, I am very 
pleased that this legislation is supported by the Department of 
Interior and the Department of Justice.
    Thank you for the opportunity to testify before you today. 
I will be pleased to answer any questions you may have, and our 
tribe will help in any way we can to secure enactment of this 
critical legislation. Thank you.
    [The prepared statement of Dr. Clarke follows:]

   Prepared Statement of Hon. Damon Clarke, Chairman, Hualapai Tribe
    Chairman Schatz and members of the Committee, my name is Dr. Damon 
Clarke. I am Chairman of the Hualapai Tribe.
    The Hualapai Tribe strongly supports S. 4104, the Hualapai Tribe 
Water Rights Settlement Act of 2022. Before I describe the major 
elements of this legislation and the critical benefits the Tribe 
receives from it, let me briefly explain to the Committee our Tribe's 
pressing water needs.
1. The Tribe's Critical Need for Additional Water
    The Hualapai Reservation encompasses approximately one million 
acres in northwestern Arizona. All lands on the Reservation are tribal 
trust lands; there are no allotments or fee inholdings. The Colorado 
River forms the 108-mile northern boundary of the Reservation through a 
portion of the Grand Canyon.
    Our Reservation is arid. It has no significant surface streams 
other than the Colorado River. It has very limited groundwater 
resources. The Tribe's groundwater wells are a depletable resource and 
well levels on the Reservation have been dropping for years. The 
Tribe's principal residential community at Peach Springs relies 
exclusively on three groundwater wells in the Truxton Aquifer, near the 
Reservation's southern boundary. Those wells were installed in 1975, so 
the piping for the well system is 47 years old and has failed in the 
recent past, leaving our community without water for several days. One 
of the wells has also suffered episodes of dangerous E-coli and 
coliform contamination and we have not been able to locate the source 
of the contamination. When that well is out of service because of 
contamination, we are unable to supply sufficient water to the 
community, so we have to implement strict mandatory conservation 
measures. Because this groundwater is the only source of water for our 
residential needs on the Reservation, we are very vulnerable to any 
short-term interruptions in supply from these wells, and also to the 
long-term decline in the water levels in the Truxton Aquifer.
    Our own water experts have studied the Truxton Aquifer and 
concluded that it can supply ``approximately 30 to 40 years of the 
Tribe's long-term demand'' and therefore is not ``a permanent water 
supply solution'' for the Tribe. In addition, the Truxton Aquifer 
extends off the Reservation and is vulnerable to depletion from off-
Reservation pumping that is out of the Tribe's control. This 
groundwater clearly is not a secure long-term water supply that the 
Tribe can rely on for the future of our Reservation population.
    The situation is even worse elsewhere on the Reservation. There is 
a small well on the east side of the Reservation that provides water to 
ranchers and wildlife in that area, but the water is not potable for 
human consumption. And there are two wells at West Water, which is on 
Buck-and-Doe Road, a gravel road that runs from Peach Springs to our 
tourist development at Grand Canyon West on the western rim of the 
Grand Canyon. The West Water wells, which are 35 miles from Grand 
Canyon West, previously provided all of the water for our activities 
there. But four years ago, the water table in those wells suddenly 
dropped because of the drought, and both wells failed.
    This crisis continues today. For the past three years, the Tribe 
has been forced by lack of water to curtail some of our operations at 
Grand Canyon West, thus threatening the heart of our on-Reservation 
economy and the main source of employment for our members. We have 
attempted to locate other sources of water that we can use to supply 
Grand Canyon West. Although we did find some off-Reservation sources, 
Arizona law prohibited us from transporting this water across basins. 
As an emergency measure, we have resorted to pumping water from the 
Truxton Aquifer and hauling it 15 miles by truck on Buck-and-Doe Road 
to the West Water site, where the water is then pumped for 35 miles out 
to Grand Canyon West. This patchwork system is burdensome, insecure and 
very expensive, but it is the only way we can continue our remaining 
operations at Grand Canyon West. And this emergency has made the Tribe 
even more dependent on the Truxton Aquifer. It also has placed 
additional stress on that Aquifer because we are now forced to use it 
to supply both Peach Springs and, more distantly, Grand Canyon West. 
Let me quote our Director of Public Works about the current situation:

        This places an even greater demand on the public water system 
        serving the community of Peach Springs. Leaving the Tribe 
        praying that the trucks don't break down, the pumps don't fail, 
        the pipeline stays together and there are no more E-coli 
        events.

    Providing Colorado River water for the Tribe to use at Grand Canyon 
West would alleviate a substantial burden on our members, who rely on 
their jobs at Grand Canyon West to support their families. Grand Canyon 
West is located a two-hour drive on a gravel road from Peach Springs, 
where virtually all tribal members now live. Thus, tribal members who 
are employed at Grand Canyon West have daily four-hour round-trip 
commutes to their jobs, and even longer in inclement weather. 
Currently, it is impossible to locate a residential community at Grand 
Canyon West because of the total lack of water there. This situation 
imposes an unsustainable burden on tribal members who live in Peach 
Springs and work at Grand Canyon West, and on their families. The Tribe 
urgently needs Colorado River water delivered to the Reservation in 
order to allow the Tribe to develop a residential community at Grand 
Canyon West so the tribal members who are employed there can reside 
closer to their jobs.
    I cannot emphasize strongly enough the importance of Grand Canyon 
West to the economic sustainability of the Hualapai Tribe. The Hualapai 
Reservation does not have the natural resources to permit commercial 
agriculture, timber or mineral development. But the Reservation's 
virtually unique location on the Grand Canyon gives the Tribe a strong 
basis to create a self-sustaining tourism-based economy. Grand Canyon 
West is the centerpiece of the Tribe's economy. Prior to the pandemic, 
the Grand Canyon Resort Corporation, a tribal corporation which 
operates Grand Canyon West and other tribal enterprises, along with the 
tribal government, employed more than 1,500 workers (more than 550 of 
whom were non-tribal members). At that point, the Hualapai Tribe was 
the second largest employer in Mohave Country in Arizona, and Grand 
Canyon West hosted over 1 million visitors a year. We believe that 
operations there will return to this capacity as pandemic restrictions 
continue to ease.
    As I noted earlier, the groundwater wells nearest to Grand Canyon 
West, which are 35 miles away, have given out. With the Colorado River 
water that the Tribe will receive if this legislation is enacted, and 
with the funding to build the infrastructure to deliver that water to 
Grand Canyon West that will be authorized by this legislation, the 
Tribe will be able to take full advantage of the potential for further 
development of Grand Canyon West, and will be able to create additional 
jobs for both tribal members and non-Indians, as well as provide new 
revenues for our tribal government.
    And there will also be significant benefits beyond this. In 2017, 
the Tribe commissioned Professor Joseph P. Kalt from the Harvard 
Project on American Indian Economic Development at the John F. Kennedy 
School of Government, to analyze the economic impact that 
implementation of our water rights settlement would have on the 
regional economy of northwestern Arizona and southern Nevada, as well 
as on the economy of the State of Arizona and the Nation as a whole. 
Professor Kalt's report, which was prepared prior to the impact of the 
recent pandemic, states that the economic development of Grand Canyon 
West that would be triggered by the water and infrastructure authorized 
by this settlement would support an average of more than 6,500 jobs per 
year in Arizona, and close to 1,000 jobs per year in southern Nevada. 
For the Nation as a whole, the project would support an average of more 
than 10,000 jobs per year, nearly $1.5 billion in federal tax revenues 
(in 2017 dollars), and a present value (in 2017 dollars) of more than 
$9.3 billion in gross domestic product (GDP) for the United States.
    The use and delivery of water for this kind of economic development 
is well within the parameters of past Indian water rights settlements. 
Most Indian water rights settlements in this century have provided 
federal funding for infrastructure development to support commercial as 
well as residential uses of water. There is, for example, ample recent 
precedent for federally-funded irrigation projects to deliver water to 
Indian reservations for purposes of commercial agricultural, where 
agriculture is the basis of a tribe's economy. And in other recent 
settlements, federally-funded projects have delivered water to support 
other kinds of economic development--including hydropower and other 
energy development, and a retail travel center. Therefore, the 
infrastructure development authorized by S. 4104 to support the 
Hualapai Tribe's tourism-based economy is completely consistent with 
past Indian water rights settlements approved by Congress.
    The Colorado River is the only feasible water supply for satisfying 
the long-term future needs of our population living in Peach Springs 
and on the rest of our Reservation. Our Tribe needs delivery of 
Colorado River water both to provide a permanent and secure water 
supply for the domestic and residential needs of our present and future 
population, and also to fully realize the opportunities for economic 
development that we have at Grand Canyon West.
2. History of Settlement Negotiations
    Over a five-year period beginning in early in 2011 and ending in 
2016, the Hualapai Tribe, in two phases, negotiated a settlement of all 
of the Tribe's federally reserved water rights with the State of 
Arizona and major private entities in Arizona. The United States 
actively participated in these settlement negotiations through a 
Federal Negotiating Team consisting of representatives from affected 
Interior Department agencies and from the Department of Justice. In 
Phase 1, the parties successfully resolved a portion of the Tribe's 
water rights--those in the Bill Williams River watershed, where the 
Tribe has a small parcel of Reservation land and tribal members have 
some allotted trust land. That phase 1 settlement was ratified by the 
Bill Williams River Water Rights Settlement Act of 2014, Pub. L. 113-
223, 128 Stat. 2096 (Dec. 16, 2014).
    In 2016, the Tribe and the State parties reached an agreement on 
Phase 2, but the Federal agencies were unprepared to support it. Since 
then, the Tribe and the State parties have worked diligently to reach 
agreement with the Federal Negotiating Team, and we are very pleased 
that we have done so this year. The legislation now before the 
Committee, S. 4104, will resolve all of the Tribe's remaining water 
rights claims on a comprehensive basis. The legislation is strongly 
supported by the Tribe, by the State of Arizona and by the private 
entities which are parties to the settlement--the Salt River Project, 
the Central Arizona Water Conservation District and Freeport Minerals 
Corporation--all of which have signed the settlement agreement. It is 
also supported by Mohave County, the local jurisdiction in which most 
of the Reservation is located. And now for the first time, this 
legislation also has the support of the Departments of the Interior and 
Justice.
    This negotiation to resolve the Hualapai Tribe's water rights, 
which has now taken us 11 years to complete, has been a very long road 
for the Tribe. Versions of this legislation to ratify our water rights 
settlement were introduced in the House or Senate, or both, in the 
114th Congress, the 115th Congress and the 116th Congress. This 
Committee conducted two hearings on the Hualapai settlement bills in 
earlier Congresses, in September 2016 and December 2017. A subcommittee 
of the House Natural Resources Committee conducted a hearing just two 
months ago, in May 2022, on the companion House bill in this Congress, 
H.R. 7633.
    Until this year, we never before had the full support of the 
Interior Department and the Justice Department for our water rights 
settlement. We are very pleased that the comprehensive settlement of 
our water rights--and S. 4104 which ratifies that settlement--now has 
the full support not only of all State parties, but of the Federal 
parties as well.
3. Elements of the Settlement
    Let me now summarize the principal elements of the comprehensive 
water rights settlement ratified by S. 4104, and also point out two 
important differences in the legislation from the earlier versions of 
the bill:

   The Act comprehensively settles all of the Hualapai Tribe's 
        federally reserved water right claims for its Reservation and 
        trust lands, including the Tribe's right to water from the 
        Colorado River.

   The Settlement Act recognizes the Tribe's exclusive rights 
        to all groundwater and surface water on the Reservation and its 
        other trust lands. The Act protects the Tribe's on-Reservation 
        groundwater by preserving the rights of the Tribe and the 
        United States to object to off-Reservation pumping in certain 
        specifically defined circumstances that could impair the on-
        Reservation groundwater resource. This is an important change 
        from earlier versions of the legislation which provided that 
        the Tribe and the United States would entirely waive their 
        rights to object to off-Reservation pumping. This legislation 
        therefore strengthens the protections for the Tribe's 
        groundwater, which is a particularly significant and positive 
        change for the Tribe with regard to the Truxton Aquifer.

   The Tribe receives an allocation of 4,000 acre-feet a year 
        of Central Arizona Project (CAP) water from the Colorado River. 
        Of this amount, 1,115 acre-feet a year will be ``firmed'' (half 
        by the United States and half by the State) until 2108 to 
        protect against future shortages in the availability of 
        Colorado River water in Arizona. The Act also provides that the 
        Tribe itself can ``firm'' additional portions of the Central 
        Arizona Project water allocated to the Tribe in any year the 
        water is available and is not needed for delivery to the 
        Reservation.

   The legislation authorizes the appropriation of $180 million 
        for a trust fund for the Tribe to use to construct an 
        infrastructure project to deliver up to 3,414 acre-feet a year 
        of water from the Colorado River to the Reservation. The 
        project, as currently planned by the Tribe, will divert water 
        from the Colorado River on the Reservation at Diamond Creek and 
        then deliver it through a 70-mile pipeline to both Peach 
        Springs and Grand Canyon West. This system will replace the 
        Tribe's reliance on the existing groundwater wells in the 
        Truxton Aquifer (except when those wells are needed as an 
        emergency backup). The legislation also authorizes the 
        appropriation of $5 million for the U.S. Geological Service to 
        use to monitor groundwater levels in the Truxton Aquifer.

    I want to point out that the provisions in this legislation 
relating to the infrastructure project also differ from earlier 
versions of this bill. Previous legislation would have ratified a 
``project-based'' settlement, and authorized funding for an 
infrastructure project to be constructed by the Bureau of Reclamation. 
S. 4104 instead will ratify a ``funds-based'' settlement, and 
authorizes an agreed-upon amount of funding to be provided to a trust 
fund for the Tribe to use to construct the infrastructure project. This 
change in approach was made at the request of the Interior Department, 
and is supported by the Tribe.

   Finally, certain lands owned by the Hualapai Tribe in the 
        Bill Williams Basin are designated by the legislation to be 
        brought into trust status, and certain other lands currently 
        held in trust for the Tribe near the Hualapai Reservation will 
        be made part of the Reservation.

4. Conclusion
    Passage of S. 4104 to ratify the Hualapai Tribe water rights 
settlement is absolutely essential if our Tribe is to attain a secure 
future on our Reservation, to accommodate future growth of our 
population and to realize the full economic potential of our 
Reservation. We have done everything possible to provide jobs and 
income to our people in order to lift them out of poverty--but the lack 
of a secure and replenishable water supply on our Reservation is our 
major obstacle that prevents us from achieving economic self-
sufficiency, a goal that Federal Indian policy has long favored. 
Passage of this legislation is essential to allow my Tribe to attain 
this goal.
    Thank you for the opportunity to testify before you today. I will 
be pleased to answer any questions you may have, and our Tribe will 
help in any way it can to secure enactment of this critical 
legislation.

    The Chairman. Thank you very much. Thank you for being 
here.
    Next, we have the Honorable Russell ``Buster'' Attebery, 
Chairman of the Karuk Tribe, Happy Camp, California.

   STATEMENT OF HON. RUSSELL ATTEBERY, CHAIRMAN, KARUK TRIBE

    Mr. Attebery. [Greeting in Native tongue.] Hello, Chair 
Schatz, Ranking Member Murkowski, y``otva, thank you for 
inviting me here to testify on behalf of the Karuk Tribe. My 
name is Russell ``Buster'' Attebery. I am Tribal Chairman.
    Our tribe is extremely grateful to Congressman Huffman, 
Senator Padilla, and Senator Feinstein for their partnership in 
this endeavor to return the sacred lands to the Karuk people. 
In Karuk language, these places are known as Katimiin and 
a>uuyich, our center of the world, Ameekyaaraam, our place for 
First Salmon Ceremony and World Renewal Ceremony, [name in 
Native tongue], the Klamath River, and [name in Native tongue], 
the Salmon River.
    Our traditional ancestral homeland encompasses a vast, 
remote territory of over one million acres in the mid-Klamath 
region of northern California, near the Oregon border. The 
seizing of these lands by the United States was done without 
the free, prior informed consent of the Karuk Tribe. Nor did 
the establishment of the National Forest System specify its 
direct effects on our people. Our people have lived and 
conducted ceremonies on these sacred lands since time began. 
The stewardship and management of these lands are vital to the 
preservation and continuation of Karuk culture, language, 
religion, and identity.
    Many aspects of our ceremonies require isolation from any 
kind of human interaction. In recent years, we have seen a 
dramatic increase in disturbances from airplanes, helicopters, 
and recreational users. This legislation will provide our 
people protection from these types of negative and 
disrespectful occurrences.
    The tribe's historic and present-day government-to-
government relationships with the United States is due in large 
part to ceremonial leaders and families conducting ceremonies 
and rites on these lands. These areas are integral to 
understanding the Karuk creation stories as well as the 
perpetuation of Karuk customs, language, and culture.
    This legislation will also provide the Karuk Tribe what 
other Americans have long had the right to do, which is freely 
exercise our religion on land that is sacred to us, without 
fear of outside disturbances, interference or interruptions. 
Our Karuk legislative team has conducted exhaustive outreach to 
educate stakeholders, our tribal neighbors, local and State 
governments, the Administration and Congress about this 
legislation and why it is so desperately needed.
    We have also facilitated productive internal discussions 
with Karuk ceremonial families and community members to ensure 
we have their support and their advocacy through this process 
of returning the center of the world to our people.
    To date, we have received no opposition to the Katimiin and 
Ameekyaaraam Sacred Lands Act. We look forward to working with 
Congress and the Administration to have this bill enacted as 
quickly as possible and return these sacred lands to their 
original stewards.
    Y``otva, thank you to this Committee for listening to my 
testimony that represents many years of advocacy on the part of 
the Karuk Tribal Council, Karuk ceremonial leaders and Karuk 
people who have waited far too long for this sacred place to be 
repatriated. Y``otva, thank you.
    [The prepared statement of Mr. Attebery follows:]

   Prepared Statement of Hon. Russell Attebery, Chairman, Karuk Tribe
Purpose
    The purpose of S. 4439, the Katimiin and Ameekyaaraam Sacred Lands 
Act, is to provide for the transfer of approximately 1,031 acres of 
Federal land into trust for the benefit of the Karuk Tribe. This land 
is our ``Center of the World'', a special and sacred place where Karuk 
people have lived, fished, prayed and fixed the world since time began, 
and continue those same traditions today. By placing this land into 
trust, this bill will forever protect and preserve our ability to 
exercise our religious beliefs in the same manner as our ancestors have 
done since the beginning of time.
Background and Need
    Ancestral Territory--The traditional ancestral homeland of the 
Karuk Tribe encompasses a vast territory of over 1 million acres in the 
Mid-Klamath region of California. The seizing of these lands by the 
United States was done without the free prior and informed consent of 
the Karuk Tribe, nor did the establishment of the National Forest 
System specify its direct effects on the Karuk people. Natural resource 
utilization and management remains a vital part of Karuk culture. The 
territory includes two counties, two Congressional Districts and 95 
percent of our ancestral territory is currently being managed by the 
United States Forest Service. As a result, the Tribe struggles to 
ensure that traditional management practices and Karuk cultural values 
are integrated into management decisions. The harvest of salmon, 
acorns, deer, elk, mushrooms and other natural products still serve as 
subsistence for many tribal families while the act of hunting, 
gathering, managing and processing these natural food products help 
define the Karuk Tribe's cultural identity.
    Cultural Significance--The Karuk Tribe's historic and present-day 
government to government relations with the United States is due in 
large part to ceremonial leaders conducting ceremonies and rites at 
Katimiin, Ameeky araam and several other ceremonial areas. These areas 
are integral to understanding Karuk cosmology and creation as well as 
the perpetuation of Karuk customs, language and culture. Enactment of 
this legislation will ensure Tribal ceremonial leaders and traditional 
practitioners will have unfettered access to these lands for inter-
generational learning and traditional and customary uses in perpetuity. 
Some aspects of our ceremonies require isolation from any kind of human 
interaction, in recent years we have seen a dramatic increase in 
disturbances from airplanes, helicopters and recreational users. S. 
4439 will provide our people protection from these types of negative 
and disrespectful occurrences. This legislation will also provide the 
Karuk Tribe what other Americans have long had the right to do, which 
is freely exercise our religion on land that is sacred to us without 
the fear of outside disturbances and interruptions.
Summary of Major Provisions
    S. 4439, as introduced, is an amended version of H.R. 6032 
introduced into the House of Representatives on November 16, 2021 by 
Congressman Jared Huffman. The Tribe has diligently conducted 
additional outreach with the Administration and the Senate version has 
incorporated those revisions: (1.) The legislation provides for the 
transfer of approximately 1,031 acres to the Karuk Tribe, the exact 
acreage and boundaries will be determined by a land survey completed 
within 180 days of enactment. (2.) The components of the National Wild 
and Scenic Rivers System that flows through this land will continue to 
be managed by the Chief of the Forest Service and the Tribe will enter 
into a Memorandum of Understanding with the Chief to ensure protection 
and enhancement of Wild and Scenic components are done in cooperation 
with the Tribe.
    This legislation when enacted will not affect valid existing 
rights, these may include land held in fee, Special Use Permits, 
Easements and other similar rights held by individuals or businesses 
before the transfer of these lands is realized.
Outreach
    The Karuk Tribe has conducted extensive outreach to cultural and 
ceremonial leaders, local Tribes, local and State governments, private 
landowners, the Administration and Congress to educate and gather 
support for this sacred lands bill. The level of support the Tribe has 
received has been both humbling and reassuring: this type of simple, 
straightforward legislation returning lands that are without question 
sacred to Tribes is of utmost importance. The Tribe has received no 
opposition that we are aware of in regards to H.R. 6032 or S. 4439. The 
Karuk Tribal Council has elevated this effort as our highest priority 
and will commit to further engagement as needed to educate and inform 
Congress and the Administration on any aspect of this legislation.

    The Chairman. Thank you very much.
    Finally, we have Dr. Patrick Rock, the Chief Executive 
Officer of the Indian Health Board of Minneapolis in 
Minneapolis, Minnesota.

    STATEMENT OF DR. PATRICK ROCK, CEO, INDIAN HEALTH BOARD

    Dr. Rock. Thank you, Chairman Schatz. Good afternoon. My 
name is Dr. Patrick Rock. I am a member of the Leech Lake Band 
of Ojibwe. I serve as the CEO and health care provider at the 
Indian Health Board in Minneapolis. We are also a member of the 
National Council of Urban Indian Health.
    Let me start by saying thank you for the opportunity to 
testify on the bipartisan Urban Indian Health Confer Act, H.R. 
5221, which passed by an overwhelming majority of 406 votes 
last November. I would also like to applaud two leaders of this 
Committee, Senators Tina Smith and James Lankford for their 
bipartisan introduction of the identical companion legislation, 
S. 4323. This legislation would require agencies and offices 
within the Department of Health and Human Services to discuss 
the important policies relating to health care for urban 
Indians with Indian health organizations.
    As a background, through the Indian Health Care Improvement 
Act, the Indian Health Service has a legal obligation to confer 
with UIOs, which is an essential tool used to ensure access to 
health services for Native people. Unfortunately, HHS has 
interpreted it to mean that only IHS has the requirements to 
confer with UIOs. It is critical to patient care that HHS and 
all agencies it operates establishes a formal confer process.
    We would like to adhere to the phrase, no policies about us 
without us. A clear communication pathway between the Federal 
health agencies and UIOs is imperative, especially during the 
ongoing COVID-19 pandemic that has disproportionately impacted 
Natives. This pandemic has demonstrated that a lack of a confer 
policy can result in missed opportunities for awareness and 
information provided to UIOs regarding Native health care which 
would otherwise be avoided through the confer process. For 
instance, key information regarding vaccine distribution for 
the initial COVID-19 vaccine rollout was miscommunicated and 
created necessary hardship. HHS initially only directed tribal 
programs, which we are not considered to be, to choose a 
vaccine distribution program. It was unclear if UIOs needed to 
decide between receiving vaccines through their State or IHS.
    In fact, due to the uncertainty around Federal decisions, 
my clinic decided to receive vaccines through our State. 
However, many UIOs, unlike mine, experienced delayed rollout 
because the Federal Government was not prepared to distribute 
vaccines through our clinics. At the House hearing on this 
bill, IHS confirmed on the record that a lack of confer policy 
delayed patient access to vaccines.
    Urban confer would also help with implementation of 100 
percent Federal medical assistant percentage for services 
provided to Medicaid beneficiaries at UIOs. Last year, Congress 
authorized this for two years in the American Rescue Plan Act, 
with the intent to increase financial resources for UIOs. But 
over a year later, our clinics are still not receiving any 
financial benefit from 100 percent FMAP through increased 
reimbursement rates.
    An urban confer policy across HHS agencies, including CMS, 
would be instrumental in ensuring that obstacles relating to 
programs and benefits that directly affect UIOs are addressed 
quickly so UIOs are better equipped to provide health care to 
their patients. Support for urban confer is strong in Indian 
Country. In fact, two years ago, the National Congress of 
American Indians passed a resolution calling for urban confer 
policy across HHS departments.
    It is important to note that urban confer policies do not 
supplant or otherwise impact tribal consultation and the 
government-to-government relationship between tribes and 
Federal agencies. Further, we have support from the 
Administration and bipartisan support from Congress.
    As such, we urge swift passage of this bill to improve 
health care deliver to Native patients who do not reside on 
reservations. We must get past the notion that only IHS has a 
trust obligation to Native people, as the Federal Government as 
a whole has responsibility to provide health are for all Native 
people.
    Thank you for the opportunity to speak on this important 
issue. I have provided written testimony to the Committee. I am 
happy to answer any questions.
    [The prepared statement of Dr. Rock follows:]

    Prepared Statement of Dr. Patrick Rock, CEO, Indian Health Board
    Chairman Schatz, Vice Chairman Murkowski, and Members of the Senate 
Committee on Indian Affairs of the United States, thank you for the 
opportunity to testify today on urban confer policies. My name is Dr. 
Patrick Rock, I am a member of the Leech Lake Band of Ojibwe and I 
serve as a medical provider and Chief Executive Officer of the Indian 
Health Board in Minneapolis, Minnesota. Established over 50 years ago, 
the Indian Health Board of Minneapolis is the oldest urban Indian 
organization (UIO) in the country which provides medical, dental, 
medication-assisted treatments, health and wellness programming, and 
counseling services to more than 5,000 American Indian and Alaska 
Native (AI/AN) patients each year. In addition, I am a member of the 
National Council of Urban Indian Health (NCUIH), which represents the 
41 UIOs across the nation who provide high-quality, culturally-
competent care to urban Indians, who constitute over 70 percent of all 
AI/ANs.
    I testify today in support of the Urban Indian Health Confer Act 
(H.R. 5221), which requires agencies and offices within the U.S. 
Department of Health and Human Services (HHS) to confer with UIOs 
regarding health care for AI/ANs living in urban areas. This 
legislation enables UIOs to engage in important dialogue with all 
divisions within HHS so that urban Indian communities are made aware of 
major healthcare policies. I will speak to you today about the 
importance of this bipartisan legislation and how it improves 
communication between federal agencies and UIOs on healthcare issues, 
and in turn, improves healthcare access for the more than 70 percent of 
AI/AN people that reside in urban areas.
    For the reasons stated herein, I urge the Members of this Committee 
to act on their commitment to improving urban Indian health and move 
forward on this legislation.
Background
    UIOs are a critical part of the Indian Health Service (IHS) system, 
which includes IHS facilities, Tribal Programs, and UIOs. This is 
commonly referred to as the I/T/U system. Unfortunately, UIOs 
experience significant parity issues compared to the other components 
of the I/T/U system, as well as other federally funded health care 
systems, which greatly impacts our services and operations. This 
includes the lack of clear communication and urban confer policies 
between UIOs and federal agencies.
    Urban confer policies are the response to decades of deliberate 
federal efforts, such as forced assimilation, termination, and 
relocation, that has resulted in 70 percent of AI/AN people living 
outside of Tribal jurisdictions. Thus, urban confer has become an 
essential tool used to address the health care needs of most AI/AN 
persons.
    Currently, only IHS has a legal obligation to confer with UIOs. It 
is crucial that HHS, and the agencies it operates, establish a formal 
confer process to communicate with UIOs on policies that impact them 
and their AI/AN patients living in urban centers. Urban confer policies 
do not supplant or otherwise impact Tribal consultation and the 
government-to-government relationship between Tribes and federal 
agencies. The lack of urban confer has enabled HHS agencies outside of 
IHS to disregard the needs of urban Indians and neglect the federal 
obligation to provide health care to all AI/ANs.
Establish Urban Confer Between HHS Agencies and UIOs
    I would like to applaud two leaders of this Committee, Senators 
Tina Smith and James Lankford, for their bipartisan introduction of the 
identical companion legislation, Urban Indian Health Confer Act (S. 
4323), which reiterates the vital importance of establishing formal 
paths of communication between UIOs and federal agencies.
    Specifically, this legislation requires HHS agencies to confer with 
UIOs on healthcare issues affecting AI/ANs and provides a forum for 
important feedback from AI/AN stakeholders. A clear communication 
pathway between federal health agencies and UIOs is imperative, 
especially during the ongoing COVID-19 pandemic that has 
disproportionately impacted AI/ANs. Missed opportunities for awareness 
and information provided to UIOs regarding AI/AN healthcare can be 
easily avoided through a confer process.
    For example, key information regarding vaccine distribution for the 
initial COVID-19 vaccine rollout in December of 2020 was poorly 
communicated to UIOs and created unnecessary hardships. HHS addressed 
initial communications only to Tribes and did not direct it to the UIO 
component of the IHS system. When HHS was asked about whether UIOs 
needed to similarly decide between an IHS or state vaccine allocation, 
it was unclear for weeks as to whether they were expected to make such 
a decision. Eventually, HHS asked UIOs to decide between receiving 
their vaccine distribution from either their state jurisdiction or IHS 
on the same day as the initial deadline (which thankfully HHS 
subsequently extended for several days). Some UIOs were informed of the 
deadline by their Area office with no formal national communication. 
Consequently, UIOs were prevented from providing input, resulting in 
many clinics experiencing serious delays in vaccine distribution. For 
example, Native American LifeLines, the Baltimore UIO, did not receive 
vaccines until just 5 days before the general public was eligible. This 
had dire consequences, as the pandemic took the lives of AI/ANs at the 
highest rates of any population. Ultimately, this flawed process could 
have been easily avoided with an urban confer policy.
    In an October 2021 House Natural Resources Subcommittee for 
Indigenous Peoples of the United States (SCIP) hearing on H.R. 5221, 
IHS Deputy Director, Benjamin Smith, confirmed the failure to properly 
communicate with UIOs around COVID-19 vaccine distribution in his 
remarks, ``Initially urban Indian organizations were not included in 
the discussion and request from the Department of Health and Human 
Services about whether urban Indian organizations would receive their 
vaccine allocation from the state or from the Indian Health Service. As 
a result, it was unclear to urban Indian organizations on whether they 
were expected to make a similar decision as tribes did. It was 
ultimately determined that the urban Indian organizations could select 
a state or Indian Health Service for their vaccine allocation. In some 
urban Indian organizations, however, there were delays in the initial 
vaccine rollout.'' \1\
---------------------------------------------------------------------------
    \1\  https://naturalresources.house.gov/hearings/remote-scip-
legislative-hearing_october-5-2021
---------------------------------------------------------------------------
    Today, the ongoing public health crisis that is COVID-19 continues 
to amplify the long-overdue need for urban confer among HHS agencies to 
adequately communicate the constantly changing healthcare policies with 
UIOs that directly impact their patients.
    An urban confer policy across HHS would require all agencies within 
HHS to engage in direct communication with UIOs on issues, resources, 
and programs that affect UIOs and their patients. The current lack of 
urban confer policies for agencies other than IHS is a significant 
roadblock to UIOs' efforts to engage with these agencies to improve 
health services for AI/ANs living in urban areas. For example, last 
year, Congress passed the American Rescue Plan Act (ARPA) which 
authorized 100 percent Federal Medical Assistance Percentage (FMAP) 
reimbursement for services provided to Medicaid beneficiaries at UIOs 
for eight fiscal quarters. The congressional intent of this extension 
was, in part, to address a longstanding inequity within the Indian 
healthcare system and to increase financial resources for UIOs during 
the COVID-19 pandemic. The ARPA FMAP extension ends in less than one 
year, but UIOs have generally not received any financial benefit either 
through cost-saving reimbursement from states or increased rates. 
Overall, UIOs cannot expect to receive any such benefit in the absence 
of guidance and advocacy from the Centers for Medicare & Medicaid 
Services (CMS), as CMS is the federal agency responsible for the 
administration of the Medicaid program. While IHS has engaged with 
urban confer with UIOs on this matter, CMS currently does not have an 
urban confer policy and thus UIOs have restricted opportunities to 
engage and collaborate with CMS on implementing FMAP in the manner 
intended by Congress. Many federal agencies do not understand that over 
70 percent of AI/ANs reside in urban areas and that UIOs are a critical 
part of the Indian healthcare system. An urban confer policy with 
agencies, such as CMS, would be instrumental in ensuring that obstacles 
relating to programs and benefits that directly affect UIOs are 
addressed quickly so that UIOs are able to access all resources 
available to provide healthcare to their patients.
    This legislation remedies these problems and codifies a proper 
confer policy between HHS and UIOs, thus ensuring that AI/AN lives are 
no longer jeopardized by the lack of adequate communication pathways 
between HHS agencies and UIOs.
Strong Indian Country and Congressional Support for Urban Confer
    The support for confer with UIOs is strong among stakeholders in 
Indian Country. In November 2020, the National Congress of American 
Indians (NCAI) passed a resolution to ``Call for the U.S. Department of 
Health and Human Services Secretary to Implement an Urban Confer Policy 
Across the Department and its Divisions.'' \2\ In October 2021, Walter 
Murillo (Choctaw Nations of Oklahoma), Chief Executive Officer of 
NATIVE Health, and President-Elect of NCUIH, testified before the House 
Natural Resources SCIP in support of H.R. 5221, citing the ongoing 
challenges that UIOs and urban AI/ANs continue to face given the 
absence of an urban confer policy across all HHS agencies.
---------------------------------------------------------------------------
    \2\ The National Congress of American Indians Resolution #PDX-20-
021. https://www.ncai.org/attachments/
Resolution_ROtzxPAdbKLfUbrnRVmUoOfklRbZgxXvXJBCqoyBgPomYTflsHu_PDX-20-
021%20SIGNED.pdf
---------------------------------------------------------------------------
    Members of Congress from both sides of the aisle have expressed 
their direct support for urban Indian health and confer policies with 
UIOs. In the same SCIP hearing on H.R. 5221, Representative Matt 
Rosendale recognized the importance of Indian parity by emphasizing 
Walter Murillo's statement of ``no policies about us, without us,'' and 
Representative Darren Soto said, ``It's time to modernize and improve 
health access for our Native Americans. This requires us to have 
greater urban access through the Indian Health Service and the U.S. 
Department of Health and Human Services, which is why we applaud Chair 
Grijalva for this great bill [H.R. 5221].'' \3\
---------------------------------------------------------------------------
    \3\  https://naturalresources.house.gov/hearings/remote-scip-
legislative-hearing_october-5-2021
---------------------------------------------------------------------------
    We are pleased that this critical legislation was ultimately passed 
in the House on November 2, 2021, by an overwhelming majority of 406 
votes.
Conclusion
    The Urban Indian Health Confer Act is an essential parity issue for 
UIOs that ensures that AI/ANs residing in urban areas continue to have 
access to high-quality, culturally competent health services. We must 
move past the notion that only IHS has a trust obligation to AI/ANs, as 
the federal government bears a responsibility to provide health care 
for all AI/AN people. Urban confer must be established across HHS to 
further improve healthcare delivered to urban Indian patients.
    We therefore urge the Senate Committee on Indian Affairs to 
continue to prioritize urban Indian health and ensure the swift passage 
of this bill, thereby enabling UIOs to continue providing high-quality, 
culturally competent care to AI/AN people, regardless of where they 
live.

    The Chairman. Thank you very much.
    I will start the questions. Assistant Secretary Freihage, 
access to Federal lands that contain tribal sacred sites is an 
important exercise of the government-to-government 
relationship. Sometimes simple access is not enough, 
particularly for the Karuk Tribe, which doesn't have a big land 
base.
    How does this bill strike the appropriate balance between 
tribal and Federal interests?
    Mr. Freihage. The bill does strike a strong balance between 
the two. I think it is consistent with the joint secretarial 
order signed by the Secretaries of Interior and Agriculture, 
number 3403, which sets the direction for co-stewardship, co-
management between the tribes and land management agencies.
    Up front, it is also important to recognize that Federal 
interest does include trust responsibilities of the tribe, 
including the sacred lands. So we take that into account, 
obviously, along with the important responsibilities of land 
management bureaus. When you consider the sacred land, the 
importance to the tribe, as Chairman Attebery noted, that this 
is the center of their world, the bill then taking the step of 
ensuring that the wild and scenic river components continue to 
be managed by the Chief of the Forest Service allows for co-
management. Then through the requirement of having an MOU with 
the Forest Service and the Karuk Tribe, that allows them to 
make sure they are on the same wavelength to ensure that we 
have that appropriate balance.
    The Chairman. Thank you very much.
    Deputy Director Smith, you know Native Hawaiians receive 
health care through HHS as a result of, as an expression of the 
Federal Government's trust responsibility. But HHS doesn't have 
an official consultation or confer policy that applies to 
Native Hawaiians at the moment.
    Do you need a statute in order to do that?
    Mr. Smith. Thank you for the question, Chair Schatz. I can 
speak from the Indian Health Service at a department level with 
regard to the tribal consultation policy as it pertains to 
federally recognized Indian tribes. It is certainly a question 
that we could take back.
    The Chairman. Let's be crisp, here. Native Hawaiians don't 
have tribal recognition. Native Hawaiians are not currently 
pursuing tribal recognition. What we are saying is that under 
the trust responsibility, because there is money being pushed 
out, is there some way to get at conferring without having to 
hang your hook on a government-to-government relationship, but 
rather the trust relationship?
    It seems to me that you have the flexibility to express the 
idea, nothing about me without me, without having to make a 
square peg fit into a round hole.
    Mr. Smith. Similar to what is at play with the proposed 
bill H.R. 5221, other operating divisions outside the Indian 
Health Service do not have a specific rule or requirement. 
There is nothing preventing them from conferring, but there is 
no requirement or policy that allows them to initiate confer.
    The Chairman. They are not allowed to do it?
    Mr. Smith. There is nothing preventing them from doing it.
    The Chairman. There is nothing preventing them from doing 
it.
    Mr. Smith. Certainly.
    The Chairman. And then you say there is no statute that 
allows them to do it? That sounds like the lack of a statute 
prevents them from being able to do it.
    Mr. Smith. There is no statute, to my knowledge, that --
    The Chairman. It seems to me that if an agency wants to 
confer, they can confer. And if using certain legal terms 
triggers a widespread freakout, we can use different words. But 
the point is, that to the extent there is trust responsibility, 
nothing about me without me. The Biden Administration, it seems 
to me, has a perfect legal right to express that through an 
internal memorandum, a new rule, a directive from the director 
of the department or one of the agencies.
    I think we are overcomplicating this, and I think there are 
a bunch of people who are going, gosh, they are not a tribe, so 
we can't. That is not what I am saying. What I am saying is, to 
the extent that there are agencies and organizations that 
receive funding from HHS they should be consulted with. I am 
hoping we can work together on this.
    Mr. Smith. We are happy to work with you on it. Thank you.
    The Chairman. Thank you very much.
    Final question for this round. Chairman Clarke, you have 
testified about the difficulties your tribe has encountered as 
a result of water shortages. How does this settlement help?
    Dr. Clarke. Thank you for that question.
    This will help because on one side of the reservation, we 
have not even looked at, on the east side, and with the drought 
as we are looking at today, we are very, very short on water. 
Like I said earlier, our water on the wells have depleted. Some 
of the wells have also collapsed. So now we are taking water 
from fire hydrants, putting it on the truck, trucking it to 
another area for it to get out to Grand Canyon West.
    In the meantime, our community is suffering because we are 
taking water from the community to go out there. If our water 
truck breaks down or has a flat, then we have to fix that, and 
again, we are short on water because there is no water going 
out there.
    On the east side of the reservation, we haven't, I mean, we 
have talked about it, but we need to get water on the east side 
as well, not just on the west side in the community, but also 
on the east side. So this would really help.
    The Chairman. Thank you very much.
    Vice Chair Murkowski?
    Senator Murkowski. Thank you, Mr. Chairman.
    Chairman Clarke, thank you for that. It sounds like not an 
idea situation as you are looking to literally truck water from 
a fire hydrant.
    Let me ask you, Mr. Freihage, the Hualapai Tribe has been 
working on completing this water settlement for nearly a decade 
now. In 2016, I recall that the tribe and the State partner 
reached an agreement on phase two. The Federal agencies at the 
time did not support it. Now we have an agreement with the 
Federal negotiating team and Interior is testifying in support 
of this.
    What happened? What transpired there in the settlement that 
allowed interior to now get behind this settlement?
    Mr. Freihage. I believe one of the factors was on the 
looking a little more narrowly, the focusing of the looking at 
the impacts of groundwater uses and how that could, the ability 
to narrow that, so that we had a better surety about there 
would truly be wet water rights for the tribe at the end of the 
process. I believe that was one of the critical factors.
    Senator Murkowski. The Chairman asked you a question about 
the MOU between the Karuk Tribe. I raised the issue of Forest 
Service in my opening. Your testimony states that the 
department supports the agreements with Indian tribes to 
collaborate in the co-stewardship of Federal waters and the 
jurisdiction of DOI and Ag. This legislation is directing the 
Chief of the Forest Service and the tribe to enter into an MOU 
to protect and enhance wild and scenic river systems, all done 
in cooperation with the tribe.
    So in addition to the MOUs, do you need any other tools to 
support the co-stewardship of lands and waters with the tribes? 
Just an example I would raise is the 638 contracts under ISDEA, 
under the Indian Self-Determination Act, they also promote co-
stewardship. Is this something that could be helpful in this 
case?
    Mr. Freihage. Yes, certainly. I think the more that other 
Federal agencies beyond especially Indian Affairs, IHS, can use 
638 contracting, self-governance compacting mechanisms, it is a 
great tool to allow to engage tribes in partnerships for co-
stewardship, co-management.
    Another key factor is in our 2023 budget we have a $14.8 
million funding request for land acquisition for tribes. That 
could be a tool also where tribes could be purchasing lands and 
end up with some joint strategies with Federal agencies. A key 
part of that is funding. Then the other part is to be able to 
do that we need, there is currently an annual cap on land 
acquisition funding that goes back to the 1934 Indian 
Reorganization Act. So if we could get that lifted to at least 
the amount we are requesting.
    Plus the 638 contracting and OSG and self-governance 
compacting, those would be two significant steps forward.
    Senator Murkowski. Okay. It has been mentioned that 
Interior, well, along with the rest of the government, has of 
course a trust responsibility to tribes. How is the Department 
of Interior going to be involved in upholding that trust 
responsibility as the tribe and Forest Service negotiate this 
MOU that is mandated under the legislation?
    Mr. Freihage. Hopefully, I think because the structure is 
sort of set up in the joint secretarial order 3403 with 
Interior and Agriculture it outlines a lot of the best 
practices and policies we can provide for continuing to engage 
with the tribe and our trust responsibility, along with the 
Forest Service, to ensure that that balance is found between 
the Federal and tribal interests. So to be consistently 
engaged.
    Senator Murkowski. Mr. Smith, you gave a pretty good 
outline there about this whole process within HHS for tribal 
consultation and the development of the confer policy. I don't 
know that I actually heard you say whether or not you, whether 
HHS actually supports the bill. I think you said that you stand 
ready to provide technical assistance. But what is the position 
of HHS on H.R. 5221?
    Mr. Smith. Thank you very much for the question. In this 
declaration of National Indian Health policy, Congress has 
specifically declared that it is the policy of the Nation to 
ensure the highest possible health status for Indians and urban 
Indians. The Department of Health and Human Services is 
committed to working with Indian and urban Indian communities 
to meet this policy.
    However, as I mentioned, only the Indian Health Service has 
a legal obligation to confer with Urban Indian Organizations. 
We are the only agency within HHS and the Federal Government at 
this time that has implemented a formal confer process. So at 
this time, I cannot speak for our departmental colleagues. But 
what I can tell you is that we have found the process to be 
successful and beneficial. We are happy to provide technical 
assistance to you.
    Senator Murkowski. I think that is kind of maybe a soft 
support, they think it is going to work, actually you know it 
can work. I am going to mark that down as a maybe.
    Mr. Chairman, my time is expired.
    The Chairman. Let's follow up together.
    Senator Murkowski. Sure.
    The Chairman. Senator Smith?
    Senator Smith. Thank you. I appreciate your question, 
Senator Murkowski, and your response as well, Senator Schatz. 
Mr. Smith, I will just say that we have been working with the 
Department of Health and Human Services for a long time, trying 
to get a definite yes, we support this. And we have so far been 
unsuccessful in getting that. However, we have, I think, 
testimony today that spoke to the power of consultation with 
urban indigenous communities. I think it is an obvious next 
step that that confer process with other parts of the 
Department of Human Services would also be useful and valuable.
    I would, Mr. Smith, ask as you return to the Department of 
Health and Human Services that you tell them that we are eager 
to work with the department, and we would appreciate it if we 
could get speedy responses and fast technical support, so that 
we can understand if there are any issues with the legislation 
so that we can resolve them in order to move it forward.
    Will you make that commitment to me?
    Mr. Smith. Thank you, Senator Smith. I absolutely will take 
that back and coordinate.
    Senator Smith. All right. Let me go to Dr. Rock, if I may. 
I am so grateful to you for joining us today. I think you are 
in a great position to help us understand some of the issues 
that urban indigenous organizations have had that could be 
resolved by this kind of confer process.
    One example that comes to mind, Dr. Rock, is an issue 
around data sharing. Senator Murkowski and I actually have a 
piece of legislation that would get at making sure the 
Department of Health and Human Services is sharing public 
health data with epidemiology centers, tribal epidemiology 
centers, urban indigenous organizations.
    Dr. Rock, could you tell us how this kind of public data 
sharing with the CDC, for example, would help you in the work 
you are doing?
    Dr. Rock. Certainly. It would help at multiple levels. For 
example, with research and patient safety, those are areas I 
think we could make a lot of strides, especially with folks 
like CDC, with vaccine distribution and things like CARES 
appropriations, pieces. Also including things like missing and 
murdered indigenous people. That is something data is key to, 
to start addressing some of these issues, especially folks like 
out in Seattle with UIHI, and the epicenter there.
    So having transparent and free flow of information helps 
all our urban Indian health organizations. We are really in a 
key place to address some of these issues.
    Senator Smith. Thank you very much. I completely agree with 
you.
    You raised in your testimony the issue of the 100 percent 
FMAP policy. We worked hard in the American Rescue Plan to 
deliver $84 million in direct funds and two years of 100 
percent Federal medical assistance percentage for services to 
urban indigenous organizations. Yet we know there have been 
issues with implementation that I think have affected UIOs in 
every State.
    Dr. Rock, can you let us know a little bit about what that 
looks like in Minnesota and how appropriate consultation might 
have made this problem a lot easier to resolve?
    Dr. Rock. Certainly, thank you, Senator. Over 20 years of 
my time has been focused on this issue of 100 percent FMAP, at 
least bringing payment parity to urban Indian health 
organizations, especially during the time of COVID. For the 
last 15 months since the FMAP provisions were enacted, we of 
course have been working with Senator Smith's office, as well 
as our governor's office on how to make this a reality. 
Unfortunately, we have yet to see really any type of activity 
or actual reimbursement occur, utilizing the 100 percent FMAP 
through the Federal system, which is extremely, extremely 
disappointing, I need to tell you.
    We continue to seek out solutions going forward. But I 
think we are going to need help with our State partners as well 
as our Federal partners, including CMS. This would be an 
important point to have access and confirm with CMS.
    Senator Smith. Thank you. I know that you all are not alone 
in having that challenge with FMAP reimbursement. Again, if 
there had been good consultation across all Department of 
Health and Human Services, that would have been easier to 
resolve. On issues of data sharing, 100 percent FMAP, I would 
say also, federally qualified health center issues, all of 
those would be easier to resolve if we had the kind of 
consultation that our bill would require.
    Thank you very much, Mr. Chair.
    The Chairman. Thank you, Senator Smith.
    Senator Hoeven, are you ready for your questions?

                STATEMENT OF HON. JOHN HOEVEN, 
                 U.S. SENATOR FROM NORTH DAKOTA

    Senator Hoeven. I will be in just a minute, thanks, Mr. 
Chairman.
    The Chairman. Do you need me to stall for a moment?
    Senator Hoeven. Yes, for like 30 seconds, just to survey 
the terrain here.
    [Laughter.]
    Senator Hoeven. We are good.
    The Chairman. Senator Hoeven.
    Senator Hoeven. Thanks, Mr. Chairman. Thanks to the 
witnesses.
    Deputy Director Smith, the Urban Indian Health Center Act 
requires the Department of Health and Human Services to confer 
with Urban Indian Organizations. Does HHS and its agencies and 
offices currently confer with Urban Indian Organizations on an 
informal basis?
    Mr. Smith. Thank you for the question, Senator Hoeven.
    As I just mentioned, at this time the Indian Health Service 
is the only Federal agency that has the legal obligation to 
confer with Urban Indian Organizations, and as such is the only 
Federal agency within the department that has a formal policy 
and process.
    Having said that, there have been instances where the 
Indian Health Service has initiated urban confer on behalf of 
other Federal agencies within the department in seeking input 
on their behalf. So I hope that answers your question.
    Senator Hoeven. I am wondering what impact formal 
consultation would have between HHS and Urban Indian 
Organizations. Talk about how that is going to change and the 
fact that it goes from informal to formal, and how you think 
that affects things.
    Mr. Smith. What I can share with you from the Indian Health 
Service experience is certainly by developing a policy, well, 
first by having confer defined in statute, which the Indian 
Health Care Improvement Act does, it defines confer as a form 
of communication that emphasizes trust, respect, and shared 
responsibility, and open exchange of opinions. That means that 
two entities are going to be listening to each other, and how 
they are going to listen.
    We further developed policy around establishing what we are 
going to talk about. So we defined in our policy as a critical 
event. To give you an example, throughout the pandemic, 
Congress provided several supplemental packages that required 
funding decisions that had a huge impact on Urban Indian 
Organizations. So we engaged in our policy, invoking our policy 
to confer with Urban Indian Organizations to solicit their 
input prior to making those funding decisions. We believe that 
did have an impact on the manner in which we made those 
decisions.
    Senator Hoeven. Do you have other examples?
    Mr. Smith. Another example, one that is actually occurring 
right now and we are very thankful to the members of the Senate 
that signed a letter to the Biden Administration earlier this 
year requesting that the Administration consider the formation 
of an Urban Interagency Work Group. Certainly, that made its 
way down through the department. In May, we sent a letter 
through our Acting Director, Ms. Fowler, to Senator Padilla 
saying that we would initiate urban confer, to look at an 
exploration of an Urban Interagency Task Force on behalf of 
government.
    So just recently, earlier this month we held our first 
urban confer session to hear directly from Urban Indian 
Organizations on what that would look like. We are actively in 
that process. We will look to going through our process to see 
what comes from the exploration of that idea of formulating an 
Interagency Work Force dedicated to Urban Indian Organizations.
    Senator Hoeven. Do you think that setting that up as a 
formal process through legislation like this would strengthen 
that process, and be a benefit? Any other thoughts on it?
    Mr. Smith. What we have experienced through the Indian 
Health Service, again, is that it really helps to identify 
critical issues and necessary input at the area, local and 
national levels on what is deemed as a critical event, whether 
it is a budget, policy issue, or those items that are outlined 
in our policy. We are happy to provide additional technical 
assistance to you on this matter.
    Senator Hoeven. Okay, thank you very much. Thank you, Mr. 
Chairman.
    The Chairman. Thank you, Senator Hoeven.
    If there are no more questions for our witnesses, members 
may also submit follow-up written questions for the record. The 
hearing record will be open for two weeks. I want to thank all 
the witnesses for their time and their testimony.
    This hearing is adjourned.
    [Whereupon, at 3:51 p.m., the hearing was adjourned.]

                            A P P E N D I X

   Prepared Statement of Theodore C. Cooke, General Manager, Central 
                  Arizona Water Conservation District
    Chairman Schatz, Vice Chairman Murkowski and members of the 
Committee, I am Theodore Cooke, General Manager of the Central Arizona 
Water Conservation District (CAWCD). Thank you for the opportunity to 
provide the views of the CAWCD on S. 4104 ``Hualapai Tribe Water 
Settlements Act of 2022'' through this statement for the record. For 
the reasons I will discuss below, CAWCD supports S. 4104.
Role of CAWCD in Arizona
    CAWCD manages the Central Arizona Project (CAP), a 336-mile canal 
system that delivers Colorado River water into central and southern 
Arizona. CAWCD's service area includes more than 80 percent of 
Arizona's population. The largest supplier of renewable water in 
Arizona, CAWCD diverts up to 1.5 million acre-feet of Arizona's 2.8 
million acre-foot Colorado River entitlement each year through the CAP 
to municipal and industrial users, agricultural irrigation districts, 
and Indian communities. Our goal at CAWCD is to provide our customers 
with an affordable, reliable, and sustainable supply of Colorado River 
water.
Background
    CAWCD, the Hualapai Tribe, the State of Arizona and other Arizona 
parties have worked for the past decade to reach a settlement that 
accomplishes the goals of fairness and certainty to all parties. H.R. 
7633 represents resolution of Phase 2 of the Hualapai settlement. Phase 
1 resolved issues relating to the Bill Williams watershed, and now 
Phase 2 resolves all remaining claims of the Tribe for water rights 
within Arizona, including claims to the Colorado River.
    Among other things, the Act would reallocate to the Tribe 4,000 
acre-feet of Central Arizona Project water, and provide federal funding 
for water-related infrastructure to the Tribe. This water would help 
address the water supply needs of the Tribe's residents on the 
reservation, as well as the Tribe's plans for economic development. The 
Act will not only benefit the Tribe by providing wet water, but will 
avoid the burden of costly litigation and provide certainty going 
forward to water users throughout the area.
Conclusion
    For the reasons noted, the CAWCD Board of Directors voted 
unanimously to support the settlement and S. 4104. We would like to 
thank Senator Sinema and Senator Kelly for their sponsorship of this 
bill, Thank you for your consideration.
                                 ______
                                 
        Prepared Statement of the U.S. Department of Agriculture
    Chairman Schatz, Vice Chairman Murkowski, and Members of the 
Committee, thank you for the opportunity to discuss the views of the 
U.S. Department of Agriculture (USDA) on S. 4439, Katimiin and 
Ameekyaaraam Sacred Lands Act.
    S. 4439 would transfer administrative jurisdiction of approximately 
1,031 acres of National Forest System land located in Siskiyou and 
Humboldt Counties, California, from the USDA Forest Service to the 
Department of the Interior and direct the Secretary of the Interior to 
take that land into trust for the benefit of the Karuk Tribe.
    The transfer of administrative jurisdiction and transfer into trust 
in the bill is subject to the condition that the Forest Service 
continues to manage the National Wild and Scenic Rivers System that 
flows through the Katimiin and Ameekyaaraam land. The bill directs the 
USDA to provide to the Secretary of the Interior a survey of the land, 
and also enter into a memorandum of understanding with the Karuk Tribe 
to establish mutual goals for the protection and enhancement of the 
river values of any component of the National Wild and Scenic Rivers 
System that flows through the land taken into trust. USDA supports 
continuing to manage the National Wild and Scenic Rivers System and 
strongly supports the development of a memorandum of understanding to 
establish mutual goals for the protection and enhancement of the river 
values. We are committed to fulfilling the trust relationship between 
the United States and Tribes.
    USDA acknowledges that the lands administered by the Forest Service 
are the ancestral homelands to American Indians and Alaska Natives and 
contain cultural and natural resources of significance to their people, 
such as sacred religious sites, burial sites, wildlife resources, and 
sources of Indigenous foods and medicines. The Katimiin and 
Ameekyaaraam land is sacred to the Karuk Tribe and vital to their 
culture and traditions.
    With the 2021 Joint Secretarial Order on Fulfilling the Trust 
Responsibility to Indian Tribes in the Stewardship of Federal Lands and 
Waters (Order No. 3403), Secretary Vilsack re-committed to ensuring 
that the USDA manages federal lands and waters ``in a manner that seeks 
to protect the treaty, religious, subsistence, and cultural interests 
of federally recognized Indian Tribes,'' through co-stewardship 
agreements. The Secretary also re-affirmed the USDA's obligations to 
Tribes in the 2021 Memorandum of Understanding Regarding Interagency 
Coordination and Collaboration for the Protection of Indigenous Sacred 
Sites and the Memorandum of Understanding Regarding Interagency 
Coordination and Collaboration for the Protection of Tribal Treaty and 
Reserved Rights.
    For all these reasons, USDA supports the intent of the Katimiin and 
Ameekyaaraam Sacred Lands Act and looks forward to continued discussion 
with the Committee and bill sponsors on provision details and 
considerations for implementation.
                                 ______
                                 
                           Wild and Scenic Rivers Coalition
                                                    August 19, 2022
Dear Chair Schatz and Ranking Member Murkowski:

    On behalf of the Wild and Scenic Rivers Coalition, we write to 
thank you for holding a recent Committee hearing on the Katimiin and 
Ameekyaaraam Sacred Lands Act (S. 4439). The Wild and Scenic Rivers 
Coalition is a national alliance of more than 60 river protection 
organizations. Coalition member organizations appreciate the Senate's 
efforts to advance this legislation that recognizes Indigenous 
sovereignty and the cultural significance of sacred lands and waters to 
Indigenous Peoples.
    The Wild and Scenic Rivers Coalition strongly supports the Katimiin 
and Ameekyaaraam Sacred Lands Act, introduced by Senator Padilla and 
co-sponsored by Senator Feinstein. This bill would return 1,031 acres 
of land along California's Klamath and Salmon Rivers to the Karuk 
Tribe. This land transfer will allow the Karuk Tribe to conduct World 
Renewal Ceremonies and other acts of religious and cultural 
significance without interruption or interference while maintaining 
Wild and Scenic River protections. We support the bill's provision to 
include the Tribe in the management and protection of the rivers within 
the returned lands.
    We support the Katimiin and Ameekyaaraam Sacred Lands Act and urge 
you to advance this important bill.

        Sincerely,
                          Lisa Ronald, National Coordinator

    On behalf of the following Wild and Scenic River Coalition member 
organizations:

    Joshua Theurer, Associate Director, Project Design, Adventure 
Scientists, Bozeman, MT

    Jack West, Policy and Advocacy Director, Alabama Rivers Alliance, 
Birmingham, AL

    David Moryc, Senior Director of Wild and Scenic Rivers and Public 
Lands Policy, American Rivers, Washington, D.C.

    Kevin Colburn, National Stewardship Director, American Whitewater, 
Cullowhee, North Carolina

    Megan Fiske, Executive Director, Foothill Conservancy, Jackson, CA

    Fred Akers, River Administrator, Great Egg Harbor Watershed 
Association, Newtonville, NJ

    Nicholas Nelson, Executive Director, Idaho Rivers United, Boise, ID

    Richard Dodds, Chair, Lower Delaware Wild and Scenic Management 
Committee, Stockton, NJ

    Dr. Denielle Perry, Director of Free-flowing Rivers Lab, Northern 
Arizona University, Flagstaff, AZ

    April Ingle, Policy Director, River Network, Boulder, CO

    Joseph Callahan, President, Taunton River Watershed Alliance, 
Taunton, MA

    Bill Napolitano, Administrator, Taunton River Stewardship Council, 
Taunton, MA

    Maggie Johnston, Executive Director, Wild Alabama, Moulton, Alabama
                                 ______
                                 
                                            Trout Unlimited
                                                      July 20, 2022
Dear Chairman Schatz, Ranking Member Murkowski, and members of the 
Committee,

    We write in support of S. 4439, The Katimiin and Ameeky araam 
Sacred Lands Act. This legislation would restore free and undisturbed 
access for the Karuk people to their sacred places by transferring 
1,000 acres along the Klamath River from the U.S. Forest Service to the 
Department of the Interior to be held in trust for the Karuk Tribe. The 
land is currently part of a larger Cultural Management Area recognized 
for its significance to the Tribe. Called ``Katimiin'' in the Karuk 
language, these 1,000 acres are the heart of the Karuk's ancestral 
territory, ``literally the center of the universe, a spiritual balance 
point for all of existence.'' The Karuk people have lived and conducted 
ceremonies at Katimiin and Ameeky araam since the beginning of time. 
These areas are integral to Karuk cosmology and creation belief as well 
as the perpetuation of Karuk customs and culture.
    Trout Unlimited has been working with the Karuk and other 
signatories to the Klamath Hydroelectric Settlement Agreement for more 
than two decades to restore the Klamath River and its once-prolific 
runs of salmon and steelhead. Ensuring that these lands will be held in 
trust for the Karuk is consistent with the overall goal of renewing the 
Klamath's ecological, cultural, and community values, and we are 
grateful to the efforts of Senator Padilla and Senator Feinstein to 
help us attain that goal while righting an historical wrong.
    We support the Karuk Tribe's efforts to ensure the repatriation and 
management of Katimiin and Ameeky araam so their ceremonial leaders, 
traditional practitioners and community members will have access to 
these lands for traditional and customary uses in perpetuity.
    We thank you for holding a hearing on this bill and urge the 
committee to favorably advance this legislation.

        Sincerely,
                      Brian J. Johnson, California Director
                                 ______
                                 
                                                YUROK TRIBE
                                                     August 3, 2022
Dear Chairman Schatz and Vice Chairwoman Murkowski,

    The Yurok Tribe submits this letter to support the Katimiin and 
Ameekyaaraam Sacred Lands Act (H.R. 6032), also known as the Karuk 
Lands Bill. This Bill was created to restore land to the Karuk Tribe 
and recognize the Karuk Tribe's role and responsibility in managing 
federal lands within its territory. By restoring these lands to the 
Karuk Tribe, who were the original stewards of such lands, the Karuk 
Tribe can exercise its tribal sovereignty and traditional practices 
without interruption. We extend our support to the Karuk Tribe through 
this Bill.
    Indeed, the Yurok Tribe supports tribal land restoration for all 
tribes and believe that tribes should support each other's land 
restoration efforts. Like the Karuk Tribe, we introduced the Yurok 
Lands Act (H.R. 7581). Our Bill was created to reclaim our role as the 
original stewards of our land by revising our reservation boundary line 
to transfer more than one thousand acres of historically Yurok land 
back to our Tribe. The Karuk Lands Bill and Yurok Lands Act are 
important legislation and promote the overall goal of tribal land 
restoration.
    Lastly, the Biden Administration supports our overall goal of 
tribal land restoration. The Biden Administration, for example, 
promised to ``provide tribes with a greater role in the care and 
management of public lands that are of cultural significance to Tribal 
Nations.'' Likewise, the Department of the Interior has launched the 
Tribal Homelands Initiative which increases opportunities for tribes to 
participate in federal lands management. We urge you to quickly take up 
and pass the Karuk Lands Bill and continue to work toward this shared 
goal of tribal land restoration.

        Sincerely,
                             Hon. Joseph L. James, Chairman
                                 ______
                                 
                                           Freeport-McMoRan
                                                      July 22, 2022
Dear Chairman Schatz and Vice Chairwoman Murkowski,

    I write to express the support of Freeport Minerals Corporation 
(Freeport) for S. 4104, the Hualapai Tribe Water Rights Settlement Act 
of 2022 (Settlement Act). The Hualapai Tribe is one of the eleven 
federally recognized Indian tribes in Arizona that still have 
unresolved water rights claims. As a water user in Arizona, we strongly 
believe that resolving these claims through settlement will reduce the 
cost and uncertainty of hostile litigation and provide certainty to 
both tribal and non-tribal water users. Settlement provides the 
necessary funding to construct and operate water-based infrastructure 
to tribal members--something that litigation cannot. This Settlement 
Act is an excellent example of successful regional collaboration to 
address the Hualapai Tribe's water rights claims.
    Freeport is one of the nation's leading producers of copper and 
other minerals. The Company is headquartered in Phoenix, Arizona, and 
its workforce in the U.S, as of 2021, included 24,700 direct employees 
and 42,000 contractors. Freeport's copper and molybdenum mining complex 
in Bagdad, Arizona, is located approximately 60 miles west of Prescott, 
Arizona and is 100 miles northwest of Phoenix, in Yavapai County. The 
open pit mine has been operating since 1945, encompassing approximately 
49,800 acres. Production at the Bagdad mine in 2021 totaled 184 million 
pounds of copper and 9 million pounds of molybdenum. The direct and 
indirect economic contribution of the mine to Arizona's economy totaled 
$282.7 million in 2020.
    Although the Bagdad operation has sufficient water sources to 
support current operations, Bagdad faces increasing competition for 
water and variability in supply availability due to the on-going 
drought and climate change. Current water supplies for the Bagdad Mine 
include access to groundwater and surface water resources in the Big 
Sandy River Groundwater Basin and the Big Sandy River in the Bill 
Williams River Watershed. The need to protect and ensure long-term 
sustainable water supplies for our Bagdad mine, as well as those of our 
neighbors in the watershed, is the reason for Freeport's involvement in 
these water rights settlements. We all share this resource and Freeport 
strongly believes that our neighboring communities, like the Hualapai 
Tribe, should have equitable access to reliable water supplies for 
their own future.
    Freeport has a unique and exceptionally cooperative relationship 
with the Tribe and greatly treasures its relationship with the Hualapai 
people. This relationship has developed through years of positive and 
collaborative settlement discussions and has resulted in Freeport 
providing the following contributions to the Hualapai Tribe:

   Assistance with the construction of a hunting bunkhouse for 
        Hualapai Game and Fish (significant source of tribal revenue)

   Emergency Operations Center for COVID response

   Microgrid solar power project

   Playground in Peach Springs

   Juvenile Detention center gardening project

   Tai Kwon Do camps

   Blanket-making classes coordinated by the Cultural Resource 
        Department

   Rope rescue training for the Emergency Response Team at 
        Grand Canyon West

   Cultural Monitor Training

   2 scholarships for tuition are awarded to Hualapai college 
        students each year

    As a precursor to this Settlement Act, Freeport played a 
significant role in the completion of the Bill Williams River Water 
Rights Settlement Act (Phase I Settlement). As a part of the Phase 1 
Settlement Freeport contributed $1,000,000 to the Tribe to assist in 
the development of professional studies evaluating alternatives for 
Colorado River water delivery. Freeport also contributed to an Economic 
Development Trust that enables the Tribe to seek the purchase of lands 
and additional water rights along the Colorado River in Arizona. 
Finally, Freeport donated a portion of the Planet Ranch lands and water 
rights to the Arizona Game and Fish Department for lease to the U.S. 
Bureau of Reclamation. This contribution provides a long-term benefit 
to the Lower Colorado River Multi-Species Conservation Program.
    Freeport is grateful for Senators Kirsten Sinema and Mark Kelly's 
support and assistance in introducing this long-awaited and critical 
piece of legislation. Freeport looks forward to our continued 
relationship with the Hualapai Tribe ensuring they, like many others, 
have access to reliable and secure water supplies. Freeport urges you 
to positively advance S. 4104.

        Sincerely,
                    Sandy Fabritz, Director, Water Strategy
                                 ______
                                 
                                        American Whitewater
                                                      July 19, 2022
Dear Chairman Schatz and Vice Chairwoman Murkowski,

    On behalf of the whitewater paddling community, American Whitewater 
writes to express our appreciation for holding a hearing on the 
Katimiin and Ameekyaaraam Sacred Lands Act (S. 4439). This legislation 
would take certain Federal land located in Siskiyou County, California, 
and Humboldt County, California, into trust for the benefit of the 
Karuk Tribe. The Katimiin and Ameekyaaraam land is located in the 
aboriginal territory of the Karuk Tribe and represents the center of 
the Karuk universe at the confluence of the Salmon River with the 
Klamath River. Restoring these unceded lands to the stewardship of the 
Karuk Tribe is a long overdue moral imperative.
About American Whitewater
    American Whitewater is a national non-profit 501(c)(3) river 
conservation organization founded in 1954 with approximately 50,000 
supporters, 6,500 dues-paying members, and 100 local-based affiliate 
clubs, representing whitewater enthusiasts across the nation. American 
Whitewater's mission is to protect and restore America's whitewater 
rivers and to enhance opportunities to enjoy them safely. The 
organization is the primary advocate for the preservation and 
protection of whitewater rivers throughout the United States, and 
connects the interests of human-powered recreational river users with 
ecological and science-based data to achieve the goals within its 
mission. Our vision is that our nation's remaining wild and free-
flowing rivers stay that way, our developed rivers are restored to 
function and flourish, that the public has access to rivers for 
recreation, and that river enthusiasts are active and effective river 
advocates. Our members live, work, and recreate in the Klamath River 
watershed and within the lands and waters included in this bill.
    Support for S. 4439--Katimiin and Ameekyaaraam Sacred Lands Act 
American Whitewater strongly supports the Katimiin and Ameekyaaraam 
Sacred Lands Act (S. 4439), introduced by Senator Padilla and co-
sponsored by Senator Feinstein. This legislation would transfer 
administrative jurisdiction of the Katimiin and Ameekyaaraam land, 
representing 1,031 acres, from the Secretary of Agriculture to the 
Secretary of Interior to be held in trust for the benefit of the Karuk 
Tribe to be used for traditional and customary uses. This would re-
establish the Karuk Tribe as the stewards of these lands for Tribal 
ceremonies, education, and cultural uses and will ensure that Tribal 
ceremonies can be conducted without interruption or interference.
    The legislation includes a condition that the Chief of the Forest 
Service shall continue to manage the component of the National Wild and 
Scenic Rivers System that flows through the Katimiin and Ameekyaaraam 
lands and allow continued access by the Forest Service for the purpose 
of managing the Klamath and Salmon Wild and Scenic Rivers. The 
legislation also includes a provision for the Secretary of Agriculture 
to enter into a memorandum of understanding with the Karuk Tribe, to 
establish mutual goals for the protection and enhancement of the river 
values of the Wild and Scenic Klamath and Salmon Rivers.
    The whitewater boating community enjoys recreational opportunities 
on both rivers that flow through lands included in this legislation. 
The Salmon River from Brannons Bar to the confluence with the Klamath 
River is known to boaters as the Lower Salmon, \1\ and the run on the 
Klamath River from this point down to Dolans Bar near Orleans, 
California is known to boaters as the Ikes Run. \2\ We understand and 
respect that when we pass through these sacred lands we come as 
visitors to a place of deep spiritual and cultural significance to the 
Karuk people and that the World Renewal Ceremonies that they hold here 
are central to their culture and identity. We have an interest in 
further educating our community on the importance of these sacred lands 
and support the Karuk Tribe in their efforts to ensure ceremonies can 
be conducted without interruption or interference. We welcome any 
opportunity to work directly with the Karuk Tribe to develop 
appropriate education and outreach materials for our community and the 
general public.
---------------------------------------------------------------------------
    \1\ Salmon River, Brannons Bar to Klamath River, American 
Whitewater National Whitewater Inventory, https://
www.americanwhitewater.org/content/River/view/river-detail/11392/main.
    \2\ Klamath River, Ishi Pishi Bridge to Dolans Bar (Ike's Run), 
American Whitewater National Whitewater Inventory, https://
www.americanwhitewater.org/content/River/view/river-detail/235/main.
---------------------------------------------------------------------------
Conclusion
    On behalf of the whitewater paddling community, thank you again for 
holding this hearing and the opportunity to provide testimony on this 
legislation. We strongly support the Katimiin and Ameekyaaraam Sacred 
Lands Act (S.4439). We urge you to move this bill through the Committee 
and to the Senate floor to re-establish the Karuk Tribe as the steward 
of their sacred lands.

        Sincerely,
                       Scott Harding, Stewardship Associate
Theresa L. Lorejo-Simsiman, California Stewardship Director
                                 ______
                                 
    Response to Written Questions Submitted by Hon. Brian Schatz to 
                            Dr. Patrick Rock
    Question 1. Can you expand on potential gaps in agency outreach and 
services for the Indian Health Board of Minneapolis resulting from the 
lack of a comprehensive HHS urban confer policy?
    Answer. The lack of an HHS urban confer policy was incredibly 
disruptive in the vaccine distribution for many UIOs, and if there had 
been such a confer policy, we could have avoided delays.
    For instance, key information regarding vaccine distribution for 
the initial COVID-19 vaccine rollout at the end of last year was poorly 
communicated to UIOs and created unnecessary hardship. HHS addressed 
initial communications only to Tribes and did not direct it to the UIO 
component of the IHS system. When HHS was asked about whether UIOs 
needed to similarly decide between an IHS or state vaccine allocation, 
it was unclear for weeks as to whether they were expected to make such 
a decision. Eventually, HHS asked UIOs to decide between receiving 
their vaccine distribution from either their state jurisdiction or IHS 
the same day as the initial deadline (which thankfully HHS subsequently 
extended for several days). Some UIOs were informed of the deadline by 
their Area office with no formal national communication. As a result, 
many of our clinics experienced delays in vaccine rollout. Had this 
critical request and deadline been communicated directly with UIOs in a 
timely manner, UIOs would not have been forced to rush their 
jurisdiction selection. This flawed process could have been avoided 
with an urban confer policy.
    Another great example might be HRSA, which operates many programs 
that dictate our ability to provide direct care to Natives in urban 
areas. Right now, there is a HRSA/IHS workgroup and we appreciate the 
Indian Health Service for involving themselves in that, but it still 
doesn't provide for our direct communication with HRSA and we cannot 
represent the day-to-day operational issues that UIOs face. We cannot 
do that when we are passing through a non-operative office like IHS.
    With more clear and direct communication, my UIO and all other UIOs 
would be aware of important healthcare policies affecting urban Indian 
communities, allowing us to better serve our urban Indian patients.

    Question 2. How has IHS's urban confer policy helped address your 
organization's needs?
    Answer. The IHS urban confer policy is an established dialogue to 
address the care needs of our Native patients. It has addressed our 
UIOs needs, as well as many other UIOs needs, in integral ways. For 
instance, IHS held an urban confer on the President's Executive Order 
on Missing and Murdered Indigenous People to get UIO input on this 
crisis affecting our community. Urban confer allowed for IHS to work 
with us to discuss prevention efforts that reduce risk factors for the 
victimization of Native Americans. However, it is the responsibility of 
HHS as a whole, not just IHS, to work with urban Native communities to 
reduce violent crime and address the MMIP epidemic.
    Ultimately, IHS's urban confer policy has helped UIOs like mine 
have an influential voice in how to best address the most critical 
issues facing Indian Country. This has allowed us to provide better 
care and health services and has empowered us to start combatting the 
most pressing health issues facing our Native clients.

    Question 3. What role would establishing an HHS urban confer policy 
play in honoring the federal trust responsibility?
    Answer. Establishing a formal urban confer process with HHS, and 
the agencies it operates, is critical in honoring the federal 
government's trust responsibility to provide health care for all 
American Indian and Alaska Native people. This urban confer process 
will ensure effective communication with UIOs on health policies that 
impact them and their Native patients living in urban areas. Currently, 
the lack of urban confer has enabled HHS agencies outside of IHS to 
disregard the needs of urban Indians, which has prevented Native 
patients from receiving critical health services. We must move past the 
notion that only IHS has a trust obligation to American Indians and 
Alaska Natives, and as such, establishing this formal urban confer 
process is integral to furthering the trust obligation of the federal 
government to provide healthcare to all Native Americans by ensuring 
clear and direct communication with urban Indian organizations.
    It must also be noted that Urban confer policies do not supplant or 
otherwise impact Tribal consultation and the government-to-government 
relationship between Tribes and federal agencies.
                                 ______
                                 
    Response to Written Questions Submitted by Hon. Brian Schatz to 
                         Hon. Russell Attebery
    Question 1. What challenges has the Karuk Tribe faced in light of 
having limited trust lands?
    Answer. First and foremost; land forms the basis for social, 
cultural, religious, political, and economical life for tribes. \1\ The 
Karuk Tribe's Ancestral Territory is just over 1 million acres. This 
area holds the history of our people since time began and has supported 
our needs and culture through a continuous and uninterrupted 
stewardship of the land. The Tribe's Aboriginal Territory consists of 
north east Humboldt County, much of Siskiyou County and portions of 
Southern Oregon. This Aboriginal Territory includes our areas of 
influence, service areas and large populations of Karuk people we 
serve. In 1905 President Theodore Roosevelt declared much of our 
Ancestral Territory the Klamath Forest Reserve, \2\ later becoming the 
Klamath and Six Rivers National Forests. Though establishment of these 
reserves did not expressly extinguish any reserved, inherent or 
retained right or title, the Karuk Tribe has purchased and deeded back 
approximately 950 acres to the United States to be held in trust. 
However, this strategy of purchasing land and deeding it back to the 
U.S. is not sustainable due to limited tribal funds and the lack of 
private property within our aboriginal territory. With the majority of 
our lands, including ceremonial areas, in areas that have multiple 
jurisdictions, management conflicts are constant. Lacking such an 
essential cornerstone to a tribe's wellbeing perpetuates the negative 
effects of prior attempts to erase our culture and our people's way of 
life. The deficit in trust land creates barriers in getting crucial 
projects completed. When pursuing projects on our trust lands we follow 
our own Tribal codes thus avoiding over-complicated and sometimes 
unnecessary additional government restrictions (i.e. State and local 
requirements).
---------------------------------------------------------------------------
    \1\ COHEN'S HANDBOOK OF FEDERAL INDIAN LAW   15.01-15.02 at 994 
(2012)
    \2\ Presidential Proclamation 544--Establishment of the Klamath 
Forest Reserve, California (1905)
---------------------------------------------------------------------------
    California is a P.L. 280 state which creates concurrent 
jurisdictions that further complicate federal and state obligations. On 
Karuk Lands, where we exercise jurisdiction as outlined in our 
Constitution, the Tribe can increase our capacity to self-govern when 
those jurisdictional responsibilities come with financial resources. 
The Tribe's compacted dollars have been woefully inadequate since we 
began to receive them. An increase to our compacted funds would allow 
the Tribe the ability to increase our capacity to meet our management 
needs.

    Question 2. Why is it important for the Karuk Tribe to have 
management authority over places that help support cultural education 
and language revitalization?
    Answer. The Karuk Tribe has steadily increased our management 
authority over our tribal lands with the vision of restoring their 
natural state and preserving our cultural and ceremonial traditions. 
Our ceremonies are vital to keeping our world in balance, they are 
conducted the same way every year since time began: we have an inherent 
right and responsibility to continue these same ceremonies, practices, 
rites and prayers to ensure our survival as Karuk People. If the Tribe 
has management authority over the land we utilize for ceremony we are 
able to conduct outreach for temporary exclusion zones, perform much 
needed maintenance and restorative activities and increase the safety 
and solitude needed for our ceremonial participants. Our language is 
fundamental to the inter-generational learning needed to ensure future 
generation of Karuk people know and understand Karuk culture and 
customs.

    Question 3. As part of S. 4439, the Forest Service will have 
continued access to certain relevant sections of the Wild and Scenic 
Rivers System. Why is this continued partnership with the Forest 
Service important and has the agency's expressed any administrative 
concerns regarding the proposed arrangement?
    Answer. The Karuk Tribe's partnership with the Forest Service has 
been necessary and important due to the intersections between land 
management, access and capacity building. The Wild and Scenic Rivers 
System designation has objectives and goals that present a challenge 
for the Karuk Tribe to support, both monetarily and within the 
framework of our ceremonies. With a future congressional appropriation, 
the Karuk Tribe could possibly administer this Wild & Scenic portion of 
the Klamath River. Because our ceremonies require long periods of 
solitude, the recreational components of this designation are in 
conflict with our traditional ways. The Forest Service has not 
expressed any administrative concerns.
                                 ______
                                 
    Response to Written Questions Submitted by Hon. Brian Schatz to 
                           Hon. Damon Clarke
    Question 1. At the hearing, you testified to the complexities and 
precariousness of water delivery on your reservation. Can you speak 
more about the economic impacts that water scarcity and insecurity have 
on the citizens of the Hualapai Tribe? Can you also further describe 
the type of resources your Tribe has to expend in order to provide 
water to your community and how S. 4104 addresses those issues?
    Answer. The Hualapai Tribe has suffered for years from a lack of 
adequate water on the Reservation. We currently rely entirely on 
groundwater in the Truxton Aquifer in the southern part of the 
Reservation as our only source of water. As I stated in my testimony, 
that Aquifer is served by three wells that are 47 years old, and that 
have been prone to malfunctions and E-coli contamination.
    These wells are the only source of water for our main residential 
community at Peach Springs. When a well is out of operation for 
mechanical reasons or because of contamination, the drop in the water 
that we can supply to the community puts enormous strain on the ability 
of our members to live in their homes. Because of lack of water, we 
have been limited in the number of new homes we can construct in Peach 
Springs. Residents of the Peach Springs community have been unable to 
maintain gardens for their personal use and enjoyment. Lack of water is 
especially acute in three subdivisions of Peach Springs--the Milkweed, 
Music Mountain and Wi Tham Bo'--where new homes cannot be constructed 
because there is no reliable water source.
    Further, our dependence on the Truxton Aquifer provides no long-
term security to the Tribe. The Aquifer extends off the Reservation and 
is therefore subject to uncontrollable pumping by landowners in Mohave 
County and to the potential for accelerated depletion.
    The Tribe has suffered economically from lack of water on the 
Reservation in a number of ways. Our major economic activity is the 
Tribe's tourist attraction at Grand Canyon West, on the rim of the 
Grand Canyon in the northwestern part of the Reservation. This is the 
main engine of the Tribe's economy, generating jobs for Tribal members 
(as well as for non-Indians living off the Reservation). The Tribe 
attracts more than a million visitors to Grand Canyon West, many from 
nearby Las Vegas. At Grand Canyon West, visitors enjoy the magnificent 
vistas of the Grand Canyon as well as presentations about the Tribe's 
history and culture. These visitors contribute to the Tribe's economy 
by paying an admissions fee and spending money in our gift shops and at 
our restaurants.
    For many years, Grand Canyon West was served by two distant 
groundwater wells at Westwater, about 35 miles away. But because of the 
drought, those wells both ran dry four years ago and have stopped 
producing. We have been forced to pump water from the Truxton Aquifer 
and then haul it by truck more than 15 miles to the Westwater wells, 
from where the water is pumped to Grand Canyon West. This is an 
expensive, insecure and burdensome process, costing the Tribe over 
$350,000 in labor and equipment costs this year. It further depletes 
the Truxton Aquifer. And because we cannot haul the quantity of water 
sufficient to serve our needs at Grand Canyon West, we have been forced 
to curtail activities there, closing restaurants and tourist 
attractions, and thereby losing the revenues we would otherwise 
receive.
    The lack of water impacts our members in another way. Grand Canyon 
West is located a two-hour drive on a gravel road from Peach Springs, 
where virtually all tribal members on the Reservation live. Thus, 
tribal employees at Grand Canyon West have daily round-trip commutes of 
four hours a day to their jobs at Grand Canyon West, and longer in 
inclement weather. Our members need the ability to live closer to their 
jobs. But it is impossible to locate a residential community at Grand 
Canyon West because of the lack of water there. This imposes an 
unsustainable burden on tribal members and their families.
    S. 4104 addresses these problems in multiple ways. First, and most 
importantly, it provides the Tribe with a quantified right to water 
from the Colorado River, which forms the northern boundary of the 
Reservation. The legislation also provides funding for the Tribe to 
develop the infrastructure necessary to deliver water from the Colorado 
River to Peach Springs and to Grand Canyon West. This will allow the 
Tribe to provide water from the Colorado River both to our members in 
Peach Springs and also to our tourist development at Grand Canyon West. 
And finally, although the Tribe will no longer be solely dependent on 
the Truxton Aquifer for our water supply, the settlement legislation 
also provides protections against off-Reservation pumping from the 
Aquifer at a rate that could threaten the Aquifer. This too will 
enhance the Tribe's long term water security.

    Question 2. You testified there is federal, state, and county 
support for S. 4104. Can you elaborate on ways in which this settlement 
agreement will impact Arizona and its residents?
    Answer. Our water rights settlement will bring enormous benefits 
not only to the Hualapai Tribe but also to Mohave County and all of 
northwestern Arizona. That is why our settlement is strongly supported 
by Mohave County as well as by Governor Ducey.
    We believe that Grand Canyon West has great potential for growth as 
a regional tourist attraction, but it cannot take advantage of this 
potential because of the severe lack of water that is needed to serve 
visitors there.
    As I noted in my testimony, the Tribe commissioned a study by 
Professor Joseph P. Kalt of the Kennedy School of Government at Harvard 
University to analyze the economic impact that enactment the Tribe's 
water rights legislation would have on the regional economy of 
northwestern Arizona and southern Nevada, as well as on the economy of 
the State of Arizona and the Nation as a whole.
    Professor Kalt testified to this Committee in December 2017 during 
the 115th Congress, at a hearing on S. 1770, an earlier version of S. 
4104. In his report, which was attached to his written testimony, 
Professor Kalt stated that there was strong evidence that the Grand 
Canyon West, if supported by adequate infrastructure, is capable of 
attracting a growing number of visitors in the coming years, thus 
generating further economic development. His report estimated that the 
economic development of Grand Canyon West that would be triggered by 
the water and infrastructure authorized by this legislation would 
support an average of more than 6,500 jobs per year in Arizona, and 
close to 1,000 jobs per year in southern Nevada. For the Nation as a 
whole, the project would support an average of more than 10,000 jobs 
per year, nearly $1.5 billion in federal tax revenues in then-present 
value, and a then-present value of more than $9.3 billion in gross 
domestic product (GDP) for the United States.
    As Governor Ducey also notes in his letter of support in this 
hearing record, providing the Tribe with access to Colorado River water 
would also diminish the Tribe's reliance on groundwater, consistent 
with the State's overall policy of preserving groundwater supplies.

    Question 3. Can you elaborate on how the legislation's proposed 
trust lands may contribute to your Tribe's ability to access water and 
develop water infrastructure?
    Answer. The legislation will take into trust the Cholla Canyon 
Ranch parcels of fee lands owned by the Tribe in the Bill Williams 
Basin. The Tribe currently has a small parcel of Reservation land in 
that Basin as well as a number of parcels of trust land allotted to 
tribal members. The Cholla Canyon parcels, which are within the Tribe's 
aboriginal homeland, are of great cultural significance to the Tribe 
since these parcels contain Cofer Hot Springs, an area of particular 
cultural importance. The flow of the Springs is currently threatened by 
development of lithium mining on nearby BLM lands. It is our hope that 
having the Cofer Hot Springs taken into trust will enhance the Tribe's 
ability to protect this sacred site.
    The Cholla Canyon Ranch also presents an opportunity for additional 
economic development for the Tribe. The Ranch is located near a major 
traffic route between Las Vegas and Phoenix. Although the Tribe has no 
specific plans yet for economic development of this land, having the 
land taken into trust preserves the potential for doing so in the 
future.
    Otherwise, the legislation confers Reservation status on a number 
of parcels of land near the main Reservation which are currently held 
in trust for the Tribe.
                                 ______
                                 
    Response to Written Questions Submitted by Hon. Brian Schatz to 
                             Benjamin Smith
    Question 1. You testified that there is no formal barrier 
preventing the Department of Health and Human Services (HHS) from 
developing an official consultation or confer policy that applies to 
Native Hawaiians. How does HHS currently engage the Native Hawaiian 
community to ensure fulfilment of the federal government's trust 
responsibility, which includes providing health care to Native 
Hawaiians?
    Answer. HHS authorities for Native Hawaiians include a number of 
programs implemented by the Health Resources and Services 
Administration (HRSA), the Administration for Children and Families 
(ACF), and the Administration for Community Living (ACL) that benefit 
Native Hawaiians. The Native Hawaiian Health Care Systems Program 
(NHHCS) is authorized by the Native Hawaiian Health Care Improvement 
Act (NHHCIA) (42 U.S.C.   11701-11714). HRSA awards funding under 
this Congressional Special Initiative to improve the provision of 
comprehensive disease prevention, health promotion, and primary health 
care services to Native Hawaiians.

    Question 1a. What are the next steps for HHS to develop an official 
consultation or confer policy for Native Hawaiians?
    Answer. HHS is committed to enhancing the health and well-being of 
all Americans, and we will work with the Department of Interior's 
Office of Native Hawaiian Relations to provide consultation where 
possible. HHS's subject matter experts are available to provide advice 
and guidance in support of care delivery, health education, and disease 
prevention to improve health among the people of Hawaii.
    Executive Order 13175, which establishes the mandate for Federal 
government consultation with federally-recognized Indian tribal 
governments, does not include Native Hawaiians. HHS agencies consult 
with Native Hawaiians pursuant to their authorizing legislation. For 
example, the NHHCIA requires consultation with Papa Ola Lokahi for 
grants or contracts to provide health care services to Native 
Hawaiians. HHS subject matter experts are available to provide 
technical assistance.
                                 ______
                                 
     Response to Written Questions Submitted by Hon. Tina Smith to 
                             Benjamin Smith
    Question 1. The Congressional intent of 100 percent FMAP for urban 
Indian organizations was to address a longstanding inequity within the 
Indian healthcare system and to provide an opportunity to increase 
financial resources to UIOs during the COVID-19 pandemic. Can you 
elaborate on the FMAP implementation status and what roadblocks HHS is 
facing due to a lack of urban confer policy?
    Answer. Under section 9815 of the American Rescue Plan Act of 2021 
(Pub. L. 117-2) (ARP), states can temporarily receive a 100 percent 
federal match for their expenditures for Medicaid services received 
through certain Urban Indian Organizations (UIOs). The Centers for 
Medicare & Medicaid Services (CMS) implements this provision and 
explained in an August 30, 2021 State Health Official letter (#21-004) 
(SHO letter) that ARP section 9815 addresses the federal medical 
assistance percentage (FMAP) that CMS pays to states for certain 
Medicaid expenditures, and does not address the payment rates that 
states opt to pay to UIOs for Medicaid-covered services. States have 
the discretion to set and adjust Medicaid provider payment rates, as 
long as the state payment rates meet certain requirements under the 
Social Security Act. In the SHO letter, CMS offered to provide 
technical assistance to states that believe adjusting their 
reimbursement rates for UIOs is appropriate.
    In that SHO letter, CMS also explained that it interpreted the 
amendments made by section 9815 of the ARP to authorize 100 percent 
FMAP for expenditures for services received by all Medicaid 
beneficiaries receiving services through such UIOs. Currently, the 
statutory language limits the 100 percent FMAP available under ARP 
section 9815 to the eight fiscal quarters beginning April 1, 2021, and 
ending March 31, 2023, with states able to claim federal matching funds 
retroactively, so long as they submit their claims for federal matching 
funds within a statutory two-year limit.
    The Department of Health and Human Services (HHS) has the authority 
to calculate IHS All-Inclusive Rates (AIR), which are reviewed and 
approved by OMB prior to being published in the Federal Register. These 
rates are used by IHS when seeking reimbursement for services, 
including services covered by Medicare and Medicaid. HHS, including 
IHS, generally does not have the authority to require that states adopt 
specific Medicaid provider payment rates for UIOs. States have adopted 
the IHS AIR as their payment rates for certain provider types.
    HHS continues to have internal discussions regarding the possible 
calculation of a UIO-Specific AIR through Urban Confer. To date, confer 
sessions occurred on July 26, 2021, and June 10, 2022, to discuss 
whether and how a UIO-Specific AIR might be developed.
                                 ______
                                 
    Response to Written Questions Submitted by Hon. Brian Schatz to 
                             Jason Freihage
    Question 1. From the Department's perspective, how have co-
management MOUs and MOAs between Tribal governments and federal 
agencies facilitated mutually beneficial stewardship practices over 
sacred sites?
    Answer. Sites sacred to Indian Tribes often occur within a larger 
landform or are connected through physical features or ceremonies to 
other sites or a larger sacred landscape. The connection to place is 
essential to the spiritual practice and existence of Indian Tribes. 
MOUs and MOAs represent one of the Department's most successful tools 
to facilitate collaborative and cooperative stewardship for sacred 
sites.
    For example, the Rappahannock Tribe re-acquired 465 acres at Fones 
Cliffs, a sacred site to the Rappahannock Tribe located on the eastern 
side of the Rappahannock River in Virginia. The Rappahannock Tribe will 
own the land, however, it will be publicly accessible and held with a 
permanent conservation easement conveyed to U.S. Fish and Wildlife 
Service. This collaborative stewardship arrangement ensures that the 
Rappahannock Tribe owns its ancestral homeland containing a Tribal 
sacred site while allowing the Department to conserve a globally 
significant Important Bird Area.
    In keeping with Executive Order 13007 (Indian Sacred Sites), the 
Department, to the greatest extent practicable, accommodates access to 
and ceremonial use of Indian sacred sites by Indian religious 
practitioners from Indian Tribes and avoids adversely affecting the 
physical and spiritual integrity of such sacred sites. During 
consultation with the Department, Indian Tribes may identify sacred 
sites and may also identify preferred treatments of such places. 
Costewardship MOUs and MOAs alert planners and resource managers to the 
potential presence of sensitive areas and are kept confidential to the 
extent permitted by law.

    Question 2. Have Tribal co-management agreements contributed to 
building Tribal capacity for cultural education opportunities, language 
revitalization, and land management across the Department? If so, how?
    Answer. Co-stewardship MOUs and MOAs actively contribute to 
building Tribal capacity for cultural education, language 
revitalization, and land management. Multiple Tribes have arrangements 
in place with the Department to implement or provide cultural 
interpretation and/or educational programming at Departmental units 
located on or near Tribal homelands across multiple land management 
bureaus. For example, an Alaska Native group has an agreement in place 
to offer seasonal interpretive programming. Many Indian Tribes in the 
lower 48 states have similar MOUs or MOAs in place. Several Tribes also 
have arrangements that support language revitalization, including a 
Montana Tribe with an agreement in place with the Department for 
creation of trilingual entrance signs for units including indigenous 
names/language and land ownership and designation information on signs.
    Multiple Tribes have agreements in place to coordinate and 
cooperatively manage Federal and Tribal lands and waters. A Tribe in 
the Pacific Northwest has received transfer and conducts full 
management of a federal fishery under a co-stewardship agreement. These 
are broad examples, and the Department is proud of the benefits to 
Tribal capacity for cultural education, language revitalization, and 
land management that result from co-stewardship MOUs and MOAs.

    Question 3. From the Department's perspective, what are some 
barriers to facilitating efficient and effective co-management policies 
between Indian Tribes and the federal government?
    Answer. Collaborative and cooperative co-stewardship agreements 
have been a component of the Department's engagement with Indian Tribes 
for many years. Following Joint Secretarial Order 3403 in November 
2021, the Department is evaluating future policies and practices to 
streamline co-stewardship MOUs and MOAs. These may include, for 
example, broader sharing of data with Indian Tribes about co-
stewardship requests and disposition of those requests, clearer 
information about points of contact regarding co-stewardship MOUs and 
MOAs, and a uniform interpretation of the Indian Self-Determination and 
Education Assistance Act's (ISDEAA) ``programs, services, functions, 
and activities'' for use by BIA and all non-BIA bureaus in determining 
eligible activities for self-governance co-stewardship activities. 
Specifically, broadening the use of ISDEAA 638 contracting and self-
governance compacts by land management agencies would facilitate 
cooperation with Tribes necessary to advance costewardship.
    One example of a barrier to co-stewardship is need for a Tribal 
land base to make use of the Good Neighbor Authority with Federal land 
management agencies. Many Tribes have very limited acreage or no land 
holdings which can be managed in ways that are complementary to Federal 
land holdings, as appropriate through existing Good Neighbor Authority 
agreements. To address this challenge, the President's Budget proposes 
$14.8 million for Tribal land acquisition. Accompanying this budget 
request, is a request to increase the annual statutory cap on land 
acquisition funding from $2 million to $10 million. The cap on land 
acquisition dates back to the original language enacted in the 1934 
Indian Reorganization Act. In today's dollars, $2 million in 1934 would 
equal over $40 million now. Lifting this cap is necessary for 
additional appropriations to be provided to advance self-determination 
and collaborative and cooperative stewardship. Additional funding to 
support increased land acquisition would eliminate one barrier to co-
stewardship. Expanding the reach of Good Neighbor Authority for Indian 
Tribes would eliminate another barrier to co-stewardship for Indian 
Tribes.

    Question 4. How can co-management policies and practices be 
integrated into the Department's efforts to facilitate Tribal climate 
resilience, adaptation, and mitigation?
    Answer. The Department has already integrated collaborative and 
cooperative stewardship agreements into our operations to facilitate 
Tribal climate resilience, adaptation, and mitigation efforts. For 
example, the Department uses prescribed burning for vegetation 
management and to restore cultural landscapes. In 2017, a land 
management unit collaborated with Great Lakes Indian Fish and Wildlife 
Commission member Tribes to conduct the first cultural burn in many 
generations. The Department looks forward to more collaboration with 
Indian Tribes to further facilitate Tribal climate resilience, 
adaptation, and mitigation through co-stewardship agreements.